1. Effectiveness of Student Cultural Diversity Learning to Provide Transcultural Nursing Care Pamela Friesen, PhD, RN and Bernita Missal, PhD, RN

2. Learning Outcomes Describe use of theoretical frameworks for nursing student cultural diversity learning during a national and international experience. Discuss implications for effects of student cultural diversity learning on their personal and professional development. Evaluate student development of cultural awareness following a cultural diversity course.

3. Minnesota

4. Land of 10,000 Lakes

5. Bethel University Private University Enrollment: 6,000

6. Nursing Department Graduate Pre-licensure Degree Completion: RN to BSN

7. Cultural Diversity in Health Care Required Course Purpose –Changing World Course Components

8. Learning Opportunities Local and international settings Cultural assessment with ethnically diverse patients Application to practice

9. Stages of Student Experience Preparation Cultural experiences Processing Evaluation

10. International Learning Senior nursing students 3-4 week duration Travel international Faculty members

11. Uganda E United Arab Emirates

12. Local Learning

13. Preparation Lecture/discussion Theoretical Framework Leininger’s Theory of Culture Care Diversity and Universality Purnell’s Model for Cultural Competence

14. Preparation (Continued) Readings Case studies Personal Cultural Heritage

15. Experiential Preparation

16. Cultural Experiences Ethnic speakers Interviews Cultural Interactions

17. Ethnic speakers

18. Interviews with Cultural Guide

19. Cultural Interactions

23. Hospitality

24. Processing of Learning Result or conclusion: –Accepting or finding meaning –Resolving explanation to the dilemma –Partial conclusions –Admitting not enough experience or knowledge so learning is complete –Resisting explanation or conclusion

25. Processing the Learning Individual processing: –Guided Journaling –Reflective Learning

26. Group Processing: Meeting together to share experiences/ thoughts

27. Role of Faculty Member Mentor Multifaceted role –Preparing for experience –Maximizing cultural experiences –Cultural safety –Debriefing Past experiences and characteristics

29. Evaluation Quantitative Research –Cross-Cultural Adaptability Inventory (CCAI) Emotional Resilience (ER) Flexibility/Openness (FO) Perceptual Acuity (PAC) Personal Autonomy (PA) – Pre and post course experience –Findings

30. Evaluation Qualitative Research –Sample 30 students in Cultural Diversity in Health Care course –Immediately following the course and at 4 months –Content analysis –Themes

31. Self-Understanding “This course provided me with a better understanding for other cultures and helped me to become more aware of my own cultural bias. Even though I thought I was culturally sensitive, I realized I was ethnocentric.”

32. Cultural Sensitivity “I have become much more aware of the different belief systems of various cultures. I have alot more patience…Hearing about the Native American culture in class helped me understand when we had a young boy in for surgery. He had several friends come ask what room he was in. It took several attempts to have them understand that he hadn’t even come back yet. The way Dr. Souchay explained the time concept made more sense to me then.”

33. Shared commonalities “I appreciate the commonalities and celebrate the differences.” “I was surprised at the similarities and enlightened by the differences. I have actually found [the similarities] to be comforting. Different cultures often have more in common than apart.”

34. Culture Care “As nurses, we need to trust that the client is the expert of their life, culture, and experiences and if we respectfully ask to learn from them, they will tell us how to care for them.”

35. Relationship Building “I tell them I interviewed [my cultural guide] and that she is from Nigeria. Then I ask [my African coworkers] where they are from. It has been an amazing experience for me! Previously my communication with them was limited. Since my interview, I have approached six people of different cultures in my unit. I now look at them through entirely different eyes. I appreciate their hard work and acknowledge they are valuable team-members.”

36. Summary Addressing needs of the changing world in the 21 st century Contribution to nursing education Contribution to nursing practice Contribution to nursing research

37. Contact Information http://cas.bethel.edu/dept/nursing/