Purpose: To assess the level of cultural competence of graduating nursing students.
Methods: This study used a pre/post design and a convenience sample. A demographic data instrument and Campinha-Bacote’s Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Student Version (IAPCC-SV©) were used to gather the data. The IAPCC-SV© is a self-administered 20-item survey that measures the four constructs of culturally proficient, culturally competent, culturally aware, and culturally incompetent. Total overall scoring of the instrument ranges from 20-80 with the levels of cultural competence comprising culturally incompetent (20-40), culturally aware (41-59), culturally competent (60-74), and culturally proficient (75-80). Higher scores depict a higher level of cultural competence.
Student nurses completed the US Department of Health and Human Services Office of Minority Health Cultural Competency Program, a three module online training program. In addition, they received additional diversity education in the courses and clinical agencies.
Results: In the fall 2014, 49 student nurses were enrolled in the Baccalaureate nursing program and completed the demographics and pre-survey. In spring 2017, forty-three of the 49 student nurses completed the post-test for an 87% return rate. Five students left the program and the sixth student was absent the day the survey was administered.
Thirty-six (83.7%) were female. Ethnicity: 41 (95.3%) White, 1 (2.3%) Black, and 1 (2.3%) Asian or Pacific Islander. Age: 38 (88.4%) 21-25 years and 5 (11.6%) 26 or older. Forty-three (100%) were enrolled full-time in the Bachelors of Science Nursing Program. On the pre-survey, 12 (27.9%) student nurses reported previous diversity training which increased to 39 (90.7%) in the spring of 2017.
The results of the paired analysis, which evaluated the differences in the IAPCC-SV scores from pre-survey to post-survey. Of the 43 student nurses, 13 (31.0%) had five contacts with persons from other cultures. Eighteen (42.9%) had four contacts, 10 (23.8%) had 3 contacts, and 1 (2.4%) had 1 contact.
There were significant changes in the IAPCC-SV score when first enrolled in the program to graduation. Improvement in scores from fall 2014 pre-survey to spring 2017 post-survey (Pre, =60.82, SD=6.83; Post, =65.72, SD=6.0). The mean score of cultural competence increased by 8.54%. The increased average total cultural competence score finds that the respondents are moving toward becoming “culturally competent (60-74 points)”.
The subscale scores for the five constructs included
- cultural awareness was (Pre, =10.07, SD=1.12; Post, =10.93, SD = 0.76) a .86 (8.54%) change.
- cultural knowledge (Pre, =08, SD=2.28; Post, =15.32, SD=2.11), a 2.24 (17.13%) change.
- cultural skill (Pre, =8.63, SD=1.48; Post, =9.05, SD=1.43), a 0.43 (4.8%) change.
- cultural encounters (Pre, =15.23, SD=1.89; Post, =16.02, SD=1.93), a 0.82 (5.38%) change.
- cultural desire (Pre, =13.81, SD=1.78; Post, =14.37, SD=1.63), a 0.56 (4.06%) change.
In spring 2017, 14.0% of the respondents are culturally aware (n = 6), 79.1% culturally competent (n = 34), and 7.0% culturally proficient (n = 3), whereas in fall 2014 the percentages are 48.8% (n = 21), 48.8% (n = 21), and 2.3% (n = 1), respectively. The changes indicate that students were moving from being culturally aware at their beginning of the program to being culturally competent and proficient when graduating from the program.
Conclusion: The results of the IAPCC-SV demonstrated that the level of cultural competence among student nurses improved during enrollment in the nursing program. The five constructs of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire also significantly increased. Respondents scored highest in the cultural desire construct. The results of this study can be used by faculty to review the curriculum and consider making changes or implementing an intervention to increase cultural competency.
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