Cultural Competence Research Articles

Revisiting Student Stories: Understanding Microaggressions and Interpersonal Conflict Within Speech-Language and Hearing Sciences Training Programs.

The current study revisits our previous research, delving deeper into microaggressions (MAs) and interpersonal conflict (IC) in speech, language, and hearing sciences (SLHS) training programs. Participants came from both marginalized and nonmarginalized backgrounds. A 39-item electronic survey based on our previous research was distributed online to 236 participants of current and former SLHS students through social media and e-mail listservs. Students that identified as belonging to marginalized and nonmarginalized groups reported high levels of MAs and IC, respectively. Linear regression revealed that the more marginalized identities a participant reported, the more aggression they experienced. Analyses also suggest that specific cultural and linguistic identities more likely predicted experiencing specific types of MAs than others. MAs and IC were largely underreported. This study highlights the quantifiable prevalence of MAs and IC in SLHS training programs. It underscores the urgent need for targeted interventions to address systemic inequities. Overall, these findings emphasize the importance of fostering an inclusive and equitable environment in SLHS, promoting cultural competence, and social justice in the professions. https://doi.org/10.23641/asha.27105613.

Evaluating intercultural learning materials from the RICH-Ed project through a non-essentialist perspective: Chinese University students’ and instructors’ perceptions

ABSTRACT Globalisation has increased cultural diversity in Chinese higher education, highlighting needs for intercultural competence development. However, suitable China-centric resources are lacking. This study evaluates intercultural learning materials developed by the RICH-Ed project, an intercultural communication textbook grounded in critical social constructionism and non-essentialist principles. The study employed a two-phase qualitative design, collecting data through questionnaires and interviews to understand students’ and instructors’ perceptions of the materials. The results indicate the RICH-Ed intercultural learning materials expanded students’ intercultural understanding. The interactive experiential learning activities enabled transformational self-reflection, challenging previous assumptions and developing appreciation for diverse perspectives. Similarly, the materials shaped instructors’ beliefs about intercultural communication. Instructors also experienced significant pedagogical shifts from essentialist to contemporary critical constructionist approaches. The collaborative lesson planning, observation, and reflection cycles built instructors’ confidence and competence in student-centred, dialogue-based methods aimed at intercultural learning goals. However, academic reading difficulties and the need for supplementary teacher training were issues identified. Recommendations include scaffolding comprehension through glossaries, discussions, and levelled reading; tailoring examples and roleplays for Chinese contexts; adding interactive multimedia; and expanding lesson studies. This utilisation-focused evaluation provides insights to strengthen emergent intercultural resources and training programmes in Chinese higher education.

Project Yarn Circle: development and pilot evaluation of a cultural connection suicide prevention program for Aboriginal and Torres Strait Islander young people

ABSTRACT Background Aboriginal and Torres Strait Islander young people experience markedly higher suicide mortality than non-Indigenous youth in Australia, yet there is little evidence of effective preventative strategies. Many are misaligned to the needs of First Nations young people due to a lack of consideration of protective factors such as community and cultural connection. Objective To date no research has examined whether increasing cultural connectedness may reduce Aboriginal and Torres Strait Islander youth suicidality. The current study outlines the development, implementation, and pilot evaluation of Project Yarn Circle, a school-based suicide prevention initiative utilising cultural education and connection. Method Project Yarn Circle was piloted by an Indigenous owned and managed youth mental health organisation, delivering 5 weekly sessions to 276 young people at 9 schools in Southeast Queensland, Australia, between 2019 and 2023. Sessions connected students to cultural knowledge and practices (stories, painting, dance, Indigenous languages) with Elders and local cultural knowledge facilitators. Results Pre- and post-program evaluation questionnaires completed 6–8 weeks apart found that participants had significantly lower suicidal ideation (GHQ-18-SS), pre 7.16, post 6.61, p = .043 higher positive ideation/reasons for living (PANSI-PI) pre 22.44, post 23.60, p = .009, and higher self-esteem (RSES) pre 16.55, post 23.60, p = .005. Analyses of cultural connectedness items co-designed for this evaluation study and validated using Exploratory Factor Analysis found that students demonstrated greater cultural identity clarity, peer cultural competence, strength from culture, salience of cultural continuity and sense of belonging. Conclusions These findings provide new evidence towards utilising cultural connectedness as an intervention mechanism in Indigenous youth suicide prevention.

Barriers and Facilitators to the Applicability of Adult Daycare Centers in Saudi Arabia: A Qualitative Study.

Adult daycare centers (ADCs) enable older adults to socialize and enjoy planned group activities while receiving healthcare services. These centers also assist caregivers by empowering them to remain in the workforce. This study aims to explore the challenges in establishing ADCs in Saudi Arabia (SA) from the perspectives of healthcare professionals, healthcare policymakers, older adults, and caregivers. Additionally, this study's objective is to identify the barriers, facilitators, and applicability of ADCs in SA. A qualitative study was conducted using semi-structured individual interviews. Inductive and deductive thematic analyses were employed to identify common themes regarding the barriers and facilitators to the applicability of ADCs in SA. Five researchers independently examined the transcripts using inductive analysis. Deductive analysis mapped the themes to Campinha-Bacote's cultural competence model. Data were collected from 46 participants, including caregivers, older adults, healthcare professionals, and healthcare policymakers. The findings highlight that the main facilitators to establishing ADCs in SA are the expected positive impact on the psychological and physical well-being of older adults and their caregivers. Conversely, cost and transportation, in addition to cultural considerations are possible barriers. This study identified the perceived benefits of ADCs for older adults and caregivers from a Saudi societal perspective. Thematic analysis showed that ADC's applicability in SA is possible, with some modifications to fit within the Saudi context. Additional efforts are necessary to promote the concepts and services that ADCs provide for older adults and to encourage support for these centers by non-profit organizations and the government.

Hybrid professional identities: exploring non-native English-speaking teachers’ lived experiences through the Cyborg Manifesto

ABSTRACT Drawing on Donna Haraway’s ‘Cyborg Manifesto’ and employing a hermeneutic phenomenological narrative enquiry approach, this article examines the complex professional identities of ‘non-native English-speaking (English) teachers (NNESTs) from immigrant backgrounds who speak English as an additional language in the Australian education system. Challenging the traditional binary division between native English-speaking teachers (NESTs) and NNESTs, this research reveals that NNESTs’ identities are fluid and multifaceted, akin to cyborgs, shaped by socio-historical discourses and influenced by determinants such as reflexivity, agency, and hybridity. NNESTs disrupt the established hierarchy in English language teaching, promoting inclusivity through their hybrid professional practices, driving pedagogical innovation, and contributing to the globalisation of education. Like cyborgs, they challenge traditional power structures and native speaker constructs, fostering a more equitable educational environment. This article endorses the recognition of ‘hybrid professional becoming’ in policy, practice, and teacher education, promising the development of intercultural teacher capabilities and inclusive, innovative, and equitable educational practices that enrich students’ English language learning experiences and reshape the field in alignment with Donna Haraway’s Cyborg Manifesto.

INTERCULTURAL COMMUNICATION COMPETENCE OF HEALTHCARE PROFESSIONALS CARING FOR PATIENTS FROM DIVERSE CULTURES

This research aims to examine the intercultural communication competence of healthcare professionals providing care and treatment to patients from different cultures. It evaluates the impact of intercultural communication on the quality and effectiveness of healthcare services. Method: The research was conducted with the participation of 280 healthcare professionals working at Alanya Alaaddin Keykubat University Hospital. Data were collected using the Intercultural Sensitivity, Intercultural Effectiveness, and Intercultural Awareness scales. Data analysis was performed using SPSS 25.0, and non-parametric tests were used for data that did not follow a normal distribution. Findings: Of the participants, 67.8% were female, 74.7% were under 25 years old, and 81.6% were single. In terms of education, 36.8% had an associate degree, and 44.8% had a bachelor's degree. The effects of demographic variables such as gender, marital status, and work department on intercultural competence were examined. Women scored higher than men in the Identity Protection sub-dimension, while married individuals scored lower than singles in the Cultural Communication Awareness sub-dimension. Paramedics had higher intercultural effectiveness scores compared to nurses. Discussion: The duration of experience significantly affected the Comfort in Communication sub-dimension. Higher education levels were associated with increased intercultural sensitivity and effectiveness scores. Those who received intercultural patient care training had higher scores, and those willing to work with patients from different cultures had higher intercultural sensitivity and effectiveness scores. Conclusion: These findings emphasize the importance of intercultural training and development programs to improve the quality of healthcare services. Enhancing healthcare professionals' intercultural communication skills is crucial for increasing patient satisfaction and the effectiveness of healthcare services.

Internationalising higher education curricula for sustainable development: considerations for indigeneity and (inter)culturality

Higher Education (HE) can play a fundamental role in the achievement of sustainable development, and particularly the Sustainable Development Goals (SDGs) as captured in the Incheon declaration. However, what approach HE should take in this mission is a contested space. In this paper, we interrogate the idea of indigeneity. The pursuit to ascertain how an indigenised approach to internationalisation can support or enhance the contribution of HE curricula towards sustainable development is driven by the understanding that for sustainable development to be achieved at all, the process of knowledge creation must strive to make integral those epistemologies that exist beyond the “West”; an understanding that aligns, in particular, with Target 7 of the United Nations (UN) SDG 4 and seeks to empower victims of epistemic violence. In doing so, we employed a bibliographic research which captured a dual approach consisting of a bibliometric analysis of literature and a review of case studies. The findings from both methods suggest that internationalisation appears in different disciplinary contexts, but these are not always aligned with indigenisation. We maintain that the construct of (inter)culturality can address aspects within the framework of indigeneity to boost the internationalisation of HE curricula and outcomes for sustainable development. Central to this are four factors, namely: the need for effective human engagement with (inter)cultural competence, medium/place of curricula interaction, the initiative form and the reach of the development.

Delivering Culturally Competent Care to Migrants by Healthcare Personnel: A Crucial Aspect of Delivering Culturally Sensitive Care

The increasing cultural and ethnic diversity within global migrant populations necessitates the provision of culturally competent care by healthcare personnel. This narrative literature review critically analyzes existing literature on the delivery of culturally competent care to migrants, highlighting key theoretical frameworks, empirical findings, and practical strategies to enhance cultural competence in healthcare settings. The review identifies significant health disparities faced by migrants, including barriers to accessing healthcare, communication challenges, and systemic issues within healthcare institutions. It emphasizes the importance of comprehensive training programs, supportive organizational policies, community engagement, and the innovative use of technology and telemedicine. Furthermore, it addresses the future directions and research gaps, calling for longitudinal studies, the development of robust metrics, and targeted strategies to overcome the digital divide and ensure data privacy. By addressing these areas, healthcare providers, educators, and policymakers can improve healthcare delivery, reduce health disparities, and ensure equitable access to care for migrant populations.

Pharmacy Students’ Self-Reported Cultural Competence in a Pharmacy Curriculum by Academic Year

ObjectiveThis study aims to explore results of a Cultural Competency Assessment of Pharmacy Students (CCAPS) survey to identify areas where cultural competence content in one college of pharmacy curriculum can be improved. MethodsThe 39-item CCAPS survey was developed and administered to Doctor of Pharmacy (PharmD) students from July 2022 (after the end of the didactic curriculum and at the beginning of experiential rotations for fourth-year students) through October 2022 (at the beginning of the Fall semester for first-year, second-year, and third-year students). Self-perception of cultural competency items were selected from the Cultural Competence Assessment Instrument and the Clinical Cultural Competency Questionnaire items. Responses were collected anonymously and analyzed in the aggregate by academic year using SPSS. ResultsFive hundred forty-one students participated, with ethnicities including White/European American (26.6%), East/South/Southeast Asian (17%, 18.5%, 5.4%), Arab/Middle Eastern (17.9%), African-American/Black (6.7%), and Hispanic (6.1%). Two-thirds of respondents identified as “very or extremely” culturally competent, and 78% reported comfort interacting with culturally diverse patients. Students scored lower on questions that assessed their comfort interacting with patients who have limited English proficiency or who refuse medications due to cultural reasons. Students in fourth year reported more difficulty practicing skills related to cultural competency in their daily life compared to students in other years. ConclusionUsing the CCAPS survey annually could help evaluate the cultural competency of pharmacy students across different academic years and identify gaps in the curriculum related to cultural competency.

The Impact of AI on Enhancing Students’ Intercultural Communication Competence at the University Level: A Review Study

This systematic review explores the transformative role of Artificial Intelligence (AI) and Information and Communication Technologies (ICT) in enhancing intercultural communication competence (ICC) at the university level. As AI increasingly integrates into educational settings, its potential to revolutionize student learning and cultural interactions is profound. The review synthesizes findings from 11 empirical studies conducted globally, assessing the impact of AI-driven tools, such as chatbots and virtual reality simulations, on students' ability to handle cultural differences. While AI offers significant benefits in personalizing learning and fostering immersive cultural experiences, challenges remain, particularly in ensuring cultural sensitivity and addressing inequalities in technology access. The review stresses the need for careful integration of AI in education, cautioning the audience about potential pitfalls and emphasizing the importance of human oversight to reduce biases and enhance cultural understanding. The pedagogical implications stress the importance of blending AI with traditional teaching methods to create inclusive learning environments that prepare students for globalized society's demands. The review also identifies areas for future research, including the long-term impact of AI on ICC and the ethical considerations surrounding AI use in education. In the end, this study contributes to the ongoing discourse on AI's role in shaping the future of intercultural education.

Policies and Practices for Cultivating Innovative Teaching and Intercultural Competence in German Teacher Education

Policies and Practices for Cultivating Innovative Teaching and Intercultural Competence in German Teacher Education

Searching for Authentic Cultural Engagement in the Classroom

Many teachers in the current public education system in the United States do not fully consider the unique societal and cultural aspects of African American and Latinx learners. As a result, many teachers could benefit from developing skills that strengthen their understanding of authentic engagement, cultural competency, and cultural congruency to aid in implementing culturally relevant and sustaining pedagogical practices that benefit the diverse learning styles of these students. Additionally, some African American/Black teachers have adopted a standalone Eurocentric approach to teaching that could further alienate and disenfranchise students of Color. To address these issues, I describe and explain the decisions and actions taken by an all-African American teaching staff at a school in North Carolina that educates a 100 percent minority student population. This autoethnographic study also highlights the cultural and academic challenges that many students face due to the shortage of teachers who understand and apply methods and approaches involving cultural competency, cultural congruency and authentic cultural engagement.

A survey of obstetrical anesthesia health equity practices at academic centers in the United States (US)

BackgroundLimited research has explored obstetrical anesthesiologists' perceptions of healthcare disparities associated with labor and delivery. The objective of this study was to evaluate the perception of obstetrical anesthesia related healthcare disparities, drivers of disparities, and potential solutions. MethodsAn online survey was emailed to division leads at Accreditation Council for Graduate Medical Education (ACGME) accredited obstetrical anesthesiology programs in the United States. The survey included a mixture of yes/no, select all that apply, and free-text questions. Descriptive statistics were used to characterize variable distribution. Free text responses were categorized into themes by selective coding. Results149 surveys were delivered, 74 surveys were conducted (50 %), and 57 were completed entirely (38 %). Fifty-seven percent of participants reported perceived presence of obstetrical/obstetrical anesthesia related healthcare disparities. Most participants reported that they consider a patient's cultural preferences during clinical management, collect race/ethnicity data, implement specific practices to address disparities, and analyze outcome data by social determinants of health. The majority of participants reported using additional relevant practice features, including translator services, quality improvement practices, provider rounds, standardized protocols, and cultural competency or diversity training. Thematic analysis of free text responses into drivers of disparities mapped to 6 themes: language barriers, racism or bias, socioeconomics or social determinants of health, access or quality of care, patient-provider interactions or cultural sensitivity, and individual patient factors. ConclusionMost academic obstetrical anesthesia center division leads reported perceived presence of obstetric anesthesia related health care disparities. Efforts should be made to devise targeted solutions to this multifaceted, pervasive problem.

Overcoming barriers in eating disorder care: advances, gaps, and recommendations for equitable assessment and treatment.

This paper provides an overview of topics discussed by clinicians and researchers invited to speak at the Canadian Nutrition Society's Thematic Conference 2023, which was centered on advances in research and practice in the assessment and treatment of disordered eating and eating disorders. Presenters emphasized the importance of understanding how systemic factors such as racism, weight stigma, and COVID-19 affect the assessment and treatment of eating disorders, and proposed strategies for addressing these inequities. In this paper, we provide actionable recommendations for clinicians working with individuals with eating disorders; professional development, cultural competence, and equitable assessment and treatment practices are discussed.

Dietetics Students’ Knowledge, Attitudes, and Beliefs on Cultural Competency Following a Cultural Food Demonstration

Dietetics Students’ Knowledge, Attitudes, and Beliefs on Cultural Competency Following a Cultural Food Demonstration

Multicultural Scholars Program Fosters Leadership Development and Cultural Competence

Multicultural Scholars Program Fosters Leadership Development and Cultural Competence

Nursing Education for Sustainable Development: A Concept Analysis.

Sustainability represents an increasingly vital yet inconsistently implemented topic in nursing education. Formal concept analysis can promote unified conceptualisation to inform sustainability integration in nursing curriculums. Analyse the concept of 'nursing education for sustainable development' using the Walker and Avant framework to clarify meaning and application in nursing programmes. The literature was systematically searched for attributes, antecedents and consequences used to formulate a concept definition, and compared to existing conceptualisations. Core concept attributes are interconnectedness of human/ecological health, sustainability-focused curriculums, competency cultivation and social justice orientations. Antecedents include recognising ecological determinants of health and committed nursing faculty. Consequences encompass the preparation of sustainability-competent nurses and elevated nursing contributions to sustainable health systems. The concept analysis provides an original synthesised perspective advancing coherence and applicability to guide sustainability education in nursing programmes through a translational framework for competency, curriculum design and content delivery approaches. We followed the guidelines outlined in the Walker and Avant framework in the conduct and reporting of this paper. No patient and public contribution.

University Students’ Levels of Motivation and Engagement, Perceived Benefits, and Challenges in MOOCS

The study identified university students’ levels of motivation and engagement, perceived benefits, and challenges in Massive Open Online Course (MOOC). It used the mixed-method research design and involved third- and fourth-year English language students (n = 61) who completed the Content-based Instruction (CBI) – MOOC offered by the Regional English Language Office, Manila, Philippines. The validated MOOC Learner Engagement and Motivation Scale (MEM Scale) was adopted to determine the learners' levels of motivation and engagement in MOOCs. A focus group discussion was also done to determine the students’ perceived benefits of and challenges in MOOCs. Results of the MEM Scale show that the students had upper-medium level of motivation (x̄ = 3.54) and a high level of engagement (x̄ = 4.22) in the CBI – MOOC. Also, the data revealed five perceived benefits of MOOCs: 1) appreciation of the self-paced learning; 2) complementation to formal learning; 3) international certification; 4) provision of professional development opportunities; and 5) attainment of intercultural competencies. Generally, the students experienced five challenges while enrolled in the course: 1) language barriers; 2) lack of social interaction; 3) digital divide; 4) time-related constraints; and 5) challenging course content. Given the benefits of MOOCs, higher education institutions (HEIs) are encouraged to incorporate open online courses in the learning experiences of their students. Further, it is recommended that HEIs extend available resources to participants to lessen the perceived challenges of MOOCs which could promote higher levels of motivation and engagement of the students in the courses.

Increasing Cultural Competency for Chinese-speaking Clients Participating in an NYC-based Food Is Medicine Program: God’s Love We Deliver

Increasing Cultural Competency for Chinese-speaking Clients Participating in an NYC-based Food Is Medicine Program: God’s Love We Deliver

"I Do Not Believe We Should Disclose Everything to an Older Patient": Challenges and Ethical Concerns in Clinical Decision-Making in Old-Age Care in Ethiopia.

Clinical decision-making in old-age care is a complex and ethically sensitive process. Despite its importance, research addressing the challenges of clinical decision-making in old-age care within this cultural context is limited. This study aimed to explore the challenges and ethical concerns in clinical decision-making in old-age care in Ethiopia. This qualitative study employed an inductive approach with data collected via semi-structured interviews with 20 older patients and 26 health professionals recruited from healthcare facilities in Ethiopia. Data were analysed using reflexive thematic analysis. Our analysis identified three key themes. First, participants highlighted perceptions that older patients' religious beliefs interfere with the clinical decisions both older patients and health professionals make. Second, older patients often receive limited information from health professionals about their diagnosis and treatment. Third, families of older patients appear to strongly influence clinical decisions made by older patients or health professionals. This research enhances the understanding of clinical decision-making in old-age care within Ethiopia, a context where such research is scarce. As a result, this study contributes towards advancing the deliberation of ethical dilemmas that health professionals who work with older patients in Ethiopia might face. A key implication of the study is that there is a need for more ethics and cultural competence training for health professionals working with older patients in Ethiopia.