Integrating Cultural Competence into a DNP Curriculum

Leininger and McFarland (2002) recommended nursing faculty incorporate a substantive transcultural nursing course into graduate programs as well as integrate transcultural nursing content into all courses so nursing students are prepared to provide culturally effective, competent, and safe care.  In 2008, the Department of Nursing developed a new Doctor of Nursing Practice program with evidence-based cultural competence integrated as a major thread throughout the graduate curriculum.  Faculty were provided instruction in transcultural nursing theory, research, and practice  along with focused content on culture, cultural diversity, cultural competence, and culture care.  Strategies for teaching faculty this content included consultations by nationally- and internationally-known transcultural nursing education experts.

Subsequently, the graduate faculty completed a survey assessing their course objectives and content intended to address the cultural competence of nurse practitioner students.  Sixty-five percent of the nursing faculty who completed the survey reported incorporating at least one objective and course content related to cultural competence.  Faculty certified in transcultural nursing mentored faculty to integrate cultural competence into their courses.  This mentorship continues to facilitate the integration evidence-based transcultural content into advanced practice registered nurse (APRN) courses.  A follow-up survey is planned to assess improvement regarding the inclusion of cultural competence in courses throughout the graduate curriculum.  Educators and researchers are challenged to measure changes following educational interventions.  To meet this challenge, graduate students have been assessed at three points in time during their APRN education using the Transcultural Nursing Self-efficacy Tool (TSET; Jeffreys, 2010) to determine their level of confidence in their knowledge and abilities to provide culturally competent care for diverse populations. Changes in overall TSET score and changes in each subscale score were examined using paired t-tests.  There was a statistically significant improvement in overall score and in each subscale score.  Additionally, the overall mean change on the TSET exceeded the goal of 25% improvement.   On average, students' scores increased by 27.8%.