Enhancing transcultural awareness in nursing education - the impact of Rainbow Intensive Program
Authors
Ana Isabel Fernandes Querido*, Anouk Verburg**, Annika Elisabet Kjallman Alm***
Presenters
Ana Isabel Fernandes Querido*, Anouk Verburg**, Annika Elisabet Kjallman Alm***
Introduction: Today’s globalization society makes transcultural nursing education, a priority. Leininger’s Transcultural nursing is the humanistic-scientific study of people from different cultures, so nurses can assist them in health and living needs. Rainbow Network - Sweden, Finland, Norway, Portugal, Netherlands, Belgium, Latvia, Lithuania partners, have operated Intensive programmes to explore contemporary nursing issues from transcultural perspective. Cultural/linguistic competence can reduce health care disparities, improving quality of care delivered to patients and nursing performance. We address nursing students´ transcultural awereness.
Objectives: Analyze the impact of the IP “Preventing and Care for people in Chronic Conditions” on students Transcultural awareness; Explore IP pedagogical structure /methods; Characterize cultural attitudes and behaviors of students participating the IP; Identify areas of cultural consciousness (Personal Reflection) and cultural competence (Service Delivery) changed; Correlate students transcultural skills - values, attitudes, behaviors in caring for culturally diverse clients and families, before and after IP.
Methodology: Quasi-experimental study without group control correlates students’ cultural competence before/after Rainbow IP. IP consisted of pedagogical strategies combined with socio-cultural activities in an international environment. A convenience sample of 78 students from Rainbow partners participating in 2010 and 2011 IPs, consented to fill in a socio demographic questionnaire and cultural competence checklist (Goode, 2002) - self-assessment of cultural awareness: Personal Reflection (values/attitudes) - Lower scores mean better attitude; Service Delivery (behaviors) - Lower scores mean better skills caring for cultural different populations, applied before and after IPs.
Results: Students were mostly women (91,0%), mean age 22,4 (+/-3,6) [19-42] years, from urban context (62,8%). During Rainbow, 44,2% attended 2nd year of nursing studies; 36,8% the 4th semester. 97,4% had clinical practice before attending the IP, Mean= 23,21 (+/-)15,56 [2; 61 weeks]. 67,9% learnt transcultural issues during nursing studies. Overall, students revealed good cultural values, attitudes and behaviors. After IP students improved respect for culture/language differences accepting clients decisions (p<0,01); showed better cultural sensibility being motivated to respond to insensitive comments/behaviors; recognized Family as decision maker (p<0,01); and revealed better understanding of communication disability and communication differences (p<0,05). They became more aware of culture background Impact in future expectations (p<0,01) and in daily living activities (p<0,05). Cultural skills improved by taking time to learn about behaviors/customs of clients culture (p<0,01), adopting strategies to overcome language barriers, providing clients written information to take home in their language (p<0,05); assessing clients linguistic ability using specific instruments (p<0,01).
Conclusions: Study provided evidence supporting the positive effect of Rainbow IP in enhancing students’ transcultural awareness. By attending the IP, students became more aware of culture differences and the importance of language skills in a transcultural context. Gains were evident in both attitudes/values and behaviors. Pedagogical strategies and English interaction in multicultural groups may explain improvements achieved in transcultural awareness. Results might be due to the group work themes “client centered care”, “family oriented care”, “empowerment”, but also listening to families’ stories, visiting health care facilities, and discussing nursing ethics. This effect should be monitored over time complemented by qualitative research.
Keywords: Cultural Competence, intensive programs, international cooperation, nursing education, pedagogy, students, transcultural nursing.
* Escola Superior de Saúde do Instituto Politécnico de Leiria, Enfermagem
** Amsterdam School of Health Professions, Nursing
*** Department of Health Sciences, Mid Sweden University