Evaluation of the cross-cultural health assessment as an interdisciplinary method of cultural competency education

Abstract

Background: Although there are numerous educational models to guide cultural competency training in health care programs, many of these remain conceptually flawed and there are few studies that examine the outcomes of training.

Purpose: The purpose of this study was to assess the effects of a multi-faceted cultural competency education module on attitudes, self-awareness, knowledge and skills of Nursing, Occupational Therapy and Athletic Training students.

Methods: The research design used a mixed methods approach, incorporating a quantitative pre- and post-class survey instrument, the Cultural Competency Assessment (CCA) instrument. A qualitative descriptive methodology using content analysis was used to analyze students’ experiences of the Cultural Assessment Interview. The M-C Form C version of the Marlowe-Crowne Social Desirability scale was used to assess if the need for social desirability influenced students' responses to the CCA. Differences in pre- and post-test scores on the CCA were analyzed by paired T tests for related samples and Repeated Measures Analysis of Variance (RANOVA). For purposes of subgroup analyses, the entire sample was divided into two groups based on course enrollment, undergraduate Nursing and Occupational Therapy. Pearson's product moment correlation was used to determine if there were a correlation between the Marlowe-Crowne Social Desirability score and score on the CCA.

Results: One hundred and nine students engaged in a 6-hour cultural competency module within their regular classes. Fifty-three students completed pre- and post-test data on the Cultural Competency Assessment Instrument, while 109 completed the Cultural Assessment Interview.  There was a significant change between pre-test (M = 10.34; s.d., 1.77) and post-test (M = 10.87; s.d., 1.77) scores on the CCA (p = .009) with no differences in changes by subgroup analysis. Students with low perceived competency (M = 9.7; s.d., 1.63) scored significantly lower than students with high perceived competency (M = 11.7; s.d., 1.68) (p = .03) at baseline. Qualitatively, students articulated new knowledge about the culture of their interviewee, identified their need for increased cultural competence and were surprised by their increase in self-knowledge.

Conclusion: Due to globalization and international migration, cultural competency is an essential part of the nursing curriculum. We have proposed several innovative and successful features of a brief cultural competency module that can be adopted for required nursing course work, both in the United States and internationally, including exercises in group communication skills, experiential exercises and the Cultural Assessment. The quality of nurse/patient communication is intricately related to patient adherence to treatment and quality of care. However, much more work must be done to assess the effectiveness of cultural competency training, especially in the clinical setting.