What is the Impact on Cultural Competence in Baccalaureate Nursing Students After an Immersion Experience in a Third World Country?

Purpose:

As the world becomes a much smaller place, the melding of cultures is inevitable and a focus on global healthcare is increasingly important. With such a diverse population, cultural awareness and cultural competence in nursing is critical to maintaining high professional practice standards.  While limited cultural awareness can be taught in a classroom setting, researchers hypothesized that cultural competence can be infinitely increased by immersion in a culture other than one’s familiar environment.  Caring for patients in a third world country while relying on basic nursing skills with few resources is a massive undertaking for a nursing student.  The experiences in the service learning arena and researching the impact on cultural competence can benefit educators as nursing curriculums struggle to provide innovative opportunities to impart the importance of cultural competence, empathetic behaviors, and caring behaviors in the nursing profession.

Methods:

For this research, eight senior baccalaureate nursing students from a small college in Buffalo, NY, USA were selected to participate in a one week healthcare immersion experience in a poor rural area of the Dominican Republic.  While in the Dominican Republic the students participated in running healthcare clinics for local residents who are the poor and underserved in the area.  Many of the patients seen have no access to the basic essentials such as electricity and clean water.  For these people healthcare is a luxury that they are unable to afford.  Following IRB approval all eight students were offered the opportunity to participate in the research study and informed consent was obtained.  There was a 100% participation rate. The students were pretested and post tested with a 20 item inventory using the “Inventory for assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version.”   In addition, participants were required to complete reflective journaling exercise and participate in group discussions.  Their experiences were compiled and responses analyzed using SPSS.

Results:

Immersion in a third world country healthcare experience did increase overall cultural competence of the baccalaureate nursing student.  Pretest and Post test scores showed a statistically significant increase in the cultural competence among the students who participated in the immersion trip.  Pretest results demonstrate students prior to the immersion experience were culturally aware with a mean score of 58 (48-65) while Post test results showed a significant improvement for the immersion students to the level of culturally competent with a mean score of 74 (69-78).  The paired samples t-test demonstrates that participation in an immersion experience in a third world country lead to cultural competence of baccalaureate nursing students t(7) = 8.3, p = 0.000.

Conclusion:

There was a statistically significant overall increase in cultural competence in this group of participants following the immersion experience in a clinical healthcare setting of a third world country. As a result of the conclusion, faculty will continue research in the area of cultural competency in order to add to the collective body of nursing knowledge.  The future experiences of each successive group of nursing students will further complement the research available.  Researchers intend to study the feasibility of long term immersion trips to examine results and include cultural competence in the nursing curriculum.  Due to the limited sample size, further research is indicated in order to be able to increase the validity of the findings.  The information obtained from this research definitively demonstrates the use of a service learning component to impact important and often difficult concepts to teach in nursing such as cultural competence, caring behaviors, and empathy.