Robin Ellis and Dr. Erin Maughan, Nursing
Main Text
The most recently published United States census indicates that nearly one fourth of the United States population is non-Caucasian (“Race and Ethnic Distribution,” 2001). Unlike the general population, nearly 90% of registered nurses identify themselves as primary Caucasian. Consequently, cultural awareness in health care has become an imperative issue.
As a result, the need for accurate tools (i.e. surveys) to measure cultural awareness in health care has increased in recent years. Gozu and associates (2007) recently conducted a systematic literature review of tools developed to measure cultural competency in health care professionals. Gozu’s study concluded that only forty five tools have been developed to measure cultural competency. Thirty-three percent of the tools demonstrated either validity or reliability with only thirteen percent demonstrating both validity and reliability. Many of the available tools were qualitative and lacked measurable outcomes. Nursing workplaces and educational institutions alike have issued measurements of cultural competency, but little research exists to the cohesiveness of these measures. Although quantitative measures of tools are available, no current study has addressed the possible qualitative differences between tools intended for use by students versus the measures intended for nurses in the workplace.
I have selected seven different measurements of cultural competency currently approved for use in the health care profession. The objective of my project is to analyze the possible qualitative differences in question content and focus based on the survey’s state population of interest. Four of the measures I have selected state that the survey should be administer to nursing students. The other three tools state that the survey is designed to be administered to nurses currently working in the workforce. By taking a closer look at the possible differences between nursing student surveys and nursing workforce surveys, I hope to uncover insights into proper survey administration and usage.
The four educational measures I have selected include the Transcultural Self-Efficacy Tool (TSET), the Cultural Awareness Scale (CAS), Caffery Healthcare Cultural Competency Instrument (CHCCI), and the Cross Cultural Evaluation Tool (CCET). The workforce related measures I have selected are the Inventory of Assessing the Process of Cultural Competence among Healthcare Professionals (IAPCC), the Cultural Competence Assessment (CCA), and the Cultural Self-Efficacy Scale (CSES).The first obstacle to my research that I encountered was trying to obtain copies of all the above mentioned surveys. After reading through copious amounts of related articles, I was able to obtain copies of all the measures except one. With the assistance of my mentor, I was able to contact the author of the Culutral Self-Efficacy Scale about obtaining a copy of the survey. I am still waiting on a response from the author and hope to establish more communication in the near future.
I have been able to draw a few preliminary conclusions with the survey data that is available to me. All four educational measures have a focus of evaluating respondents’ comfort level in addressing cultural issues. In addition, participant’s knowledge level regarding cultural issues is addressed. All the measures require some degree of self reflection and request participants to rate their personal feelings regarding cultural implications in nursing care. Few questions are asked regarding how participants have handled culturally controversial issues. Also, the actions that participants have taken are not discussed in detail. In short, only basic understanding and personal reflections regarding cultural competency are analyzed in the education surveys. In contrast, the workforce measures focus on how much participants value the cultural aspects of nursing and how they address cultural issues in practice. Basically, the workforce measures focus more on the application of cultural knowledge and less on self-reflection and feelings regarding culture. The differences in education versus workforce measures could reflect the gap between education and practice.
In order to further analyze the possible differences in these measures, I plan to make a table that will include critical information about each survey. Some possible column categories include definition of cultural competency, sample survey questions, stated population of interest and frequency of survey use in health care. Hopefully, this table will allow for easy comparisons and contrasts of the measures and further illustrate the above stated conclusions.
In addition to creating a table, I hope to be able to compute some qualitative statistical data that will help to analyze the data more objectively. In order to accomplish this, I have arranged for a statistical consultation with a senior student in the statistics department to review some possible methods of data analysis.
At the completion of my research, I hope to be able to publish my findings in an academic journal. Some possible journals for publication include NLN: Nursing Education Perspectives, or International Educator (publication of NAFSA). I also hope to be able to present my findings at a professional research conference. Some possible conferences include ACHNE (Association of Community Health Nurse Educators) conference, NAFSA: Association of International Educators, National League of Nursing, or the Global Health Conference.
Overall, this has been an extremely valuable learning project for me. I have been able to experience first-hand the rewards and barriers of research in my field. In addition, I have been able to use critical thinking skills as I have worked to draw conclusions from various research sources. I plan to implement these skills when I enter the nursing profession and advocate for continual research in health care.
References
- Gozu, A., Beach, M. C., Price, E. G., Gary, T. L., Robinson, K., Palacio, A., Smarth, C., Jenckes, M., Feuerstein, C., Bass, E. B., Powe, N. R., & Cooper, L. A. (2007). Self-administered instruments to measure cultural competence of health professionals: A systematic review. Teaching and Learning in Medicine, 19(2), 180-190.
- US Equal Employment Opportunity Commission. (2001, June 1). Race and ethnic distribution in
the United States based on the 2000 Census. Retrieved from http://www.eeoc.gov/stats/
census/states.html