Level Of Cultural Competence Research Articles

Immediate and longitudinal effects of incorporating health literacy and cultural competency into a yearlong pharmacy curriculum

ObjectiveTo determine the immediate and longitudinal effects of incorporating health literacy and cultural competency (HL-CC) concepts into one semester of pharmacy school. MethodsHL-CC concepts were incorporated into three fall semester courses for first-year professional pharmacy students. Students completed a 23-item Likert-type health literacy instrument (perceptions, understanding, and application) and the Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals—Student Version (IAPCC-SV©, Campinha-Bacote, 2007) pre–post fall semester (n = 53, 100% response rate) and post-spring semester (no concept incorporation, n = 52, 98% response rate). Data were analyzed using Wilcoxon signed rank tests to examine the differences between pre- and post-semesters for the health literacy assessments and the IAPCC-SV© assessments. ResultsStudents’ perceptions, understanding, and application of health literacy principles had significant improvements in the fall semester, but some attrition was seen after the spring semester. Students’ cultural competency levels increased during the fall, and their overall IAPCC-SV© scores did not significantly change during the spring. ConclusionsIntegrating HL-CC concepts throughout one semester can be useful for improving pharmacy students’ knowledge and skills in these areas. Concepts should be reinforced throughout the curricula to maintain their knowledge and skills.

간호대학생의 문화적 역량과 문화간호역량 교육요구 분석

Purpose This study evaluates the level of cultural competence (CC) and educational needs for cultural competence in nursing (CCN) in undergraduate nursing students. Method A self-report instrument was used to measure CC and educational needs for CCN. Questionnaires were completed by 330 nursing students in three nursing colleges. Descriptive statistics, a t-test, an ANOVA, Pearson correlation analyses, and multiple regression were used to analyze the data. Result The mean CC score was 2.99 and the mean CCN educational needs score was 7.1. CC positively correlated with educational needs for CCN. The regression model explained 36% of the variance in CC. Factors affecting CC were school grades, multicultural education experience, frequency of meeting foreigners, length of encounters with foreigners, foreign-language fluency, and degree of interest in multicultural nursing. Conclusion To strengthen the CC of students, nursing educators should develop an educational program for CCN and incorporate CCN into nursing school curricula. Keywords: Cultural competence, Education, Needs assessment, Nursing student 주요어: ë¬¸í™”ì  역량, 교육, 요구 ì‚¬ì •, 간호대학생

Insights Gained From a Cultural Contexts Counseling Course in a Rural Setting

The intention of this study was to explore the ways in which graduates of a master’s level counseling program reflect their knowledge and experiences gained during a required course entitled, “Cultural Contexts in Counseling.” Seven graduates of the counseling program participated in the study. The study took place at a state university located in a rural, racially homogenous region of the northeast. Using a qualitative design, the researcher, who was also the course instructor, solicited feedback from her former students who had taken the course at least one year prior to the time of the study. Participants responded via email, answering questions regarding their level of cultural competency before and after taking this class, whether there were any activities and/or experiences that the participants feel changed the way they view and/or interact with people unlike themselves and what were they, and were there any aspects of this course that participants feel impact them on a regular basis? The responses were then coded for themes and gleaned for similarities in opinion regarding the course’s strong points. The findings indicate that all participants felt strongly about the long-term impact of a couple of the course activities in regard to their cultural competence as counselors. The implications of these findings contribute to the field of best practices in multicultural education, particularly for universities in rural settings.

Translation and evaluation of the Cultural Awareness Scale for Korean nursing students.

To evaluate the effectiveness of a curriculum for achieving high levels of cultural competence, we need to be able to assess education intended to enhance cultural competency skills. We therefore translated the Cultural Awareness Scale (CAS) into Korean (CAS-K). The purpose of this study was to evaluate the cross-cultural applicability and psychometric properties of the CAS-K, specifically its reliability and validity. A cross-sectional descriptive design was used to conduct the evaluation. A convenience sample of 495 nursing students was recruited from four levels of nursing education within four universities in the city of Daejeon, South Korea. This study provided beginning evidence of the validity and reliability of the CAS-K and the cross-cultural applicability of the concepts underlying this instrument. Cronbach's alpha ranged between 0.59 and 0.86 (overall 0.89) in the tests of internal consistency. Cultural competency score prediction of the experience of travel abroad (r=0.084) and the perceived need for cultural education (r=0.223) suggested reasonable criterion validity. Five factors with eigenvalues >1.0 were extracted, accounting for 55.58% of the variance; two retained the same items previously identified for the CAS. The CAS-K demonstrated satisfactory validity and reliability in measuring cultural awareness in this sample of Korean nursing students. The revised CAS-K should be tested for its usability in curriculum evaluation and its applicability as a guide for teaching cultural awareness among groups of Korean nursing students.

A survey of cultural competence of critical care nurses in KwaZulu-Natal

Background. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA). Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities. Objective. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA. Methods. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R) cultural competence questionnaire. Results. The overall cultural competence score for the respondents was 70.2 (standard deviation 7.2) out of a possible 100, with 77 (74%) of the respondents scoring in the awareness range, 26 (25%) in the competent range, and only 1 in the proficient range. Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses. Conclusion. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.

Perceived Levels of Cultural Competence for School Social Workers: A Follow-Up Study

The purpose of this article is to report on findings from a follow-up study that examined the relationship among social work education programs, postgraduate professional development, and school social workers’ perceived levels of cultural competence in practice with urban minority youth. The initial study demonstrated that African Americans perceived a higher level of cultural competence than their Anglo American counterparts did. Findings highlight the need to understand the processes by which practitioners become culturally competent for urban school social work practice. Underscoring the importance of professional development, the authors determined that geographic location of practice may serve as a factor that influences how practitioners anticipate the need for culturally competent practice with diverse populations. Implications for practice and future research are discussed.

Utilizing the Intercultural Development Inventory® to develop intercultural competence.

PurposeHealth care professional education programs in the United States have been charged to devise strategies to increase the racial and ethnic diversity of the workforce (Health Resources and Services Administration, Nursing Workforce Diversity (NWD) http://bhpr.hrsa.gov/nursing/grants/nwd.html, 2014). The purpose of this charge is to develop a healthcare workforce that can better provide culturally relevant care to meet the needs of diverse communities. The purpose of this study was to assess the cultural competency of students, faculty, and staff from a small Midwest-university college of nursing.MethodsThis study was part of a larger interventional study to enhance the cultural development of the College of Nursing faculty, staff, and students. The sample for this study included 314 participants (students, faculty, and staff) in phase one of the parent study. Phase one included the initial administration of the Intercultural Development Inventory (IDI®) over a two year period with analysis of the pre-test results. Phase two includes the implementation of cultural development interventions with a post-test IDI® survey and is currently in process.ResultsIDI® aggregate results were similar for students and faculty/staff in that most participants scored at the Minimization level according to the IDI®. Ninety-eight percent of student participants overestimated their level of cultural competency. Minority students had higher cultural competency scores in terms of developmental orientation (M = 98.85, SD = 14.21) compared to non-minority students (M = 94.46, SD = 14.96).ConclusionsOverall, the IDI® was a valuable self-reflection tool to assess cultural development. At the individual level, it has allowed for self-reflection and awareness to the reality of cultural development, attitudes, and values. At an institutional level, the aggregate results provided a framework for the examination of department policies, procedures, and curriculum design with the ultimate goal of graduating a more culturally competent nursing workforce to serve the greater community.

The Impact of Cultural Competence Education on Short-Term Medical Mission Groups: A Pilot Study.

There are large numbers of short-term medical mission (STMM) groups traveling yearly from the United States to underdeveloped countries. Medical professionals educated in the Western biomedical model of treatment have an ethnocentric view of how to treat illness. The purpose of this pilot study was to demonstrate that a 2-hour culturally sensitive educational program administered to medical professionals travelling to Haiti on a STMM could raise their cultural competency as measured by a specific tool. The participants were invited to a short educational program designed to help them understand their own biases and make better treatment decisions for their patients based on the five constructs of Dr. Campinha-Bacote's cultural competence model. Following an evidence-based educational program, the members of the STMM groups demonstrated improved levels of cultural competency. This program could provide an appropriate way to raise the cultural competency of medical mission health care providers.

When Knowledge Is Not Enough: Elements to Strengthen Intercultural Sensitivity Among Professionals of Social Services in Andalusia (Spain)

ABSTRACT.This study examines social services delivery in Andalusia, Spain, to determine the degree of cultural adaptation of its workers, given the important migratory flows taking place in the region during recent years. This study investigates the main characteristics of those workers with a high level of intercultural sensitivity (IS) and their cultural competences. The survey included 298 professionals with a validated IS scale along with questions related to the degree of intercultural contact and competence. A series of scales for the IS levels was created, and correlation analyses were carried out depending on the variables used. Results revealed high levels of self-attributed cultural competence and training as well as low levels of awareness and motivation for intercultural encounters. Theoretical knowledge appeared to be the only aspect in correlation with all dimensions of IS. Important deficits have been also observed when examining the type and intensity of contact among professionals and people of foreign origin. This highlights the need to transform knowledge in culturally adapted responses. Future research is necessary to deepen knowledge on how these aspects affect professional interventions.

Cultural competence education for practicing physicians: lessons in cultural humility, nonjudgmental behaviors, and health beliefs elicitation.

Although numerous studies have examined cultural competence training, debate still exists about efficacious approaches to this training. Furthermore, little focus has been placed on training and evaluating practicing physicians. A skills-based course on culturally competent diabetes care was developed and subsequently tested in a controlled trial of primary physicians caring for patients enrolled in one state's Medicaid program. We hypothesized that physicians completing the course would show higher levels of self-reported cultural competence as measured by a Cultural Competence Assessment Tool (CCAT) than those in the control group. Differences in CCAT subscale scores were also compared. Ninety physicians completed the study, with 41 in the control and 49 in the intervention group. Most were female (66%), with an average age of 44, and 12 years in practice. There were no significant differences on total CCAT score (212.7 ± 26.7 for control versus 217.2 ± 28.6 for intervention, p = .444) or subscales measuring cultural knowledge. There were significant positive differences on the subscales measuring physicians' nonjudgmental attitudes/behaviors (subscale score 2.38 ± 0.46 for control versus 2.69 ± 0.52 for intervention, p = .004) and future likelihood of eliciting patients' beliefs about diabetes and treatment preferences (3.11 ± 0.53 for control versus 3.37 ± 0.45 for intervention, p = .014). There was, however, a significant negative difference on the subscale measuring cultural self-awareness (3.48 ± 0.36 for control versus 3.26 ± 0.48 for intervention, p = .018). A predominantly skills-based approach to training physicians did not change aggregate measures of cultural competence, but did affect key attitudes and behaviors, which may better reflect the goals of cultural competence training.

Perceived Cultural Competence Levels in Undergraduate Athletic Training Students

ContextAs the patient population continues to diversify, it is essential that athletic training students (ATSs) are educated to provide culturally competent care. This high-quality health care within the context of a patient's race, ethnicity, language, religious beliefs, or behaviors is a foundation of professional practice.ObjectiveDetermine undergraduate ATSs' levels of cultural competence and their variability by gender, race, and year in school.DesignCross-sectional design.SettingCommission on Accreditation of Athletic Training Education–accredited undergraduate athletic training programs.Patients or Other ParticipantsATSs enrolled in their programs' professional-education phase (N = 421), of which 366 were Caucasian and 55 were students of color.InterventionStudents completed a 20-question online Likert survey using Qualtrics. Items were based on prior research and a nursing measurement tool, rated on a 1 to 4 scale (from strongly disagree to strongly agree, respectively; maximum score of 80), and found to be reliable (Cronbach α = 0.721).Main Outcome MeasurementsOverall cultural competence score, means, and standard deviations were calculated for all students by gender, race/ethnicity, and year. One-way analyses of variance also compared each category.ResultsHigher scores on the research tool demonstrate higher levels of cultural competence. There were no significant differences found between gender and year in school. Students of color showed higher overall cultural competence scores than Caucasians (F1,420 = 29.509, P < .01). The mean overall cultural competence score was 58.36 ± 5.26.ConclusionsStudents of color demonstrated higher levels of cultural competence, which is possibly because of their personal history and experiences. The current study demonstrates that athletic training programs must seek to better educate students on providing culturally competent care.

From Pro Loco to Pro Globo

The status of English as an international language means that in language learning and translational contexts it has become a moving target. Within translational contexts the issue is especially relevant to translations into English where the envisaged readership is international. This paper discusses issues which arise from translations of Italian tourist texts into English submitted by a group of advanced-level Italian university students. Translation of this nature entails a transition from the local to the global for the benefit of mostly non-native speakers of English, but such a shift is not without complications. One of these is that from an early age Italian students are nurtured on Standard British English and that codified target-language parameters are easily accessed for Standard British English, but not for English as a Lingua Franca (ELF). At the same time, knee-jerk insistence on a major variety of English has its pitfalls; the translator must be sensitive to the fact that the envisaged target readers, extremely heterogeneous on account of their vastly different levels of linguistic and cultural competence, may read off diverse meanings from a single text, or at least react to it in diverse ways. The second half of the paper provides a range of examples of student translations into English for an envisaged international readership.

“Everyone just keeps their eyes closed and their fingers crossed”: Sexual health communication among black parents and children in Nova Scotia, Canada

BackgroundBlack Canadian youth remain disproportionally affected by an array of social and health issues, including sexually transmitted infections. While research exists in support of the involvement of parents as a key means to prevent or modify harmful behaviours among youth, less is known about how parent–child communication can serve as a prevention intervention strategy within Black families in Canada. This study explores sexual health communication between Black parents and youth in Nova Scotia and identifies facilitators, obstacles and issues that families face in dialoguing about sexual health.MethodsFocus groups and in-depth interview sessions were held with a diverse sample of parents of Black youth, health and education professionals, and Black youth in Nova Scotia, as part of a larger study aimed at exploring parent–child communication on sexual health and HIV. The research team worked in partnership with and received feedback from key informants and a community advisory committee throughout the various stages of this study. All sessions were audio-taped with permission and thematic analysis was carried out on the verbatim transcripts.ResultsSix key themes emerged from the data analysis in relation to parent–child communication within Black families in Nova Scotia: 1. the gendered nature of [sexual] health communication; 2. fear and uncertainty as obstacles; 3. open and honest dialogue from an early age as a facilitator; 4. media as both a catalyst and a barrier; 5. peers as a catalyst; and 6. time constraints as an obstacle.ConclusionsThe findings of this study reveal that parent–child communication regarding sexual health promotion within Black families in Nova Scotia remains varied and is heavily affected by a myriad of intersecting determinants of health faced by Black youth and their parents. Health promotion interventions aimed at fostering and supporting parent–child communication on sexual health must simultaneously target both parents and youth and further, such efforts must engage a high level of cultural competency in order to better meet the needs of this population.

Racial/Ethnic Disparities in Depression and Its Theoretical Perspectives

The purpose of this review is to look at racial/ethnic disparities in the diagnosis of depression and its treatment and to explain the dynamics and causes of these racial/ethnic disparities in depression by looking at several theories, such as perceived racism, cultural competency, and other theories. Perceived racism is that the perceptions of an environmental stimulus as being racist affects the coping responses of ethnic/racial minorities, which alters psychological and physiological stress responses, and finally affects health outcomes negatively. A lower level of cultural competence can lead to health disparities. In addition, lower socioeconomic status and health care providers' beliefs and behaviors about patients' race/ethnicity and class can affect depressive symptoms as well as diagnosis and treatment. In order to reduce these racial/ethnic disparities in depression, diverse interventions should be developed to improve depression outcomes for ethnic minority populations based on these theoretical perspectives.

Multicultural Training Experiences as Predictors of Psychology Students' Cultural Competence

The psychologists in the western world, including Australia, are required to be culturally competent because of the cultural diversity of these societies. Previous studies conducted in North America and Europe have found multicultural teaching, clinical experience with culturally diverse clients, and discussion of multicultural counselling issues in supervision to be related to the practitioner's cultural competency. The present study examined factors contributing to trainee psychologists' perceived level of cultural competence. It was hypothesised that multicultural teaching, clinical experience, and supervision would be related to students' level of cultural competence. One hundred twenty‐seven postgraduate clinical psychology students completed an online survey battery that included demographic information, a social desirability measure, and the Multicultural Mental Health Awareness Scale. This hypothesis was partially supported. Clinical experience and supervision focusing on multicultural issues were found to be related to participants' perceived cultural competence; however, multicultural teaching was not. These results provide insight into how universities around Australia can facilitate future psychologists' competence in working with clients from different cultural backgrounds.

Multicultural Environments and Their Challenges to Crisis Communication

Grounded theory analysis was applied to qualitative interviews with 25 communication professionals concerning cultural influences on crisis. This approach yielded several findings. First, public relations practitioners had difficulties in defining multiculturalism, often equating cultural diversity with communicating with Latinos. Second, interviewees saw cultural differences as just one aspect of diversity, emphasizing that age, religion, and education differences also affect corporate discourse. Third, although professionals considered culture a key element of crisis management, they did not feel prepared to handle the challenges of a multicultural crisis, nor did they report that they used culturally adjusted crisis strategies often. By integrating cultural competence and crisis management frameworks, this study provides the foundation for an in-depth understanding of crises, where scholars and professionals can pair crisis strategies with audiences’ cultural expectations. Training initiatives focused on increasing levels of cultural competence can make organizations and communication professionals ready to the challenges of a global market.

Expression of Cultural Competency within the Context of English Teacher Training (The Case of Lithuanian University of Educational Sciences)

Th article deals with the expression of cultural competency of pre-service teachers of English. It emphasizes the effcts of globalization on the training of foreign language teachers as well as highlights the necessity of raising their cultural competency. with this aim, a quantitative research has been conducted. The questionnaire consisted of several sections, which aimed at identifying pre-service teachers’ opinion about the relation between language and culture, the importance of the development of cultural competency, the current level of students’ cultural competency, and possibilities to develop it at university. The study included 119 respondents. They were 1–4-year students of English philology at Lithuanian University of Educational Sciences.The research has determined that almost all pre- service teachers of English observe a close link between language and culture, and distinguish two notions of the concept culture: culture as human relations with themselves, others and the surrounding environment (approx. 2/3 of respondents), and culture as human production (approx.1/3 of respondents). A greater half of students emphasize the ethnic nature of culture. About 90 % of pre-service teachers maintain that they develop their cultural competency during the classes at university, while travelling and communicating to foreign culture representatives. Besides, most students (80 %) assess their current level of cultural competency as very high or high. They state that the feel are able to communicate in different cultural contexts, and are able to initiate and keep a conversation with representatives of other cultures. Most students believe that they receive sufficient cultural education at university. Among the study subjects most significance is attached to the courses of Country Studies, Present-Day English and Literary Text Analysis. However, future teachers would prefer more classes and meetings with native speakers, more cultural events organized at university and more possibilities to participate in student exchange programmes.

Evaluating Culture: Sociology, Aesthetics and Policy

This article contends that a sociologically-informed approach to aesthetic value can be usefully connected to debates regarding cultural policy. Such an approach can encourage reflexivity on the part of policy makers and cultural arbiters, making them sensitive to their privileged position in social space and aware of the differential levels of access to culture experienced by the public they serve. Furthermore, it can inform research into the process of evaluation that takes place at an individual and collective level. The article advocates research into the dynamics of the evaluative moment, which involves paying close attention to the interplay between the individual or group or community and the cultural object. The ways in which different social groups interact with and evaluate cultural objects will in part be determined by their social origin and levels of cultural competence. However, these contextual factors do not provide the whole picture. To zoom in on the dynamics of the evaluative moment means also to keep the cultural object in sight, to be aware of the properties of cultural objects as well as of the sensibilities and dispositions that enable their appreciation.

Assessing Pharmacy Students’ Self-Perception of Cultural Competence

Pharmacists play an increasingly important role in medication therapy management, which requires communicating effectively with patients. Pharmacy students completed the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire, and their results were used to identify patterns in self-assessment of cultural competence. In general, students rated their knowledge as less than their skills and attitudes. Important differences were found by race, comparing each group with its counterparts: African American students rated their perceived competencies regarding patient discrimination and barriers to health care at a significantly higher level; Asian American students rated their attitudes to engaging in self-reflection and their knowledge in multicultural issues at significantly lower level; and White students rated their awareness regarding racial dynamics at a significantly lower level. It is recommended to consider the students' cultural, racial, and ethnic backgrounds before developing curriculum in cultural competence and, perhaps, to develop targeted educational interventions for specific groups.

Racial Disparities in Depression Care among Older Adults: Can the Perspectives of Clinicians and Patients be Reconciled?

Depression is highly prevalent and debilitating in late life. It affected 3.8 million older Americans in 2005, and its prevalence is expected to increase to 6.6 million in 2025. Despite its prevalence and associated negative health outcomes, depression is not diagnosed and treated equally among older Americans. An under-recognition and under-treatment of depression in minority elders exists, which has lead to significant disparities between Whites and non-Whites. These disparities challenge our principles of equality, equity and adequacy and, in their most extreme form, become human rights issues. As a result, eliminating health disparities has become a priority of the US Federal government. Practitioners must address differences in the diagnosis and treatment of depression among clients served. Increased levels of cultural competency and educating clients will help reconcile differences between clinicians and their patients and lead to increased understanding of client needs, while decreasing disparities in depression care and diagnosis.