Over the past few decades, the U.S. population compositions dramatically become racially and ethnically diverse. Because the confluence of minorities to health care disparities, the U.S. federal government and healthcare institutions are establishing guidelines, regulations, and ethical requirements to achieve the goal of delivering culturally appropriate care to all minorities. In recognition of the impact of cultural diversity on health outcomes, the National League for Nursing (NLN) implemented specific initiatives “The Power of Diversity: Embracing Differences in Heritage and Thought” in 2008 and called to action “Creating Inclusive Academic Environments” for building a strong and diverse nursing workforce to advance nursing care in 2016. However, promoting student cultural competence is an ongoing process and eliminating barriers to learning using cost-effective teaching strategies has been a challenge in nursing education. Even with faculty’s understanding of the role and responsibility to nurture student cultural competence, faculty do not feel prepared to teach for meeting the foreseeing needs.
Supposed that nursing faculty are not aware of their own culture and others, do not feel comfortable to approach diversity, or are not sure what or how they should strategically teach, how can they for sure teach students in a culturally competent manner? It is noted that a gap in research has shown faculty need to identify their own cultural competence and know what and how they can effectively promote student learning of culturally competent care in a consistent and systematic way across the nursing program. The purpose of this mixed-method study was to explore nursing faculty cultural competence and understand their perspectives of teaching culturally competent care to students. The research questions were: (1) What is the status of nursing faculty cultural competence? (2) What are the perspectives and lived experience of promoting student cultural competence among nursing faculty?
Methods:
A convenience sample of nursing faculty from a university in the U.S. participated in this mixed-method study. Before collecting data, the university institutional review board granted this study and nursing faculty were fully aware of the study objective. This mixed-method study using a convergent concurrent design was conducted to integrate the triangulation of data for having a deeper understanding of faculty cultural competence in teaching. The Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R©) was the tool used to assess the status of faculty cultural competence. Semi-structured interviews were implemented to collect narrative data of faculty perspectives in teaching nursing student cultural competence. All 14 eligible nursing faculty from a university received an email invitation for participation in taking the IAPCC-R. In total, 13 out of 14 surveys were returned with a 93% response rate. For the exploratory-descriptive approach of the qualitative method, a purposeful sample of seven nursing faculty voluntarily participated individual face-to-face interviews after signing the consent form.
Results:
The 13 faculty who completed the IAPCC-R survey had an average age of 54 ranging from 33 to 68 and consisted of 10 (76.9%) females and 3 (23.1%) males. The majority of the participants were White, non-Hispanic (n = 12, 92.3%), and currently had a clinical job (n = 6, 46.2%). The level of cultural competence among the participants measured by the IAPCC-R was 75.38 (SD = 8.55), indicating faculty were culturally competent based on Campinha-Bacote’s (2007) definitions. Regarding the mean score of each subscale, the lowest average score of the subscale was cultural knowledge (M = 2.62, SD = .45), followed by cultural skill (M = 2.82, SD = .51), cultural encounters (M = 2.89, SD = .42), cultural awareness (M = 3.18, SD = .62) and cultural desire (M = 3.57, SD = .34). Three faculty members defined culture is habits, ways of thinking and doing things that people in a particular group share with each other. Six faculty perceived cultural competence is to be open to adapt and accept diversity and to appreciate and recognize diversity. Regarding faculty perceptions of teaching student cultural competence, five themes were developed including communication skills, cultural skills, engaged-learning, activities for practice, and be positive.
Conclusion:
It is recommended that nursing curricula should facilitate students to provide culturally appropriate health care with attention to health disparities in valuing diversity and inclusivity of increased diverse populations. It is noted that some barriers such as lack of examples and resources, lack of understanding student cultural competence, and take time to develop effective activities for student learning might hinder faculty teaching of cultural competence. Institution support such as providing more diverse faculty members or taking inclusion as a core value might encourage faculty in exploring cost-effective strategies in a culturally diverse manner. Future studies might recruit more diverse faculty from various nursing departments in order to have rich data for understanding the need for promoting faculty teaching student cultural competence.