Academic journal article Nursing Education Perspectives

Cultural Competence in Rural Nursing Education: Are We There Yet?

Academic journal article Nursing Education Perspectives

Cultural Competence in Rural Nursing Education: Are We There Yet?

Article excerpt

Cultural competence in the nursing workforce is critical to reducing health disparities. The purpose of this multimethod study was to assess the capacity of nurse educators and nursing education programs throughout the state of Wyoming to promote culturally congruent practice. Current nurse educators, clinical partners, and master's of science in nursing students were surveyed regarding their perceived cultural competence, and cultural and diversity content was assessed in nursing education programs across the state.

Understanding levels of cultural competence and gaps in competence was a first step toward improving cultural competence among nurse educators and clinical educators in this largely rural area. The findings provide insight into the current capacity to teach cultural competencies within the full range of nursing programs, that is, associate degree (ADN), bachelor's degree (BSN), RN to BSN, and master's level programs.

Wyoming is the ninth largest state in terms of land mass and the least populated state in the United States. Approximately 200,000 residents in 17 of the 23 counties in the state are medically underserved (Wyoming Office of Rural Health, 2009). Given that Wyoming has one public university and seven community colleges, most nurses educated in the state are initially prepared at the ADN level.

The Leadership Education to Advance Practice (LEAP) RN/BSN/MSN Preparing Nurse Educators project was funded by the Health Resources and Services Administration through an Advanced Education in Nursing grant. The overall goal of the project was to facilitate nurses' progression to the MSN education program and to promote the ability to teach diversity and increase cultural competency across the curriculum. The project included an emphasis on cultural competence and rurality as components of diversity for MSN nurse educator students.

BACKGROUND: CULTU RAL COMPETENCE

The Sullivan Commission (2004) recommended promoting diversity and cultural competence for health professionals, students, faculty, and health care providers. The American Association of Colleges of Nursing (AACN) also recognized "a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care" (2013).

The National League for Nursing (NLN, 2009) urged expansion of the definition of diversity beyond the context of ethnicity. It has further called for expansion of public investment in initiatives that "enrich and sustain culturally competent nursing education that leads to equitable, evidence-based health care delivery" (2013, p. 2). However, health disparities persist in the United States. Underserved segments of the population, including racial and ethnic minorities, persons in rural and geographically isolated areas, and those in lower socioeducational and socioeconomic groups continue to experience poor health outcomes.

Recent evidence indicates a significant positive correlation between levels of cultural competence among nursing faculty and the number of minority nursing graduates from the study school (Ume-Nwagbo, 2012). Further, culturally competent faculties are more likely to integrate cultural concepts throughout the nursing curriculum. Promoting diversity in nursing education programs, as well as fostering the development of cultural competence among all levels of nursing students, is important when preparing nurses to deliver high quality, patient-centered care. However, despite demonstrated links between cultural competence of health care professionals and the ability to provide higher quality patient care, as well as the availability of education strategies and models proposed to improve the integration of cultural competencies in nursing education (Engebretson, Mahoney, & Carlson, 2008), research on competence reveals that pedagogic approaches inadequately prepare nurses to work with people from diverse cultures (Larson, Ott, & Miles, 2010). …

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