Teaching in a culturally congruent manner is important to the nursing discipline. Cultural norms and ways of learning influence learning expectations, which may influence the development of critical thinking skills, clinical reasoning, and clinical judgment in nursing students. The purpose of this presentation is to describe a systematic literature review on the impact of culture on learning, including teaching and curricular implications. This review examined literature in healthcare, education, and social sciences. The examination concluded that culture does affect learning. To best prepare nursing graduates to provide safe and effective patient care that meets complex healthcare needs globally, it is imperative that nurse educators teach in a culturally congruent manner.
Background:
Different cultural groups demonstrate and define critical thinking in different ways (Tian & Low, 2011). Some even struggle with related concepts, such as questioning those considered experts or authority figures, questioning published literature, and asking questions in class. In a literature review related to problem-based learning methods to promote critical thinking among nursing students from differing cultures, the researcher found scant data in nursing scholarship that examined the relationship between culture and learning (Sommers, 2014). The researcher concluded that in order for nurse educators to prepare nursing graduates to meet patient care needs globally, they need to teach in a culturally congruent manner, and therefore, need to know more about how culture affects learning (Sommers, 2014).
Learning style preferences vary with individuals’ cultural values (Holtbrügge & Mohr, 2010). Approaches to learning are embedded in the learner as socio-cultural issues and the learners’ background shapes and influences approaches to learning (Brown, Ward-Panckhurst, & Cooper, 2013). Therefore, it is vital that nurse educators understand the needs of ethnically diverse students to develop culturally sensitive and supportive educational environments in nursing education (Veal, Bull, & Miller, 2012).
Methods:
The PubMed, CINAHL, ERIC, PsychINFO, and ProQuest databases were searched for papers published between 2010 and 2015. The search was limited to articles and dissertations that accessible in the English language. Inclusion criteria included a description of how learning was affected or related to culture and a description of a particular viewpoint or particular audience. Varied combinations of the search terms culture, learning theory, learning approach, learning behavior and student were used. The initial search identified 206 papers. Once duplicates were removed and full text reviewed, 31 papers met the criteria. An additional two papers were added during a secondary search for a total of 33 papers reviewed.
Results:
Thematic analysis identified four major themes that describe the effect of culture on learning: a) occurrence of surface learning among non-Western students, b) the effect of previous educational experiences on learning, c) the effect of cultural values on learning, and d) teaching strategies to promote learning. The five teaching strategies identified to promote learning were a) maintain awareness, b) respect culture, c) provide support programs, d) utilize technology, and 5) develop reflective practices.
Conclusion:
As there is an effect of culture on learning, nursing educators need to consider culture when teaching, not to change core outcomes of a program, but to culturally contextualize teaching styles, assessments, and activities so that students successfully achieve the core outcomes. Students from different cultures have different perspectives; how they learn and process information is also different; therefore, culturally appropriate evaluation systems should be used to evaluate the learning (Henze & Zhu, 2012). Since learning is closely linked with culture, different cultures have different norms related to critical thinking, roles of students and instructors, and learning styles.
Furthermore, how students previously learned greatly influences current learning preferences and expectations. It is important to recognize and respect students’ different cultural backgrounds and expectations regarding learning to assist the students in meeting the objectives and expectations of a unique curriculum that may involve new ways of learning. This will include adapting teaching methods but not essential learning outcomes of the curriculum. Adapting the teaching methods will include additional coaching and instruction to students, culturally contextualizing the teaching method, being aware of one’s own cultural learning norms, and using a variety of teaching methods and styles to meet different learning style preferences.
More research is needed regarding how culture affects learning in nursing education and what teaching practices work best in nursing education with students with diverse cultural backgrounds. To meet the challenging, complex, and unpredictable demands of today’s healthcare needs globally, nurse educators must be prepared to recognize that culture does affect learning and be willing to adapt and develop teaching strategies for use with diverse cultures that promotes critical thinking, clinical reasoning, and clinical judgment. The themes from the literature on culture and learning, as well as the themes relevant to teaching strategies that promote cultural congruence, provide faculty direction for self-assessment and a review of the curriculum to promote cultural congruence.