The Use of High-Fidelity Simulation to Teach Cultural Competence in the Nursing Curriculum

Predisposing Factors of Intercultural Sensitivity Among Nursing Students: A Predictive Correlational Design

INTRODUCTION

Intercultural sensitivity in health care improves health care quality due to effective communication, intervention, and increased satisfaction. The present study aimed to compare the intercultural sensitivity of undergraduate nursing students in two different countries and identify predisposing factors of intercultural sensitivity.

METHODS

A predictive correlational study was conducted with 980 undergraduate nursing students at a university in Turkey and the United States. A questionnaire and the Intercultural Sensitivity Scale were used for data collection.

RESULTS

Multiple linear regression revealed that the country in which nursing students were studying, and speaking a second language were found as significant predictors of intercultural sensitivity in the current study. The findings of the two-way variance analysis indicated that the interaction effect between nursing students in two schools and sociodemographic variables was not statistically significant (p > .05).

DISCUSSION

Nursing students from both universities presented a moderate level of intercultural sensitivity. This level is low compared with previous results reported in the literature. The study findings may help faculty administrators make new arrangements in the nursing curriculum and contribute to providing equal, and non-discriminatory health services to people. Intercultural education programs within the curriculum should be offered as independent courses and/or integrated within courses to develop culturally competent knowledge, awareness, and skills throughout undergraduate nursing education.

Compassion or Corruption? Temporalities of Care and Nationhood in Papua New Guinean Nursing Education

Nurse educators in Papua New Guinea (PNG) must prepare students for often demoralizing working conditions. This article analyzes classroom and practical lessons in a PNG Highlands nursing college. A variety of pedagogical practices, including role plays and other simulation technologies, were used to socialize students to imagine patients' relatives while making clinical decisions, and to contemplate their own relatives and ancestors in reflecting on their moral commitments to health care. Such practices generate a mode of medical citizenship shaped by a regime of biocommunicability in which Christianity and education are thought to transform one's capacity to detach from the emotional appeals of kin. These pedagogies link the individual subjectivities of health workers to a persistent, though fragile, vision of the nation in which transgenerational, urban-rural kinship is a synecdoche for nationhood (and its deferral), despite professional counternarratives that cast these kinship ties as a slippery slope toward "corruption." [medical citizenship, temporalities of care, nursing simulation, nationhood, Papua New Guinea].

Enhancing Cross-Cultural Competence of Medical and Healthcare Students with the Use of Simulated Patients-A Systematic Review

Increasing cultural and linguistic diversities of populations have created a challenge for medical educators to provide authentic learning experiences fostering cross-cultural understanding and interprofessional attitudes of students. Simulations with actors portraying patients (commonly referred to as simulated patients) are effective learning modalities to teach students to provide culturally competent care and influence the quality of patient-centered care. The aim of this systematic review was to identify and synthesize available evidence on the use of simulations with simulated patients as a learning intervention to teach cultural competence to the students of healthcare professions. The PubMed, Medline Complete, and CINAHL databases were searched for articles, which resulted in 27 papers being included in the review. Results revealed that engaging students in cross-cultural interactions with patients increases their level of cultural competence, confidence, and learning satisfaction, and therefore, simulations with simulated patients can serve as a powerful reinforcement of cross-cultural education.

Impact of a 10-week disability elective on health professions students' attitudes towards disabled persons

BACKGROUND AND PURPOSE

Disability is overlooked in health provider training despite the growing number of patients and providers with a disability. In-depth training on delivering outstanding care is provided as part of training for health professions, however little guidance is provided on how to interact with patients with disabilities.

EDUCATIONAL ACTIVITY AND SETTING

Students enrolled in a 10-week interdisciplinary elective at the University of California, San Francisco were asked to participate in the study. Students who consented to participate completed a pre-intervention assessment that incorporated the Interaction with Disabled Persons Scale (IDP) and Marlowe-Crowne Social Desirability Scale Short Form C (MC). At the conclusion of the elective, participating students retook both surveys as part of a post-intervention assessment.

FINDINGS

There was a significant difference in IDP score and non-significant difference in MC score following the elective. There was a positive but non-significant correlation between the paired results for the IDP and MC surveys.

SUMMARY

Following completion of a 10-week disability awareness curriculum, there was a significant improvement in health professions students' perceptions towards persons with disabilities.

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.

Measuring the effect of simulation experience on perceived self-efficacy for interprofessional collaboration among undergraduate nursing and social work students

Barriers to effective interprofessional collaboration may include insufficient knowledge of other professional roles and inexperience using effective communication skills. Improving self-efficacy for interprofessional collaboration may enhance the ability to practice expertly within the interprofessional environment of healthcare. This article examines the results of a multiple methods pretest/posttest study that used the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale to determine self-reported perceptions of self-efficacy development following participation in a trauma simulation. Participants included 74 undergraduate nursing students and nine undergraduate social work students. Findings included a significant increase in perceived self-efficacy from pretest to posttest for both groups. Nursing majors and participants who reported previous interaction with a member of another profession scored significantly higher on the posttest. Qualitative data were analyzed through thematic content analysis which produced three themes: an improved understanding of the importance of communication and the interconnection of interprofessional roles; a realistic simulation which challenged the students; and an increased appreciation for teamwork. These findings suggest that challenging simulations with pre-licensure students can increase undergraduate students' perceived self-efficacy for interprofessional collaboration and contribute to an improved understanding of interprofessional team roles and communication.

Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students

This descriptive, correlational, cross-sectional study examined nursing students' educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for attitude and lower scores for skill and knowledge. For cultural competency, participants scored much higher for cultural awareness and sensitivity than behavior. There was no statistically significant difference between scores for patient safety and cultural competencies by nursing school. The results support the need for curriculum development to include all important aspects of patient safety and cultural competencies in various teaching/learning venues.

Toward Cultural Competency in Health Care: A Scoping Review of the Diversity and Inclusion Education Literature

PURPOSE

To explore best practices for increasing cultural competency and reducing health disparities, the authors conducted a scoping review of the existing literature.

METHOD

The review was guided by 2 questions: (1) Are health care professionals and medical students learning about implicit bias, health disparities, advocacy, and the needs of diverse patient populations? (2) What educational strategies are being used to increase student and educator cultural competency? In August 2016 and July 2018, the authors searched 10 databases (including Ovid MEDLINE, Embase, and Scopus) and MedEdPORTAL, respectively, using keywords related to multiple health professions and cultural competency or diversity and inclusion education and training. Publications from 2005 to August 2016 were included. Results were screened using a 2-phase process (title and abstract review followed by full-text review) to determine if articles met the inclusion or exclusion criteria.

RESULTS

The search identified 89 articles that specifically related to cultural competency or diversity and inclusion education and training within health care. Interventions ranged from single-day workshops to a 10-year curriculum. Eleven educational strategies used to teach cultural competency and about health disparities were identified. Many studies recommended using multiple educational strategies to develop knowledge, awareness, attitudes, and skills. Less than half of the studies reported favorable outcomes. Multiple studies highlighted the difficulty of implementing curricula without trained and knowledgeable faculty.

CONCLUSIONS

For the field to progress in supporting a culturally diverse patient population, comprehensive training of trainers, longitudinal evaluations of interventions, and the identification and establishment of best practices will be imperative.

Underrepresentation of Racial Diversity in Simulation: An International Study

AIM

The purpose of this study was to: 1) examine the presence of racial diversity in simulation centers globally and 2) determine the opinion of the simulation community related to incorporation of a diversity component into international simulation standards.

BACKGROUND

Leading organizations in nursing education recommend improved efforts toward diversity and inclusion. Research suggests a lack of diversity in simulation-based education.

METHOD

This study employed a mixed-methods design.

RESULTS

Quantitative results demonstrated an underrepresentation of racial diversity in manikins, body parts/task trainers, standardized patients, and simulation facilitators. Two thirds of respondents indicated that international simulation standards should recommend a diversity component. Qualitative findings indicated categories of: 1) challenges of purchasing, realism, and availability; 2) importance of diversity in simulation; 3) representation of the regional population; 4) more diversity considerations needed; and 5) presence of diversity.

CONCLUSION

There is a continued need for diversity advocacy efforts in nursing education.

Student-Developed Simulations: Enhancing Cultural Awareness and Understanding Social Determinants of Health

BACKGROUND

National and global initiatives to address the social determinants of health (SDH) are on the rise. On a parallel trajectory, increased cultural awareness is emerging as an integral strategy to improve the understanding of these social contributions to disease states, health inequities, and health disparities.

METHOD

Undergraduate nursing students developed modalities and role-played simulations as a teaching and learning strategy. The simulations demonstrated how nurses assess patients' unique needs and offer support and resources regarding patients' socioeconomic, cultural, and environmental needs.

RESULTS

The student-developed simulations were an interactive teaching and learning strategy that offered several benefits, such as improved interpersonal skills, learned specific nursing roles, and improved cultural awareness.

CONCLUSION

Student-developed simulations are an innovative teaching strategy for improving cultural awareness and learning more about SDH. [J Nurs Educ. 2017;56(4):243-246.].

Assessment of cultural competence in Texas nursing faculty

BACKGROUND

Cultural competence [CC] is an essential component of nursing education and nursing practice yet there is a gap in the research evaluating CC in faculty and how to practically develop this skillset for faculty members.

OBJECTIVES

To explore CC in faculty as evaluated with the Nurses' Cultural Competence Scale [NCCS] and apply the findings to the Purnell Model of Cultural Competence [PMCC] to guide professional development opportunities for faculty members.

DESIGN

This was a concurrent mixed-methods study.

SETTING

Faculty members teaching in Texas nursing programs were recruited for the study. Quantitative data was collected using an online survey tool and qualitative data was collected over the phone.

PARTICIPANTS

89 Texas faculty members completed the quantitative strand and a subset of 10 faculty members completed the qualitative strand.

METHODS

Descriptive statistics were used to examine the quantitative data and Strauss and Corbin's methodology guided the evaluation of the qualitative data. These two strands were used to support the results.

RESULTS

Faculty in Texas are moderately culturally competent. The qualitative findings support the application of the PMCC to the areas identified by the NCCS.

CONCLUSION

The PMCC may be applied to the application of culture and values in nursing professional education as supported by the NCCS. Recommendations are to include the PMCC as a structure for the creation of professional development opportunities for faculty.

Development and psychometric testing of the satisfaction with Cultural Simulation Experience Scale

Decreasing the numbers of adverse health events experienced by people from culturally diverse backgrounds rests, in part, on the ability of education providers to provide quality learning experiences that support nursing students in developing cultural competence, an essential professional attribute. This paper reports on the implementation and evaluation of an immersive 3D cultural empathy simulation. The Satisfaction with Cultural Simulation Experience Scale used in this study was adapted and validated as the first stage of this study. Exploratory factor analysis and confirmatory factor analysis were undertaken to investigate the psychometric properties of the scale using two randomly-split sub-samples. Cronbach's Alpha was used to examine internal consistency reliability. Descriptive statistics were used for analysis of mean satisfaction scores and qualitative comments to open-ended questions were analysed and coded. A purposive sample (n = 497) of second of nursing students participated in the study. The overall Cronbach's alpha for the scale was 0.95 and each subscale demonstrated high internal consistency: 0.92; 0.92; 0.72 respectively. The mean satisfaction score was 4.64 (SD 0.51) out of a maximum of 5 indicating a high level of participant satisfaction with the simulation. Three factors emerged from qualitative analysis: "Becoming culturally competent", "Learning from the debrief" and "Reflecting on practice". The cultural simulation was highly regarded by students. Psychometric testing of the Satisfaction with Cultural Simulation Experience Scale demonstrated that it is a reliable instrument. However, there is room for improvement and further testing in other contexts is therefore recommended.