Ready for the World: Preparing Nursing Students for Tomorrow

Qualified Nurses’ Perceptions of Cultural Competence and Experiences of Caring for Culturally Diverse Patients: A Qualitative Study in Four European Countries

Background: European nurses are expected to provide appropriate care for patients from diverse cultural backgrounds. However, there is limited knowledge and understanding of this process. The aim of this study was to analyse the perceptions of culture and experiences of caring for patients from diverse cultural backgrounds of a purposive sample of qualified nurses from four European countries, namely Belgium, Portugal, Spain and Turkey. Methods: A qualitative phenomenological approach was selected in order to understand complex phenomena through the participants’ lived experiences, meanings and perspectives. Individual interviews and focus groups took place with 28 staff nurses and 11 nurse managers from four European countries. The sociodemographic and cultural characteristics of the sample were described and analysed using descriptive statistics. Qualitative data were transcribed verbatim, translated into English and analysed following Braun and Clark’s phases for thematic analysis. Results: Five themes and twelve subthemes emerged from thematic analysis of the transcripts. The themes included: (1) relevance of culture for nursing; (2) culture in the healthcare service; (3) qualities of the healthcare professionals; (4) challenges to culturally competent care; (5) becoming a culturally competent nurse. Conclusions: There are challenges to the delivery of culturally congruent care, namely language and communication difficulties, prejudices and stereotyping in the health service, a tendency for ethnocentrism, a lack of education and training in cultural competence and a lack of support from the health service to facilitate new ways of acting.

Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review

When assessing the fragility that characterizes the health of an immigrant person, a culturally competent transformation of the nurse-patient teaching-learning process is necessary. Therefore, it is considered essential to incorporate cultural competence and intercultural communication in higher nursing education.

Objective

To determine the content and knowledge of cultural competence and intercultural communication offered in higher education in nursing courses.

Design

The Campinha-Bacote model of cultural competence was used as the primary reference.

Method

A scoping review was conducted about studies published in the period 2003 and 2020. The research was conducted between May and October 2020. More than a hundred documents (books, chapters, articles, conference proceedings) have been consulted.

Results

Undergraduate nursing courses and postgraduate education move toward promoting cultural competence and sensitivity through teaching strategies.

Conclusions

Teaching projects that combine multiple competencies are more effective, including teacher training. A predominant element is a need for continuous and transversal projects. University nursing education must adapt culturally competent curricula.

Perception and Experience of Transcultural Care of Stakeholders and Health Service Users with a Migrant Background: A Qualitative Study

INTRODUCTION

While European health policies do frequently take into consideration the ideas and experiences of their users, the voices of minority and marginalized communities are not often heard. European healthcare services must address this issue as the number of healthcare users with an MM background increases.

AIM

To explore the perspectives of key stakeholders and healthcare users with an MM background on transcultural care in four European countries.

DESIGN

Qualitative phenomenological study.

METHODS

Semi-structured, individual interviews were conducted with stakeholders and MM users. Interviews were translated and transcribed verbatim and were carried out from February to May 2021. Descriptive statistics was used to describe the characteristics of the sample; qualitative data were analyzed thematically following Braun and Clarke's phases, resulting in 6 themes and 18 subthemes.

RESULTS

For stakeholders and MM users with long-established residence in their respective countries, cultural differences involve different family and community norms, religious beliefs, lifestyles, and habits. These components are perceived as in tension with healthcare norms and values, and they mediate in two key and related aspects of the relationship between MM users and healthcare providers: accessibility and communication.

CONCLUSIONS

Communication and access to healthcare are key to MM health service users, and they are the most frequent sources of misunderstanding and conflict between them and healthcare professionals.

IMPACT

It is important to extend the investigation of cultural issues in healthcare to stakeholders and MM users. There is no doubt that healthcare professionals should be trained in cultural competence; however, cultural competence training is not the only area for improvement. There should be a change in paradigm in healthcare services across Europe: from individual to organizational integration of culture and diversity.

Nursing Lecturers' Perception and Experience of Teaching Cultural Competence: A European Qualitative Study

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers' perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers' perception of culture and experience of teaching cultural competence. Semi-structured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark's phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the transcripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be developed.

The situation of nursing education in Latin America and the Caribbean towards universal health

OBJECTIVE:

to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health.

METHOD:

quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries.

RESULTS:

a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods.

CONCLUSION:

there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.

OBJETIVO:

avaliar a situação da educação em enfermagem e analisar o quanto os programas de educação em enfermagem, no nível de Bacharelado na América Latina e no Caribe, estão preparando graduados a contribuir para o alcance da Saúde Universal.

MÉTODO:

estudo quantitativo, descritivo/exploratório, transversal, realizado em 25 países.

RESULTADOS:

um total de 246 escolas de enfermagem participaram do estudo. O corpo docente com nível de Doutorado totalizou 31,3%; sem o Brasil o número fica reduzido a 8,3%. A razão entre experiências clínicas nos serviços de atenção primária à saúde e nos serviços hospitalares foi de 0,63, indicando que os estudantes têm mais experiências clínicas nos cenários hospitalares. Os resultados sugeriram necessidade de aprimoramento relacionada ao acesso à Internet; tecnologia da informação; acesso para portadores de deficiências; avaliação do programa, do corpo docente e dos estudantes; e aos métodos de ensino/aprendizagem.

CONCLUSÃO:

há heterogeneidade na educação em enfermagem na América Latina e no Caribe. Os currículos de enfermagem incluem, geralmente, os princípios e valores da Saúde Universal e da atenção primária à saúde, bem como aqueles princípios subjacentes às modalidades de educação transformativa, como o desenvolvimento de pensamento crítico e complexo, a solução de problemas, a tomada de decisão clínica baseada em evidências, e aprendizagem contínua. No entanto, é preciso promover uma mudança de paradigma na educação em enfermagem que inclua mais treinamento na atenção primária à saúde.

OBJETIVO:

evaluar la situación de la educación en enfermería y analizar en qué grado los programas de educación de enfermería a nivel de grado en América Latina y el Caribe están preparando a los graduados para contribuir al logro de la Salud Universal.

MÉTODO:

se llevó a cabo un estudio transversal, cuantitativo, descriptivo y exploratorio en 25 países.

RESULTADOS:

participaron en el estudio 246 escuelas de enfermería. El porcentaje de profesores con títulos de doctorado fue de 31,3%; pero, si se excluye a Brasil esta cifra se reduce a 8,3%. La proporción de la experiencia clínica adquirida en los servicios de atención primaria de salud en relación con la adquirida en servicios hospitalarios fue de 0,63, lo que indica que los estudiantes adquieren la mayor parte de su experiencia clínica en entornos hospitalarios. Los resultados mostraron una necesidad de mejorar el acceso a internet; la tecnología de la información; la accesibilidad para las personas discapacitadas; la evaluación de los programas, de los profesores y de los estudiantes; y los métodos de enseñanza y aprendizaje.

CONCLUSIONES:

hay heterogeneidad en la educación en enfermería en América Latina y el Caribe. En general, los programas de estudios de enfermería han adoptado los principios y los valores de la Salud Universal y la atención primaria de salud, así como los principios que sustentan las modalidades de educación transformadora, como son el desarrollo del pensamiento crítico y complejo, la solución de problemas, la toma de decisiones clínicas basadas en la evidencia y el aprendizaje a lo largo de toda la vida. Sin embargo, hay necesidad de promover un cambio en el paradigma de la educación en enfermería, a fin de que abarque más capacitación en la atención primaria de salud.

Global health competencies according to nursing faculty from Brazilian higher education institutions

OBJECTIVES

to identify the agreement of faculty affiliated with Brazilian higher education institutions about the global health competencies needed for undergraduate nursing students' education and whether these competencies were covered in the curriculum offered at the institution where they were teaching.

METHOD

exploratory-descriptive study, involving 222 faculty members who answered the Brazilian version of the "Questionnaire on Core Competencies in Global Health", made available electronically on the website Survey Monkey.

RESULTS

participants predominantly held a Ph.D. (75.8%), were women (91.9%) and were between 40 and 59 years of age (69.3%). The mean and standard deviation of all competencies questioned ranged between 3.04 (0.61) and 3.88 (0.32), with scores for each competency ranging from 1 "strongly disagree" to 4 "strongly agree". The results demonstrated the respondents' satisfactory level of agreement with the global health competencies.

CONCLUSIONS

the study demonstrated a high mean agreement level of the nursing faculty from Brazilian HEI with the global health competencies in the questionnaire. The curricula of the HEI where they teach partially address some of these. The competencies in the domain "Globalization of health and health care" are the least addressed.

International nursing students and what impacts their clinical learning: literature review

This paper reviews the sparse literature about international nursing students' clinical learning experiences, and also draws on the literature about international higher education students' learning experiences across disciplines as well as nursing students' experiences when undertaking international clinical placements. The paper aims to identify factors that may impact international nursing students' clinical learning with a view to initiating further research into these students' attributes and how to work with these to enhance the students' clinical learning. Issues commonly cited as affecting international students are socialisation, communication, culture, relationships, and unmet expectations and aspirations. International student attributes tend to be included by implication rather than as part of the literature's focus. The review concludes that recognition and valuing of international nursing students' attributes in academic and clinical contexts are needed to facilitate effective strategies to support their clinical practice in new environments.