Influence of International Service Learning on Cultural Competence

Multiple curricular approaches are being used to teach cultural competency to nursing students in the United States in accordance with accrediting board standards. As nurse educators are searching for evidence based teaching practices, this article reviews the most commonly current teaching methods being used. Although a variety of methods are being implemented, little empirical evidence exists to suggest any one methodology for teaching cultural competency for nursing students produces significantly better outcomes. The use of clinical experiences, standardized patients and immersion experiences have produced the most favorable results which increase student awareness, knowledge and confidence in working with ethnically diverse patients.

For decades, experts have documented racial and ethnic disparities in health care and acknowledged the complex and contributing factors to substandard healthcare for ethnic minorities. (Betancourt, 2003; Rust et al., 2006; Institute of Medicine, 2002). Poor patient outcomes occur when there is a lack of culturally competent care from the health care provider (Institute of Medicine, 2002; Smedley, 2003). Language barriers, food preferences, cultural beliefs that impact healthcare practices, and physical variations among ethnic groups which may alter pharmacological effects, all impact the quality of care provided.

The additional problem is that nurses who are not well trained to be culturally competent often do not correctly or adequately address the unique needs and preferences of ethnic minorities. If a nurse is untrained in assessing, evaluating and adjusting care plans to meet these unique needs, nursing care and treatment may be compromised. Many nurses state they feel inadequate and uncomfortable in providing culturally appropriate and sensitive care to clients of an ethnicity different from their own, which may compound the problem of disparate care for minorities (McHenry, 2007). Research findings report that students graduating from baccalaureate programs do not feel prepared to work in a multicultural society (Bernal & Froman, 1987; Coffman, Shellman and Bernal (2004); Kulwicki & Boloink, 1996; Bond, Kardong-Edgren, & Jones 2001).