Integrating Cultural Competence through Service Learning in the Graduate Nursing Curriculum: A Clinical Experience with underserved and vulnerable populations for Family Nurse Practitioner Students

                                                                           Abstract

Teaching knowledge in context, integrating classroom and clinical teaching, fostering clinical reasoning, and emphasis on role formation are essential shifts suggested to transform nursing education (Benner, Sutphen, Leonard, Day, & Schulman, 2009). Service learning as a curricular strategy, aimed at cultural competence, supports the identified essential components of transformation, and facilitates the development of cultural competence. The necessity for curriculum development is established to reflect the The Essentials of Master’s Education in Nursing (American Association of Colleges of Nursing, 2011), and the need for curricular changes in the graduate nursing program responsive to an evolving health care environment (Clabo, Giddens, Jeffries, McQuaide- Jones, Morton, & Ryan, 2012).   The National Organization of Nurse Practitioner Faculties (2012) identifies patient-centered care that incorporates and recognizes cultural diversity as a core competency for nurse practitioners. Nurse Practitioner faculty are challenged to prepare compassionate, competent practitioners who can provide quality care to diverse populations.

A service learning requirement was integrated into the initial clinical experience for Family Nurse Practitioner Students. Under the supervision of nurse practitioner faculty, students provided health care to migrant farmworkers and their families. Faculty and students worked in collaboration with student interpreters from another University, and state funded health care workers. The direct measure utilized for the service learning was reflection through journaling. Guided reflections were recorded prior to the service learning experience, and after the service learning experience. In addition, students completed a pre-test, post-test measure of competency. Evaluation of the service learning component demonstrated students were able to achieve academic course goals, appreciate the role of the nurse practitioner role while working with underserved populations, and translate classroom knowledge to the clinical environment; all within a cultural context.