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Cultural competency can be a challenging and overwhelming topic for students to understand. A West Florida Associate Degree Nursing Program currently incorporates cultural competency as part of the program curriculum, but the information included is sporadic or minimal in some courses. Cultural education is included in all stages of human growth and development, from childbirth/childrearing to death and dying. Incorporating online continuing education modules from the Culturally and Linguistically Appropriate Services (CLAS) along with clinical hours in a diverse community setting may assist in solidifying the education of cultural competency and awareness.
The purpose of the pilot project is to provide senior student nurses with additional online educational training coupled with their community clinical to enhance their knowledge about cultural competency. In addition, to improve the students’ clinical skills in communicating with patients from other cultures. The aim of the project is to determine if incorporating a cultural competency educational modules at the associate level, would be effective in improving the cultural competency skills as well as awareness among senior nursing students.
Methods:
An inferential comparative design using a pre and post-test method was implemented to evaluate students’ knowledge and awareness related to cultural competency before and after an educational intervention. Using the test-retest method design is used to better gain a better understanding of specific information that was gained following the pilot study. The author also discusses that the results from the test-retest method can be used to make same group comparisons. It not only gives validity and reliability as an assessment tool, but also as an educational tool.
Dr. Campinha-Bacote’s (IAPCC-SV©) is a copyright tool used with written permission from the author. It is a 20 question, 4 point Likert scale assessment tool, and took 10-15 minutes for the students to complete. Reliability of the IAPCC-SV© revealed a Cronbach’s alpha of .783 (Fitzgerald, 2009). The IAPCC-SV© is based on Dr. Campinha-Bacote’s (2007) theoretical model of cultural competence in healthcare delivery. The (IAPCC-SV©) assessed the students’ level of understanding in the following characteristics of cultural competency: desire, awareness, knowledge, skill, and encounters.
The opportunity to participate in the pilot study was offered to 55 students enrolled in NUR 2811L (Preceptorship) during the course orientation. The 26 students who participated in the project were asked to complete the Campinha-Bacote’s Inventory questionnaire (IAPCC-SV©), and then asked to complete the continuing education program on line while they were working to fulfill their required clinical hours in a community setting. Participants were given written navigational instructions to access the education modules. Participants registered on http://ccnm.thinkculturalhealth.hhs.gov. This is publically accessible website, is free of charge and not copy righted. Experts with the U.S. Department of Health and Human Services Office of Minority Health developed this educational online training module that relates to the CLAS Standards to improve patient care delivery.
Results:
Fifty-five students were eligible for participation in the pilot study; twenty-six students (52%) agreed to participate in the project. These participants (n= 26) completed the pre-test. One student dropped out of the study prior to completing the post-test. The online modules along with the clinical experience showed some improvement as evidenced by the mean score of the student nurses on the IAPCC-SV© assessment pre-test was 62.73 and the post-test was 69.80 which indicated that the students as a group were culturally aware and competent. No participant pre or post-test scored in the Culturally Incompetent range. Four students scored in the Competently Proficient range pre-test and five students scored in that range on the post-test. One interesting finding was that eleven students scored in the Culturally Aware range, but shifted to the Culturally Competent and Culturally Proficient range on the post-test.
Conclusion: The IAPCC-SV©was administered to 26 senior nursing students in an associate degree nursing program. Twenty-five senior nursing students completed the evaluation tool following the educational study.
Examination of multiple teaching strategies further strengthens the importance that more research needs be accomplished by nursing educators on teaching strategies to improve cultural competence for student nurses. Few studies have examined the impact of the CLAS online modules in relation to improving cultural competency in healthcare workers. But these results have demonstrated that the combination of online modules and clinical experiences did increase cultural competency mean scores between the pre and post-test. And the results of the individual characteristics demonstrate that the CLAS online modules aided the students in increasing their cultural knowledge while the community clinic rotations aided the students in increasing their cultural skills. While all characteristics revealed an increase from pre to post-test, an increase in the areas of cultural knowledge and cultural skill were quite significant.