Aligning Traditional Wisdom with Modern Educational Goals

Cultural competence in health care is designed to ensure that health professionals are able to provide quality health care to culturally and ethnically diverse populations. Cultural competence can be effective for improving health professionals' knowledge, attitudes and skills and patient satisfaction. The impact of cultural competence education and training included in university-based professional training of health professionals is relatively unclear. This study aims to describe the characteristics and assess the methodological quality of published evaluations of cultural competence education and training interventions targeting university based health professionals in training. A systematic search of the cultural competence literature identified 16 published evaluations of cultural competence education and training interventions included in university based professional training of health professionals. Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Nine studies evaluated the integration of cultural competence into health or medical curriculum, four evaluated a cultural immersion experience, and three evaluated cultural awareness education and training. Positive outcomes commonly reported were improvements in students' knowledge of cultural competence and attitudes towards Indigenous and culturally diverse peoples. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Eleven studies conducted a quantitative and five studies a qualitative evaluation. Strengths of quantitative evaluations included adequate study designs and valid and reliable measurement instruments. Selection bias and poor attrition were the main limitations of quantitative evaluations. Qualitative evaluations were adequate on most methodological criteria but the reporting of ethical and some methodological issues was less than adequate. There is insufficient evidence to provide a strong basis for recommending the inclusion of specific cultural competence education and training strategies in the professional training of university based health professionals. Future evaluations should compare similar types of strategies, and extend their measurement of outcomes beyond those relating to the knowledge, attitudes and skills of health professionals, to those relating to health care outcomes of ethnically diverse peoples.

The study is devoted to the Internet poetry, the structure and composition of which are based on the creative use of Internet technologies. Based on the “Discussions about electronic literature” (1997-1998), the study gives analysis of opinions of researchers, poets and critics about the prospects for application of various technologies in the Internet poetry. The optimistic predictions made in the late 1990s are compared with examples of the actual implementation of technology-based intermediality in the modern Internet poetry. Some poetic phenomena such as a collection of poems written on the Google Map (“Marshrut 91” by Alexander Samoilov) as well as experimental hypertext works, including those created on the basis of the “paper” poems are analyzed in the study. At the same time, the authors give serious consideration to ideas of researchers about the modern communicative situation in the Internet poetry. The conclusion is made that despite many expectations associated with the possible creative use of technologies in the Internet poetry, the latter is currently taking a different path. This path is mainly associated with a new type of communication in the “poet – audience” system, while the use of creative Internet environments, online games, hypertexts and expressive means of other media is becoming quite a rare phenomenon: the modern audience expects sincerity, emotions and interactivity from an Internet poet rather than a game or an original technological solution.

For many years, intercultural communicative competence (ICC) has been discussed to elucidate the development of students’ awareness, skill, and experience in regard to intercultural communication. Yet, practical suggestions for enhancing teachers’ or teacher educators’ practice in intercultural communication classrooms are scarce. To fill this void, this article presents the use of culture-based digital storytelling (DST) tasks to promote intercultural awareness and identity in multicultural classroom settings. To begin with, this article explores how DST tasks are designed to mediate students representing their cultural identity and building their intercultural awareness through a pedagogical intervention of DST. Then, reflection is presented to give potential practical implications for teachers and teacher educators in designing and implementing DST-mediated cultural learning. Courses: Language, Culture, and Society; Intercultural Communication; Cross-Cultural Understanding; any course with an intercultural communication unit/cultural study. Objectives: After completing this project, students are able to: (1) express their cultural identities from their point of view verbally and visually; (2) maximize their multimodal literacy and design creatively; (3) activate their background experiences to illustrate their intersecting cultural ideas critically; (4) further enhance their critical thinking and cultural awareness; (5) reflect their cultural identities in enhancing their intercultural competence; and (6) apply cultural identity theory to demonstrate and analyze their cultural ideas.

For the past 20 years, cultural competence initiatives in medicine have addressed quality improvement, language access, refugee health and systemic racism. Many initiatives encourage postgraduate trainees to share their biases in caring for diverse patients. However, trainees may feel disappointed and insulted when such initiatives assume no prior exposure to cultural competence programming, are viewed as efforts towards ‘political correctness’ rather than skill development, and presuppose social distance among patients and providers.1 Medical educators need new cultural competence models as globalisation makes cross-cultural service provision a worldwide phenomenon. We designed a course around hypothetical recommendations that cultural competence initiatives should anticipate trainee resistance, occur early in training to make a professional difference, include case-based learning and avoid uncomfortable self-disclosures.1 All second-year psychiatry trainees (n = 12) at Columbia University underwent a 12 week course based on the Cultural Formulation Interview (CFI). The CFI consists of 16 questions and will be included in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V); prior DSMs have had wide international circulation. The CFI revises the DSM-IV Outline for Cultural Formulation, the cultural assessment with the largest evidence base in psychiatric education. The first 5 weeks consisted of reviewing social science theories underpinning CFI development (curriculum available) and residents sharing experiences surrounding their acculturation processes as doctors and psychiatrists. The last 7 weeks consisted of practising the CFI as classmates reviewed one-page summaries of CFI questions and answers with current patients. In each 50 minute lecture, instructors reviewed learning objectives, encouraged discussions on how cases corroborate or refute CFI social theories and solicited course feedback. Instructors met with trainees outside of class to examine how culture affects diagnostic assessment, treatment planning and continuity of care for each patient presentation. All trainees stated that they had cultural competence training in medical school. They appreciated the individual approach to culture in the CFI that avoids stereotyping patients through broad generalisations (‘the Asian patient’, ‘the immigrant’, etc.). Certain themes elicited high participation: (i) trainees discussing their own acculturation within the cultures of medicine and psychiatry, (ii) cross-cultural miscommunication despite using hospital cultural and linguistic brokers, and (iii) The relevance of cultural competence to formulating and implementing care for actual patients. The least participation occurred when trainees were asked to reflect on their racial, ethnic, linguistic or socio-economic backgrounds in relation to individual patients. Trainees may find self-reflection in cultural competence initiatives more productive when they can discuss professionalisation experiences or actual cases leading to skill development. This mode of self-reflection may feel less threatening than asking trainees to imagine how their attitudes or biases affect clinical care. Future studies can examine whether this model of cultural competence elicits feasibility and acceptability with larger trainee samples over time.

The importance of providing mental health from a transcultural perspective in establishing a therapeutic alliance is recognized. However, it is currently unknown how many mental health practitioners in the Netherlands feel capable of providing mental healthcare from a transcultural perspective, or if they are familiar with the Cultural Formulation Interview (CFI). The CFI is a tool used in mental health care to gather culturally relevant patient information, enhancing cultural sensitivity in treatment. It is also unknown if there is a difference between psychiatrist and psychiatry residents in terms of their cultural competence. This study aimed to assess the self-appraised cultural competence of Dutch psychiatrist and psychiatry residents, including their knowledge of the CFI, and the need for further training. A cross-sectional study was conducted among psychiatrists and psychiatry residents by means of an online questionnaire. Ninety-seven mental health practitioners completed the questionnaire. Of the psychiatrists 70% and of the residents 76% reported that treating patients from cultural backgrounds different from their own background is challenging. Only 44% of psychiatrists and 34% of residents considered themselves sufficiently culturally competent, and 56% and 47% respectively, were uninformed about the CFI. The majority of psychiatrists and residents (70 vs 84%) indicated a need for more training in cultural competence. The majority of psychiatrists and residents in The Netherlands considered treating patients from different cultural backgrounds a challenge, reported feeling insufficiently culturally competent, lacked experience with the cultural formulation interview and reported a need for more training in cultural competence.

Effect of a mobile app-based cultural competence training program for nurses: A pre- and posttest design

BackgroundThe Emergency Department is widely regarded as the epicenter of medical care for diverse and largely disparate types of patients. Physicians must be aware of the cultural diversity of their patient population to appropriately address their medical needs. A better understanding of residency preparedness in cultural competency can lead to better training opportunities and patient care. ObjectiveThe objective of this study was to assess residency and faculty exposure to formal cultural competency programs and assess future needs for diversity education. MethodsA short survey was sent to all 168 Accreditation Council for Graduate Medical Education program directors through the Council of Emergency Medicine Residency Directors listserv. The survey included drop-down options in addition to open-ended input. Descriptive and bivariate analyses were used to analyze data. ResultsThe response rate was 43.5% (73/168). Of the 68.5% (50/73) of residency programs that include cultural competency education, 90% (45/50) utilized structured didactics. Of these programs, 86.0% (43/50) included race and ethnicity education, whereas only 40.0% (20/50) included education on patients with limited English proficiency. Resident comfort with cultural competency was unmeasured by most programs (83.6%: 61/73). Of all respondents, 93.2% (68/73) were interested in a universal open-source cultural competency curriculum. ConclusionsThe majority of the programs in our sample have formal resident didactics on cultural competency. Some faculty members also receive cultural competency training. There are gaps, however, in types of cultural competency training, and many programs have expressed interest in a universal open-source tool to improve cultural competency for Emergency Medicine residents.

To provide a comprehensive understanding of the cultural adaptation and professional integration experiences of migrant nurses in the receiving country. A convergent parallel mixed methods design with concurrent sampling was employed. Professional nurses who migrated from various Middle Eastern and North African countries, including Egypt, Syria, Palestine, Yemen, Jordan, Iraq and Saudi Arabia, were enrolled. The Quantitative data was collected through an online questionnaire involving open-ended questions for the qualitative data. Data was collected from November 2023 to March 2024. One hundred five nurses responded to the quantitative questionnaire, and 32 answered the open-ended questions. The findings revealed that mean scores for cultural competence and professional self-concept were 83.41 ± 12.90 and 76.28 ± 11.16, respectively. Migrant nurses experienced challenges such as language barriers (91.4%), social interaction (82.9%) and difficulties adapting to daily living activities (100%). The majority of them reported positive outcomes as better working conditions (91.4%), higher standard of living (89.5%) and professional development opportunities (94.3%). Nurses emphasised accepting cultural diversity, participating in cultural competency training, building relationships with local colleagues and utilising support mechanisms and mentorship for cultural adaptation. This study highlighted the importance of support systems, cultural competency training and integration initiatives to facilitate successful adaptation and professional integration. Orientation programs and cultural competency training should be developed to support migrant nurses. Initiatives should include language acquisition support, financial assistance for certification programs and promotion of diversity and inclusion in healthcare settings. This study addressed the challenges migrant nurses face when transitioning to a new cultural and professional environment. It found that migrant nurses experience difficulties with language, social interaction and daily living activities. The research impacted healthcare institutions by guiding the development of orientation programs and cultural competency training, supporting policymakers in addressing systemic barriers and empowering migrant nurses with practical strategies for adaptation. This study adhered to the Good Reporting of A Mixed Methods Study (GRAMMS). No patient or public involvement.

Introduction: Populations, Problems, and Resources in a Global Society.- The Human Face of Globalization.- Globalization: Psychological Problems and Social Needs.- National and International Professional Resources.- Introduction: Education and Training Perspectives in Transition.- Transitions Integrating Research and Practice.- Transitions in Psychotherapy, Clinical Diagnosis, and Assessment.- Transitions in Professional Training.- Introduction: Multicultural Education/Cultural Competency Training.- Research Foundations of Cultural Competency Training.- Striving for Cultural Competence: Moving Beyond Potential and Transforming the Helping Professions.- Cultural Competency Training in Professional Psychology.- Introduction: Using Professional Resources Effectively.- A Cultural Competency Training Model.

BackgroundVirtual patients are educational tools that may be described as case-based interactive computer simulations of clinical scenarios. In terms of learning outcomes, improved clinical reasoning skills and knowledge acquisition have been shown. For further exploring the role of virtual patients in medical education, a greater focus on context-specific cases, combined with suitable educational activities, has been suggested. A knowledge gap has been identified in cultural competence in primary care. As primary care physicians are often the main medical providers for patients with refugee backgrounds, they would probably benefit from improved training focusing on how to apply cultural competence in everyday work. Using virtual patient cases, as a complement to clinical training, may be one way forward. The aim of this study was therefore to explore a learner perspective on the educational use of a virtual patient system designed to contribute to training in cultural competence in a primary care context.MethodsThree virtual patient cases portraying patients with refugee backgrounds were developed. The cases addressed various issues and symptoms common in primary care consultations, while also incorporating intercultural aspects. The system also provided the informants with individualized feedback. Primary care physicians and medical students were invited to test the cases and participate in an interview about their experience. Data was analyzed using qualitative content analysis.ResultsThe analysis generated the theme Virtual patients might help improve cultural competence in physicians and medical students by complementing knowledge gained through the informal curriculum. Informants at different educational levels found it suitable as a tool for introducing the topic and for reflecting on one’s own consultations. It could also compensate for the predominant informal manner of learning cultural competence, described by the informants.ConclusionsVirtual patients could be useful for gaining cultural competence in a primary care context. Advantages that could benefit learners at both pre- and post-graduate levels are decreased dependence on the informal curriculum and being presented with an illustrative way of how cultural competence may be applied in the consultation.

BackgroundThe increasing growth of migrant populations in Spain has changed the cultural profile of healthcare system users. Cultural competence in health care settings has become an increasing worry for health professionals, specifically for nurses. Therefore, the training in cultural competency of nursing students is indispensable. ObjectiveTo explore the views on the use of high-fidelity simulation in fourth-year nursing students to improve their cultural competence. MethodsA qualitative descriptive study was conducted with an interpretative phenomenological approach. Before and after taking part in simulated scenarios, 56 semi-structured interviews were conducted. We explored the perceptions of the nursing students when addressing a simulated clinical case with a patient who is a migrant, including the training deficiencies in cultural competences perceived before the simulation, the benefits perceived, and the improvement suggestions. We also analyzed their views on the skills and knowledge developed during the simulation experience. ResultsBefore entering the simulation scenario, we found the existence of insecurity, uncertainty, and cultural differences in the nursing students, with the main worry being the language barrier. They also mentioned the need to improve their intercultural communication and cultural adaptation of the care in their training. After finishing the simulation, they indicated positive aspects, aspects to be improved, learning acquired, and learning to be strengthened, highlighting the existing cultural differences and asking for training on cultural competence. ConclusionsThe use of high-fidelity simulation provides a positive learning experience, which increases a student's comfort when working with patients of varied cultural origins. Its usefulness in teaching is found in its capacity to develop communication skills and interpersonal skills, such as empathy, in the students. This study provides evidence on the importance of specific training on cultural competence in the Nursing Degree, and the usefulness of high-fidelity clinical simulation to achieve this.

Purpose: Culturally competent health care providers understand cultural attitudes, values, beliefs and practices and are able to use this knowledge to guide patient care. Rising oral health disparities among racial...

Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.

Forgiveness has the potential to resolve painful feelings arising from nurse-patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness. The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence-forgiveness association among nurses using structural equation modeling. The research applied a cross-sectional correlational design. The study included 380 nurses eight hospitals in southern Iran. The Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed. Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1-10 years. The proposed model showed that nurses' empathy intermediated the association between nurses' cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ2/df = 2.85). Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses' cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients.

Background: Global migration and increasing cultural diversity have made cultural competence a necessary component of quality health care. In clinical practice, nursing and laboratory services are major patient interfaces where culturally mediated beliefs, behaviors, and communication styles directly influence the process of care. Mismatch in these interactions can lead to misdiagnosis, non-adherence, and health disparities. Aim: This systematic review aims to synthesize the literature between 2015 and 2025 to understand how cultural factors impact patient interactions in nursing and laboratory practice and to evaluate strategies for developing cultural competence in these services. Methods: A systematic search was conducted in PubMed, CINAHL, PsycINFO, and Scopus. The search terms used were "cultural competence," "nursing," "phlebotomy," "laboratory medicine," "patient interaction," "health disparities," and "cultural factors." Results: Cultural factors significantly impact care, including explanatory models, communication barriers, religion-based preferences, and family involvement. These factors affect patient consent, compliance, and follow-up care. Interventions like professional medical interpretation, cultural competency training, and culturally tailored patient education improve patient satisfaction and diagnostic accuracy. Conclusion: Cultural competence is crucial for safe, effective, and equitable nursing and laboratory practice. Institutional policy should include trained interpreters, culturally sensitive protocols, and a diverse workforce, promoting cultural humility.