Development and Evaluation of Cultural Competence Course on Undergraduate Nursing Students in Vietnam
Abstract
:1. Introduction
2. Materials and Methods
2.1. Development of the Cultural Competence Course
2.2. Study Design and Participants of Cultural Competence Course
2.3. Instruments for Course Evaluation
2.3.1. Quantitative Measures
2.3.2. Qualitative Measures
2.4. Ethical Considerations
2.5. Data Collection
2.6. Data Analysis
3. Results
3.1. Quantitative Findings of Effects of Cultural Competence Course
3.1.1. Baseline Characteristics of Students
3.1.2. Effectiveness of Cultural Competence Course among Nursing Students
3.1.3. Level of Student Satisfaction
3.2. Qualitative Results of Effects of Cultural Competence Course
3.2.1. Nursing Student’s Perspective on Cultural Competence Course
3.2.2. Nursing Students’ Reflection of Field Experience
4. Discussion
4.1. Development of a Cultural Competence Course
4.2. Evaluation of a Cultural Competence Course
5. Conclusions and Suggestions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- American Association of Colleges of Nursing. Cultural Competency in Nursing Education. Available online: https://www.aacnnursing.org/Education-Resources/Tool-Kits/Cultural-Competency-in-Nursing-Education (accessed on 31 March 2020).
- National League for Nursing. Achieving Diversity and Meaningful Inclusion in Nursing Education: A Living Document from the National League for Nursing. 2016. Available online: http://www.nln.org/docs/default-source/about/vision-statement-achieving-diversity.pdf?sfvrsn=2 (accessed on 23 May 2020).
- Liu, J.; Gill, E.; Li, S. Revisiting cultural competence. Clin. Teach. 2020, 18, 191–197. [Google Scholar] [CrossRef] [PubMed]
- Chang, L.-C.; Chiu, C.-W.; Hsu, C.-M.; Liao, L.-L.; Lin, H.-L. Examining the implementation of teaching and learning interactions of transition cultural competence through a qualitative study of Taiwan mentors untaking the postgraduate nursing program. Nurse Educ. Today 2019, 79, 74–79. [Google Scholar] [CrossRef] [PubMed]
- Choi, J.-S.; Kim, J.-S. Effects of cultural education and cultural experiences on the cultural competence among undergraduate nursing students. Nurse Educ. Pract. 2018, 29, 159–162. [Google Scholar] [CrossRef] [PubMed]
- Susan, Y.; Guo, K.L. Cultural Diversity Training. Health Care Manag. 2016, 35, 94–102. [Google Scholar] [CrossRef]
- Farber, J.E. Cultural Competence of Baccalaureate Nurse Faculty: Relationship to Cultural Experiences. J. Prof. Nurs. 2018, 35, 81–88. [Google Scholar] [CrossRef]
- Liu, W.; Stone, T.E.; McMaster, R. Increasing undergraduate nursing students’ cultural competence: An evaluation study. Glob. Health Res. Policy 2018, 3, 1–10. [Google Scholar] [CrossRef] [Green Version]
- Stiles, A.S.; Schuessler, Z.; James, L. Comparison of Two Methods of Teaching Culture to Bachelor of Science in Nursing Students. J. Nurs. Educ. 2018, 57, 609–613. [Google Scholar] [CrossRef]
- General Statistics Office of Vietnam. Population and Houses Census. Available online: https://www.gso.gov.vn/en/population-and-houses-census/ (accessed on 24 February 2019).
- Grundy, J.; Wang, X.; Hirabayashi, K.C.; Duncan, R.; Bersonda, D.; Eltayeb, A.O.; Mindra, G.; Nandy, R. Health and immunisation services for the urban poor in selected countries of Asia. Infect. Dis. Poverty 2019, 8, 26. [Google Scholar] [CrossRef]
- Trinh, H.N.; Korinek, K. Ethnicity, education attainment, media exposure, and prenatal care in Vietnam. Ethn. Health 2016, 22, 83–104. [Google Scholar] [CrossRef]
- Ha, D.T.; Nuntaboot, K. New competencies required for nurses as compared to the national nursing competency standards in Vietnam. Kontakt 2020, 22, 92–95. [Google Scholar] [CrossRef]
- Kang, S.; Ho, T.T.T.; Nguyen, T.A.P. Effects of a global health nursing program on Vietnamese and South Korean students. J. Nurs. Educ. Pract. 2016, 6, 135–142. [Google Scholar] [CrossRef] [Green Version]
- Horvat, L.; Horey, D.; Romios, P.; Kis-Rigo, J. Cultural competence education for health professionals. Cochrane Database Syst. Rev. 2014, 5, CD009405. [Google Scholar] [CrossRef]
- Worden, M.K.; Tiouririne, N.A.-D. Cultural competence and curricular design: Learning the hard way. Perspect. Med. Educ. 2018, 7, 8–11. [Google Scholar] [CrossRef] [Green Version]
- Lee, Y.-W.; Lin, H.-L.; Tseng, H.-L.; Tsai, Y.-M.; Lee-Hsieh, J. Using Training Needs Assessment to Develop a Nurse Preceptor–Centered Training Program. J. Contin. Educ. Nurs. 2017, 48, 220–229. [Google Scholar] [CrossRef]
- Patel, S.R.; Margolies, P.J.; Covell, N.H.; Lipscomb, C.; Dixon, L.B. Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State. Front. Public Health 2018, 6, 113. [Google Scholar] [CrossRef] [Green Version]
- Tobase, L.; Peres, H.H.C.; De Almeida, D.M.; Tomazini, E.A.S.; Ramos, M.B.; Polastri, T.F. Instructional design in the development of an online course on Basic Life Support. Rev. Esc. Enferm. USP 2017, 51, e03288. [Google Scholar] [CrossRef] [Green Version]
- Molenda, M. In Search of the Elusive ADDIE Model. Perform. Improv. 2015, 54, 40–42. [Google Scholar] [CrossRef]
- Campinha-Bacote, J. The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care. J. Transcult. Nurs. 2002, 13, 181–184. [Google Scholar] [CrossRef]
- Gagne, R.; Briggs, L.; Wager, W. Principles of Instrructional Design, 4th ed.; College Publishers: Fort Worth, TX, USA, 1992. [Google Scholar]
- Purnell, L. Update: The Purnell Theory and Model for Culturally Competent Health Care. J. Transcult. Nurs. 2018, 30, 98–105. [Google Scholar] [CrossRef]
- Kirkpatrick, D.L.; Kirkpatrick, J.D. Implementing the Four Levels; BerrettKoehler Publishers: San Francisco, CA, USA, 2007. [Google Scholar]
- Perng, S.-J.; Watson, R. Construct validation of the Nurse Cultural Competence Scale: A hierarchy of abilities. J. Clin. Nurs. 2012, 21, 1678–1684. [Google Scholar] [CrossRef]
- Fieger, P. Measuring Student Satisfaction from the Student Outcomes Survey. National Centre for Vocational Education Research. 2012. Available online: https://eric.ed.gov/?id=ED532394 (accessed on 12 March 2018).
- World Health Organization. Process of Translation and Adaptation of Instruments. Available online: http://www.who.int/substance_abuse/research_tools/translation/en/ (accessed on 16 December 2021).
- Elo, S.; Kyngäs, H. The qualitative content analysis process. J. Adv. Nurs. 2008, 62, 107–115. [Google Scholar] [CrossRef]
- Elo, S.; Kääriäinen, M.; Kanste, O.I.; Pölkki, T.; Utriainen, K.; Kyngäs, H. Qualitative Content Analysis. SAGE Open 2014, 4, 1–10. [Google Scholar] [CrossRef]
- Noble, A.; Nuszen, E.; Rom, M.; Noble, L.M. The Effect of a Cultural Competence Educational Intervention for First-Year Nursing Students in Israel. J. Transcult. Nurs. 2013, 25, 87–94. [Google Scholar] [CrossRef]
- Park, H.S.; Jang, H.J.; Jeong, G.H. Effects of a cultural nursing course to enhance the cultural competence of nursing students in Korea. J. Educ. Eval. Health Prof. 2019, 16, 39. [Google Scholar] [CrossRef]
- Kaihlanen, A.-M.; Hietapakka, L.; Heponiemi, T. Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training. BMC Nurs. 2019, 18, 1–9. [Google Scholar] [CrossRef] [Green Version]
- Byrne, D. Evaluating Cultural Competence in Undergraduate Nursing Students using Standardized Patients. Teach. Learn. Nurs. 2019, 15, 57–60. [Google Scholar] [CrossRef]
- McKesey, J.; Berger, T.G.; Lim, H.W.; McMichael, A.J.; Torres, A.; Pandya, A.G. Cultural competence for the 21st century dermatologist practicing in the United States. J. Am. Acad. Dermatol. 2017, 77, 1159–1169. [Google Scholar] [CrossRef]
- Chen, H.-C.; Jensen, F.; Measom, G.; Bennett, S.; Nichols, N.D.; Wiggins, L.; Anderton, A. Factors Influencing the Development of Cultural Competence in Undergraduate Nursing Students. J. Nurs. Educ. 2018, 57, 40–43. [Google Scholar] [CrossRef]
- Lin, C.-J.; Chang, P.-R.; Wang, L.-H.; Huang, M.-C. Cultural competence course for nursing students in Taiwan: A longitudinal study. Nurse Educ. Today 2015, 35, 1268–1274. [Google Scholar] [CrossRef]
- Chen, H.-C.; Jensen, F.; Measom, G.; Nichols, N.D. Evaluating Student Cultural Competence in an Associate in Science in Nursing Program. Teach. Learn. Nurs. 2018, 13, 161–167. [Google Scholar] [CrossRef]
- Chang, L.; Chen, S.-C.; Hung, S.-L. Embracing diversity and transcultural society through community health practicum among college nursing students. Nurse Educ. Pract. 2018, 31, 156–160. [Google Scholar] [CrossRef] [PubMed]
- Chen, H.-C.; McAdams-Jones, D.; Tay, D.L.; Packer, J.M. The impact of service–learning on students’ cultural competence. Teach. Learn. Nurs. 2012, 7, 67–73. [Google Scholar] [CrossRef]
- DeBonis, R. Effects of Service-Learning on Graduate Nursing Students: Care and Advocacy for the Impoverished. J. Nurs. Educ. 2016, 55, 36–40. [Google Scholar] [CrossRef] [PubMed]
- Bernard, M.; Rickett, M. The Cultural Value of Older People’s Experiences of Theater-making: A Review. Gerontologist 2016, 57, e1–e26. [Google Scholar] [CrossRef] [Green Version]
Course Contents | Time (h) | Instructional Strategies | Assessment Methods |
---|---|---|---|
Culture Describe a definition of culture and its impact on related health and illness. | 2 | Lecture, Watching Movie and documentary, Discussion | Quiz, Reflective writing |
Cultural Diversity Discuss cultural diversity, its impact on health care. | 2 | ||
Cultural Nursing Competence Focus on an understanding of cultural competence and effective strategies for promoting culturally competent nursing care. | 4 | ||
Culturally Competent Nursing Care in Vietnamese context Explain an understanding of culturally competent nursing care in Vietnamese setting. | 2 | ||
Service learning program and case study conference (Experimental group I) Explain an understanding of culturally competent nursing care Perform cultural assessment by using Purnell model Group reflection and individual reflection about the impact of field experience | 4 | Service learning, Guest presentation, Home visit Group presentation | Reflective writing, Group report |
Relevant data sources and best evidence in providing culturally competent nursing care (Experimental group II) | 4 | Group presentation | Reflective writing, Group report |
Variables (N = 60) | Exp. I (n = 20) | Exp. II (n = 20) | Con. (n = 20) | χ2/F | Cramer’s V | p |
---|---|---|---|---|---|---|
Means ± SD/n (%) | ||||||
Age (years) | 20.30 ± 0.57 | 20.05 ± 0.22 | 20.40 ± 0.50 | 2.41 | 0.10 | |
Religion | 3.11 | 0.16 | 0.54 | |||
Buddhism | 1 (5.0) | 0 (0.0) | 1 (5.0) | |||
Christian | 0 (0.0) | 2 (10.0) | 2 (10.0) | |||
No religion | 19 (95.0) | 18 (90.0) | 17 (85.0) | |||
Take care of race or ethnic patients | 1.56 | 0.16 | 0.46 | |||
Yes | 4 (20.0) | 5 (25.0) | 2 (10.0) | |||
No | 16 (80.0) | 15 (75.0) | 18 (90.0) | |||
Live in environment with people with diverse ethnicity | 0.17 | 0.05 | 0.92 | |||
Yes | 5 (25.0) | 5 (25.0) | 6 (30.0) | |||
No | 15 (75.0) | 15 (75.0) | 14 (70.0) | |||
Encountered special patients | 1.05 | 0.13 | 0.59 | |||
Yes | 13 (65.0) | 12 (60.0) | 15 (75.0) | |||
No | 7 (35.0) | 8 (40.0) | 5 (25.0) | |||
Total NCCS scores | 113.65 ± 16.22 | 113.40 ± 12.11 | 120.55 ± 10.82 | 1.88 | 0.16 | |
Cultural Awareness | 37.95 ± 5.32 | 38.15 ± 4.06 | 39.20 ± 3.83 | 0.46 | 0.64 | |
Cultural Knowledge | 20.00 ± 4.97 | 19.55 ± 4.89 | 22.40 ± 3.98 | 2.18 | 0.12 | |
Cultural Sensitivity | 22.75 ± 3.68 | 23.65 ± 3.69 | 24.25 ± 3.37 | 0.89 | 0.42 | |
Cultural Skills | 32.95 ± 7.43 | 32.05 ± 6.11 | 34.70 ± 4.46 | 0.97 | 0.39 |
Variables (n = 60) | Group | T1 | T2 | Difference (T1–T2) | t | p |
---|---|---|---|---|---|---|
Mean ± SD | ||||||
Cultural Awareness | Cont. | 39.20 ± 3.83 | 37.55 ± 5.19 | 1.65 ± 5.15 | 1.43 | 0.17 |
Exp. I | 37.95 ± 5.32 | 38.00 ± 6.22 | −0.05 ± 6.19 | −0.04 | 0.97 | |
Exp. II | 38.15 ± 4.06 | 35.05 ± 7.16 | 3.10 ± 7.28 | 1.90 | 0.07 | |
Cultural Knowledge | Con. | 22.40 ± 3.98 | 25.15 ± 8.63 | −2.75 ± 9.01 | −1.36 | 0.19 |
Exp. I | 20.00 ± 4.97 | 20.40± 5.73 | −0.40 ± 5.34 | −0.34 | 0.74 | |
Exp. II | 19.55 ± 4.98 | 19.90 ± 4.32 | −0.35 ± 5.31 | −0.29 | 0.77 | |
Cultural Sensitivity | Con. | 24.25 ± 3.37 | 25.35 ± 4.51 | −1.10 ± 4.46 | −1.10 | 0.28 |
Exp. I | 22.75 ± 3.68 | 24.75 ± 4.69 | −2.00 ± 5.05 | −1.77 | 0.09 | |
Exp. II | 23.65 ± 3.69 | 23.95 ± 5.10 | −0.30 ± 5.89 | −0.23 | 0.82 | |
Cultural Skill | Con. | 34.70 ± 4.46 | 36.80 ± 6.59 | −2.10 ± 6.50 | −1.45 | 0.17 |
Exp. I | 32.95 ± 7.43 | 33.10 ± 7.35 | −0.15 ± 8.28 | −0.08 | 0.94 | |
Exp. II | 32.05 ± 6.11 | 30.95 ± 7.37 | 1.10 ± 6.25 | 0.79 | 0.44 | |
Total NCCS scores | Con. | 120.55 ± 10.82 | 124.85 ± 15.69 | −4.30 ± 15.77 | −1.22 | 0.24 |
Exp. I | 113.65 ± 16.22 | 116.25 ± 17.69 | −2.60 ± 17.09 | −0.68 | 0.52 | |
Exp. II | 113.40 ± 12.11 | 109.85 ± 16.13 | 3.55 ± 17.43 | 0.91 | 0.37 |
Variables (n = 60) | Group | T1 | T2 | T3 | T4 | Source | F | p |
---|---|---|---|---|---|---|---|---|
Mean ± SD | ||||||||
Cultural Awareness | Cont. | 39.20 ± 3.83 | 37.55 ± 5.19 | 37.60 ± 5.22 | 40.00 ± 5.25 | Group | 0.55 | 0.582 |
Exp. I | 37.95 ± 5.32 | 38.00 ± 6.22 | 41.70 ± 4.87 | 41.05 ± 3.93 | Time | 10.29 | <0.001 | |
Exp. II | 38.15 ± 4.06 | 35.05 ± 7.16 | 41.65 ± 3.76 | 41.20 ± 4.01 | Time × Group | 2.75 | 0.017 | |
Cultural Knowledge | Con. | 22.40 ± 3.98 | 25.15 ± 8.63 | 23.50 ± 5.06 | 23.25 ± 4.18 | Group | 3.72 | 0.030 |
Exp. I | 20.00 ± 4.97 | 20.40± 5.73 | 32.50 ± 4.74 | 32.00 ± 4.00 | Time | 55.54 | <0.001 | |
Exp. II | 19.55 ± 4.98 | 19.90 ± 4.32 | 31.15 ± 4.85 | 31.40 ± 4.64 | Time × Group | 15.51 | <0.001 | |
Cultural Sensitivity | Con. | 24.25 ± 3.37 | 25.35 ± 4.51 | 25.50 ± 3.99 | 26.30 ± 3.01 | Group | 2.89 | 0.064 |
Exp. I | 22.75 ± 3.68 | 24.75 ± 4.69 | 30.65 ± 3.15 | 30.15 ± 4.65 | Time | 25.75 | <0.001 | |
Exp. II | 23.65 ± 3.69 | 23.95 ± 5.10 | 29.25 ± 4.52 | 29.05 ± 4.21 | Time × Group | 3.93 | 0.002 | |
Cultural Skill | Con. | 34.70 ± 4.46 | 36.80 ± 6.59 | 35.60 ± 6.00 | 35.50 ± 5.88 | Group | 7.87 | 0.001 |
Exp. I | 32.95 ± 7.43 | 33.10 ± 7.35 | 49.75 ± 7.10 | 47.10 ± 6.22 | Time | 64.23 | <0.001 | |
Exp. II | 32.05 ± 6.11 | 30.95 ± 7.37 | 48.25 ± 6.36 | 48.20 ± 8.91 | Time × Group | 17.13 | <0.001 | |
Total NCCS scores | Con. | 120.55 ± 10.82 | 124.85 ± 15.69 | 122.20 ± 12.54 | 125.05 ± 10.17 | Group | 7.59 | 0.001 |
Exp. I | 113.65 ± 16.22 | 116.25 ± 17.69 | 154.60 ± 15.54 | 150.30 ± 15.74 | Time | 66.73 | <0.001 | |
Exp. II | 113.40 ± 12.11 | 109.85 ± 16.13 | 150.30 ± 16.38 | 149.85 ± 18.68 | Time × Group | 15.99 | <0.001 |
Variables (n = 40) | Total (n = 40) | Exp. I (n = 20) | Exp. II (n = 20) | t | p |
---|---|---|---|---|---|
Mean ± SD | |||||
Teaching | 4.55 ± 0.37 | 4.62 ± 0.30 | 4.48 ± 0.42 | 0.86 | 0.36 |
Assessment | 3.95 ± 0.54 | 3.98 ± 0.46 | 3.92 ± 0.62 | 2.04 | 0.16 |
Generic skills, learning experiences | 4.19 ± 0.52 | 4.38 ± 0.43 | 4.00 ± 0.48 | 0.25 | 0.62 |
Overall satisfaction | 4.40 ± 0.44 | 4.48 ± 0.45 | 4.33 ± 0.44 | 1.89 | 0.18 |
Category | Subcategory |
---|---|
Nursing student’s perspective on cultural competence course | Journey to cultural competence |
Satisfaction with cultural competence course | |
Suggestion for improvements | |
Nursing student’s reflection of field experience | Obtaining cultural experiences |
Expanding understanding of cultural competence through field experience |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ho, T.-T.-T.; Oh, J. Development and Evaluation of Cultural Competence Course on Undergraduate Nursing Students in Vietnam. Int. J. Environ. Res. Public Health 2022, 19, 888. https://doi.org/10.3390/ijerph19020888
Ho T-T-T, Oh J. Development and Evaluation of Cultural Competence Course on Undergraduate Nursing Students in Vietnam. International Journal of Environmental Research and Public Health. 2022; 19(2):888. https://doi.org/10.3390/ijerph19020888
Chicago/Turabian StyleHo, Trang-Thi-Thuy, and Jina Oh. 2022. "Development and Evaluation of Cultural Competence Course on Undergraduate Nursing Students in Vietnam" International Journal of Environmental Research and Public Health 19, no. 2: 888. https://doi.org/10.3390/ijerph19020888
APA StyleHo, T. -T. -T., & Oh, J. (2022). Development and Evaluation of Cultural Competence Course on Undergraduate Nursing Students in Vietnam. International Journal of Environmental Research and Public Health, 19(2), 888. https://doi.org/10.3390/ijerph19020888