Predictors of cultural competence among nursing students in the Philippines: A cross-sectional study

Child health care nurses' cultural competence in health visits with children of foreign background

AIM

The aim of this study is to investigate child health care nurses' cultural competence in health visits with children and their families of foreign background.

DESIGN

A cross-sectional design combined with a qualitative explorative design.

METHODS

The nurses assessed their cultural competence using a modified version of the Clinical Cultural Competency Questionnaire. Interviews were used to obtain a detailed description of the nurses' cultural competence.

RESULTS

The nurses assessed themselves as rather culturally competent. They scored above mid-score in the total score for cultural competence and on all subscales. Education in cultural diversity at the nurses' workplace had the highest association to cultural competence. The nurses described their awareness as recognizing each child and her/his family rather than their cultural background, and viewing the child as a unique part of her/his cultural context. Despite their high scores on cultural competence, the nurses described a lack of cultural knowledge and explained their need of further knowledge.

Nursing Cultural Competence in Israel: Does Practice Make It Better?

Because of globalization, immigration, and mass exodus from countries due to political conflicts, there is an ever-changing mix of people with diverse cultural backgrounds who require institutions to provide continuing education to ensure that effective services are provided to everyone. Part of the transcultural challenges involves religion, socioeconomic differences and languages, and ethnic backgrounds that differ. The objective of this study was to examine whether a transcultural training program for undergraduate nursing students in Israel could enhance students' cultural competence. In this study, 319 senior undergraduate nursing students were asked to complete the Transcultural Health Care Screening Questionnaire as a measure of their cultural competence. The students' cultural competence was satisfactory but less than it had been in previous years. The authors suggest that cultural competence needs to be considered as a contextual, developmental, and experiential process that requires ongoing attention and curricular revisions.

The Effect of Institutional Support on the Cultural Intelligence of Nursing Students

Background:

Cultural intelligence is important for studying, working, and living in multicultural societies. Previous studies have indicated that training and learning support are important for improving students’ cultural intelligence. The purpose of this study was to investigate the effect of institutional support on cultural intelligence.

Methods:

933 nursing students in three countries, among Malaysia, the Philippines, and Thailand, answered a rating scale questionnaire. A structural equation model was used to examine the effect of institutional support on cultural intelligence.

Results:

Institutional support had a statistically significant effect on cultural intelligence, with an effect size of 0.57.

Conclusion:

For promoting cultural intelligence divided into three aspects, the first concerns the implementation of multicultural experiences in curricula; the second involves extra-curricular activities for being applied in multicultural situations; and the last regards encouraging teachers to realize the importance of culture and integrating cultural content in their teaching and in the students’ learning.

Nursing students' experience of learning cultural competence

INTRODUCTION

European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds.

MATERIALS AND METHODS

A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal.

RESULTS

5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice.

CONCLUSION

The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.

Cultural Competence of Turkish Nurses and Nursing Students: An Integrative Literature Review

INTRODUCTION

Turkish population is characterized by its great cultural diversity, thus, Turkish nurses and nursing students often interact with patients of different cultural backgrounds from theirs. Cultural competence is needed to provide qualified contemporary nursing care. This study aimed to explore the literature on the cultural competence of Turkish nurses and nursing students.

METHODOLOGY

The Whittemore and Knafl review methodology was used to extract, summarize, and synthesize data of 15 primary research articles published between January 2011 and January 2021. The search was done in the Turkish Academic Network and Information Center-ULAKBIM (PubMed, TRDizin, DergiPark).

RESULTS

Three themes were identified: cultural competence, cultural-related problems, and importance of training on transcultural nursing.

DISCUSSION

Appropriate educational courses on transcultural nursing should be implemented in Turkish nursing schools as well as in continuing education programs for Turkish nurses.

Addressing the effects of transcultural nursing education on nursing students' cultural competence: A systematic review

AIM

This study aimed to synthesize the findings of studies evaluating educational programs providing curricular transcultural nursing education.

BACKGROUNDS

Nursing care education about cultural diversity and experience with taking care of patients from different cultures and special populations are significant factors that could likely influence cultural competence. The effect of transcultural nursing education given to nursing students has been investigated by different researchers and different methods. Addressing the effects of transcultural nursing education on nursing students' cultural awareness, knowledge and attitudes can contribute to future transcultural nursing education activities and the creation of training content.

DESIGN

This study was a methodological systematic review study.

METHODS

Methodological quality was assessed following the PRISMA guidelines. PubMed, Science Direct, APA PsycArticles, OVID, EBSCO, and Web of Science databases were searched from 2010 to 2020. The following keywords were used: "Transcultural nursing", "education", "curriculum", "course", "effectiveness", "cultural competence", "knowledge", "skills", "attitudes", and "nursing students". Studies published in peer-reviewed journals in English using both experimental and quasi-experimental designs were included.

RESULTS

Total of 11 research papers, (n = 1375) nursing students' outputs were included in this review. Cultural competence interventions/programs were provided as part of the core theoretical courses or as elective courses. Different durations and types of teaching methods included debates, discussions, case scenarios, practicums, simulation, international learning projects, experiential learning, storytelling, and traditional teaching lectures. In ten studies, an increase in the level of culture-related competences was reported as statistically significant (p < 0.05).

CONCLUSIONS

Limited studies have generally proven the effectiveness of transcultural nursing education provided to nursing students. Education content, training methods and training periods were not standard in the literature. More comprehensive, valid and reliable measurement tools are needed to evaluate the education provided for nursing students.

How much can our universities do in the development of cultural intelligence? A cross-sectional study among health care students

BACKGROUND

Cultural intelligence reflects the competence to adapt to new cultural settings. Universities offer students various opportunities to gain cultural learning and develop cultural intelligence. However, there has been little empirical research to compare the effects of cultural learning and other related psycho-social factors in this process.

OBJECTIVE

This study explores the importance of cultural learning and identifies the unique contribution of cultural education in universities to health care students' cultural intelligence.

DESIGN

Cross-sectional survey study.

METHODS

271 health care students completed a survey measuring social desirability, demographics, personality, prior cultural exposure, previous cultural learning and cultural intelligence.

RESULTS

Hierarchical regressions showed that cultural learning could affect cultural intelligence and its three components (i.e., metacognition, cognition, motivation, and behaviour) under the control for related psycho-social factors. However, its effect on the behavioral component was not significant. Considering the different types of cultural learning, overseas study experiences were more related to cultural intelligence, compared to in-class cultural learning.

CONCLUSION

Cultural learning, especially overseas study experiences, plays a significant role in the development of health care students' cultural intelligence.

Improvement in the Cognitive Aspects of Cultural Competence after Short-Term Overseas Study Programs

Universities are providing short-term overseas study programs for healthcare students to increase their cultural competence (i.e., capacity to work effectively in cross-cultural situations). However, there is limited empirical research evaluating the effects of these programs using well-controlled research designs. In the present research study, undergraduate healthcare students in an Australian university were selected as participants. Group 1 (n = 32) participated in a short-term overseas study program in Asia (i.e., China, Vietnam, Singapore, and Taiwan), whereas Group 2 (n = 46) stayed in Australia to continue their university education as usual. All participants completed a self-developed demographic questionnaire, Cultural Intelligence Scale, and Multicultural Personality Questionnaire. Cultural competence was surveyed pre- and post-short-term overseas programs. After controlling for prior overseas experiences and the open-mindedness trait, an ANCOVA indicated that Group 1 had a significantly higher scores than Group 2 in cultural knowledge (p < 0.05), but not in cultural awareness, attitude, or skills. It is suggested that short-term overseas study programs may increase healthcare students’ cultural knowledge, a component of competence, and that more needs to be accomplished to improve other areas of cultural competence.

The effect of ethnocentrism and moral sensitivity on intercultural sensitivity in nursing students, descriptive cross-sectional research study

BACKGROUND

Factors affecting intercultural sensitivity and care are becoming an increasingly important issue due to ethnic diversity. Nurses play a crucial role in care and therefore should keep up with this trend and improve their intercultural sensitivity.

OBJECTIVE AND DESIGN

This descriptive cross-sectional study investigated the effects of ethnocentrism and moral sensitivity on intercultural sensitivity in nursing students.

METHODS AND PARTICIPANTS

Data were collected using a demographic characteristics questionnaire and the Intercultural Sensitivity Scale, Generalized Ethnocentrism Scale, and Moral Sensitivity Scale. The sample consisted of 1343 nursing students. The Pearson correlation coefficient was used to determine correlations between scale scores. Multiple linear regression was used to determine the effects of ethnocentrism, moral sensitivity, and demographic characteristics on intercultural sensitivity.

RESULTS

Intercultural sensitivity was found to be negatively correlated with ethnocentrism and positively correlated with moral sensitivity. Ethnocentrism predicted intercultural sensitivity more than moral sensitivity. Ethnocentrism and moral sensitivity explained 16.8% of the total variance of intercultural sensitivity. However, ethnocentrism affected intercultural sensitivity more than moral sensitivity did (beta = -0.406).

CONCLUSION

Nursing education should adopt strategies to reduce ethnocentrism by helping students develop cultural competence and intercultural sensitivity. Such education can equip nurses to provide higher quality care to patients of different cultural backgrounds.

Cultural competence among pre-graduate nursing students, new graduate nurses, nurse mentors, and registered nurses: A comparative descriptive study

BACKGROUND

Achieving and improving cultural competence in nursing is an ongoing process, beginning in the student period and continuing through the professional career.

OBJECTIVES

The present study aims to compare pre-graduate students, newly graduated nurses, registered nurses, and nurse mentors in Taiwan in terms of their respective levels of cultural competence, and to determine associated influencing factors.

DESIGN

A comparative cross-sectional study.

SETTINGS

Three universities and three hospitals (one regional hospital and two teaching hospitals) in Taiwan.

PARTICIPANTS

A total of 756 nurses/students (103 pre-graduate nurses, 321 newly graduated nurses, 101 registered nurses, and 231 nurse mentors).

METHODS

The Cultural Competence Scale for Pre-Graduated Students to Licensed Professionals was used to measure the cultural competence level. One-way analysis of variance and hierarchical regression analysis were used for statistical analysis.

RESULTS

For overall cultural competence and the subscales of knowledge, awareness, and skills, the pre-graduate students scored lower than the other three groups. Experience of caring for patients from diverse cultures and countries significantly influenced the cultural competence of all four groups. Ability to speak fluent English and receiving cultural competence education during nursing education only significantly influenced the cultural competence of the pre-graduate and new graduate nurses. Current job position and primary practice setting significantly influenced the cultural competence of the registered nurses and nurse mentors.

CONCLUSION

Pre-graduate students, newly graduated nurses, registered nurses, and nurse mentors have differing levels of cultural competence and differing influencing factors. Cultural competence education that accords with the influencing factors for each nursing position would continuously cultivate nursing staff's cultural competence.

Intercultural readiness of nursing students: An integrative review of evidence examining cultural competence educational interventions

With the mounting reports of culturally insensitive care and the reported challenges nurses experience when caring for culturally diverse patients, developing the intercultural readiness of nursing students is a necessity. However, little is known as to the success of cultural competence educational interventions in undergraduate nursing curricula and there remains a lack of consensus within the literature as to how it should be structured, organised and facilitated. Incorporating an integrative review method, this study synthesised international research on educational interventions used in preparing student nurses to care for culturally diverse patients. A systematic literature search of all published studies between 2013 and 2017, in CINAHL, Scopus, Medline, PubMed, Embase, Cochrane, Education Source and PsycINFO databases were performed. The PRISMA checklist was used to guide the review process. Six hundred and twenty-four studies were screened for eligibility and the analysis of the fourteen included studies are presented within two overarching themes; increasing knowledge and understanding and developing commitment and confidence. Engaging student nurses in learning activities that augment their understanding of, and commitment to, providing culturally competent care must include a variety of integrated culturally responsive pedagogical approaches made explicit and continuously developed across all learning opportunities.

European intensive care nurses' cultural competency: An international cross-sectional survey

OBJECTIVES

To determine the level of cultural competence of European critical care nurses.

DESIGN

A multi-country survey performed in 2017 as a part of the European project Multicultural Care in European Intensive Care Units.

METHOD

Online survey of critical care nurses in 15 European countries (n = 591) using the Healthcare Provider Cultural Competence Instrument consisting of 49 items divided into five subscales: awareness and sensitivity, behaviour, patient-centred orientation, practice orientation and self-assessment. Descriptive and correlational analyses were performed.

RESULTS

Critical care nurses scored highest for 'awareness and sensitivity' (M = 5.09, SD = 0.76), and lowest for 'patient-centred communication' (M = 3.26, SD = 0.94). Nurses from northern and southern Europe scored higher across all subsets of the cultural competence instrument (all subsets, p < 0.001) than nurses from central Europe. Speaking other languages significantly correlated with higher scores in all subscales (all > 0.05) except 'practice orientation'. Previous education on multicultural nursing significantly correlated with higher scores in all subscales (all > 0.01) except patient-centred communication; and visits to other countries was negatively correlated with all subscales (all, p > 0.001) except patient-centred communication.

CONCLUSION

Being exposed to cultural diversity in different ways, like living in a multicultural country, speaking a second language and visiting other countries may influence development of cultural competence. Therefore, programmes which facilitate multicultural clinical practice are strongly recommended in nursing education.

Evaluation of a nurse-led education program to improve cross-cultural care for older people in aged care

BACKGROUND

Cultural diversity is significant in aged care facilities. Registered nurses play a leading role in the care setting. Nurse-led education interventions to improve the cultural competence of aged care workers are in high demand.

AIM

The aims of the study were to evaluate the effect of a nurse-led cross-cultural care program on cultural competence of Australian and overseas-born care workers.

DESIGN

A pre- and post-evaluation design and a sub-group analysis.

SETTINGS AND PARTICIPANTS

This study was undertaken in four large-sized aged care facilities in Australia. Direct care workers were invited to participate in the study.

METHODS

The intervention lasted 12 months. Data were collected at baseline, 6 months and 12 months using the Clinical Cultural Competency Questionnaire and site champion reports. One-way ANOVA was applied to determine the changes of outcomes over time for the whole group. A mixed effect linear regression model was applied in the sub-group analyses to compare the differences of outcomes between the Australian-born and overseas-born groups.

RESULTS

One hundred and thirteen staff participated in the study including Australian-born (n = 62) and overseas-born (n = 51). Registered nurses were trained as site champions to lead the program. The results showed a statistically significant increase in participants' scores in Knowledge (p = .000), Skills (p = .000), Comfort Level (p = .000), Importance of awareness (p = .01) and Self-Awareness (p = .000) in a 12-month follow-up. The increased scores in the Skills (p = .02) and Comfort Level (p = .001) were higher in the Australian-born group compared to the overseas-born group. The results also showed a statistically significant increase in participants' overall satisfaction scores with the program at 12 months (p = .009). The overseas-born group demonstrated a higher score in Desire to Learn More (p = .016) and Impact of the Program on Practice (p = .014) compared to the Australian-born group.

CONCLUSION

A nurse-led cross-cultural care program can improve aged care workers' cultural competence.

Integrating Competency-Based Didactic and Experiential Global Health Learning for Dental Students: The Global Health Learning Helix Model

The aim of this study was to evaluate the feasibility and preliminary outcomes of immersive integrated experiential and didactic courses in strengthening competency-based global health learning in dental education. To address global inequities in oral health and student interest in global health, the Harvard School of Dental Medicine introduced two global health courses in 2017-18. The first was a didactic course in the core predoctoral curriculum, and the second, in collaboration with the Inter-American Center for Global Health, was a five-day elective experiential learning course in rural Costa Rica. The experiential course was an extension of the didactic course. All 33 second-year dental students completed the didactic course, and three of those students completed the experiential course. A pre-post survey and a six-month follow-up survey on self-reported knowledge based on course learning objectives were administered. The experiential course students also completed journals and interviews for qualitative analysis. Thirty-two students completed the pre-post didactic course surveys, for a response rate of 94%. There was a 100% response rate on the pre-post didactic surveys by those students who participated in the experiential learning course. While the experiential learning group scored similarly to the class average before the didactic course, they had higher scores than the class averages both immediately after and at the six-month follow-up. All three students reported that the experiential learning course was "extremely effective" in building on what they learned in the didactic course. Qualitative analysis of the journals and interviews suggested enhanced learning from the combination of didactic and experiential methods. These preliminary results support the Global Health Learning Helix Model, a theoretical competency-based teaching model for ethical student global health engagement to better prepare the future generation in tackling oral health disparities both locally and worldwide.

Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital

BACKGROUND

Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years.

AIM

The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses.

METHOD

The study was conducted at İzmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used.

RESULTS

The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent.

CONCLUSION

Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

School nurses' self-assessed cultural competence when encountering children of foreign origin: A cross-sectional study

The purpose of this study was to investigate associations between school nurses' self-assessed cultural competence in health visits with children of foreign origin and demographic variables, by using a cross-sectional design. A Web-based questionnaire assessing cultural competence and demographic variables was distributed to a nationally representative sample (n = 816) of school nurses in Sweden. Data were analyzed using regression analysis. School nurses assessed themselves as culturally aware and moderately culturally competent, but not as culturally knowledgeable, culturally skilled, or comfortable in cultural encounters. Cultural competence was related to education in cultural diversity, how often nurses encounter children of foreign origin, and nurses' country of origin. In total, these variables explained 23.6% of the variation in school nurses' cultural competence. Because school nurses regard themselves as moderately culturally competent, a foundation for promoting children's health on equal terms in school health care exists. However, education in cultural diversity combined with other additional strategies is needed to further strengthen school nurses' cultural knowledge, skills, and comfort level in encounters with children of foreign origin.

"Cultural awareness requires more than theoretical education" - Nursing students' experiences

Cultural awareness in healthcare providers is considered one of the most important factors in improving the efficiency and quality of care in a diverse population. Thus, education in cultural awareness needs to be an essential component in nursing education. This study, which uses a qualitative design, aimed to investigate cultural awareness in nursing students in Sweden. Focus groups were used to collect data from 12 students. Three categories were identified as follows after qualitative data analysis of the interviews: 1) desire to learn, 2) learning by doing and 3) caring beyond boundaries. The result clearly indicates that students are willing to learn more about how to care for people with different cultural backgrounds. However, this learning is not always available in official lecture-based education. In fact, most awareness about cultural aspects of healthcare is developed from practice and informal education. Finally, the result also revealed the importance of nurses being able to see the individual beyond the culture, and being aware of their own prejudice. In conclusion, education offers limited opportunities for nursing students to become culturally aware. Nursing education can be improved by strengthening both theoretical and practical tasks involving cultural awareness.

The Cross-Cultural Competence Inventory: Validity and psychometric properties of the Polish adaptation

Background

Due to changes in Polish society resulting from a significant inflow of immigrants to Poland, the need to develop the cultural competences of various professional groups who have contact with immigrants in their work has increased. These groups should include healthcare professionals, especially because of the significant increase in the number of culturally diverse patients. Therefore, medical education in Poland has had to rapidly adapt to this novel situation. For instance, the teaching process should be now more focused on the development and evaluation of the cultural competences of prospective health care workers. However, there is still a lack of standardized, valid and reliable instruments to assess cross-cultural competences among healthcare professionals. The purpose of the present paper was to describe, for the first time, the translation, adaptation, and psychometric evaluation of the Polish version of the Cross-Cultural Competence Inventory.

Methods

Across two studies, we examined psychometric properties of the Cross-Cultural Competence Inventory (CCCI) such as reliability (i.e. internal consistency, test-retest reliability, factor structure) and validity (i.e. theoretical, criteria, convergent). In the first study, 408 participants (75% were healthcare professionals) completed the Polish version of the CCCI and the Positive/Negative Attitude Towards Culturally Divergent People Questionnaire. In the second study, 317 participants (97% were healthcare professionals) completed the CCCI twice, with an interval of at least 22 days. In addition, across two study sessions, participants completed questionnaires constructed to measure (a) cultural intelligence, (b) need for cognitive closure, (c) emphatic sensitiveness, (d) emotional intelligence, (e) self-esteem, (f) social desirability, and (g) personality. Finally, to additionally examine the theoretical validity, 36 professional cross-cultural competence trainers completed the CCCI during a one-session study.

Results

Our findings confirm the reliability and validity of the CCCI. More precisely, in study 1 we proved the theoretical validity and reliability (i.e. internal consistency) of the CCCI. While the assumed structure did not fit the data well, all items were significantly related to the general factor, thus providing strong support for the usage of the total score of the CCCI. In study 2, we additionally estimated the test-retest reliability and theoretical, criterion and convergent validity. Across two studies we were able to successfully confirm these psychometric properties. The reliability was satisfactory and ranged from .83 to .86. We also observed a high and significant positive correlation between CCCI and the Cultural Intelligence Scale, which measures a concept similar to the one measured by CCCI. In addition, a significant relationship between intercultural competences (CCCI) and other variables such as personality, empathic sensitivity, emotional intelligence, self-esteem (positive correlations) and the need for cognitive closure (mainly negative correlation) were demonstrated.

Conclusions

The obtained results support the usage of the CCCI questionnaire in scientific research, such as, for example, among healthcare professionals (nurses, doctors) and students of medical fields (nursing, medicine).

Nursing students' cultural competence in caring for older people in a multicultural and developing region

BACKGROUND

Health disparities exist among different cultural groups in a multicultural society. Older people from minority groups usually face greater challenges in accessing and utilizing healthcare services due to language barriers, low levels of health literacy and cognitive impairment.

OBJECTIVES

The aims of this study were to measure nursing students' cultural competence in the context of caring for older people from diverse cultural backgrounds and explore associated factors affecting their cultural competence in order to inform curriculum design in Xinjiang, China.

DESIGN

A cross-sectional study design.

SETTINGS

The study was undertaken in the School of Nursing, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, China.

PARTICIPANTS

Students enrolled in a 4-year Bachelor of Nursing Program.

METHODS

Students' cultural competence was measured using a validated Chinese version of Cross-cultural Care Questionnaire. Data were collected using a self-administered survey.

RESULTS

The number of students in the survey was 677. Of those students, 59.5% of them were from an ethnic group other than Han Chinese. A higher proportion of students from ethnic groups, other than Han Chinese, were able to fluently speak a language other than Chinese and used this language in their study and daily lives. Nursing students demonstrated low scores in knowledge, skills and encounters subscales for cultural competence, but had a relatively high score in awareness across all academic years. Findings from students' responses to open-ended questions reveal the need to integrate cross-cultural care and gerontological care into the nursing curricula and support students to apply gerontological knowledge to practice in clinical placements.

CONCLUSIONS

Nursing students enrolled in a 4-year Bachelor degree program in a multicultural and less developed region demonstrated lower scores on cultural competence and recognized the need to develop crosscultural and gerontological competencies.

A Multicountry Perspective on Cultural Competence Among Baccalaureate Nursing Students

PURPOSE

To assess cultural competence among nursing students from nine countries to provide an international perspective on cultural competence.

DESIGN

A descriptive, cross-sectional design.

METHODS

A convenience sample of 2,163 nursing students from nine countries was surveyed using the Cultural Capacity Scale from April to November 2016.

RESULTS

The study found a moderate range of cultural competence among the students. The ability to teach and guide other nursing colleagues to display culturally appropriate behavior received the highest competence rating, while the ability to discuss differences between the client's health beliefs or behaviors and nursing knowledge with each client received the lowest competence rating. Differences in cultural competence were observed between students from different countries. Country of residence, gender, age, year of study, attendance at cultural-related training, the experience of taking care of patients from culturally diverse backgrounds and patients belonging to special population groups, and living in a multicultural environment were identified as factors affecting cultural competence.

CONCLUSIONS

The international perspective of cultural competence among nursing students provided by this study serves as a vital preview of where nursing education currently stands in terms of providing the necessary preparatory competence in the cultural aspect of care. The variation of cultural competence among nursing students from different nations should serve as a cue for designing a focused yet multimodal nursing education program in guiding them to be culturally sensitive, culturally adaptive, and culturally motivated.

CLINICAL RELEVANCE

The training of nursing students in providing competent culturally appropriate care should be ensured considering that adequate preparation of nursing students guarantees future competent nursing practice, which can positively impact the nursing profession in any part of the globe.

Cultural competence among nursing students in Saudi Arabia: a cross-sectional study

AIM

This study assessed the cultural competence of nursing students in a Saudi University.

BACKGROUND

With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team.

METHODS

A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version.

RESULTS

The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence.

DISCUSSION

The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background.

CONCLUSIONS

Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved.

IMPLICATIONS FOR NURSING & HEALTH POLICY

With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in Saudi Arabia and other countries.