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Transcultural nursing is a discipline that emphasizes culturally competent care for diverse populations, recognizing the influence of culture on health beliefs, values, practices, and outcomes. It requires nurses to respect cultural differences and similarities, but faces challenges in curriculum design, faculty development, and student assessment. This paper explores transcultural nursing education’s current state and future directions, addressing the American Association of Colleges of Nursing essentials for integrating cultural content into nursing curricula, reviewing Madeleine Leininger’s transcultural nursing theory, diversity, equity, and inclusion concepts, and discussing the main challenges of transcultural nursing education, including lack of student diversity, training, and resources. Strategies to overcome these challenges include interprofessional collaboration, cultural immersion, and evidence-based practice. The paper concludes with howemergency department nurses should incorporate this into practice. [ABSTRACT FROM AUTHOR]

Background: Working in a culturally diverse environment entails a moral and professional responsibility to provide culturally competent care. This has been recognised as an important measure to reduce health inequalities, improve the quality of care and increase patient satisfaction. The aim of this study was to assess the level of cultural competence in nursing students a decade after the introduction of transcultural nursing content into the nursing curriculum in Slovenia., Methods: A descriptive cross-sectional design with 180 s-year nursing students as a convenience sample was used. Cultural competence was assessed using the Cultural Competence Assessment Tool (CCATool) via an online survey. IBM SPSS facilitated statistical analysis, using descriptive statistics and inferential methods, including the chi-square test. Non-parametric tests (Mann Whitney U, Kruskal-Wallis H and Wilcoxon signed-rank) were used for non-normally distributed data (Shapiro-Wilk test, p < 0.05). The significance was set at p ≤ 0.05., Results: The results indicate that students demonstrate a high level of cultural competence, although there is room for improvement in terms of cultural sensitivity, as determined by coding the CCATool. The results also show a remarkable contrast between their self-assessed scores and the objective scores obtained from CCATool coding of the statements in each subscale (p < 0.005). In addition, significant differences (p = 0.002) are found in subscale "Cultural Knowledge" particularly between students who have lived abroad for more than 6 months and those who have not. The latter group has a higher score in the CCATool, indicating greater cultural knowledge., Conclusions: The study suggests that the presence of transcultural elements in the Slovenian nursing curriculum is associated with higher self-reported levels of cultural competence among nursing students, although the present research design does not allow for causal interpretations. This competence is of immense importance in preparing students for their future professional environment. However, it is crucial to further refine the nursing curriculum, especially through greater integration of transcultural content in all health disciplines. In addition, the introduction of innovative teaching and learning approaches can better prepare students to deal with the diverse cultural experiences they will encounter in their nursing careers., (© 2023. The Author(s).)

Background: Qualified individualised nursing care should be provided to all communities and ethnic groups with free of ethnocentrism., Aims: To evaluate nurses' individualised care behaviours and ethnocentric attitudes and predict the relationship between their individualised care behaviours and ethnocentric attitudes., Design: A descriptive and exploratory study., Methods: This study was conducted with 250 nurses working in a public and two private hospitals in a city, an area with many refugees. Data were collected using the Ethnocentrism Scale and Individualised Care Behaviours Scale. Structural equation model analysis to test hypothetical model and descriptive statistics were used., Results: Nurses working in the private hospitals had a higher individualised care decision control mean score. Those nurses who enjoyed spending time with people from different cultures had lower mean ethnocentrism scale scores, higher individualised care clinical status, personal life and decision control status subscales mean scores compared to other nurses. Mean scores of the individualised care personal life and decision control status subscales of the nurses who followed the literature on transcultural nursing was higher. A significant relationship between the ethnocentrism levels and individualised care behaviours was identified. Accordingly, the ethnocentric attitudes of the nurses negatively affected their individualised care behaviours, and the model established between the two concepts is statistically appropriate., Conclusions: Nurses who work in private hospitals, receive intercultural nursing education and enjoy spending time with different cultures have higher individualised care behaviours and lower ethnocentrism levels. Ethnocentric attitudes of the nurses negatively affected their individualised care behaviours. Care strategies should be developed that consider the factors that will maximize individualised care practices that minimize ethnocentric behaviours among nurses., Implications for the Profession: Increasing awareness on individualised care behaviours, ethnocentric attitudes and effected factors will contribute to improve of nursing care quality of nurses while giving care to individuals from different cultures., (© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: One of the facets of nursing care, as a holistic profession, is cultural care. Considering the role of culture in individuals' health behaviors, nurses are recommended to be mindful of cultural care. Since nursing educators should be culturally competent to teach cultural care to students, this study aimed to determine the cultural competence of nursing educators of medical sciences universities in the 2nd regional planning in Iran., Methods: The current research was a descriptive and survey study framed within Campinha-Bacote's cultural competency model. All nursing educators of universities of medical sciences in the 2nd regional planning of Iran (Tabriz, Urmia, Ardabil, Khoy, Maragheh, Sarab, and Khalkhal) were considered as research units, and the cultural diversity questionnaire for nursing faculties (CDQNE-R) was sent to them. Out of 129 questionnaires sent, 84 were turned back. The data were analyzed by the SPSS 22 software., Results: The results of this study showed that the research participants agreed with the subscales of cultural awareness, cultural knowledge, cultural skill, and cultural desire according to Sealey and Yates' interpretation scale. Also, the research units cast doubts on the cultural encounter subscale. The mean scores of the participants' responses to the questions of every subscale equaled 4.11, 3.52, 3.71, 3.38, and 3.93 for the subscales of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire, respectively. Likewise, the mean scores of participants' responses to the subscales of transcultural educational behaviors and general cultural competence equaled 3.90 and 3.73., Conclusions: The nursing faculties participating in the present study agreed with the 4 sub-models of Campinha-Bacote cultural care and the presence of cultural competence criteria. Also, the research units had doubts about the cultural encounter subscale. This result means that the research participants were undecided about their level of participation in face-to-face interactions with people from different cultural, racial, and ethnic groups. According to the results of the study, it is important to hold transcultural nursing training workshops and courses to maintain and improve the level of cultural competence of nursing faculties at universities of medical sciences in the 2nd regional planning in Iran., (© 2023. The Author(s).)

Introduction: As part of its mission to advance Transcultural Nursing worldwide, the Transcultural Nursing Society Scholars upholds the central role of the discipline and cultural competence in advocacy, empowerment, and transformation of the life conditions of disadvantaged populations. This White Paper affirms the Scholars' core belief in the value of Transcultural Nursing and culturally competent care in addressing social determinants to promote health equity., Methods: The Scholars Education Interest Group proposes recommendations for changes in education, practice, and research undergirding the discipline and expand cultural competence to directly address social structural and historical forces that perpetuate health vulnerability in diverse populations., Results: Collaborative leadership between the TCNS Scholars, Board of Trustess and members should develop initiatives to foster implementation of the recommendations and promote global dissemination of exemplars in education, research and practice., Discussion: Collaborative implementation of recommendations will generate evidence of health equity outcomes through TCN and culturally competent care.

Objective: Cultural competence is instrumental in reducing health equities. Addressing cultural competence at higher education level in healthcare students lays a solid cultural competence foundation for professional practice. The use of vignettes as a teaching intervention was effective because it allowed the use of role-modelling in real-life situations.The study aimed to enhance cultural competence in undergraduate pharmacy students using a self-directed online interactive cultural competence module embedded with three vignettes (case scenarios)., Method: This study was an exploratory longitudinal mixed method (survey and written feedback) study and used a convenience sample of 90 pharmacy students at an Australian University. Students' self-perceived transcultural self-efficacy was evaluated pre- and post-intervention using Jeffreys' Transcultural Self-Efficacy Tool (TSET) which is a validated outcome measure., Key Findings: Vignettes were effective in teaching cultural competence as shown by significant (P < 0.0005) changes pre- to post-intervention in cognitive, practical and affective domains scores using TSET. The affective domain had the least positive mean score change. There was no significant association between any of the demographic factors such as age, gender or birthplace/parents' birthplace and changes in any of the three domains. Cronbach's alpha of >0.90 in all domains confirmed the test's internal consistency and reliability., Conclusions: The findings were indicative of the students' positive receptivity to learning cultural competence and that they had a well-developed understanding of cultural competence. Further research is needed to determine why most cultural competence teaching methods produce little or no meaningful change in enhancing the affective domain., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: This study aimed to evaluate the impact of a transcultural nursing course on enhancing the cultural competency of graduate nursing students in Korea. We hypothesized that participants’ cultural competency would significantly improve in areas such as communication, biocultural ecology and family, dietary habits, death rituals, spirituality, equity, and empowerment and intermediation after completing the course. Furthermore, we assessed the participants’ overall satisfaction with the course., Methods: A before-and-after study was conducted with graduate nursing students at Hallym University, Chuncheon, Korea, from March to June 2023. A transcultural nursing course was developed based on Giger & Haddad’s transcultural nursing model and Purnell’s theoretical model of cultural competence. Data was collected using a cultural competence scale for registered nurses developed by Kim and his colleagues. A total of 18 students participated, and the paired t-test was employed to compare pre-and post-intervention scores., Results: The study revealed significant improvements in all 7 categories of cultural nursing competence (P<0.01). Specifically, the mean differences in scores (pre–post) ranged from 0.74 to 1.09 across the categories. Additionally, participants expressed high satisfaction with the course, with an average score of 4.72 out of a maximum of 5.0., Conclusion: The transcultural nursing course effectively enhanced the cultural competency of graduate nursing students. Such courses are imperative to ensure quality care for the increasing multicultural population in Korea.

Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals., (© 2022 John Wiley & Sons Australia, Ltd.)

Introduction: Since nurses and nursing students interact with culturally diverse clients in health care settings, training programs are required to improve cultural competence and self-efficacy among them. This study aimed to investigate the effect of an online cultural care training program on cultural competence and self-efficacy among postgraduate nursing students., Methods: The present interventional study used random sampling to allocate 80 postgraduate nursing students into the intervention and control groups. Cultural care training program was held for the intervention group., Results: No significant difference in cultural competence and self-efficacy scores was found between the intervention and control groups in the pretest. However, the intervention group scored higher in terms of cultural competence and self-efficacy after the intervention., Discussion: Given cultural diversity and prevalence of medical tourism, nursing instructors need to pay special attention to cultural care education at all academic levels.

Aim: The aim of this study is to evaluate the impact of Chinese native culture education based on Chinese native culture on the intercultural competence of undergraduate nursing students., Method: A quasi-experimental design with pretest and posttest was used. We recruited nursing students from 4 classes of the School of Nursing in our hospital in 2016 as research subjects. Undergraduate nursing students ( n = 79) who completed one semester of education in indigenous Chinese culture completed a demographic questionnaire and the transcultural self-efficacy tool (TSET). Chinese native culture education is the topics related to nursing, consistent with the culture of Chinese patients under the background of Chinese native culture, including the dietary habits, taboos, religions, values, particularly Chinese medicine, and specific diseases. The control group ( n = 91) was students who did not participate in Chinese native culture education and completed the instrument during the same time frame., Result: Students who participated in Chinese native cultural education significantly improved their transcultural self-efficacy in three dimensions: cognition, emotion, and practice. Compared with the control group, the students in the cultural education group had higher change scores in three sizes of transcultural self-efficacy., Conclusion: When strengthening cultural education for undergraduate nursing students, adding content related to Chinese native culture can improve their transcultural self-efficacy and meet the growing cultural needs of patients., Competing Interests: The authors declared no potential conflicts of interest concerning the research, authorship, and publication., (Copyright © 2022 Rong Wang et al.)

Introduction: Turkish population is characterized by its great cultural diversity, thus, Turkish nurses and nursing students often interact with patients of different cultural backgrounds from theirs. Cultural competence is needed to provide qualified contemporary nursing care. This study aimed to explore the literature on the cultural competence of Turkish nurses and nursing students., Methodology: The Whittemore and Knafl review methodology was used to extract, summarize, and synthesize data of 15 primary research articles published between January 2011 and January 2021. The search was done in the Turkish Academic Network and Information Center-ULAKBIM (PubMed, TRDizin, DergiPark)., Results: Three themes were identified: cultural competence, cultural-related problems, and importance of training on transcultural nursing., Discussion: Appropriate educational courses on transcultural nursing should be implemented in Turkish nursing schools as well as in continuing education programs for Turkish nurses.

The provision of culturally competent care helps reduce healthcare inequalities. There is a positive association between the cultural competence of nursing professionals and patient satisfaction, and also between nurses' self-efficacy and patients' adherence to treatment. While training in this respect is important, the self-assessment of skills should also be addressed. To produce a culturally-validated Spanish-language version of the Transcultural Self-Efficacy Tool (TSET) for use in undergraduate nursing studies, and to evaluate its implementation within the Spanish educational system. This cultural adaptation and psychometric validation study was carried out with student nurses from two universities. International standards were followed for the translation and cultural adaptation of the questionnaire. All students completed the questionnaire twice, the second time 14 days after the first. Those who took the Transcultural Care course at the University of Málaga also completed the questionnaire a third time, after concluding this study subject. The reliability, discriminatory capacity, stability and sensitivity to change of the questionnaire were tested and confirmed, and a confirmatory factor analysis was performed. A total of 286 students took part in this study. Overall, the TSET obtained a reliability score of 0.978, according to Cronbach's alpha test. In relation to nationality of origin, the discriminatory capacity of the questionnaire was −1.067 (−1815 a −0,320) = 0.005. Stability, assessed at 14 days using the intraclass correlation coefficient, was 0.901 (0.873 a 0.923) <0.001. The before-after sensitivity to change for those who took the Transcultural Care course was 1.820 (1558 a 2083) <0.001. This Spanish-language version of the TSET is culturally suitable for the educational context of undergraduate nursing students in Spain, and its psychometric validation was performed with satisfactory results. • A Spanish-language version of the Transcultural Self-Efficacy Tool is presented. • The questionnaire has been culturally adapted in accordance with international standards. • Extensive validation was performed to evaluate reliability, stability, discriminatory capacity and sensitivity to change. • The Tool is appropriate for use in the Transcultural Care course taken by undergraduate nursing students in Spain. [ABSTRACT FROM AUTHOR]

Introduction: As the cultural diversity among patients increases, it becomes important for nurses to be prepared and efficient in providing culturally congruent care. The purpose of this study is to examine the factors influencing transcultural self-efficacy (TSE) among Korean nurses., Methodology: A descriptive cross-sectional survey was used, and 131 nurses with foreign patient-care experience were recruited from a university tertiary hospital., Results: The mean TSE score of participants was 5.27 out of 10 ( SD = 1.50). The practical subscale of TSE was the lowest, while the affective subscale was the highest. A regression analysis revealed that education level, cultural competence, and intergroup anxiety are predictors explaining 58.8% of its variance ( F = 27.5, p < .001)., Discussion: A low level of TSE causes avoidant behavior and ineffective communication in foreign patient care, resulting in unsatisfactory clinical performance. Effective education programs and administration guidelines may be critical for nurses to improve their TSE.

Introduction: European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds., Materials and Methods: A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal., Results: 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice., Conclusion: The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Nursing curriculum must include unique ways to enhance students' cultural sensitivity to ensure the provision of culturally competent care to our diverse populations. Academic community engagement (ACE) is a pedagogy used to teach course concepts through service., Methodology: This was a qualitative study analyzing nursing students' written reflective journals following their service at a Native American powwow using Lincoln and Guba's model. The purpose was to examine if the ACE experience influenced their development of cultural sensitivity., Results: Reflective journals of 34 first-semester nursing students, enrolled in a nursing specific culture course, were analyzed. Three themes were identified: (a) engagement, (b) cultural sensitivity, and (c) humility and altruism., Discussion: The development of self-awareness and the revelation by students of the importance of culturally sensitive care was a key finding supporting the use of ACE as a reliable teaching strategy in nursing education.

Background: The term Third Mission refers to the activities with which universities interact directly with the communities and the territory of reference, combining the objectives of the third mission with the two traditional missions: teaching and research.  These were the premises that guided the Nursing Studies Course of the University of Parma, with the goal of implementing a structured path of "Intercultural Nursing" on a demo-ethno-anthropological basis., Methods: The path taken was divided into several phases: arrangement of moments of interaction with students; teaching activity aimed at students based on the relationship between ethno-anthropological knowledge, aspects of migration medicine and social legislation; direct meetings with representatives of some communities present in the Parma area., Results: The interaction with students was achieved through meetings called "Cultural Coffee". The first meetings, in the measure of 4-5, took place in the period October-December 2013, subsequently, the same number of meetings was repeated in the following years. In 2019, two important results were achieved: the creation of an ADE (teaching chosen by the student) dedicated to multiculturality. Another activity of the "Intercultural Nursing" course involve the students with some communities in the Parma area., Conclusion: The results of this experience and the underlying idea that these aspects, if addressed in the basic training, can be for the professionals most expendable in the workplace, provide reasons to continue the path started. The international comparison on the intercultural skills of nurses, indicates collaboration and partnership with communities, as fundamental elements for a complete and effective assistance.

Purpose : To examine the effect of Transcultural Nursing education on nursing students' Professional Values, Empathic Skills, Cultural Sensitivity and Intelligence. Design : A posttest quasi-experimental study with a control group. Methods : The participants were second year nursing students (n = 125). The experiment group was composed of students who had enrolled in the Transcultural Nursing course (n = 65). The control group consisted of students who did not enroll in this course (n = 60). Findings : The posttest scores of the experiment group in the scales were significantly higher than those in the control group ( p < .01). Conclusion : Transcultural nursing course is an effective method to increase the professional values, empathic skills, cultural sensitivity and intelligence of students.

Introduction: Nursing programs requiring a short-term cultural diversity immersion experience can impose financial, family, and work schedule hardships for graduate students. This study aimed to measure changes in cultural practice, awareness, sensitivity, and behaviors before and after completing an online cultural diversity course without travel. Methodology: A quasi-experimental pretest/posttest design collected data from a convenience sample of graduate nursing students ( n = 37) enrolled in a 16-week online course using the Cultural Competency Assessment (CAS/CCB), Culturally Congruent Care for Advanced Nursing Course Objectives (CCCAN-CLO) and Teaching/Assignment Inventory tools. Results: There was a statistically significant increase in graduate nursing students' cultural competency postcourse scores: CAS, t (36) = -5.16, p < .001; CCB, t (36) = -5.42, p < .001; CCCAN-CLO, t (36) = -6.21, p < .001. Students identified conducting cultural interviews and online discussions as the most effective teaching strategies and assignments for learning cultural diversity content. Conclusion: Effective approaches for teaching graduate nursing students' cultural diversity for practice are available for online learners.

Objectives: The aim of this study was to determine the knowledge, attitudes, and prejudices of nursing students regarding the provision of transcultural nursing care to refugees., Methods: The sample of this comparative descriptive study was composed of 317 volunteering nursing students living in Ankara, Turkey. Descriptive statistics were presented as number, percentage, and mean ± standard deviation. The relationships among dependent and independent variables were analyzed with Pearson chi-square test. p ≤ 0.05 was accepted as statistically significant., Results: The mean age of the students was 21.19 ± 1.66 years; 88.6% were female. Only 30.0% (n = 95) of students (predominantly seniors) were educated on transcultural nursing. Statistically significant differences were found among grades of nursing students on the answers to the items, "Refugees are under coverage of general medical insurance system," "The concept of 'Health' differs from culture to culture," "Cultural features of the patient are important for caring nurse," "In order to provide care to only refugees and foreign patients, nurses from other cultures should be employed in hospitals," "Interpreters should be employed in hospitals 24 hours for services for refugees," and "According to my observations, refugees and their relatives admitted to the hospital are not respecting the healthcare workers and hospital rules." In addition, there was a statistically significant difference in students' comfort level with nursing care activities between those students who were literate in a foreign language and those who were not literate in a foreign language., Conclusions: Our findings show that attending lectures on transcultural nursing in a curriculum of seniors and being literate in a foreign language had a positive impact on the attitudes of students in terms of the provision of medical care to refugees. It is recommended that nursing programs integrate lectures on transcultural nursing into the curricula of all four grades of nursing education and encourage students in language learning to better serve our disadvantageous guests., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: The purpose of this phenomenological study is to reveal how senior staff who have engaged in the development of a transnational nursing curriculum make sense of the opportunity., Background: Merging two, country specific curricula for a dual award bachelor degree nursing program, taught exclusively in China through 'flying faculty' model is an innovative way to deliver a global nursing education. As with any innovation, lessons can be learned through reflection, to streamline future institutional investments which are responsive to country specific needs., Methods: Four senior staff involved in curriculum development were recruited through purposive sampling. Semi structured interviews were undertaken to elicit data on their experiences during the merger., Discussion: Five main themes were key to participant's sense making during the curriculum development process. These were: managing and overcoming differences in expectations and pedagogy, meeting deadlines, engaging stakeholders and the need to think creatively. All participants revealed there had been a significant learning curve during the process, and highlighted the benefits of this in their own development., Conclusions: Participants perceived transnational education curriculum development as complex. They cited differences in learning, teaching, pedagogy and quality processes as factors to address and identified the most crucial elements to success, were communication, mutual engagement, meeting deadlines and the ability to think creatively. Their continual efforts to understand systems and processes allowed them to make sense of this complex undertaking., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Introduction: Standardized patient simulation can be an effective strategy to foster cultural competence education., Methodology: Guided by the Cultural Competence and Confidence Model, this grant-funded, longitudinal, one-group, pretest and posttest study used the Transcultural Self-Efficacy Tool (TSET) to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students' ( n = 53) transcultural self-efficacy. Developed by following recommended guidelines and standards, the DSPS had content validity review. It aimed to improve students' knowledge, skills, and attitudes with regard to providing culturally competent nursing care. The statistical methods included t-tests, McNemar's test, correlation analyses, and Mann-Whitney U-test., Results: The DSPS influenced statistically significant changes (increase) in students' transcultural self-efficacy perceptions ( p < .05). All students regardless of background benefited from formalized cultural competence education., Discussion: Evidence-based strategies such as the DSPS can offer a valuable guide for educators to foster cultural competence education.

Background: Higher education institutes are witnessing an increase in the cultural and ethnic diversity of their student population. While this adds to the learning experience, there is a dearth of evidence examining how students on nursing programmes, from different cultural and ethnic backgrounds learn with and from each other. There is need for a greater understanding of the factors that both facilitate and inhibit intercultural learning within the classroom., Objectives: This study explored the perceptions and experiences of home students on a postgraduate nursing programme, of intercultural learning within the classroom., Design: A qualitative descriptive design was used., Settings: Home students enrolled on a suite of postgraduate nursing programmes in one region of Ireland who were registered for co-scheduled modules with international students, were recruited to participate on a voluntary basis., Participants: Fourteen home students (13 females and 1 male) were purposively sampled., Methods: Data were collected using digitally recorded one to one semi-structured interviews (ten 'face to face' and four telephone). Data were thematically analysed using a modified version of Braun and Clarke's (2006) framework., Results: This study describes the value of intercultural learning in the classroom and draws attention to some of the challenges experienced by home students. Furthermore, it highlights the importance of exploring similarities, whilst respecting differences in prior educational experiences, learning styles and cultural backgrounds. The overarching theme, Navigating intercultural learning describes home students' experiences of developing awareness, connecting and sharing cultural knowledge., Conclusions: Intercultural learning takes time and requires commitment, emphasising the need for careful consideration of facilitation techniques, preparation, support and planning pedagogies that encourage effective intercultural learning. The findings make a valuable contribution to existing knowledge on internationalising nurse education, specifically with regards to intercultural relations and the perceptions and experiences of teaching and learning in intercultural classrooms., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: The nursing literature examining effective methods to teach transcultural self-efficacy demonstrates inconsistent findings. This study evaluated the effectiveness of a nursing stand-alone culture course with concurrent field experiences compared with the standard integrated culture content in the curriculum in increasing transcultural self-efficacy in nursing students., Method: This quasi-experimental, static-group comparison used the Transcultural Self-Efficacy Tool to measure outcomes. The treatment group consisted of first-semester nursing students (n = 53) enrolled in a pilot 2-credit culture course. The control group consisted of graduating senior nursing students (n = 19) who had culture integrated throughout the curriculum., Results: The posttest of the first-semester students in the treatment group scored higher than either their pretest or the graduating senior students (control group)., Conclusion: The stand-alone culture course had a greater positive effect than the integrated culture content on students' transcultural self-efficacy. [J Nurs Educ. 2018;57(10):609-613.]., (Copyright 2018, SLACK Incorporated.)

Background: In recent years, many ASEAN countries, including Malaysia have embraced Transnational Higher Education (TNHE) post-registration top-up nursing degree programmes. These are bridging programmes that allow registered nurses to upgrade their diploma qualifications to a degree level., Purpose: To investigate the teaching and learning experiences of Malaysian nurses on Transnational Higher Education post-registration top-up degree programmes in Malaysia., Design: Hermeneutic phenomenology and the ethnographic principle of cultural interpretation were used to explore the views of eighteen Malaysian nurses from two UK and one Australian TNHE universities (determined by convenience and snowball sampling methods) to ensure data saturation. Semi-structured interviews were conducted in English and Bahasa Malaysia (Malaysian language) to enable nurses' voices to define, describe and evaluate their TNHE classroom experiences., Data Analysis: Data were analysed using thematic analysis., Findings: The nurses' experiences within the short one or 2 weeks TNHE intercultural teaching and learning environment identified four categories: language and teaching and learning issues; TNHE degree requirements, guidance and support; shock and coping strategies and acclimatisation. They suggest there was a conflict between the assumptions and expectations of the TNHE 'flying faculty' and nurses' about the programme of study. There were also mismatches between Western and Malaysian pedagogical preferences, guidance and support, and professional values., Implications for Education/practice: There is a need for TNHE 'flying faculty' to internationalise the theoretical knowledge to reduce cultural incongruities and dissimilarities. Cultural immersion will stimulate intercultural views and knowledge to equip nurses for promotional and/or global opportunities whilst enabling the 'flying faculty' to create new learning environments. The research provides insights to inform TNHE provider institutions to improve teaching and learning to enable nurses to make the theory-practice connection., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Based on 2015 annual report of foreign spouse populations were above 507,266 people in Taiwan. Most of them (68%) came from Mainland China, 29% from south-east Asia. 92% of foreign spouses were female (2015). Therefore, a challenge arises for nursing students to provide care to clients with multiple cultural variations in Taiwan. The study objectives were to explore the related factors of cultural care competence and estimate the effects of a short-term reinforced cultural course. The study used a quasi-experimental design. All participants were investigated to measure that changed in cultural competence before and after the community practice period. Of 95 participants, 46 experimental group students engaged with 3 times workshops. The study was conducted from May to August in 2015 at Southern Taiwan. The study results showed a significantly improvement of transcultural nursing competence from comparing control group with experimental group by ANCOVA analysis (p < .05). The study approved that the cultural workshop along with the community health nursing practice curriculum might develop students' transcultural nursing competence. In the future, in order to providing cultural sensitively care, a sustained transcultural curriculum should be advocated at Nursing schools in Taiwan., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Nurses must learn essential skills based in transcultural nursing to address issues of equity and social justice. The development of a model for nursing practice for an urban nurse-led drop-in center for individuals experiencing marginalization provides an opportunity for student nurses to learn transcultural nursing skills that shifts care from acknowledging the need of others to accompanying others on their health journey. The practice model provides the opportunity for undergraduate and graduate nursing students at Augsburg University to de-emphasize tasks and build relationships. Students learn to listen to others' stories and acknowledge their struggles in the margins. Four stages of nursing practice skills, acknowledging others' needs, attending to their struggles, affirming strengths, and ultimately accompanying others, are taught and experienced. At the core of the nursing practice model is the concept of "hospitality." The nursing practice model serves as guide for student nurses to learn to suspend disbeliefs, withhold judgment, and ultimately reduce stereotypes and stigma to offer a safe space for individuals living in the margins seeking care. The future of nursing requires essential knowledge, skills, and attitudes that shift care from need-based care to accompaniment to address health inequities and provide culturally appropriate care.

Because culture affects virtually every aspect of life, including health beliefs, customs, and practices, it is imperative that nursing students recognize and value its critical importance to the people whom they will care for as clients/patients. Hence, the notion of culture must be introduced early on in nursing programs and threaded throughout the entire curriculum.

Purpose: The Doctor of Nursing Practice (DNP) degree is the most advanced clinical leadership role in nursing. Curricula prepare these students to design, implement, evaluate, and continuously improve high-quality culturally specific health care delivery and outcomes., Design: Guided by the cultural competence and confidence model, the Transcultural Self-Efficacy Tool was used to assess the impact of an enhanced cultural competence curriculum on transcultural self-efficacy perceptions of DNP students ( n = 54)., Method: The study used a pre-post paired t test, nonexperimental design., Findings: A significant gain from pre- to postmeasure in students' overall transcultural self-efficacy was demonstrated., Discussion: Changes in DNP students' transcultural self-efficacy were identified after completing an enhanced cultural competence curriculum., Conclusions: Transcultural self-efficacy may be influenced by formal education and learning experiences of DNP students., Implication for Practice: Educational outcomes research can demonstrate the impact of a DNP programs curriculum on meeting national and professional goals for culturally competent nursing practice.

Background: Online learning formats are prevalent in current higher education. Given the changing student demographics and the drive for creativity in educating a technology-savvy student, it is imperative to incorporate innovative and alternative learning modalities to engage these students., Method: This pilot study was designed as a quality improvement program evaluation comparing the effects of an online learning module with traditional classroom delivery of transcultural nursing content using a posttest two-group survey design in associate degree nursing students. The students' perceived knowledge and confidence were investigated after receiving the lecture for both the online and in-class groups., Results: Data analysis revealed the online cohort perceived themselves as more knowledgeable concerning the ways that cultural factors influence nursing care, but not more confident in providing culturally competent care., Conclusion: Due to the students' perceived knowledge gain, this pilot study supports the use of online learning modules as being more effective than the traditional classroom delivery of transcultural nursing content. [J Nurs Educ. 2017;56(6):368-372.]., (Copyright 2017, SLACK Incorporated.)

Background: Overseas recruitment has been vital to the contribution of staff growth in the National Health Service (NHS). In 2011, high nursing vacancy rates within critical care required that overseas nurses were recruited. The recruited nurses were placed in an Overseas Nurses Program (ONP), a course designed to assist overseas nurses in adapting to the NHS., Aim: To describe the experiences of nurses recruited from India who participated in an ONP., Design: A qualitative, research approach was chosen to gather descriptions of the lived experiences of nurses from India transitioning to London, to work in critical care settings., Method: A descriptive qualitative approach was taken using in-depth, semi-structured and audio-taped interviews. They were conducted over a 69-day period (30 November 2012 to 6 February 2013) with 16 nurses from India. The nurses were questioned about challenges, experiences and differences; they were also asked to make suggestions for other nurses undertaking an ONP in the future. Interviews were transcribed verbatim into a formal written style with NVivo10., Results: Eleven females and five males aged 25-33 years who had completed up to four years of university training participated in this study. The themes extracted were autonomy and responsibility, language, culture (food and climate), loneliness and work challenges (ONP and essay writing). Participants identified that they would have benefited if pre-allocated mentors from non-English speaking countries who had previously been through the transition process were available to assist them with their personal and professional integration into a new country., Conclusion: Autonomy disparity, language barriers and cultural differences need to be recognised and acknowledged by multi-disciplinary teams, by allowing sufficient time and additional support for non-English nurses undergoing ONPs., Relevance to Clinical Practice: Overseas nurses would benefit from being mentored by another nurse from a similar culture, with a non-English background. It may be feasible for overseas nurses to receive training in cultural competencies to improve disparities., (© 2015 British Association of Critical Care Nurses.)

Purpose: Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated background factors to cultural competence, and furthermore to establish whether teaching multicultural nursing was implemented in nursing education., Design: A structured Cultural Competence Assessment Tool was used in a correlational design with a sample of 295 nursing students in southern Finland., Findings and Conclusions: The level of cultural competence was moderate, and the majority of students had studied multicultural nursing. Minority background (p = .001), frequency of interacting with different cultures (p = .002), linguistic skills (p = .002), and exchange studies (p = .024) were positively associated to higher cultural competence., Implications for Practice: To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad., (© The Author(s) 2016.)

Some nurse educators lack training in the educational methods that facilitate learning among underrepresented groups. Limited awareness of equitable pedagogical practices could threaten the academic achievement of underrepresented groups and hinder efforts to make the nursing profession more heterogeneous. Training in multicultural education could strengthen the capacity of educators to create culturally responsive learning environments. This quasi-experimental study examined the impact that training in critical multicultural education had on the multicultural attitudes, awareness, and practices of 37 nurse educators. A pre-posttest design without a control group found that the training was an effective way to strengthen the multicultural awareness and attitudes of nurse educators, although there was little impact on the multicultural practices. The nation's capacity to improve the quality of health care hinges upon educators who can create inclusive learning environments and graduate diverse nurses. The findings could inform policies seeking to promote diversity and inclusion in nursing education., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The Institute of Medicine and the American Association of Colleges of Nursing advise that professional nursing education include development of a high level of cultural competency. A 10-day learning experience to Ireland for nursing students at the University of Detroit Mercy, an independent Catholic university, sponsored by the Sisters of Mercy and the Society of Jesus (Jesuit Fathers), helped them develop a philosophy of Mercy care and build cultural competence. Learning focused on the life of Catherine McAuley, Irish culture, spirituality, social justice, reflective thinking, and a value-centered professional education.

The preparation of future baccalaureate-prepared nurses will require undergraduate students to have both cultural awareness and global or international health competencies in order to meet the increasingly complex health care needs of a diverse community. Additionally, the nursing accrediting bodies have identified global healthcare as an area of core knowledge for clinical nurses. In order to meet the workforce needs, and provide global education of the undergraduate student body, we designed an international clinical experience within the undergraduate Community/Population Health course. The purpose of this article is to provide a guide for faculty in the planning, infrastructure needs, and implementation of a global clinical experience for undergraduate nursing students, in the context of the United States with addressing university concerns for student safety and security while abroad., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

Cultural competence is a mainstay in health care and nursing education. With the expansion in the number of distance-based nursing programs across the country, innovative teaching methods for distance learning faculty are required to instill cultural competence in students. Faculty must be deliberate when planning distance-based learning activities that incorporate cultural experiences. This article describes several such strategies including the creative use of blogging, recorded lectures, the online synchronous classroom, social media, and cultural immersion projects. These methods capitalize on existing information technologies and offer distance-based students the opportunity to connect with one another, as well as develop the awareness, sensitivity, and respect that is required when providing culturally competent care. These teaching methods are modifiable to meet the teaching and learning needs of the faculty and the students, thereby allowing educators to support the integration of cultural competence into patient care for distance students., (© The Author(s) 2014.)