Promoting and Assessing Cultural Competence, Professional Identity, and Advocacy in Doctor of Physical Therapy (DPT) Degree Students Within a Community of Practice

Abstract

Background and Purpose. Cultural competence is a criterion for a Doctor of Physical Therapy (DPT) degree professional and reference to it is contained in many American Physical Therapy Association (APTA) core documents. Possession of cultural competence is critical for health care providers, where regard for individual patient differences is quintessential for attaining positive health outcomes. With the globalization of society, academia has responded through increasing the number of study abroad opportunities for students. While physical therapy educators can use study abroad to promote DPT student exposure to diverse cultures, they are challenged to design pedagogy that prepares and assesses learning outcomes (eg, profession identity, advocacy) that are related to the development of cultural competence. The purpose of this article is to describe an innovative educational model designed to facilitate and assess the development of cultural competence, professional identity, and advocacy in DPT students. Method/Model Description and Evaluation. The model, embedded in a 2-semester capstone, enabled 14 DPT students to prepare academically and participate in a 9-day study abroad experience at the For His Children (FHC) orphanages, located in Quito and Latacunga, Ecuador. A blending of the cultural competence frameworks developed by Purnell and Campinha-Bacote informed the model. Academic preparation included study about the Ecuadorian culture, cultural awareness activities, research on the diagnoses affecting the children at FHC, and design of appropriate therapeutic interventions. Assessment of DPT students’ learning was accomplished using 3 methods: the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV), 2 reflective papers completed pre and post study abroad, and 2 posttravel focus groups. Outcomes. Paired t tests were run for aggregate data and for the 5 constructs comprising the IAPCC-SV. All comparisons were statistically significant (P < .05) indicating an increase in overall cultural competence and for each construct: (1) cultural desire, (2) cultural awareness, (3) cultural knowledge, (4) cultural encounters, and (5) cultural skill. Qualitative analysis of reflective papers and focus group data resulted in 5 themes: (1) strength of the community, (2) integration of clinical skills within an uncluttered environment, (3) inner beauty of the child, (4) becoming a professional, and (5) cultural shift. Discussion and Conclusion. Our model allowed 14 DPT students to integrate academics and experience, problem-solve collaboratively, advocate for the underserved, and develop as a professional. IAPCC-SV posttest scores documented a significant increase in cultural competence. Reflective data illuminated student realization of the contextualized nature of learning that occurs within a community of practice. In addition, students recognized application of the core values in action. Cultural competence is relevant for positive health outcomes. Study abroad experiences are popular strategy for promoting cultural competence in students, and models that include assessment and reflection are important for documenting learning outcomes.