Establishing the Reliability of Using the Cross Cultural Adaptability Inventory With Physical Therapist Students

Abstract

Background and Purpose. Health care professionals (HCPs) in the United States are beginning to realize that they work in a multicultural, multiethnic, and culturally diverse society. Prior research has shown that limited or lack of cultural adaptability and cultural competence by HCPs is potentially dangerous to patient care and treatment outcomes. Prior to studying the cultural adaptability of physical therapist (PT) students, the reliability of using cross-cultural instruments needs to established. The purpose of this study was to establish the reliability of using the Cross Cultural Adaptability Inventory (CCAI) with PT students. Subjects. The sample consisted of 288 entry-level master's degree PT students. Methods. The CCAl, a 50-item instrument that measures the construct of cultural adaptability on 4 dimensions (emotional resilience, flexibility/openness, perceptual acuity, and personal autonomy) was administered during the fall academic semester. Results. Data were analyzed and the reliability was estimated using the Cronbach alpha coefficient of internal consistency. The total score had an estimated reliability of .90. Discussion and Conclusion. The data supported the hypothesis that the CCAI is a reliable instrument for use with PT students. Further research could explore the cross-cultural adaptability levels of faculty, students, and clinical practitioners. Key Words: Cross-cultural adaptability, Cross Cultural Adaptability Inventory, Physical therapy, Reliability. INTRODUCTION Physical therapy professionals in the United States are beginning to realize that they live in a multicultural, multiethnic, and diverse socioeconomic society. The complexity of this society challenges the physical therapist to review and relearn the help-giving process. all people deserve to have their ethnicity valued by culturally competent nurses' and hopefully by culturally competent physical therapists. However, there is virtually no research in this area. What little there is has shown that limited or lack of cultural competence for practicing health care professionals (HCPs) has been identified as inappropriate and potentially hurtful and harmful to client care outcomes.1 The accurate and reliable measurement of cultural adaptability is important in physical therapy education, research, and practice. Prior to 1998, physical therapy programs were not required to include and/or address individual or cultural differences, cultural sensitivity, or cross-cultural awareness or any content related to cultural diversity within their academic curricula.25 In addition, the research on cultural issues within the physical therapy profession was nonexistent. However, in 1997, the American Physical Therapy Association (APTA) began to address this topic when it included section 2.1 (Individual and Cultural Differences) in the Professional Practice Expectations of APTA's A Normative Model of Education: Version 97.5 Professional Practice Expectation 2: Individual and Cultural Differences states that students needed to be sensitive to individual and cultural differences when engaged in physical therapy practice, research, and education.5(p69) As a result, APTA, a professional organization that influences program accreditation and provides guidelines on professional ethics, provided a reason for including the foundations of cross-cultural adaptability (CCA) in both the master's and doctoral-level training of physical therapist (PT) students. However, there is another motivation for CCA that is less pragmatic and more implicit than professional mandates and guidelines. It is the philosophical ideology of wanting to respect differences of cultural groups and of envisioning multicultiiralism as a peaceful process of coexistence in the 21st century. Consequently, there is a need to evaluate the CCA of PT students. However, one must first determine its reliability with this population. While no physical therapy-specific cultural instruments are available, there are a variety of instruments used by other allied health care professionals that explore various cultural components, including the Cultural Attitude Scale (CAS),6. …