Nursing students' experience of learning cultural competence

Nursing Students' Perception of Caring for Culturally Diverse Patients: A Hermeneutic Phenomenological Study

BACKGROUND

This study examined the phenomenon of prelicensure nursing students caring for culturally diverse patients.

METHOD

Individual interviews were conducted with undergraduate nursing students using a hermeneutic phenomenological approach. Qualitative research experts conducted the interviews, transcribed the data, and followed van Manen's methodology for analysis.

RESULTS

Eleven nursing students participated in the study. Data were collected from April to August 2022. The average length of the student interviews was 32 minutes. Four themes were identified: (1) communication issues; (2) access to care; (3) nurse background; and (4) trust and respect.

CONCLUSION

This study highlights the importance of caring for culturally diverse patients. Policymakers and health care leaders can use the findings to support legislative proposals for enhancing culturally diverse patient safety and health equity. Based on these findings, nurse educators and preceptors can adapt their clinical teaching approaches accordingly, and nurse managers can benefit from the results when hiring new graduate nurses. [J Nurs Educ. 2024;63(6):373-379.].

Examining Cultural Comfort and Knowledge in Undergraduate Nursing Students After the Implementation of an Online Educational Animation on Providing Care for Muslim Patients

INTRODUCTION

With rapidly growing members of the Islamic faith, health care providers should expect to care for Muslim patients regardless of their chosen specialty. The quality of care provided hinges on their knowledge and understanding of Islam. This study aimed to analyze the influence of an educational animation on undergraduate nursing students' cultural comfort and knowledge concerning the health care needs of Muslims.

METHODS

An educational animation was created addressing the unique health care needs of Muslim patients. Surveys (pre, post, 6 weeks) (n = 658) assessed cultural comfort and knowledge on covered topics.

RESULTS

Student knowledge (pre: 12.4 ± 0.1; post: 14.4 ± 0.2; p < .01) and cultural comfort (pre: 4.0 ± 0.03; post: 4.1 ± 0.03; p < .05) increased after viewing the online educational animation. The increase in knowledge was sustained at 6 weeks. Students recommended additional topics for the future.

DISCUSSION

This study highlights how an innovative educational animation can enhance students' understanding of providing care for Muslim patients, positively impacting patient outcomes.

Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study

AIM

This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic.

BACKGROUND

Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries.

METHOD

This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0.

RESULTS

The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses.

DISCUSSION

Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Culture of patient care among international nursing students: a focused ethnographic study

BACKGROUND

This study was conducted to describe and explain the culture of patient care in international nursing students.

METHODS

This qualitative study was conducted using focused ethnography. Participants (n = 21) were purposefully selected from non-Iranian international students and their nursing instructors. Data collection included semi-structured interviews, and field-note taking. Data were analyzed with the Roper and Shapira inductive approach of ethnographic content analysis.

RESULTS

The cultural model of the study included the acquisition of cultural competence through acceptance of differences and finding commonalities. Subcategories were: "avoiding cultural bias", "trying to be on the path of adaptation", "appealing to the support and companionship of colleagues", "coping with culture shock", "acculturation", "getting help from cultural intelligence", "cultural empathy", and "language and communication enhancement".

CONCLUSION

Cultural competence is teachable. The pattern of formation is through accepting differences and searching for commonalities. Suggestions for promoting the culture of care among international students include effective use of peer groups and teaching different national ethnicities and cultures.

Evaluation of the impact of "speak out" and "human libraries" educational methodologies on nursing students' attitudes toward immigration

Introduction

Measuring and understanding attitudes toward migrants is crucial in Health Sciences professionals. Nursing students, as future professionals in the healthcare system, must be comprehensively trained and prepared from the undergraduate level to effectively face the challenges of caring for health and disease processes in an increasingly globalized world. Our study aims to determine the level of attitudinal change in nursing students for immigrants, based on a training intervention with sessions of coexistence with immigrants in Spain.

Methods

Quasi-experimental controlled and non-randomized study, carried out in 2019 in Nursing School La Fe, Valencia (Spain), with 201 participants (74 intervention group, 127 control group). Instrument: Attitudes toward Immigration Instrument (IAHI) questionnaire. Educational techniques of the training intervention: Speak outs and Human Libraries. Descriptive statistical analysis and comparison of results between groups was performed.

Results

The participants in the intervention group showed significant changes in attitude modification, both in the total score of the questionnaire and in 4 of the 5 dimensions (pre-post intervention medition). When comparing the differences between the intervention group and the control group, we observed significant differences in 3 of the 5 dimensions: equality principles and policies, positive favorability, and negative favorability.

Conclussion

Sessions involving coexistence, discussion, and reflection with immigrants, as educational intervention methods for nursing students (Speak outs and Human Libraries), are useful and effective tools to promote positive attitudinal changes toward immigrants within the healthcar context in nursing students.

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.

The development of cultural competences in nursing students and their significance in shaping the future work environment: a pilot study

BACKGROUND

Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia.

METHODS

A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05.

RESULTS

The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge.

CONCLUSIONS

The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers.

Predictors of nursing students' intentions to participate in an internationalization-at-home program: The roles of expectancies for success and subjective task value

BACKGROUND

Internationalization-at-home programs are a unique opportunity for those who had been planning to study abroad to learn global clinical practices and cultures at home. However, the factors influencing the motivation of students to join such programs remain unexplored.

OBJECTIVE

To investigate the relationship among expectancies for success, subjective task value, and the intention to participate in an internationalization-at-home program, and to identify key factors predicting such an intention among undergraduate nursing students.

DESIGN

A descriptive correlational design with a predictive approach was adopted.

METHODS

A total of 522 undergraduate and postgraduate nursing students in a Hong Kong university participated in the study. Intention to participate in the program was assessed using the Comprehensive Relative Autonomy Index. Expectancies for success and subjective task value were assessed as potential predictors. A multiple linear regression analysis was adopted to examine the predictive effects.

RESULTS

The participants were aged 17-31 years (mean = 20.95, SD = 2.39). Those who reported having previously participated in the program (β = 0.10, p-value = .014), greater intercultural communication competence (β = 0.14, p-value = .003), greater perceived social competence (β = 0.11, p-value = .031), and a higher subjective value of the program (β = 0.28, p-value<.001) expressed a greater intention to join the program. Collectively, the three variables accounted for 14.7 % of the variances in intention to participate in the program.

CONCLUSIONS

Cultural self-efficacy, intercultural communication competence, perceived social competence, individual interest, foreign language learning motivation, and subjective value of the program were found to be key factors predicting the intention of nursing students to participate in internationalization-at-home. Future studies can provide interventions to address these factors and enhance the benefits of internationalization-at-home programs.

Exploring the education in cultural competence and transcultural care in Spanish for nurses and future nurses: a scoping review and gap analysis

BACKGROUND

Globalization and population migration have led to increasingly culturally diverse societies, which has made nursing education in cultural competence and transcultural care a priority. This includes the ability to provide person-centered and culturally congruent care, even within one's own culture. However, this sort of training has been developed and implemented in practice comparatively more by English-speaking societies. Therefore, the aim of this study was to identify the existing educational initiatives for nurses and future ones in cultural competence and transcultural care in Spanish and explore their didactic characteristics in terms of teaching and learning formats, contents, skills, and evaluation methods at different academic levels.

METHODS

A scoping review was carried out by following the specific PRISMA recommendations and those of the Joanna Briggs Institute guidance throughout PudMed, Web of Science, Embase, Google Scholar, and Cinahl databases and also gray literature in the form of official documentation that later was complemented with a gap analysis including training programs published by Spanish and Latin-American educational institutions and the approaches of key academic informants.

RESULTS

The published evidence on nursing training in cultural competence or related topics in Spanish-speaking higher education for nurses is limited. Specific nursing programs in Spanish-speaking universities are primarily found in Spain, with fewer options available in Latin America. These contents are offered either as optional subjects or immersed in other courses and mainly taught in theoretical sessions. Practice in real contexts is supposed to be evaluated transversally under the cultural scope according to national educational recommendations though barely visible in students' evaluation reports. Even though postgraduate training dedicated to these issues exists, it is still limited, mixed with other contents, and generally depends on a few researchers investigating and publishing on the topic from very specific universities.

CONCLUSIONS

It is essential to establish a common global strategy including Spanish-speaking countries in nurses' higher education and professional training on topics focused on cultural competence as well as the provision of nurses' social and cultural sensitivity towards their own culture and to define whether those that currently exist are effective. It is also crucial that this training was evaluated in practice in order to achieve enough impact on students, health organizations, and population health.

The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students

Objective

Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency.

Methods

A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups.

Results

There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000).

Conclusion

The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.

Using graphic medicine in teaching multicultural nursing: a quasi-experimental study

BACKGROUND

Comics, as an art form that combines words and images, can be used with great success in teaching nursing students. Teaching content on multicultural issues is not easy, especially since, in addition to knowledge, it is important to pay attention to communication skills, attitudes of respect, openness or empathy, among others. It is difficult to recognize or discuss these attitudes without student involvement. Graphic stories, comic strips provide such opportunities and facilitate learning new content, even those difficult to communicate naturally and spontaneously. The aim of this paper is to present the possibilities of using the graphic method, in particular comics and graphic novels, in teaching nursing, based on the example of multicultural nursing.

METHODS

Quasi-experimental intervention study with a quantitative approach, guided by the STROBE tool The survey was conducted March-May 2022 among State University of Applied Sciences in Piła students. First, students' knowledge of cultural issues was assessed, then they were randomly assigned to two groups. One group had classes using a comic book, and the other group had classes using traditional methods. After the class, the students' knowledge was assessed again. Descriptive statistical analyses were performed to obtain the mean, median, standard deviation (SD). Data followed a normal distribution. Data was verified by the t-Students test for independent groups.

RESULTS

Respondents' knowledge on cultural issues before taking the course was satisfactory, with a mean score of 19.1. After completing the course, knowledge on cultural issues increased and was rated as very good and the mean score for all respondents was 26.9. Statistical analysis showed that there was statistical significance between the groups and the number of points achieved in the posttest. Respondents in the intervention group scored higher than those in the comparsion group.

CONCLUSION

The use of the graphic method, which is one of the forms of active learning, in teaching cultural content to nursing students has positive didactic effects. Students achieve better learning outcomes in terms of knowledge, skills and attitudes in a way that is more engaging. This makes learning difficult topics, such as a cultural issue, more effective. It would be worth considering using this method for other courses and/or at other universities as well.

The Perception of Nurses about Migrants after the COVID-19 Pandemic: Close Contact Improves the Relationship

Nurses have faced during the COVID-19 pandemic a tough professional situation in which they have had to work in a resource-limited context and with a high probability of COVID-19 transmission. In today's multicultural societies, care for immigrant patients is also included. In our study, we have delved into the perception of hospital nurses towards migrant people in the context of the COVID-19 pandemic. We used a qualitative methodology with a phenomenological approach. Semi-structured interviews were conducted with 16 nurses. Seven categories emerged and were distributed in the three blocks of the interviews: (a) perception before the pandemic: prejudices make a mark and communication problems; (b) perception after the pandemic: prejudices weaken and communication worsens; and (c) how to improve care: improve communication, more nurses, and no need for training. The approach in the interpersonal relationship between nurses and patients during the pandemic has improved health care. Proposals arise to overcome the language barrier such as the incorporation of intercultural translators-mediators and professionals of foreign origin. There is a lack of awareness of the need for training in cultural competence on the part of the nurses in the study.

Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021

Aim

Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective.

Objective

This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice.

Design

A scoping review of the literature.

Method

The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021.

Results

The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods.

Conclusion

Educational training for cultural competence is necessary for today’s nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.