ASSESSING AND BUILDING CAPACITY FOR PROMOTION OF CULTURAL COMPETENCIES WITHIN NURSING EDUCATION PROGRAMS IN A FRONTIER STATE Connie Diaz Swearingen, MS, RN, PHCNS-BC, CNE Pamela N. Clarke, RN; MPH, PhD; FAAN Fay W. Whitney School of Nursing University of Wyoming ACHNE June 2012
Disclosures Neither Pam Clarke nor Connie Diaz Swearingen have any commercial interests to disclose.
Acknowledgement The LEAP: RN/BSN/MSN Nurse Educators Project is funded by a HRSA Advanced Education in Nursing Grant
Objectives 1. Understand the rationale for program emphasis on the development of skill in teaching cultural competency across the nursing curriculum at all levels of formal education. 2. Analyze results of multi-method assessment of the capacity of WY nursing education programs to promote cultural competence among nursing students. 3. List strategies that support the development of increased skill in teaching and modeling cultural congruency in nursing practice.
LEAP from RN to MSN: Preparing Nurse Educators Outreach and Recruitment project funded by the Health Resources and Services Administration (HRSA) through an Advanced Education in Nursing grant designed to: 1) increase the number of masters prepared nurses through strategic partnerships, 2) increase diversity and knowledge of cultural competencies among the current and future nursing workforce. 3) increase the leadership capacity among the nurse educator workforce.
Project Strategies Multi-disciplinary Professional Advisory Board provides recommendations for identification and recruitment of future nurses and current associate degree nursing students, particularly those from underrepresented groups. Education regarding cultural competency and diversity provided to nurses, educators and students in BSN, RN/BSN, and MSN programs. Outreach to current ADN nursing students and practicing RNs to provide information regarding availability of distance education for RN/BSN and MS completion.
Multi-Method Assessment Components Quantitative Self-Report Assessment among Current Nurse Educators across all public nursing education programs Qualitative Email survey and focus groups Dialogue with individuals faculty and program staff
Survey Tool: Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals- Revised (IAPCC-R ) (Campinha-Bacote, 2002) Measures overall Cultural Competence Score 5 Subscales (ASKED)
Self-Assessment: Sample Demographics Race/Ethnicity White African American Asian Hispanic/ Latino UW Faculty 100% 10% CC Faculty 100% 26% MSN Students 92% 4% 4%
Self-Assessment: Sample Demographics AGE 20-29 yrs 30-39 yrs 40-49 yrs 50-59 yrs 60+ UW Faculty 5% 10% 55% 30% CC Faculty 25% 5% 70% MSN Students 8% 35% 38% 19%
Self-Assessment: Sample Demographics Years in Nursing 0-10 10-19 yrs 20-25 yrs 30+ UW Faculty CC Faculty MSN Student 41%% 59% 41% 22% 37% 23% 77%
Self-Assessment Results: IAPCC-R IAPCC-R Results Overall Cultural Competency Awareness Knowledge Skill Encounters Desire UW Faculty 73 16 12 15 14 17 CC Faculty 72.1 15.7 12.2 13.7 14.1 17 MSN Students 70 15 12 14 13 17
Qualitative: Curriculum Content Approaches: Focus groups (university), survey of community colleges, review of syllabi Faculty participation represented all nursing programs in state: ADN, BSN, MS Additional Informal data from outreach reports were considered in analysis
Qualitative themes Rural as primary culture addressed University masters level: rural vs urban Purnell, Leininger, Bushy models specifically addressed Curricula focused on ethnicity, alternative healing, religious differences, lifestyle only one college specifically addressed the care and issues related to undocumented persons Case studies seemed to be application of skill
Graduate Content Social justice, poverty, social determinants of health (epidemiology), rural culture Theory: personal philosophy of nursing Evidence-based practice: understanding patient preferences
Something was missing: Informal dialogue via outreach and face to face contact Tribal college serious issues with university [trust] Outreach partners wanted to help Nurse educators. well what can we do when an Am Indian misses a week of school? we have our standards Professional Advisory Committee members: brainstorm strategies.
Conclusions Complexity of the construct Development of skills
Recommendations: (future strategies) 1. Ongoing faculty development Support training and education for UW faculty Continue Annual Cultural Competency Workshop in conjunction with state-wide Nursing Education Summit
Recommendations 2. Education opportunities for students Identification and development of supporting course content, including modules, case studies, supplemental materials and teaching tools Facilitate opportunities for encounters and reflection Clinical teaching practicum in Honduras Purposeful reflection related to culture, diversity, and client centeredness, including reflective journaling, case studies, clinical post-conference discussions
Recommendations: 3. Continued collaboration and shared learning with community/education partners