Academic journal article Journal of Cultural Diversity

Immersion in Another Culture: One Strategy for Increasing Cultural Competency

Academic journal article Journal of Cultural Diversity

Immersion in Another Culture: One Strategy for Increasing Cultural Competency

Article excerpt

Abstract: Educating nursing students in the United States to be culturally competent is a challenge. Undergraduate and graduate nursing students, including nurse-midwifery students were paired with faculty on a short-term transcultural nursing experience in Choluteca, Honduras. Students provided health screenings, prenatal assessments, and birth attendance. Learning objectives were designed to improve cultural competency in the healthcare setting for nursing students. A case study exemplar in the labor and delivery setting is presented. As a result of the cultural immersion experience, the student demonstrates versatility and flexibility in clinical practice, reflecting the skills necessary to adapt interventions to populations and circumstances.

Key Words: Women's Health, Cultural Competence, Nursing Education, Honduras

Academia has been challenged over the last several decades to educate students to function effectively in an increasingly diverse nation. Educators in the health professions have been encouraged to improve the cultural competence of their students. Lynn Callister (2005) suggests that cultural competence includes both culture-specific and culturegeneric knowledge, attitudes, and skills that are applied in patient care settings. According to the United States Office of Minority Affairs, cultural competence is the ability to care for patients with diverse values, beliefs and behaviors, including tailoring health care to meet the patient's social, cultural, and linguistic needs. Preparing students to be culturally competent upon graduation, however, is neither easy nor straightforward. It requires numerous strategies to assist students in understanding their own attitudes and beliefs, and imparting information to close gaps in knowledge. One strategy used by faculty members in one school of nursing is to engage faculty and students in a brief but intensive immersion experience in another culture. An example of the implementation of this strategy of a short one-week experience in Choluteca, Honduras delivering care in a rural setting is described. The range of services provided during this community outreach included health screenings, prenatal assessments, and birth attendance. The objectives of this experience included the following:

1. increase the student's capacity to value diversity;

2. acquire cultural knowledge;

3. provide appropriate care in a new cultural context;

4. increase skills in providing care through an interpreter (or improving own skills in another language); and

5. acquire skills in working collaboratively with providers in another country.

BACKGROUND

Honduras is a developing country where health services and resources are limited. Table 1 shows key economic and health measures comparing Honduras to the United States (U.S.), e.g., infant and child mortality is more than six times greater in Honduras then in the US, life expectancy at birth in Honduras is far below U.S. statistics, and less than half of the births are attended by a professional in Honduras, as compared with 92% in the U.S. The number of physicians per 10,000 is approximately one-third that of the U.S. The per capita income in Honduras is one-tenth compared to that in the U.S. It is within this context that a faculty-student short-term transcultural experience occurred. Not only are there differences in language and culture, there are stark differences in the health care delivery system, the resources available to health professionals, and access to care due to financial and physical constraints, e.g., distance from clinic or hospital.

The daily schedule of the group is presented as well as one specific case to illustrate the multiple dimensions of this experience from the student's perspective. In presenting this case and its discussion, the value of this experience is highlighted.

DAILY EXPERIENCE

The student group was comprised of 15 nursing students, both graduate and undergraduate, and 10 dental students. …

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