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The purpose of this research study was to determine through techniques associated with program theory-driven evaluation science (Donaldson, 2007) whether the program inputs of an associate degree program, located in a culturally diverse urban location, can produce intended program outcomes. These program outcomes are aligned with the definition of cultural competence for nursing students: cultural attitude, cultural knowledge, and cultural skill (AACN, 2008), and have been adopted by the accrediting organization for Associate Degree Nursing Programs (ACEN, 2013). The current research reviewed the extent to which nursing students meet the program’s accreditation requirements of cultural competence. Through this comprehensive assessment of curriculum, curriculum implementation, and program goals, this research has yielded data that can be generalized to other nursing programs governed by the same accreditation standards.
Methods:
The method for this research study used a program theory-driven evaluation design, where program inputs were reviewed to determine their role in meeting program outcomes. This evaluative approach looked at cultural competency theory, accreditation standards, program objectives, adult learning theory, program curriculum, and implementation of curriculum. The evaluation identified how cultural competency of students is evaluated by the nursing program, as well as how program objectives associated with cultural competency align with accreditation standards on cultural competency. A causal-comparative non-experimental research design reviewed cultural competency levels of a control group (freshmen nursing students entering the nursing program) and an experimental group (senior nursing students completing the nursing program) to produce data reflecting cultural competency levels of students based on Campinha-Bacote’s Cultural Competency Tool (IAPCC-SV, 2007).
Results:
The results of the study showed that using a causal-comparative non-experimental design embedded in the conceptual framework, the results of data analysis from 110 nursing students yielded statistical significance between those students entering the nursing program and those students graduating the nursing program in relation to the cultural concepts of knowledge, skill, and overall level of cultural competence. Thus, based on the results of this research the target college did meet both the program objectives and the accreditation standards of graduating culturally competent nurses. Using program theory-driven evaluation proved to be an effective research design to evaluate the ability of an associate degree program in northeastern United States in meeting program objectives and accreditation standards. Since the ACEN and CCNE accreditation organizations share similar accreditation standards on cultural competence and include similar exemplars of how cultural competency has been introduced into nursing programs, this research design could be replicated with few modifications.
Conclusion:
In conclusion, a review of the literature revealed a gap in the evaluation of a whole program, rather than evaluation of a specific cultural project or cultural course embedded in the curriculum of nursing programs. Most research studies that had been conducted were reflective of only baccalaureate curriculums, and did not show statistical significance in the attainment of cultural competence; rather, statistical significance was revealed in one or two of the five cultural constructs which make up cultural competence. Based on data analysis, this research study showed a statistically significant difference in cultural competency between nursing graduates (experimental group) compared to the beginning nursing students (control group). Additionally, this research design showed how the conceptual framework of program theory-driven evaluation can be adapted to the field of nursing education, and provided the two year nursing program with the validation they needed to confirm that their program objectives were being met with their curriculum and implementation of the curriculum by their faculty.