Cultural Competence and Confidence in Nursing Students: A Triangulated Approach to Evaluate Domains of Learning

Purpose and Theoretical Rationale

The purpose of this triangulated comparative design of cohorts of pre-licensure nursing students is to describe trends over time in self-efficacy strength as measured with the Transcultural Self-Efficacy Tool (TSET) and to interpret reflective narratives of students engaged in learning through cultural immersion during a medical mission.  Reflective narratives provide in-depth understanding of perceptions about the social context of diverse populations and develop critical thinking skills.  Jeffreys (2010) Cultural Competence and Confidence Model (CCC) guides this research to examine changes in self-efficacy perceptions in the cognitive, practical, and affective domains of learning about care for diverse client populations.  Assessment of curricular programs is needed to evaluate cultural competence and cultural safety perceptions of students to provide diagnostic-prescriptive data.  Cultural safety may best be assessed with written narratives that reflect student perceptions of how a client describes cultural care, taking into account the providers’ awareness of their own attitudes about health-care interactions and the environment of care.

Subjects

Pre-and-post TSETs were completed by students in traditional face to face transcultural nursing courses or cultural immersion mission trips.  Students in cultural immersion wrote reflective narratives about their experiences.   

Method 

All participants completed the 83-item TSET that has supported reliability, stability, and construct validity in three subscales evaluating transcultural self-efficacy strength and changes over time.  The subscales provide a measure of the cognitive, practical, and affective learning domains.  TSET scores will be analyzed for differences between and within groups.  Reflective narratives will be examined and interpreted to gain in-depth understanding of the lived experience of students engaged in cultural immersion using the CCC Model as a guiding theory about self-efficacy beliefs, cultural confidence, and cultural safety.

Discussion 

Preliminary results of TSET scores and interpretation of the reflective narratives will be discussed.  Data analysis is in process at this time.