The effect of cross-cultural training on cross-cultural skills, adjustment, and performance in a transcultural nursing context

This thesis examines the effects of information-based versus experientially-based cross-cultural (C/C) training programs on the adjustment and performance of nurses in a domestic transcultural nursing context. Mediating and moderating constructs were derived from the international C/C management literature and Social Cognitive Theory (Bandura, 1986). Mediating constructs include the nurse's C/C self-efficacy regarding (1) the effective application of her cultural knowledge (hypothesized to mediate the relationship between C/C training rigor & C/C adjustment) and (2) her ability to perform interactive nursing activities with culturally-different patients (hypothesized to mediate the relationship between C/C training rigor & C/C performance). Moderating constructs include perceptual flexibility (i.e., tolerance for the particular kind of ambiguity that is posed by transcultural situations; hypothesized to moderate the relationship between C/C training rigor & each type of C/C self-efficacy), cultural-distance (i.e., between nurses and their patients hypothesized to moderate the relationship between each type of C/C self-efficacy & its corresponding outcome of C/C adjustment or performance), and intensity of interaction (i.e., frequency and breadth of the interactions required by nurses with patients of diverse medical conditions; also hypothesized to moderate the relationship between each type of C/C self-efficacy & its corresponding outcome of C/C adjustment or performance).;These relationships were examined via a quasi-experimental cross-sectional design in 9 Toronto hospitals. Subjects (148 staff nurses & their supervisors) completed questionnaires with reliable measures that tapped into the constructs of interest. Self & supervisor performance appraisals were sought.;Results partially supported the hypothesized model. Theoretical implications included: (1) the positive effect of C/C training on C/C performance generalizes to a domestic C/C context; (2) the positive effect of C/C training on C/C adjustment does not generalize to an environmentally-turbulent, domestic C/C context; (3) C/C skills may be effectively operationalized in the form of C/C self-efficacy; (4) these two operationalizations of C/C self-efficacy are differentially related to C/C training and performance; (5) prior C/C exposure facilitates transfer of training insofar as the exposure is contextually similar to the work environment; and (6) perceptual flexibility is significantly correlated to C/C adjustment and performance but does not impede learning. The key practical implication is that C/C training can improve nurses' C/C performance.