We have to start with cultural humility among nurse educators. If we focus on ourselves, we'll model appropriate cultural behavior to our students. That's the first step.

We have to start with cultural humility among nurse educators. If we focus on ourselves, we'll model appropriate cultural behavior to our students. That's the first step.

Thanks John, I appreciate the approach/modeling of humility as the starting place where faculty are explicit about a diversity of experiences and perspectives.

Eunice, our colleagues concerned with the historical and cultural contexts of our original people in New Zealand, Australia and Canada have been exploring "cultural safety" and relational practice as it relates to education and practice of diversity and culture/context.

Look to the Canadian Association of Schools of Nursing document here (and others): http://www.anac.on.ca/Documents/Making%20It%20Happen%20Curriculum%20Project/FINALFRAMEWORK.pdf

New research is showing the merits of a multi-leveled approach with stand alone courses, as well as global citizenship concepts and learning objectives that are integrated throughout a curriculum (including clinical practice). Sharon Simpson is completing an EdD at Simon Fraser University on the topic of global citizenship and nursing education - watch for that!

Great conversation - thanks - more innovation, critique, scholarship and dicussion needed

Thanks John and Sonia for the great discussion. I agree that nurse educators must first become culturally aware, sensitive and have the desire to become culturally competent in order to have a cultural impact on the students.

From my experience faculty often claim that cultural concepts are integrated in their courses or throughout the curriculum but if the students learning outcomes are evaluated that piece is often missing. Therefore, I agree with Sonia's suggestion of using a multilevel approach with stand alone courses as well as investing in study abroad programs.

I am completing my dissertation study on "The Cultural Competence Level of Junior and Senior Baccalaureate Nursing Students in a Selected Historically Black College and University" So look out for the results.

I would like to suggest to develop Related Learning Experience Record with integration of cultural competence. I agree with Eunice that cultural concepts are integrated throughout the curriculum. An assessment tool how cultural competence is used will help. Cultural competence is integral in psychodynamic nursing. Effective use of self in everyday interaction in various setting is part of cultural competence.

I believe that cultural competence is developed through awareness of self and one's own culture, "textbook" and classroom learning and discussions, and through individual experiences with others from a different country and culture. I believe that all nursing programs should offer cultural immersion experiences for both undergraduate and graduate students. I have taken nursing students on healthcare missions to developing countries for several years. My dissertation was on the impact of their experiences, and the findings positively support the need for faculty to offer these opportunities for students. Although these experiences add to student tuition expenses, i believe the gains far outweigh the cost.

One way I have seen cultural competence effectively integrated into nursing curriculum was by providing a forum for nursing students from various cultures to speak about their culture and explain to their peer what they felt was important for them to know about their background. (This provided a great learning opportunity for the students[speakers as well as their peers] and the teachers)

Juanita and Martha,

I agree with both suggestions. However as Martha rightly stated cultural immersion can be expensive. Faculty have tried to suggest that in our program but it always boils down to lack of finacial resources. I have been able to develop an annual celebration of culture program in our department. Students and faculty across campus participate. During this program students present poster presentations on different health beliefs or dietary habits from different cultural perspectives, oral presentations and videos on selected topics, as well as sharing dishes from various cultures, etc. I think that this gives them exposure that they would otherwise not have unless they travel abroad.

I have been teaching health disparity/health policy class since 2008 to graduate nursing students. We start the class by reading a cultural anthology by Anne Fadiman called "When the Spirit Catches You, You Fall Down". I teach this course online and I spend time in the discussion forum asking students to relate their experiences reading this book. It does not place the health care professionals in a positive light. In the book (for those who have not read it) the child with epilepsy is from the Hmong culture and the nurses and physicians who provide her care do not realize that the family does not understand, nor do they agree with the treatment plan.

My students universally site this as one of the most meaningful part of the course for them. They gain a new appreciation for the unspoken and unknown needs of the patient. It helps them be more open to examining their own prejudices and miscommunications with patients and families. The second strategy I use is to send them to an internet site where they can take online quizzes that identifies their hidden prejudices. They write a reflection paper about this experience. The majority of students find this to be an enlightening experience.

If anyone has additional learning strategies for students to learn this content I would truly appreciate hearing about them.

Often times there is an assumption that educator s are well versed in understanding cultural competency. A descriptive study I have conducted with colleagues in South America (manuscript under development) reveals that often times educators themselves are limited in their knowledge, beliefs and awareness of cultural competency. It raises the question, "How can someone teach about something that they have limited knowledge, particularly a topic as value-laden and potentially challenging as culture?"