As part of the SON undergraduate program expansion, a curricular analysis indicated a gap in the undergraduate program regarding the inconsistency, and sometimes nonexistence of diversity and inclusion content, an industry standard and program goal.
The terms cultural competence, sociocultural, or diversity and inclusion are all words to describe the social climate and the ability of one to assess, perceive, or see and understand another’s perspective. This concept is vital in healthcare and directly impacts the care given, the care received, and the overall patient health outcomes, further affecting the dollars spent, and potentially wasted, on inefficient and ineffective health care (American Nurses Association, 2018; Institute of Medicine, 2011; 2015; National League for Nursing 2017). Many organizations have guidelines and initiatives for healthcare providers to consider in determining culturally competent care. Additionally, literature is clear regarding the impact that diversity and inclusion has on intra- and interprofessional relationships, provider and patient relationships, as well as organizational and community relationships (Health Professionals for Diversity Coalition, 2017; American Association of Colleges of Nursing, 2015). However, literature is lacking on how best to implement these guidelines. The purpose of the project was to focus on three domains: student assessment, faculty assessment and development, and the undergraduate curriculum.
Methods:
Each of the three domains has a similar focus on baseline assessment with an implementation plan and goal for ongoing assessment (American Association of Colleges of Nursing, 2015; Creech et al., 2017; Montenery, Jones, Perry, Ross & Zoucha, 2013; National League for Nursing, 2017). In order to assess the baseline mindset of students, the Intercultural Development Inventory was used (Hammer, 2015). As stakeholders, faculty and student buy-in is essential to working towards better outcomes and decreased health disparities for future patients by demonstrating the vital knowledge, skills, and attitudes that nurses in today’s healthcare system need.
Results:
An independent-samples t-test conducted to compare the pretest/posttest of both groups. When comparing the pretest of the two groups, there was not a significant difference in the IDI scores for intervention (M = 91.33, SD = 15.09) and the control (M = 92.64, SD = 13.66); t(115) = 0.493, p = 0.62).
However there was a significant difference in the post IDI scores for the intervention group (M = 101.21, SD = 17.59) as compared to the control group (M = 94.25, SD = 18.73); t(115) = -2.07, p = 0.04).
Additionally, when completing a paired-samples t-test for the control group there was not a statistically significant difference in the pre IDI score (M = 92.64, SD = 13.66) and the post IDI score (M = 94.25, SD = 18.73); t(55) = -0.76, p = 0.451.
However, when comparing the paired-samples t-test for the intervention group there was a significant difference in the pre IDI score (M= 91.33, SD = 15.09) and the post IDI score (M = 101.21, SD = 17.59); t(60) = -5.38, p < .001.
Conclusion:
This project allowed program-wide assessment to establish baseline data, develop a three-tiered approach for implementation, with on-going evaluation and sustainability.