Table 3 Curriculum of the cultural care training
Goal: To improve cultural competence of senior undergraduate nursing students | |||
|---|---|---|---|
Target group: undergraduate nursing students in intervention group (n = 37) | Educational methods: Tutorials and lectures PowerPoints Case reports and Scenario Educational video and video clip, audio-visual material Interactive forum and discussion Role playing Web-based learning Oral reports and storytelling Expression of work-based experiences and self-reflection Presentation of articles and their important points Book reading Questions and answers | Evaluation method: Questionnaire and comparison of pre-test and post-test scores | |
Expected duration: 5 two-hour sessions in 6 weeks | |||
Sessions | Topics | Objectives and educational contents | Assignment for students |
1 | - An introduction to multicultural education - Familiarity with culture and components of cultural diversity | - The aims of multicultural education in higher education and nursing - Definitions of culture, ethnicity, nationality, and race - Culture iceberg model and components of culture -Understanding of cultural history, cultural diversity, factors affecting cultural diversity such as biological variations, age, religion, nutrition, social and economic context, language, roles related to sexual identity, etc. - Culture, ethnicity and cultural subgroups in Iran and cultural diversity in southeastern Iran - Group history, health status, and epidemiology of minority groups - Bio-physiological determinants of health, and illness of minority groups -The underlying factors and the impact of race/ethnicity, culture, and class on clinical decision-making - Identification of healing traditions and beliefs of clients at the workplace and education | - Book reading about culture of Kerman and southeastern Iran - Investigation of a culture and cultural diversity in clients of a clinical setting and a health center daily -Writing of a work-based experience with assessment of patient’s background when providing care - Writing of brief project to assess culture of an individual, family, and/or community to appreciate the specific and universal aspects of culture - Provision of the autobiography assignment to explain that everything we do emanates from who we are |
2 | -Cultural care and nursing process -Cultural competence in the organization | - Definition of cultural care or culturally Congruent Care, and cultural competence (individual, system, or organizational) -Prerequisites for cultural competence - The importance of creating cultural competence among nursing students -Integration of culturally congruent care into the stages of nursing process: Assessment: LEARN model, BELIEF model, 4 c model and documentation of clients’ health beliefs/model of their illness and health Nursing diagnoses Implementation of interventions Evaluation of outcomes - Cross-cultural communications and a model for effective cross-cultural communications, data gathering and documentation - Standards for culturally congruent care - Organizational cultural competence - Analysis of cultural competency issues in health systems and organizations -Strategies and barriers to organizational competency (clinical, organizational and structural) - Demonstration of respect for a patient’s cultural and health beliefs -The importance of curiosity, empathy, and respect in patient care - National documents/standards - Healthy People 2020 etc. for culturally congruent care - The importance of diversity in health care as well as its challenges and opportunities | - Doing scenario project - Designing a plan of care based on inferences that are culturally meaningful and congruent with the patient’s culture - Assignment addressing integration of cultural care into nursing process with a case study: - Cultural assessment of a client with interview using LEARN model and cultural interview report -Nursing diagnoses, implementation of interventions, and evaluation for the case study - Reading educators’ suggested articles -Writing viewpoints on a video about culturally cross-cultural communication presentation and discussion |
3 | Models of cultural care and process of gaining cultural competence in nursing | - Comparing and applying models of effective cultural care: - Leininger’s Sunrise model (culture care preservation/maintenance, culture care accommodation/negotiation, culture care re-patterning / restructuring, culture brokering ( -Giger and Davidhizar’s evaluation model (communication, space, social organization, time, environmental control, and biological variations) -Purnell’s model of cultural competence (culture or heritage, communication, family and organization roles, labor issues, high-risk behaviors, nutrition, pregnancy, death, spirituality, health care measures, and health care professionals) - Campinha–Bacote’s model (cultural awareness, cultural knowledge, cultural skills, cultural exposure, and cultural desire) - Orlandi’s model (cognitive, affective, and psychomotor domains in cultural competence), cultural sensitivity and incorporation of culturally sensitive approaches to nursing care -Respect for a patient’s culture and health beliefs and use of negotiating and problem-solving skills in decision-making shared with a patient | - Doing scenario project - A case study addressing actions and interventions of cultural care based on Leininger’s Sunrise model - A case study addressing assessment of a client based on Purnell’s model - Reading educators’ suggested articles -Writing viewpoints on a video presentation |
4 | -Cultural competence outcomes -Barriers and challenges of cultural competence | - Positive consequences of cultural competence and cultural care delivery -Equality of health, social justice, health literacy, - Barriers to cultural care and recognition of potential biases affecting clinical encounters, clinical decision-making and quality of care: (stereotyping, prejudice, discrimination, racism, ethnicity, cultural destructiveness, cultural imposition, cultural conflict, cultural shock, cultural blindness, cultural incapacity) - Description of access method, historical, political, environmental, and institutional factors - Barriers to effective patient care, such as diagnostic inaccuracies, unintentional patient exploitation, racial and ethnic inequalities and disparities, group communication difficulties, diagnostic inaccuracies, and unintentional patient exploitation. -Data on health disparities in community, state, or in the nation and provision of information about local community leader(s) and community groups/resources serving this community | -Case study and writing information on how to acknowledge personal biases, patient stereotyping, assumptive bias and the confounding of ethnicity with socioeconomic status, and their effects on the client’s health - Data review: - Review of an article - National Healthcare Disparity Reports -Writing viewpoints on a video presentation |
5 | -Providing cultural care to immigrants -Summary, questions and answers | - Migration and cultural diversity in immigrants -Immigration status and conditions - Complementary medicine and common diseases among immigrants -Process of acculturation in immigrants -Patterns of cultural acculturation: cultural assimilation, separation, integration, marginalisation -Culturally congruent care for immigrants -Strategies for health education programs with cultural competence for immigrant clients - Summary and conclusions - Question and answer | - Assignment addressing culturally competent care on an immigrant client with case study-based learning, cultural reading literature - Writing a scenario for an immigrant client - Reading educators’ suggested articles -Writing viewpoints on a video presentation |