Purpose: Health disparities are a growing concern in the United States. In order to reduce the incidence of health disparities, it is imperative that nurses deliver culturally competent care. Leading bodies of nursing have included appropriate cultural care in their accreditation standards. However, there is no consensus in the literature about effective ways to integrate cultural competence into the curricula of bachelor of science in nursing programs. Simulation is an effective teaching tool that allows students to practice nursing skills in a controlled environment. Simulation using standardized patients (SPs) allows a systematic cultural assessment that is consistent for each student.
Methods: This research study used quasi-experimental mixed-method design to evaluate the level of cultural competence in undergraduate nursing students. A convenience, non-random sample of sophomore level undergraduate nursing students participated. The control group received a specifically designed lecture on cultural competence. The intervention group received both the lecture and a specifically designed simulation using SPs from diverse backgrounds. Both groups received the pretest at the beginning of the semester. The control group received the posttest two weeks after the lecture and the intervention group received it two weeks after simulation. Control group participants received the simulation at a later time. The simulation consisted of a mini-nutritional assessment, physical assessment, and brief health history with SPs from diverse backgrounds. Study Measures: The Inventory Assessing the Process for Cultural Competence Among Healthcare Professionals – Student Version (IAPCC-SV) tool developed by Campinha-Bacote was used for pretest and posttest in both groups. Several open ended questions were also used to gather qualitative data. Theoretical Framework: Campinha-Bacote’s conceptual model was integrated in the class lecture and simulation and guided this research.
Results: Descriptive statistics were used to analyze the mean of the control group and intervention group pretest and posttest. There were 38 participants in this study. An analysis of covariance (ANCOVA) with repeated measures showed a statistical significance for time effect (pretest v. posttest) F (1,36) = 48.819, p <. 001and large effect size (partial eta squared = .576). However, the interaction between the control and intervention groups was not statistically significant: F (1,36) = .077, p = .782. In addition, a between-groups F test showed the group effect was not significant: F (1,36)=. 117, p = .73. Open-ended questions revealed students felt it helped with communication skills.
Implications: Consequently, further nursing education research is needed in the area of using SPs as an effective teaching strategy to evaluate cultural competence in undergraduate nursing students.