Critical Cultural Competence Research Articles

Innovative cultural care training: the impact of flipped classroom methods on critical cultural competencies in psychiatric nursing: a quasi-experimental study

IntroductionHealthcare systems are encountering a growing number of diverse and multicultural clients due to globalization and migration. To effectively address the challenges associated with cross-cultural interactions, nurses require a comprehensive framework of critical cultural competencies. One potential approach to enhancing these competencies in mental health care settings is to use innovative methods such as the flipped classroom in cultural care training programs. This study evaluated the effect of using the flipped classroom method in cultural care training on the critical cultural competencies of nurses working in a psychiatric hospital.MethodsThis quasi-experimental study involved 70 nurses working in a psychiatric hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran. Through random sampling, the nurses were allocated into two groups of intervention (n = 35) and control (n = 35). The intervention group participated in a cultural care training program using the flipped classroom method, which consisted of four sessions conducted over a four-week period. To evaluate the nurses’ critical cultural competence, the Almutairi’s Critical Cultural Competence Scale was administered before the training and again one month later.ResultsThe study findings indicated no significant differences in the scores of critical cultural competencies between the intervention group (4.53 ± 0.64) and the control group (4.73 ± 0.42) during the pre-test stage (t = 1.53, p = 0.13). Both groups had a similar perception of critical cultural competencies, which was not particularly positive. However, in the posttest stage, the intervention group (5.33 ± 0.49) demonstrated a significant increase in critical cultural competencies compared to the control group (4.75 ± 0.44) (t = 5.14, p = 0.001).ConclusionThe study results indicated that the use of the flipped classroom method in the cultural care training program effectively enhanced the critical cultural competencies of nurses. Given the importance of cultural care in both physical and psychiatric care settings for multicultural clients, it is crucial for nurses to receive ongoing in-service education that utilizes innovative and active methods such as the flipped classroom.

Reliability and Validity Assessment of Almutairi’s Critical Cultural Competence Scale

Many attempts have been made to measure practitioners’ cultural competence in such a diverse area as nursing and health care. However, we find little to no evidence of such an attempt in the field of social work. In many studies, the Critical Cultural Competence Scale developed by Almutairi had proved to promote well being, equity and safety of practitioners, their family and service providers with the strong evidence for its psychometric properties. This paper presents the reliability and validity assessment of adapted Almutairi’s Critical Cultural Competence Scale (CCCS) for Indian context with 33 social work practitioners of National Capital Territory (NCT) of India practicing in different fields. For examining the validity, face validity and readability were assessed, and Cronbach’s Alpha was used to assess reliability. The final refined 3 component, 35 items scale is consistent with the three-factor measurement models in the most academic literature on the subject.

Voices on Language Teacher Stereotypes: Critical Cultural Competence Building as a Pedagogical Strategy

ABSTRACT The present study explores foreign English teachers’ (FETs) personal experiences with stereotypes and their use of critical cultural competence (CCC) building activities in Japanese university English as a foreign language (EFL) classes. The data was obtained through open-ended interviews with Japanese university FETs from diverse ethnic and cultural backgrounds. Interpretative phenomenological analysis (IPA) was employed to capture the participants’ lived experiences and how they made sense of their experiences in the language classroom. The findings indicated that FETs can be subject to phenotypical, gender, and personality stereotypes in Japanese educational settings. Japanese English language education, in-group’s commitment to collective identity, and the mass media’s reinforcement of out-group stereotypes accounted for the existence of the aforementioned stereotypes. The study concludes that integrating CCC building activities into language education can be an effective pedagogical approach to develop students’ intercultural sensitivity and foster globally competent students with communicative English language skills.

Critical cultural competence of clinical nurses in China: A cross‐sectional survey

To determine the level of critical cultural competence (CCC) among Chinese clinical nurses and explore its influencing factors. Previous research has only focused on the theoretical model of CCC and the development of assessment tools; however, no large-scale study has been conducted on the level of clinical nurses' critical cultural competence and its influencing factors. Clinical nurses in 14 Level A tertiary hospitals (n=3858) were surveyed using Almutairi's Critical Cultural Competence Scale (CCCS). Descriptive, univariate, and multivariate analyses were performed. The mean score of CCC was 4.44 (SD=0.33). Critical empowerment (M=4.85, SD=0.58) and critical awareness (M=3.57, SD=0.99) had the highest and lowest scores, respectively. Female nurses, nurses in the nursing department, and nurses with higher positions had higher CCC. The CCC of clinical nurses can be strengthened through targeted training, especially considering the fact that male and low-ranking nurses who had the lower level of CCC work in different departments. Implications for nursing management Hospital administrators should pay attention to the importance of culture and cultural differences among different countries or ethnic groups. Creating an equal and fair nursing environment and encouraging nurses to provide critical cultural nursing is important.

L1 Speakers’ Attitudes toward L2 Speakers’ Negation Use in French

Cet article a pour objectif d’explorer les attitudes de 157 locuteurs de français L1 âgés de 20 à 60 ans envers l’usage de la négation par trois locutrices de français L2. Selon les grammaires prescriptives, l’expression de la négation exige la présence du “ne” préverbal et d’un forclusif. L’omission de “ne”, pourtant fréquente à l’oral, n’est que rarement enseignée sous prétexte que les locuteurs L1 désapprouvent l’usage des registres non formels par les locuteurs L2. Adoptant la méthodologie des faux-couples, je teste cette allégation. L’omission ou la rétention de ne par les locutrices L2 influencent-elles les jugements sociaux des 157 témoins ? Leurs jugements varient-ils en fonction de leur âge, genre ou profession ? Les témoins estiment deux des locutrices L2 plus polies et plus distinguées quand elles retiennent le ne; les jugements sur la troisième locutrice ne suivent pas cette tendance. Il apparaît aussi que l’omission ou la rétention du ne influence l’évaluation de l’aptitude à diriger des locutrices. Ces résultats invalident l’hypothèse selon laquelle les locuteurs L1 voudraient que les locuteurs L2 privilégient la norme prescriptive indépendamment de tout contexte. En conclusion, je présente quelques applications pédagogiques (découverte des significations sociales des variantes stylistiques et développement de la compétence culturelle critique).

Transformative Pedagogies: New Perspectives for Spanish and Portuguese Classrooms (Part 2)

Transformative Pedagogies: New Perspectives for Spanish and Portuguese Classrooms (Part 2) Rachel Mamiya Hernandez, Comfort Pratt, and Martha Vásquez Transformation is a process rather than a singular or isolated event. Collectively we are just beginning to comprehend the full global impact of the pandemic, racial violence, protests, and political and economic instability, which at times feels overwhelming and disorienting. These circumstances can make us inquire how we can best leverage the momentum and lessons of 2020 to forge deeper, more meaningful learning experiences that should result in purposeful transformation of our beliefs, thinking, and practices. This, indeed, is the focus of this Special Feature. Antiracist scholar Ibram X. Kendi (2020) reminds us, “The soul of justice breathes life, freedom, equality, democracy, human rights, fairness, science, community, opportunity, and empathy for all.” Empathy is at the heart of these articles on transformative learning. Perhaps it may seem contradictory that in this past year that has been so tethered to technology, this fundamental emotional response has emerged as a common thread. However, this speaks to the transformative power of empathy. Several works in this Special Feature focus on empathy building through active engagement with stories. Regardless of their context or medium, stories resonate deeply with us and help us understand the lived experiences of others and, in turn, our own. This Special Feature demonstrates ways in which building empathy can bring to life forgotten histories, provide guidance in contemplating complex identities, dispel myths, help reshape curricular and assessment practices, challenge the status quo, and lead to action. Rooted in the Aristotelian method of walking and talking, Callejeando Sevilla histórica: Una caminata antirracista por la ciudad, brings to life the forgotten history of Black communities in the city of Seville, Spain. Weaving together historic places, texts, and contemporary issues, John Beusterien, Chloe Ireton, and Sara Pink bring to life experiences of the free and enslaved populations that once inhabited the city. The three part structure of the unit consists of the preparation for the walk which includes readings on the historical context, the walk which takes them to important places like La Capilla de Nuestra Señora de Los Ángeles, La Puerta del Osario, and La Plaza del Salvador, and then reflect through collaborative projects which connect the experience with contemporary racism and sensibility to cultural differences, among other topics. Through examining the history embodied in the city, this multidisciplinary, antiracist, place-based approach brings forth ideas that can be readily adapted to many different places and contexts. [End Page 329] Carmen Granda, in “Addressing Antiracism in an Undergraduate Spanish Class with Authentic Materials,” points out that classrooms should reflect the realities of the outside world, and uses a lens of social justice to break down barriers, address issues of race, racism, and representation, and ultimately develop empathy in learners. She points out that the Black Lives Matter movement has put in the limelight issues of race and racism in Afro-Latinx communities in the United States. She also emphasizes that there has been relatively less focus on the experience of Black, African, and Afro-descendant communities in Spain. Through texts like Desirée Bela-Lobedde’s Ser mujer negra en España and the short film Querido Baltasar, students learn about a variety of issues surrounding the experiences of Black women and girls in Spain. She illustrates how we can help students develop critical cultural competence by recognizing the intersectionality of our identities, understanding the similarities and differences, and recognizing stereotypes and unfairness, and empowering them to take action and speak out against injustice. In “Responding to Crisis with Creativity: Open Integrated Performance Assessments,” Leah Kemp and Liana Stepanyan call attention to the importance of offering students opportunities to connect with others and create community, particularly during the tumult and uncertainty of the pandemic. They point out that traditional textbooks can often fall short and seem unidimensional, contrived, and out of touch. The authors propose the use of Open Educational Resources (OER) as an avenue for creating deeper, more responsive learning experiences. In particular, this article looks at the development of OER assessments in the form of Integrated Performance Assessments (IPA) and brings in student perspectives on how the...

The construction of the tourist gaze in English textbooks in South Korea: exploring the tensions between internationalisation and nationalisation

ABSTRACTThis study investigates how larger ideological tensions related to internationalisation and nationalisation are manifested in local education systems, especially in English textbooks. We begin this exploration with a review of the School Curriculum of the Republic of Korea. Using three textbooks as cases; we examine how they reflect and manage the tensions presented in the Curriculum. We argue that these tensions are managed through the construction of a tourist gaze, which is both directed inwards, in the construction of Koreanness, and outwards, in the construction of a global citizen. Through the medium of English, learners are both tourists, viewing their own culture from the perspective of the ‘other,’ while they are being prepared to be ‘tour guides,’ learning how to explain this perspective to the ‘other’ in the other's language, English. When focused outwards, the tourist gaze constructs representations of foreign cultures because it is through learning English that Korean learners become global citizens and are able to connect to ‘others,’ to make friends, and to travel the world. We conclude with considerations of ways to go beyond the tourist gaze, as teachers and learners use the tensions in more constructive ways – namely, to develop critical cultural competence.

Relating Almutairi’s critical cultural competence model for healthcare providers transitioning to Qatar

Healthcare providers can be enticed to work in the Middle East due to fascinations with the culture, wealth, and opportunities for personal and professional development. Working in multicultural healthcare environments requires addressing complexities with cultural hierarchies, religion, class systems, and gender. It also requires understanding of the region’s history, as well as knowledge about cultural and social norms. The authors use qualitative accounts, from lived experiences to illuminate their transition to work in Qatar. Upon reflection of their experiences, the authors recommend using a Critical Cultural Competence model as a guide for healthcare providers undergoing transition and longer-term adaptation for promoting cultural safety for healthcare providers and their patients. Some authors of this article have previously published “Recommendations for healthcare providers preparing to work in the Middle East: A Campinha-Bacote cultural competence model approach” (Journal of Nursing Education and Practice, 2017). However, after reflecting upon their experiences as nurse educators living in the Middle East, the authors concluded that Almutairi, Dahinten, and Rodney’s (2015) Critical Cultural Competence Model is more suitable for health care providers transitioning to Qatar. This model addresses necessary elements needed to transition to a new culture, but also includes personal narratives and experiences, which maybe helpful to transitioning to work in another culture. Almutairi et al.’s model (2015) reconceptualises and enriches the concept of transitioning to Middle Eastern multicultural contexts. The aim of this paper is to provide recommendations using Almutairi et al.’s Cultural Competence Model to assist healthcare providers in transitioning to work in Qatar. Another aim is to provide guidance for healthcare professional development in multicultural contexts. Discussion as to how the model may foster a more relevant approach will ensue. Experiential knowledge and narratives are threaded throughout the paper to provide a lived account of the use of this Critical Cultural Competence model by healthcare workers, who have transitioned to the Middle East.

Developing Multicultural Self-awareness Through a Transformative Learning Experience

The purpose of this qualitative case study was to explore the ways that a change in perspective can create a better understanding of cultural identity. This study addressed: (1) How does a self-awareness transformative learning experience develop critical cultural competence in career and technical education instructors? (2) How does the practice of critical reflection construct career and technical education instructors’ ability to develop self-awareness of critical cultural competence? (3) How does involvement in critical discourse construct career and technical education instructors’ ability to develop self-awareness of critical cultural competence? A three-phase professional development experience rooted in multicultural education provided key elements of transformative learning.

Perceptions of the critical cultural competence of registered nurses in Canada

BackgroundCultural diversity often leads to misunderstandings, clashes, conflicts, ethnocentrism, discrimination, and stereotyping due to the frequent intersection of many variables, such as differences in traditions, behaviours, ethical and moral perspectives, conceptions of health and illness, and language barriers. The root of the issue is related to the way people conceptualise differences and the unique cultural and historical circumstances that have shaped different groups’ heritages. In this study, therefore, we aimed to investigate the perceptions of critical cultural competence (CCC) of registered nurses working in various hospitals across the province of British Columbia, Canada.MethodData were collected using Almutairi’s Critical Cultural Competence Scale (CCC Scale) with a random sample of 170 registered nurses. This scale measures four essential multidimensional components of the CCC model: critical awareness, critical knowledge, critical skills, and critical empowerment. Data were analysed using descriptive and inferential statistics (Kruskal-Wallis test).ResultsThe data revealed that participants’ perceptions of CCC were positive with a mean score of 5.22 out of 7.00 for the total number of items (n = 43) and a standard deviation of 0.54. The mean scores for the CCC subscales ranged from 4.76 (for critical skills) to 5.42 (for critical empowerment). The results indicated a statistical difference in CCC perceptions based on participants’ age and country of birth with p = 0.05 < 0.05 and 0.029 < 0.05, respectively.ConclusionNurses’ age (experience) and country of birth may influence their perceptions of CCC as gaining cultural competence requires exposure to caring for patients from various cultures and countries, and is associated with cultural knowledge and awareness. Therefore, this finding reveals that healthcare organizations must provide ongoing cultural education programs to increase their nursing staff’s level of cultural competence so they are better able to deal with the difficulties that might arise during cross-cultural interactions.

Factor Structure of Almutairi’s Critical Cultural Competence Scale

This paper reports on a psychometric study conducted to explore the factor structure and refine the Critical Cultural Competence Scale (CCCS). Critical Cultural Competence (CCC) functions to promote the safety, equity, and well-being of patients, their families, and health care professionals. The development process of this measurement scale was systematic and iterative, and included generating a pool of potential items based on the theoretical definitions of CCC. In this study, conducted with a sample of 170 registered nurses from British Columbia, Canada, we used Principal Component Analysis (PCA) to explore the factor structure of the initial set of 84 items as a final step in developing the CCCS. The final version of the measure consists of 43 items, and the PCA results supported a four-factor solution consistent with the theoretical underpinnings of the scale. Future research is recommended to further assess the construct validity of this newly created scale.

Critical Cultural Competence in Social Work Supervision

ABSTRACTThis study identifies the elements of critical cultural competence in social work supervision, discusses barriers to effective supervision, and frames culture as an asset. To more fully explore cultural competence in social work supervision, the research included a survey of 262 social workers to assess their experiences with their workplace supervisors. The authors propose improved practices for critical cultural competence in supervision with a diverse workforce, including consideration of the intersectionality of social class, power relations, identity, and oppressed groups in supervision.

Outcome Findings of an Undergraduate Certificate Program in Cultural Competency

ABSTRACTIn 2010 a Midwestern School of Social Work developed a certificate program named “Critical Cultural Competence” to supplement existing coursework in support of culturally competent practice among graduating bachelor’s in social work (BSW) students. This certificate program was popular among social work students and was made available to undergraduate students across the university. Outcome findings from the first four cohorts of students who completed the certificate between 2012 and 2015 show that they made significant positive gains in their appreciation of differences among others and a greater desire to interact with others who are different from themselves. Both the coursework and the study-abroad experiences contributed to these significant differences. At the end of the two-year program, students better understood the meaning of cultural competence and the experience of it as a “journey” rather than a competency that can be achieved.

Construct Validity of Almutairi's Critical Cultural Competence Scale.

Cultural diversity in health care settings can threaten the well-being of patients, their families, and health care providers. This psychometric study evaluated the construct validity of the recently developed four-factor, 43-item Critical Cultural Competence Scale (CCCS) which was designed to overcome the conceptual limitations of previously developed scales. The study was conducted in Canada with a random sample of 170 registered nurses. Comparisons with the Cultural Competence Assessment instrument, Scale of Ethnocultural Empathy, and Cultural Intelligence Scale provided mixed evidence of convergent validity. Modest correlations were found between the total scale scores suggesting that the CCCS is measuring a more comprehensive and conceptually distinct construct. Stronger correlations were found between the more conceptually similar subscales. Evidence for discriminant validity was also mixed. Results support use of the CCCS to measure health care providers' perceptions of their critical cultural competence though ongoing evaluation is warranted.

Almutairi'sCriticalCulturalCompetence model for a multicultural healthcare environment

The increasing demographic changes of populations in many countries require an approach for managing the complexity of sociocultural differences. Such an approach could help healthcare organizations to address healthcare disparities and inequities, and promote cultural safety for healthcare providers and patients alike. Almutairi's critical cultural competence (CCC) is a comprehensive approach that holds great promise for managing difficulties arising from sociocultural and linguistic issues during cross-cultural interactions. CCC has addressed the limitations of many other cultural competence approaches that have been discussed in the literature. Therefore, the purpose of this study is to define the construct of CCC and the theoretical components of the CCC.

Moving Forward Towards a Positive Ethical Healthcare Climate in a Multicultural Context

Many countries around the globe are experiencing a demographic shift in their populations, due to several factors, including immigration, acculturation, mobility of workforces and so forth. These factors have contributed to the creation of multicultural environments characterized by differences in cultures, values, beliefs, ethical and moral perspectives, and languages, as well as historical, political and economic circumstances of their members. In healthcare settings, such diversity and the associated socio-political factors can pose ethical challenges for healthcare providers, and patients and their families alike. Almutairi’s model of critical cultural competence (CCC) is a promising approach designed to address the complexities that arise during cross-cultural interactions in healthcare settings. Healthcare settings are imbued with socio-political challenges related to class, racialization, poverty and gender. The ultimate goal of CCC is to provide a positive ethical climate that promotes cultural and physical safety as well as equity in health care environments. CCC approach can influence organizational policy, healthcare professional orientation and continuous professional educational initiatives.

An integrated framework of critical cultural competence and anti-oppressive practice for social justice social work research

Qualitative research continues to excite interest in social work inquiry spurring, in the process, a corresponding interest in social justice research. Yet, much remains to be done concerning the development of innovative frameworks for doing social justice social work research. Lack of effective research tools stymies social workers’ efforts at responding appropriately to the needs of culturally diverse service users and the structures that oppress them. This article introduces an integrated framework of critical cultural competence and anti-oppressive practice for doing qualitative social work research. Juxtaposing the cultural sensitivity powers of critical cultural competence with the social justice values of anti-oppressive practice enhances understanding of the salience of culture in human behavior, while promoting deeper appreciation of difference and the effects of oppression as experienced through social identities.

Critical Cultural Competence for Culturally Diverse Workforces

Critical Cultural Competence for Culturally Diverse Workforces

Critical Cultural Competence for Culturally Diverse Workforces

In this article, we argue that attaining equity, and therefore peace in health care delivery, necessitates that nursing and other health care professions more carefully attend to the sociocultural context in which health care is delivered. That sociocultural context includes culturally diverse patients, families, and communities, as well as health care providers who are themselves culturally diverse. We draw on findings from Almutairi's doctoral research with health care providers in Saudi Arabia to argue for what he has identified as critical cultural competence for health care providers. In so doing, we explicate the complexity of cultural and linguistic issues and power relations induced by race, class, and gender that can contribute to vulnerabilities for health care providers and recipients alike.

Epiphanies and learning in a postcolonial Malaysian context: A preliminary evaluation of international social work placements

This article discusses preliminary findings from a study of international placement learning of British social work students in social welfare settings in Malaysia. Research data generated focuses on the learning processes experienced by the students placed in an unfamiliar, postcolonial context with an emphasis on issues relating to diversity and developing critical cultural competence. Future sustainability and benefits of such placements are also reviewed.