The Development And Evaluation Of The Multicultural Nursing Competence Training Program For Undergraduate Nursing Students In Chinese Context

ObjectiveThe aim of this study is to develop the Multicultural Nursing Competence Training Program based on the Campinha-Bacote’s cultural nursing competence model for undergraduate nursing students in the Chinese culture context,and to verify it feasibly and effectively in nursing educational practice.MethodsThe study is the mixed research,which consisted of two phases.The first phase is on the development of the Multicultural Nursing Competence Training Program(MNCTP)for Chinese undergraduate nursing students.The second phase is to utilize and evaluate the scheme feasibly and effectively in education.The study in the first phase was conducted with literature review and analysis and expert consultation methods.A large number of relevant literatures were firstly read and analyzed to understand the domestic and overseas status quo about multicultural nursing competence training,and then we clarified the influence factors of multicultural nursing competence.And the the draft of MNCTP was designed guided by the Campinha-Bacote’s culture competence model.Then the MNCTP was modified through specialist consultation and the final version was decided at last.The study in the second phase involved the implementation and eveluation of MNCTP with the quantitative and qualitative research methods.122 participants from the nursing undergraduates of grade 2016 of Zhenzhou University were recruited into the study,and assigned to the experiment group(n=61)and control group(n=61)randomly.The control group experienced the routine course learning and other activities,while in the exception of the above,the experiment group added the 8-week MNCTP.The multicultural nursing competence and self-efficacy were measured with the Cultural Competence Assessment-Chinese Version(CCA-CV)and the Transcultural Self-efficacy Scale-Chinese Version(TSET-CV)before the training,at the end of the training and after three months to collect the qualitative data.The statistic analysis was conducted by SPSS 21.0 software.In order to understand the effect of the training deeply,we recruited eight participants from the experiment group to receive the semi-structured interviews to feedback their learning experience.The qualitative data were coded and extracted the themes by the Colaizzi’s 7-step analysis method.ResultsThe study recruited 122 undergraduate nursing students,but 5 students dropped out.At last,the total 117 participants completed the study,including 57 in the experimental group and 60 in control group.1.Comparison of CCA-CV pretest and posttest between the two groupsFor the experiment group,the overall score of cultural competence is promoted from pretest(4.38±0.54)to posttest(4.77±0.48)after 3 months;The subdivision of cultural awareness and sensitivity is increased from pretest(5.15±0.54)to posttest(5.41 ± 0.52),the score of cultural behaviors is also increased from pretest(3.79±0.73)to(4.27±0.69).The total score of cultural competence in the experimental group is obviously higher than that in the control group and the P value is less than 0.05(P<0.05),which is statistically significant.2.Comparison of TEST-CV pretest and posttest between the two groupsFor the experimental group,the overall score of transcultural self-efficacy is promoted from pretest(6.31 ±0.90)to posttest(7.01 ±0.69)after 3 months.Among them,the total score of transcultural self-efficacy in the intervention group immediately after the training and 3 months after the training improved compared with that before the training,and the difference was statistically significant(P<0.05).Compared with the control group,the total score of transcultural self-efficacy of nursing students in the intervention group is higher than that in the control group,and the difference was statistically significant(F=19.359,P<0.001).3.Results of the qualitative data analysisThrough semi-structured interviews,8 trainees gave us their feedback and reflection when they experienced the 8-week multicultural nursing competence training.Four themes and nine sub-themes are extracted from the interviewing material.Theme 1 is Improvement of cultural awareness including self-evaluation of cultural competence,transformation in perspective,interest in multicultural nursing;Theme 2 is Promotion of overall competence including skillfully making multicultural nursing plan,having better multicultural nursing communication skills;Theme 3 is Desire for multicultural nursing practice,including understanding clients’ cultural needs actively,learning dialects and customs of different cultures;Theme 4 is the Advise for the training program including the enrichment of training methods,reduction in learning difficulty.Conclusion1.The Multicultural Nursing Competence Training Program are developed based on the Campinha-Bacote’s cultural nursing model combining with Chinese cultural characteristics.The MNCTP is suitable to apply in Chinese context.2.The MNCTP has been verified feasible and effective in enhancing nursing students’ cultural competence and the transcultural nursing self-efficacy.