Military Cultural Competence Research Articles

The Importance of Military Cultural Competence

Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.

Military Cultural Competency: Understanding How to Serve Those Who Serve

<p>Institutions of higher education who serve military populations need clear understanding of federal regulations and of military organization best practices in education. They also need a baseline understanding of the broader military population, as well as the unique challenges and opportunities for military subgroups, based on branch, type, and extent of service. The intent of this article is to provide a baseline understanding of military populations, including the unique needs, challenges, and opportunities for service to population subgroups (i.e., active duty service members, prior service members, including disabled veterans and retirees, and military family members). Overall, we propose that “military cultural competence” is a unique cultural competence which is necessary to develop both at the institutional level and for individual staff and faculty, in order to ensure appropriate service for military students in higher education.</p>

Assessment of Military Cultural Competence: A Pilot Study.

Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists. An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general. Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care. The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.

Military Culture Implications for Mental Health and Nursing Care

With over 13 years of war and military combat operations, the number of veterans, military families, and service members with mental health needs continues to increase across civilian and federal healthcare services. Knowledge about severe battle wounds, traumatic brain injury, and traumatic stress has influenced the delivery of healthcare. The invisible wounds of war associated with brain injury and traumatic stress will increase clinical care challenges into the foreseeable future. The purpose of this article is to describe two interrelated concepts, military cultural competence and stress injuries. The authors also differentiate stress reactions versus stress injury. Nurses with military cultural competence and knowledge about stress injuries will be better able to deliver patient-centered care to patients with military culture experiences.

Supporting Student Veterans: Utilizing Game-Based Role-Plays with Virtual Humans to Build Military Cultural Competency and Helping Behaviors in Faculty and Staff

Veterans and military service members enter the classroom with valuable life and leadership experience; however, transitioning to student life represents unique challenges. Like the larger veteran population, student veterans may bring to campus the negative aftereffects of their combat experiences in the form of Post-Traumatic Stress, substance abuse, depression, and thoughts of suicide. To better support and retain the nation’s growing number of student veterans, higher-education institutions are beginning to train faculty and staff to more effectively understand and meet the needs of student veteran populations. This study examines the impact of a new and innovative game-based virtual training simulation where users role-play with emotionally responsive virtual student veterans to understand the unique value veterans bring to campus, the obstacles they face in their pursuit of a college degree, effective tactics for managing challenging conversations and the best practices for connecting student veterans exhibiting signs of psychological distress with appropriate support services. Longitudinal data showed significant (p

The Importance of Developing Military Cultural Competence

A gentleman walks into the emergency department. He is greeted by the registration clerk, who asks him a few key questions. She determines that he should be seen by the triage nurse right away because he stated that he has chest pain. When the triage nurse sees him, she asks why he came to the emergency department. He answers simply, “Chest pain.” She notes that he is alert and oriented. He has a steady gait, is muscular, appears to be physically fit, and is demonstrating no obvious signs of distress.

Case Report: Military Subcultural Competency

The military is comprised of numerous subcultures. These subcultures can dramatically impact perceptions of illness and care. Although efforts are currently underway to improve the military cultural competence of all health care providers, efforts to improve the subcultural competence of military providers require attention. Military providers, although part of the military culture, may not appreciate their patients' military subculture or be aware of the impact their own subculture plays on the encounter. To illustrate potential difficulties, a case is described where limited military subcultural competence disrupted care. As the military medical corps continues to integrate across service lines, this case underscores the importance of training military physicians to assess the influence of a service member's specific military subculture.

From Death to Life

Experiences of 17 female Iraq War veterans were explored to understand the challenges of reintegrating into civilian life and the impact on mental health. All respondents completed preliminary electronic surveys and participated in one of two focus groups. High levels of distress exist among veterans who are caught between military and civilian cultures, coping with war experiences, feeling alienated from family and friends, and attempting to negotiate gender and identity. Narrative is identified as a means of resolution. Recommendations include development of social support and transition groups; military cultural competence training for therapists, social workers, and college counselors; and further research to identify appropriate military response and paths to successful reintegration into society.

Promoting Military Cultural Awareness in an Off-post Community of Behavioral Health and Social Support Service Providers

Due to U.S. military Base Realignment and Closure (BRAC) efforts and ongoing Overseas Contingency Operations, the number of military servicemembers and veterans seeking civilian-based services has increased. As the military presence grows in previously underrepresented areas, the need for culturally competent providers will also increase both on and off military installations. The purpose of this article is to promote military cultural awareness, while suggesting ways to enhance existing community behavioral health and social support services. It builds on a review of the extant literature and findings from a community assessment to introduce civilian providers to some specific issues affecting servicemembers and their families. A framework describes ways to increase military cultural competence and build community capacity to enhance civilian-based services. In addition, two appendices list some common military terminology and multiple training resources available through military organizations and websites.

Developing Military Cultural Competency in Health Care Providers

Developing Military Cultural Competency in Health Care Providers

When Veterans Return: The Role of Community in Reintegration

Experiences of Iraq and Afghanistan war veterans were explored to understand the challenges of reintegrating into civilian life and the impact on mental health. Respondents completed preliminary electronic surveys and participated in one of six focus groups. High levels of distress exist among veterans who are caught between military and civilian cultures, feeling alienated from family and friends, and experiencing a crisis of identity. Narrative is identified as a means of resolution. Recommendations include development of social support and transition groups; military cultural competence training for clinicians, social workers, and college counselors; and further research to identify paths to successful reintegration into society.