Evaluating Cultural Competence in the Clinical Practicum

Article excerpt

ABSTRACT

Aim. The main purpose is to introduce a tool for evaluating the extent of culturally specific care provided for a diverse clientele, the frequency of cultural assessments, and the development of culturally sensitive and professionally appropriate attitudes, values, and beliefs.

Background, Legal, ethical, and accreditation mandates demand theoretically based, valid, comprehensive tools to assess aspects of culturally specific care; yet no relevant ones existed.

Method. The Cultural Competence Clinical Evaluation Tool (CCCET) was administered at the end of a second semester medical-surgical nursing course (n = 161).

Results. The Content Validity Index (CVI) was 0.91. The reliability coefficients provided evidence for internal consistency.

Conclusion. Student and teacher ratings were relatively close, suggesting that respondents took the task of CCCET completion seriously and honestly, that cultural competence was a visible theme throughout the course, and that students and instructors worked closely together in the clinical practicum setting to achieve learning objectives (including cultural competence).

Key Words Cultural Competence--Clinical Education--Cultural Assessment--Evaluation--Cultural Diversity--Measurement Tools

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RESEARCH AND EDUCATIONAL INTERVENTIONS AIMED AT ENHANCING CULTURAL COMPETENCE EDUCATION, REDUCING HEALTH DISPARITIES, AND FACILITATING THE APPLICATION OF CULTURALLY CONGRUENT CARE FOR DIVERSE POPULATIONS ARE URGENTLY NEEDED (American Association of Colleges of Nursing, 2008, 2009, Kardong-Edgren et al., 2010; National League for Nursing, 2005, 2007, 2009; 2012; Transcultural Nursing Society, 2011; US Department of Health and Human Services, 2009). Ongoing evaluation of educational innovations is a normal expectation of accrediting agencies. Results from evaluation studies permit diagnostic-prescriptive teaching interventions based on empirical evidence (Oermann & Gaberson, 2009) while expanding theory development and enriching understanding of the multidimensional, complex process of cultural competence education. Although the literature reports different measurement tools concerning cultural competence (Capell, Veenstra & Dean, 2007; Douglas & Paequiao, 2010; Cozu et al., 2007; Harper, 2008; Jeffreys, 2010a), a comprehensive, valid approach for measuring culturally specific care provision, cultural assessments, and the development of affective learning within the clinical practicum experience has been glaringly absent.

The main purpose of this article is to present a new tool for evaluating the extent of culturally specific care provided for a diverse clientele, the frequency of cultural assessments, and the development of culturally sensitive and professionally appropriate attitudes, values, and beliefs among undergraduate nursing students exposed to an integrated approach to cultural competence education. Specifically, the following research questions were explored:

* To what extent is culturally specific care provided by students during the clinical practicum?

* Which cultural assessments are implemented more frequently and which are implemented less frequently during the practicum?

* To what extent do culturally sensitive and professionally appropriate attitudes, values, or beliefs change during the clinical practicum?

The results of this study will provide evidence of reliability and validity for the new Cultural Competence Clinical Evaluation Tool (CCCET). A new tool for gathering descriptive data about the clinical practicum/agency site concerning the presence of diversity and health disparity problem areas is also introduced. The article concludes with implications for nurse educators in academia and practice settings.

Background Jeffreys' Cultural Competence and Confidence (CCC) model is a theoretical framework for teaching cultural competence (Douglas & Pacquiao, 2010). …