Transcultural Competence Research Articles

International nursing students and clinical learning environments: A convergent mixed-methods study

AimTo acquire a comprehensive understanding of the international nursing students' clinical learning environments, comparing and contrasting qualitative and quantitative insights. BackgroundThe influx of international nursing students has increased in Italy and across Europe. These students, diverse in culture and language, encounter significant challenges to their education in clinical learning environments. Designconvergent mixed-methods research. MethodsQualitative and quantitative data were collected concurrently and independently, with equal emphasis, following a QUAL-QUANT structure. Qualitative analysis used descriptive content analysis, while quantitative data were based on descriptive and correlation analyses on surveys using the CALD scale. ResultsOverall 96 international nursing students participated in 24 focus groups. The CALD scale mean scores ranged from 2.7 to 4.5. The qualitative analysis presented two overarching themes: factors that promote a successful clinical learning environment and factors that inhibit a successful clinical learning environment in international students. The integration of qualitative and quantitative data generated four concordant and one discordant meta-inferences about the learning environment. ConclusionsCulturally sensitive clinical learning environments are imperative for the holistic development of international nursing students. Nurse educators must cultivate transcultural competencies and pedagogical skills to enhance the competencies and skills of this student population effectively.

Support from Physicians as a Key Enabling Factor for Rehabilitation Utilization in Migrants with Back Pain: A Longitudinal Analysis

In Germany, medical rehabilitation is provided to promote work ability and health in the case of chronic illness and to avoid early disability pensions. Studies have shown that employees with a history of migration are less likely to seek medical rehabilitation. The aim of this paper was to examine which factors influence the use of medical rehabilitation services in migrants with back pain.We used data from a German cohort study also including migrant employees aged 45 to 59 years. Participants reported back pain in the last 3 months and completed a baseline questionnaire in 2017. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. Proportional hazard models were fitted to identify factors that were associated with utilized rehabilitation measures.Data of 552 participants were included, and 25 individuals utilized rehabilitation during follow-up. Sex (women: HR = 3.05; 95% CI: 1.10; 8.45), higher job insecurity (HR = 1.02; 95% CI: 1.00; 1.03), support from physicians and therapists (HR = 2.22; 95% CI: 1.52; 3.24), proportion of foreigners (HR = 3.27; 1.17; 9.15), and the self-reported need for rehabilitation (HR = 3.23; 95% CI: 1.12; 8.60) were associated with utilization.In summary, informational and practical support provided by physicians and therapists on medical rehabilitation services seems to be a key predictor of rehabilitation utilization. Our findings, therefore, support the call for transcultural competence to be more widely incorporated into the education of medical and health professionals to counteract health care disparities.

Increasing transcultural competence in clinical psychologists through a web-based training: study protocol for a randomized controlled trial.

In mental health care, the number of patients with diverse cultural backgrounds is growing. Nevertheless, evaluated training programs for transcultural competence are missing. Barriers for engaging in transcultural therapy can be identified in patients as well as in therapists. Besides language barriers, clinical psychologists report insecurities, for example, fear of additional expenses when involving a language mediator, ethical concerns such as power imbalances, or fear of lack of knowledge or incorrect handling when working with patients from other cultures. Divergent values and concepts of disease, prejudices, and stereotyping are also among the issues discussed as barriers to optimal psychotherapy care. The planned study aims to empower clinical psychologists to handle both their own as well as patients' barriers through a web-based training on transcultural competence. The training includes 6 modules, which are unlocked weekly. A total of N = 174 clinical psychologists are randomly assigned to two groups: the training group (TG) works through the complete training over 6 weeks, which includes a variety of practical exercises and self-reflections. In addition, participants receive weekly written feedback from a trained psychologist. The waitlist control group (WL) completes the training after the end of the waiting period (2 months after the end of the TG's training). The primary outcome is transcultural competence. Secondary outcomes consist of experiences in treating people from other cultures (number of patients, satisfaction and experience of competence in treatment, etc.). Data will be collected before and after the training as well as 2 and 6 months after the end of the training. This randomized controlled trial tests the efficacy of and satisfaction with a web-based training on transcultural competence for German-speaking clinical psychologists. If validated successfully, the training can represent a time- and place-flexible training opportunity that could be integrated into the continuing education of clinical psychologists in the long term. DRKS00031105. Registered on 21 February 2023.

Effectiveness of Internet-Based Training on Psychotherapists’ Transcultural Competence: A Randomized Controlled Trial

Treating culturally diverse patients (CDPs) presents considerable challenges for psychotherapists, including language barriers, differing beliefs, and insecurities. Improving their transcultural competence requires training, but empirical evidence is lacking. This 6-week randomized controlled trial evaluated the impact of standardized internet-based training on psychotherapists’ transcultural competence (i.e., awareness, engagement, and handling challenges). Demographic data were collected before training. Transcultural competence was measured at pre-training, post-training, and 3-month follow-up. Training satisfaction was assessed at post-training and follow-up visits. In the guided training group (GTG; n = 83), psychotherapists received hands-on training with practical exercises, weekly knowledge assessments, and online feedback. The second condition comprised a non-guided control group (CG; n = 90) that received only text-based training. Primary analyses on both intent-to-treat ( n = 173) and completer analyses ( n = 95) indicated significant improvements in transcultural awareness and engagement after 6 weeks of training for both groups. Significant within-group improvements were noted, as evidenced by large Cohen’s d effect sizes for both groups. No between-group differences were observed. Qualitative assessments revealed that GTG participants evaluated the training’s concept and content significantly more positively than CG participants and felt significantly less insecure about treating CDPs. Such training could pave the way for the long-term development of innovative, culturally sensitive mental health care services that more effectively meet the needs of CDPs.

Cultivating translingual and transcultural competence in a multilingual university

ABSTRACT Globalisation and its sibling, internationalisation, have led to the development of multilingual, multicultural universities, which are often branded as pathways to global success. However, these universities may not adequately consider the challenges that stakeholders face in adapting to these new environments. This paper investigates the implications of internationalisation for policy, pedagogy and practice by surveying policy, faculty, staff, and students of three multilingual programmes at a Spanish university. A document analysis, questionnaire, interviews, and focus groups were used to explore institutional strategy, student identity and agency, teacher pedagogy and practice, and staff guidance and support. The study applied a translingual and transcultural competence lens that focused on critical awareness, reflexivity, and the ability to operate between languages and cultures while building relationships. The findings reveal a strong programmatic focus on multilingual and intercultural development, a wide range of plurilingual and pluricultural identification and practices among students, the centrality of a teacher's role in facilitating and modelling translingual and transcultural competence, and a presently underexplored at-home/abroad nexus. The study implies a need for more community building beyond the classroom and across domestic and international students, greater empowerment of teachers, and a need for students to reflect and engage with each other.

TRANSCULTURAL COMPETENCE OF THE PERSONALITY AS A CONDITION FOR THE EFFICIENCY OF PROFESSIONAL TRAINING OF FUTURE MUSIC TEACHERS IN UKRAINE AND CHINA

The article highlights the importance of transcultural competence of future music teachers in the process of professional training of students of art higher education institutions of Ukraine and China. The psychological and pedagogical mechanisms of professional formation of future music teachers are substantiated. The historical aspect of the development of music education in the People's Republic of China is considered. The author scientifically confirmed that a creative, socially responsible and active personality is characterized by a sense of the new, a critical attitude to the surrounding world, an awareness of his place and role among others. and intra-psychological educational actions.Key words: transcultural competence, external and internal regulation, physical and mental activity, value orientations of the individual, professional training, teachers of musical art.

Mini-ethnography for medical students. Inquiry-based learning to foster transcultural competences

Abstract Background Transcultural competences are important for health professionals in plural societies. But if ‘culture’ is addressed in medical curricula, the underlying concepts are often not up to date with constructivist approaches of social sciences. Instead of teaching multiple definitions and complex theory, medical students can be familiarized with the perspective of these sciences through a methodologically structured exposure. Objectives An ethnographic field exercise was included in a clinical elective on refugee health care for medical students at a German university between 2016 and 2023. An anthropologist introduced the scientific perspective as well as participant-observation as qualitative method. Evaluations after introducing the task were analysed and a qualitative content analysis after completion was done to discern if learning goals were reached. Results 130 students participated in the ethnographic exercise. Perceived relevancy for medical education varied (4-p; M = 2,6; SD = 0,7; n = 81); 47% of students regarded written reflection as enhancing competencies (5-p; M = 3,3; SD = 1,2; n = 107). Many considered the exercise as demanding, but interesting. The field protocols show it sharpened perception, ‘culture’ became one of many factors impacting on interactions. Learning to separate description from interpretation, students were able to reflect on own thoughts, evaluations, stereotypes and emotions. Awareness of context-dependency and structural embeddedness of medical encounters, critical assessment of power-dynamics, political issues, service quality and professional ethics in a resource constrained setting were fostered. Conclusions An anthropological approach and self-experience as participant observer can provide medical students with the opportunity to cultivate situational awareness and a holistic, multi-layered, structurally sensitive perception that may be more helpful in dealing with the challenges of diversity than presumed knowledge about ‘cultures'. Key messages • Ethnographic exercises linked with exposure to refugee settings help to foster transcultural and structural competences of medical students without the need for an extensive study of culture theory. • Essentialist culture concepts within medical education can be countered by short theoretical updates and inquiry-based learning within contexts characterised by diversity and exclusion.

Russian nurses’ readiness for transcultural care of palliative patients

Palliative care involves an approach aimed at improving the quality of life of patients and their families, who are forced to cope with the problems associated with life-threatening diseases. This definition includes a growing group of patients around the world. It requires an extension of the definition of patients in need of palliative care in countries such as Russia and a significant improvement in the work of nursing personnel with these patients. This study aims to determine the level of preparedness of nursing personnel for specialized care (transcultural care) and the quality of care provided to palliative patients. The presented findings of the study demonstrate the relevance of developing transcultural competence, which enables significant improvement in the quality of life of palliative patients. The analysis of medical workers’ assessment of the level of specific training and their intercultural preparedness was conducted based on hospices (Moscow). A survey was conducted among 113 medical workers of the middle level of education aged between 28 and 56 (average of 44.2 years) and experience in palliative care ranged from 3 to 18 years (average of 9.5 years). The Intercultural Readiness Check (IRC) test, widely used to assess nursing staff worldwide, was used for the survey to determine the level of readiness for transcultural care. A strong correlation was found between a number of the test scales and measures of participants’ age and experience. The presented material demonstrates the realization of an interdisciplinary approach to the issues of specific training of nursing personnel in the field of “transcultural care” in providing palliative care to incurable patients.

Cultural competence in a primary healthcare center in Santiago de Chile: a mixed methods design.

The immigrant population in Chile is growing significantly, challenging the health care system's capacity to provide sensitive and effective care. To assess the cultural competence of Chilean primary health workers. This mixed-methods study used a quantitative scale and semi-structured interviews to examine the cultural competence of a Chilean primary health care team in their care for the international migrant population. The study pointed to specific variables that were associated with increased cultural competence, including age, intercultural life experiences, and having received relevant training. The two approaches produced largely convergent results. The dimensions of cultural competence with the highest scores on the quantitative scale were also the theoretical dimensions with the greatest discursive density in the qualitative analysis. The analysis provides a starting point for policies aimed at the development of cultural competence in the national scenario, suggesting a general direction to foster transcultural competence in health, such as formal training and the promotion of informal spaces ofsensibilization.

Pertinence de l’approche transculturelle pour améliorer la relation de soins en période périnatale

The international literature review highlights higher neonatal morbimortality in migrant patients and their babies. The explanatory hypotheses include late pregnancy follow-up with difficulty accessing care, language barriers, and different cultural representation in pregnancy support. On the one hand, we propose to explain the cultural factors that can impact the caring relationship during the perinatal period. On the other hand, we set out tools for anthropological and psychological understanding to enhance the sharing of cultural representations around pregnancy follow-up, the needs of a baby, and obstetrical or postnatal complications. The request for a specialised transcultural opinion needs to be more systematic; the transcultural posture is adaptable to each care professional. This requires the professional to address explicitly the impact of culture in care and consider their own cultural distance. Specialised advice is recommended in certain situations of cumulative vulnerability (complex trauma, perinatal depression with cultural coding of symptoms), blockage or refusal of care for cultural reasons and to avoid cultural misunderstandings. We detail two modalities: mediation and a discussion group around cultural issues set up in the maternity ward. The institutional work we propose within the multidisciplinary team in the maternity ward also allows the acquisition of transcultural competencies.

A preliminary research on transcultural capacity in global public health: from the view of public health professionals

BackgroundTranscultural capacity is a key component of consolidated global public health assistance cooperation (GPHAC). The aim of this study is to investigate the transcultural capacity perceptions of public health professionals from China’s disease control and prevention system after relative training in order to provide a reference for enhancing transcultural capacity during the practice of GPHAC.MethodsA cross sectional qualitative survey in which self-administrated questionnaire with 5 open ended questions was used. The questionnaire was disseminated on the completion of an online training for China’s senior public health professions on transcultural capacity in GPHAC. Descriptive statistics, word frequency analysis and content analysis were used to analyze the questionnaire data.ResultsTotally, 45 participants took part in this training, 25 of them voluntarily participated in this survey. The participants demonstrated the need for transcultural competence in public health services and suggested improvement in the course content arising from their wealth of knowledge and practical experience in the field. 96% of the participants considered that the training course was “very necessary” and “meaningful”. The most interested topics were “Overview of transcultural adaptation and GPHAC”, “Transcultural adaptation and response” and “African culture and health”. The contents about “Country-specific analysis on cultural factors in public health”, “rapid transcultural adaptation” and “more specific practical experiences in diverse cultural backgrounds” were suggested to be added in future training. The participants considered that transcultural capacity ensured the smooth progress of GPHAC and they both could complement each other, transcultural adaptation was the premise of gaining trust and reaching cooperation, it can be conducive to the health assistance professionals to integrate into local cultural life, facilitating their foreign assistance work to be effective and efficient, and impart experiences well. The participants hoped to put the concept into action.ConclusionThe importance of transcultural competence in GPHAC is becoming a consensus of public health professionals. Enhanced transcultural competence reflected in the attitude of public health as well as other health workers would promote GPHAC and would foster efficient emergency health response management among many countries.

СИМВОЛИЗМ ТРАНСКУЛЬТУРАЛЬНОГО ХУДОЖЕСТВЕННОГО ТЕКСТА КАК МЕХАНИЗМ УСИЛЕНИЯ КОГНИТИВНОЙ АКТИВНОСТИ ЧИТАТЕЛЕЙ

Using transcultural fiction by V. Nabokov, K. Ishiguro, Lan Cao and Anya Ulinich as its case studies this article examines the role of symbolism in the texts created by bilingual writers. The article proposes to define transcultural symbols as a special type of literary images synergetically representing ideas and themes of at least two cultures and expressing the unique translingual/transcultural authorial modality. The aim of the article is to analyse major functions of transcultural symbols in creating transcultural literary texts and to determine their significance for enhancing readers’ cognitive activity. The article proves the hypothesis that transcultural symbols might be viewed as a creative result of the bilingual authors’ reflection over complex mechanisms of “semiotic condensation” representing cultural memory, contributing to the increased expressivity, emotivity and ludic modality of transcultural fiction and requiring advanced trascultural/translingual competence on the part of its readers. The findings of the research prove that it is the combination of elements of stylistic and linguo-semiotic analyses that might provide an effective methodology for interpreting transcultural fiction and transcultural symbolism of such texts, in particular. The overall outcome testifies to the importance of further research into varied mechanisms of foregrounding transcultural symbols in fiction, and to the relevance of investigating possible ways to develop readers’ transcultural competence

Need for training or already OnTracc? Development and psychometric properties of an online transcultural competence questionnaire among psychotherapists.

The prevalence of mental disorders among people with migration experiences is high. Studies have shown that despite the increasing number of patients from different cultures requiring therapy, treating them is still a major challenge. Furthermore, professional training aimed at improving transcultural competence is rare, and psychometric instruments assessing transcultural competence require improvement. Accordingly, this study aimed to develop and evaluate an online transcultural competence questionnaire (OnTracc) to assess transcultural competence among psychotherapists. Based on extensive literature research and expert interviews, 38-self-report statements referring to aspects of transcultural therapy (e.g., skills, knowledge, and awareness) were compiled. In two studies, 306 psychotherapists completed the OnTracc questionnaire. The multicultural counseling inventory (MCI), personality factors (BFI-K), experience in transcultural therapy, and demographic data were assessed as control variables. The exploratory factor analysis (EFA) revealed a 3-factor structure. The reliability of the scale ranged from ω = 0.73 to 0.81. These scales demonstrated substantial convergent and discriminant validity with the BFI-K and MCI subscales. Factorial validity was confirmed through confirmatory factor analysis. This validated inventory is the first to assess transcultural competence in therapeutic settings in the German language. Further analysis of the factorial validity of the different samples is recommended. Given the increasing diversity in the therapeutic landscape, additional development could help close the gap between the evolving treatment demands of culturally diverse patients and the lack of consideration in mental health and education.

Forcibly displaced persons and mental health: A survey of the experiences of Europe-wide psychiatry trainees during their training.

Many European countries have seen increasing refugee populations and asylum applications over the past decade. Forcibly displaced persons (FDPs) are known to be at higher risk of developing mental disorders and are in need of specific care. Thus, specific training for mental health professionals is recommended by international health organizations. The aim of this exploratory study was to assess the experience of clinical work with FDPs among psychiatric trainees in Europe and Central Asia as well as their interest and specific training received on this topic. An online questionnaire was designed by the Psychiatry Across Borders working group of the European Federation of Psychiatric Trainees (EFPT) and was distributed via email through local networks among European trainees from 47 countries between March 2017 and April 2019. Answers of 342 psychiatric trainees from 15 countries were included in the survey analysis. A majority of trainees (71%) had had contact with FDPs in the last year of their clinical work. Although three-quarters expressed a strong interest in the mental health of FDPs, only 35% felt confident in assessing and treating them. Specific training was provided to 25% of trainees; of this subset, only a quarter felt this training prepared them adequately. Skills training on transcultural competencies, post-traumatic stress disorder, and trauma management was regarded as essential to caring for refugees with confidence. Although psychiatric trainees are motivated to improve their skills in treating FDPs, a lack of adequate specific training has been identified. The development of practical skills training is essential. International online training courses could help meet this pressing need.

A transformative model for culturally-informed social work and health professions education

ABSTRACT This article introduces a curricular design that brought together faculty and members of local immigrant and oppressed groups to build, teach, and evaluate a culturally-informed social work course. Course design was grounded in multiple theories including transcultural competence theory, critical multicultural social work theory and transcultural perspective. Trauma-informed principles guided content and teaching methodologies. A culturally-informed survey was developed to measure learning outcomes and feedback was gathered from student focus groups. Survey themes indicated students benefited from learning with and from cultural stakeholders and valued the integration of cultural- and trauma-informed perspectives.

Professional Trajectories in Migrant Biographies of Qualified German, Romanian, and Italian Movers

This article tackles the issue of professional inclusion of “knowledgeable” migrants under consideration of the paradigmatic life course framework. It thus aims to contribute to international research on human capital valorisation. The comparative analysis of this study is grounded on qualitative data from 30 in‐depth interviews with German, Romanian, and Italian qualified movers in Italy and Germany, who did not migrate for reasons resulting from economic hardship or poverty, but rather to improve their living conditions on familial (tied movers), professional, or socio‐cultural level. Our research aimed to investigate their professional trajectories and corresponding skill utilisation. Findings of the study confirm two predominant tracks of professional integration in the labour host context characterised either by transcultural competence transfer and utilisation or by professional re‐invention and skills acquisition. Particular attention within the data analysis and corresponding conclusions has been paid to potential dynamics for social and economic up and downward mobility and the role of the three heterogenous (more and less privileged) national and cultural backgrounds for brain circulation.

What if we focus on developing commonalities? Results of an international and interdisciplinary Delphi study on transcultural competence

This article seeks to articulate an invitation to rethink the success factors of global cooperation by using a relational approach. It presents the initial results of a 3-stage Delphi study that was conducted in 2020 with a panel of around 50 experts from different countries and disciplines in order to better understand the concept of transcultural competence. The study questions specifically invited the experts to focus on (1) the determinants of people’s perceptions of cultural diversity, (2) the role and creation of commonalities, (3) the competences that support an approach to cultural diversity aiming at commonalities, and (4) the formulation of corresponding conceptual conclusions as a point of departure for further research and practical application.The results suggest that a relational view could be interpreted as a common denominator within the Delphi group. Following such a relational approach, the core aspirations of a revisited concept of transculturality include to consider individuums in their relations, to refer to context-specific events, constructive processes and the connotation of the beyond, which implies the possibility, ability and willingness of creating new commonalities (without excluding the existence of differences). A relational understanding of cultural complexity thus views cultural commonalities and differences not as opposites, but as complementary resources for cooperation. It thereby hints towards a process-perspective of competence, as well as towards the departure from a static concept of identity in favor of the concept of belonging, which is inherently relational.

Competence building in child mental health -A Norway-Cambodia transcultural experience

The prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income countries. Collaboration between institutions from high-income countries and institutions in resource-poor settings may enhance professional competence. This may be a key to bridging the gap between service needs and ability to meet those needs. However, there are challenging issues in transferring knowledge from a Western context to a different cultural and socioeconomic situation. The aim of the present study is to describe significant aspect of a transcultural competence building project in Cambodia in child mental health from the perspective of the staff. A Norwegian expert team developed and implemented a program at Centre for Child and Adolescent Mental Health (Caritas-CCAMH) in collaboration with the staff two weeks per year over a 14-year period. The study has a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. The multidisciplinary staff described a learning process characterized by collaboration in planning and implementation. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the teaching process. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of capacity building despite the differences in socio-economic conditions and learning styles. This model of continuity, low-investment, and low-intensity capacity-building may enrich the child and adolescent mental health settings in low- and middle-income countries.

A scoping review of international mindedness and related concepts in music education, 2000–2020

AbstractInternational mindedness (IM) is a term often used by the International Baccalaureate (IB), international schools and researchers in the field of international education. However, within the discipline of music education, this concept remains relatively unexplored. Conducted as a scoping review, using Arksey and O’Malley's (2005) framework, this study charts the research literature that explores IM and its related concepts within music education settings. A broad definition of music education was adopted, incorporating both formal and informal learning environments. Related concepts to IM, used as search terms, were taken from two IB commissioned reports (that is, Castro, Lundgren and Woodin, 2013; Singh and Qi, 2013). Only primary studies, with a publication date between 2000 and 2020, were included. In total, 218 studies satisfied the inclusion criteria, the majority of which addressed the concepts of multicultural education, intercultural competence, cultural awareness and social inclusion. No primary studies were included for the concepts of common humanity, human rights education, language rights, omniculturalism, transcultural competence and world mindedness/citizenship. Only four primary studies were found that address IM, conducted by the same two researchers, leading the author to question whether future research exploring IM in music education settings is a worthwhile endeavour. In sum, although a significant amount of literature was found through this scoping review, several concepts remain underdeveloped, or completely unexplored, within the field of music education.

Pushing political, cultural, and geographical boundaries: Distributed co-design with children from Namibia, Malaysia and Finland

Previous research and initiatives in participatory design (PD) with children has focused on co-located participation, leaving a paucity in theoretical and empirical work on geographically distributed on-line co-design with children. This gap presents a unique opportunity for children across the globe to become co-designers of their own digital inclusive learning environment. From a political perspective we strive for a pluriversal design of a hybrid distributed participatory design space using a transcultural approach. Thus in this paper we literally push boundaries in PD as (1) we reflect on two exploratory studies where we engaged children from Finland together with ”underrepresented children in PD”, namely from Namibia and Malaysia, thereby contributing to pluriversality; (2) we expand the concept of transcultural competencies in digital design inspired through co-designing with mixed groups of children from different geographical locations; (3) we raise practical issues requiring attention and further research, namely team building considering goals, social relations, skills and roles of participating children, facilitation goals and challenges, and technologies to enable conducive geographically distributed co-design.