Indigenous Community Health and the Nursing Student Experience: Exploration of Cultural Competency

Sandra Cadena, Walden University

Abstract

Introduction: Cultural diversity in the U.S.continues to expand, resulting in increasing demands for new nurses to incorporate cultural competency in nursing care. Integration of cultural content into nursing education programs has been a goal advocated by nursing education institutions. Theoretical frameworks of this study are Leininger's Transcultural Nursing Care,Campinha-Bacote's process of cultural competency development, including themes of cultural desire,awareness, knowledge, skill,& encounter,and Purnell's Cultural Competency Model. Purpose:to determine whether a 3-week Panama community clinical immersion in international nursing had any additional effect on students' self-perceived cultural competence.

Method(s): Quasi-experimental design, utilizing the Caffrey Cultural Competence in Health Scale(CCCHS), a 28 item, Likert scale. Three years of data collected as a component of curriculum evaluation. Two groups of undergraduate students self-selected to either 1)the Curriculum(C)control group(n=60),not participating in the international experiences, or 2)students who did participate,the Panama Clinical Immersion(PCI) group(n=42).The semester before the international experience,both groups completed the CCCHS(pretest). Three months upon returning from the trip(post-test),both groups completed the CCCHS.

Results: Using an independent samples t test, pretest mean scores on the overall CHCCS of the 42 students in the PCI group(mean= 3.19,SD=.41) and the 60 students in the C group(mean=3.41, SD=.58) were not significantly different(p=.28). Pretest and posttest CCCHS scores of all 102 students concerning perceived cultural competence:60 students in the Curriculum group=21 improved, 30 showed no change,9 worsened; 42 students in the PCI group=38 improved,4 showed no change. The item showing the greatest improvement for students in the PCI group was, "Overall, how would you evaluate your abilities to provide culturally competent care in the clinical setting to clients from a culture other than your own?"Effect size=3.44 for PCI students; Effect size=.14 for Curriculum group.

Discussion & Conclusions: Students in the Curriculum group demonstrated moderate improvement in perceived culturally competent attitudes, knowledge, and skills over 2 semesters. Students in the PCI group gained much more than their classmates in their perceived cultural competence as a result of the immersion program.