4Evidence-Based Practice Project- Paper on D.docx

4
Evidence-Based Practice Project- Paper on Diabetes
Evidence-Based practice project- Closed Loop Insulin Delivery
System on Type 1 DiabetesThe metabolic and endocrine
dysfunction in other words T-cell mediated autoimmune disease
is called diabetes mellitus (DM) which contains sky-rocketing
influencing in morbidity and mortality of life. This paper is to
elaborate the research article based on the treatment of
childhood diabetes with the close loop insulin delivery system
(CLIDS). Therefore, CLIDS is also known as the artificial
pancreas which is being considered under the best therapeutic
approaches for the control over the sugar in type 1 diabetes.
“Closed loop delivery system is an innovative tool which is
made up of synthetic materials, it works as a substitute of the
pancreas by recognizing plasma glucose concentration, and
computing the needs of insulin requirements and also it

provides the exact amount of insulin as needed” (Sasi &
Elmalki, 2013).
Research and Clinical Findings:
The research of innovative health care system was researched
by many of the popular researchers in the 21"st century. The
writer is also very interested in this research article which was
by(Thabit et al) which is located in the New England Journal of
Medicine in 2015. “Home Use of an Artificial Beta Cell in Type
1 Diabetes” This research paper basically provides information
for the patient to improve their quality of life by helping them
out with certain practices giving them right information base do
the organization and providing them the safety of artificial
pancreas for home settings. This study was specifically lead by
the where there are 58 participants from two different age
groups starting age of 6-18 years and also it includes 25
participants from age group 18 to 33 which involves involved
type 1diabetes and the duration of the study was 12 weeks.
Conduction of study was done as a closed-loop insulin delivery
system versus sensor-augmented pump (SAP) therapy; in adult,
CLIDS was used during the day and night and children group
used sensor only overnight during the 12 weeks study time
period while during the same time frame the sensor-augmented
pump therapy used for the control group. However, both study
and control group were under continuous monitoring of glucose
through the continuous glucose monitoring device (CGMD) By
the use of CGMD, glucose level recorded on CGMD ranging 70
to 180 mg per deciliter is considered as the primary endpoint for
adult group and 70 to 145 mg per deciliter for children group
(Thabit et al., 2015).
The research paper elaborates the effectiveness of artificial
pancreas over SAP in both children and grown-up adult for
maintaining the blood glucose level. CLIDS tracks the target
blood glucose where they compare it to SAP as well. The
practice round was done during the day and night with the
adults and for children, it was only at the night time. There was
not any limited controlled for the right way glucose level which

really helped for reducing the incidence of hypoglycemia and
the mean glycated hemoglobin level in adults throughout the
study was been lowered for the certain period. Diabetes patient
is thankful for having CLIDS to control blood glucose level and
there should be a certain amount of hypoglycemic state in their
actual house setting with no kind of medical controlled.. (Thabit
et al., 2015).
Significance of the Study in Diabetes and Nursing Practice
Back in 1920, the quality of diabetic patient life was very poor
with very short lifespan because of lack of treatment options.
Also, there was a huge change in the advancement of modern
health system brought up various changes and technologies in
modern insulin regimens and insulin therapy. Diabetic patients
were required to get improved care by having a quality of life
(Hay, 2010). Strict diet, exercises which may close loop insulin
delivery system and this is considered as the good option for
living the quality of life, it also has the higher chance of
controlling the blood glucose level, also prevent the
hypoglycemia and overcome all the difficult challenges of
intensive insulin therapy, (Thabit & Hovorka, 2012).The main
reason behind this research paper is to explain the important use
of CLIDS in type 1 diabetes. In this situation patients in freely
living in house setting without any control of medical and with
the great reduction of risk of hypoglycemia. Therefore, younger
kids are usually susceptible to have the effects of
neuroglycopenia such as seizures, somehow have a connection
with hypoglycemia during their sleeping hour time. Thus, over
the night closed-loop insulin delivery system helps to get over
the risk of hypoglycemia in children.
The specific role that has to be played by the nurses as
specialist is getting Tougher by how the number of diabetic
cares is increasing day by day and this time period for nurses
are being really difficult because they have to be really
sensitive based on the general care in prevention, treatment and
also for the management of diabetes. Diabetes is considered as

one of the complicated health issues which have a higher chance
of affecting the multisystem such as kidney, retina, peripheral
nerves, and heart. The control and management of diabetes are
very crucial. The earliest diagnosis of diabetes, refer for
patients to an endocrinologist for their treatment to achieve the
therapeutic goal and evaluate the further long-term
complications are some of the major responsibilities of nurses.
This paper concludes the “extended uses of a closed-loop
system at home over a period of 12 weeks without any close
supervision. It is feasible in adults, children, and adolescents
with type 1 diabetes” (Thabit et al., 2015). The recommends of
CLIDS over SAP has really been beneficial for the education of
the patients about the CLIDS organization. This helps them to
guide improving their quality of life. To conclude, the paper is
based on bringing up the changes in the treatment of Type
diabetic patients where the patient’s lifestyle will totally be
improved from how it was before.
References
Hay, K. E., (2010). The roles of the open loop insulin delivery
system and the artificial pancreas in diabetes treatment. Masters
and Doctoral Projects. Paper 328.
http://utdr.utoledo.edu/graduate-projects/328
Sasi, A., & Elmalki, M. (2013). Design and Analysis of a
Sliding Table Controller for Diabetes. ICA, 04(03), 301-308.
http://dx.doi.org/10.4236/ica.2013.43035
Thabit, H., & Hovorka, R. (2012). Closed-Loop Insulin Delivery
in Type 1 Diabetes. Endocrinology And Metabolism Clinics Of
North America, 41(1), 105-117.
http://dx.doi.org/10.1016/j.ecl.2011.12.003
Thabit, H., Tauschmann, M., Allen, J., Leelarathna, L.,
Hartnell, S., & Wilinska, M. et al. (2015). Home Use of an
Artificial Beta Cell in Type 1 Diabetes. New England Journal
Of Medicine, 373(22), 2129-2140.

http://dx.doi.org/10.1056/nejmoa1509351
Directions for part 2 of your assignment:
Select 3 of the critical incidents below and analyze them. Your
analysis should contain at least
three scholarly references each that pertain directly to the
incident. Your analysis should be
completed as formal written report in APA format. You can take
the format of an executive
briefing or a training session. The analysis should be complete
and supported by literature, not
an opinion piece.
After you select three critical incidents, choose from the
following cultural orientations and
themes as they relate to your critical incidents (may be more
than one). Explain how your
chosen critical incident relates to one or more cultural
orientation(s) and theme(s) in your report:
Universalism/Particularism
Power Distance
Hierarchy/Equality
Individualism/Collectivism
Space: Private/Public

Face
Communication: High/Low Context
Communication: formal/ informal
Communication: direct/indirect
Communication: non-verbal
Competitiveness
Thinking
Learning Style
Interpersonal Distance and Touch
Time
Death/dying
Cheating
Customs
Knowledge
Teacher/student
Relationship building
Discipline

Apology
Work ethic
Conflict
Respect
Parenting
Negotiating
Gender roles
What is cultural competency?
Culture is commonly defined as a shared system of beliefs and
values that shapes a group's
behavior. People interpret the behavior and communication of
others through their own cultural
biases and typically will identify anything that is different from
their own values as "wrong" or
"inappropriate."
Communication styles are based largely on cultural values. One
researcher who helps us
understand cultural values around the world is Geert Hofstede.
He lists the following five cultural
dimensions and describes how they vary across cultures
(Hofstede, 1967–2009).
Power distance is the extent to which a group of people accept
the unequal distribution of power
among different segments of their society. Venezuela, the
Philippines, and Mexico have high

power distance and accept the inequality in their societies,
whereas Denmark, Austria, and the
United States are among the countries that have low power
distance, or low tolerance for
inequality.
Individualism is the value that a culture places on individual
rights and well-being, as opposed to
collective rights and well-being. Australia, the United States,
and Great Britain tend to be
individualistic countries, whereas Colombia, Japan, and Nigeria
tend to be collectivist.
Masculinity is the value that a culture places on assertiveness
and competitiveness. Japan,
Mexico, and Austria are among the more masculine societies,
whereas Denmark, Sweden, and
Norway are among the more feminine societies. Typically, the
more masculine cultures will also
stress a greater difference between gender roles in the society.
Uncertainty avoidance is the degree to which a culture is
comfortable with doubt and ambiguity.
Cultures that tend toward high uncertainty avoidance will seek
to avoid multiple choices or
positions. Greece, Portugal, and Japan tend to be high on
uncertainty avoidance, whereas
Singapore, Sweden, and the United States tend toward low
uncertainty avoidance and are more
comfortable with choice and ambiguous situations.
Polychronic cultures tend to value tradition and long-term goals
over short-term goals. Countries
such as Brazil, Spain, and China are more patient and less

interested in time management,
whereas in monochronic countries such as Germany and the
United States, the focus is on
"saving time," "making time," or "not wasting time."
Additional information about cultural competency is located in
our course and at this web site:
http://geert-hofstede.com/dimensions.html
You will want to conduct your own research to learn more
information about cultural
competencies for the purpose of this assignment.
_____________________________________________________
_______________________
________________________________
Critical Incidents
What are critical incidents?
Critical incidents are tools for increasing our awareness and
understanding of human attitudes,
expectations, behaviors, and interactions. They are intended to
engage participants at a
meaningful, personal level as they examine attitudes and
behaviors that might be critical to their
effectiveness in the roles they are already performing or pre-
paring for (in the workplace, in
educational settings, and in society at large).
Critical incidents in intercultural communication training are
brief descriptions of situations in
which a misunderstanding, problem, or conflict arises as a result

of the cultural differences of
the interacting parties, or a problem of cross-cultural adaptation
and communication.
Choose 3 of the following critical incidents for your
assignment:
1. A student was not satisfied with her new class. She wanted to
move to a higher class. First,
she consulted the student advisor who said that she could not
move up at this time. The
student, still unsatisfied with this answer, asked the other
student advisor. The second student
advisor gave her the same answer. Next, she made an
appointment to see the coordinator of
the Language Training Program. The coordinator consulted the
student’s teacher and the
student’s test scores and explained to the student that, according
to the guidelines, she was
unable to move to the next level at that time. The student was
still not satisfied and made an
appointment to see the dean and then intended to talk to the
president of the college.
Meanwhile, the teacher couldn’t understand why the student
did not just accept her decision.
She also could not understand why the student could not see
that there were policies in place
so that no matter how high up she went in the college hierarchy,
it would not change the
outcome for her.
2. Jane entered her classroom after the morning coffee break
and saw a group of students

looking at photos. A young woman in her twenties was showing
the photos. The photos were of
a three-month-old infant. The teacher commented that the baby
was very cute. Then the teacher
noticed that the baby was in a coffin and, after a pause,
commented that the baby had died. The
woman said yes, and then the teacher asked her a few more
questions about the child. The
teacher was surprised. This group of students had been together
for only two weeks. Later, the
word “undertaker” came up as a vocabulary word in the same
class. When the teacher
explained the meaning, the student went on to describe in detail
the process of preparing her
baby’s body for burial. The teacher wondered if she should talk
to the student privately to
explain that some people might be uncomfortable with this
topic. The teacher certainly was!
3. Sandra gave her students a grammar test. During the test, a
student was looking at another
student’s answers and writing them on his paper. The teacher
asked him to do the test on his
own. The student continued to look at the other student’s
answers. The teacher took his paper
away and threw it into the garbage in full view of all the other
students to make the point that the
student’s answers were not an indication of his understanding
of the grammar and that it was
pointless to write the test if he was just going to cheat. The
student was very upset and went to
the office to complain.
4. My friend liked her class, but she felt that the teacher was
very cold. She said the teacher just
taught grammar and never asked about the students’ families or

talked about her own.
5. Mark entered his LINC (Language Instruction for Newcomers
to Canada) class on the first
day and introduced himself to the class. The first lesson was
designed to work on all four skills
and to give students the chance to get to know their teacher.
Mark began by telling the students
that he, too, was an immigrant to Canada and that he was going
to share his biography with the
class. Their first assignment was to ask him questions and take
notes about what they heard.
Next, they had to write several paragraphs about him and hand
it in later that week. On the day
that it was due, all the students had done the work except for
one. Mark asked her why she had
not done her home- work, and she answered that she did not
need to know about him. Mark
explained that the assignment was designed to work on a variety
of specific English skills that
she needed to improve her ability to communicate in English.
After that, she did not really
participate in class. She did her own work and paid attention
only when there was something
that interested her.
6. Sandra is a fun-loving teacher teaching in the LINC program.
At the beginning of every
course, she explains the classroom and school guidelines,
including the rule about being late.
After about a week and a half, one of her students started to
arrive late for class every morning.
Sandra likes to treat things in a light- hearted manner, and so
when the student walked in late
one morning, Sandra said “good evening” to her and everyone
laughed. Sandra had done this

before with other students. The student ignored Sandra and went
and sat down. Sandra felt a
little annoyed and so she asked the student about being late. The
student then yelled at Sandra
and said, “You don’t talk to me like that!” Sandra told her that
she should apologize for being
late. Later, Sandra approached her privately and apologized to
her even though she felt that the
student should apologize first. The student also apologized but
later stopped coming to class
altogether.
7. Len teaches the evening TOEFL (Test of English as a Foreign
Language) class. One day
there was a conflict between a student who wanted to do more
listening practice in class and a
student who wanted to focus only on grammar. The next day,
one of the two students came to
Len’s office to talk to him about the class. She told him that she
thought they had studied
enough grammar and that they needed more listening practice.
She assured him that she was
not trying to tell him what to teach. A week later she invited
Len to come to her home so that she
could show him something. He did not go. Then she sent him
an e-mail, thanking him for his
teaching and complimenting him on his looks. This made him
very uncomfortable, so he made a
conscious attempt to avoid her outside of class.
8. Jacquie taught English for 10 years in China and Japan. When
she returned to Canada, she
started teaching in the LINC program. She really enjoyed the
multicultural classroom and felt

challenged to meet the learning needs of her diverse class. She
was, however, having a lot of
trouble with one student who seemed very glum and critical.
This student, 45, had a doctoral
degree (also called Ph.D.) from her country. She never smiled in
class and seemed to test
Jacquie every time she taught grammar or vocabulary. In fact,
Jacquie felt that the student
enjoyed upsetting her. One day, Jacquie confronted the student
in class and told her that she
should change to another class if she was not satisfied. The
student didn’t leave after this
confrontation but seemed more content and did not second-
guess Jacquie after that.
9. There is a student in my class who is always late. That is not
the only problem. When I ask
him a question, he goes on and on and on and makes the rest of
the class wait and wait. I want
to tell him to get to the point. Finally, I have to cut him off
because he loses track of the time he
is taking up in class on his issue. I tell him that if he wants to
continue talking about it, he’ll have
to do it on his coffee break. He doesn’t understand our concept
of time. We are on a strict
schedule and things have to be done by a certain time; as well,
things are scheduled to take a
certain amount of time. I don’t like it either—I hate it.
10. It was break time and two students were having a
conversation in the hallway. When the
break was over, Janet called everyone back to class. The two
students continued their
conversation. When Janet asked them to come in, one of the
students looked at her as if to say,
“you are so abrupt and rude. You want me to return to class?

Can’t you see that I am in the
middle of a social conversation?” Janet felt annoyed.
11. George really infuriated me because when it was time to
hand in his assignment, he gave
me a whole bunch of lame excuses. It really upset me because I
felt that he was not taking his
work seriously and did not pay attention to the deadlines. I
explained the assignment very
carefully and put the deadlines up on the board—so when he
made up excuses to cover
himself, he really made me mad. I felt bad, though, because
there was another student who
didn’t have his assignment done either, but he apologized and
said he’d hand it in later that day.
He never did hand it in on that day; he handed it in a few days
later, but since he had
apologized, somehow I accepted that and was nice to him.
12. A man in his early twenties was walking home from school
one day when he passed by a
small group of girls of junior high school age. The girls laughed
at him, and he felt very upset
and disrespected. If he had been at home, he would have
disciplined them right there in the
street and then taken them home to their fathers and the fathers
would have supported him. He
knew that he couldn’t do that here.
13. A young woman had recently arrived in Canada ready to
start a new life. She found the
weather a little cold but still enjoyed wearing the same style she
wore at home—tight skirts and
tight tops that had low neck- lines. After about a month, she

began to notice people staring at
her. She thought they were looking at her because she was a
foreigner. Then one day some-
one told her that only prostitutes dressed that way. She felt
angry and insulted.
14. A man was walking past a cemetery when he noticed
something very odd. To make sure he
wasn’t mistaken, he went in to take a closer look. He was very
surprised to see two names on
the tombstone he was looking at. One was the name of someone
who had already died, and
next to it was the name of someone who was still living. The
tombstone had a birth date but no
death date on it. He just couldn’t believe it!
15. Two women in their late fifties were walking along the
street holding hands when a truck
drove by and the passenger shouted “lesbo”13 at them. They
were very upset that people
thought they were lesbians, and so they stopped holding hands
like that. They couldn’t
understand why some people had a problem with two women
holding hands. It is a normal thing
to do.
16. Irene and her husband recently met a couple that had just
immigrated to Canada. Irene and
her husband were having a party at their house, so they decided
to invite their new friends.
When the couple arrived, there were three other couples there
already. The man entered and
shook hands with the men but not with any of the women. Irene
was insulted.
17. A man commented one day that the reason there are so many

single women in Canada is
that they are lazy. His female friend was surprised and insulted
by his attitude.
Workplace
18. Peter went downtown to an office to pick up some
documents. When he arrived, he went to
the front desk and talked to the receptionist. The receptionist
was very helpful and seemed to go
out of his way to make sure Peter wouldn’t have any trouble
getting what he needed. Peter was
very happy with the service and thought about how different it
was from the service in his
country. About half an hour later, he was just getting ready to
leave the office when he real- ized
that he had one more question. The receptionist was not at his
desk, but Peter saw him in the
hallway so he rushed out to catch him. Instead of helping Peter,
the man told him that he was on
his break and that Peter would have to wait until he got back.
Peter was surprised by the
receptionist’s response.
19. Mary was working in a laboratory at the university as part
of a work placement program. She
really enjoyed her job and felt that things were going very well.
She worked hard and took her
job very seriously. Her work placement supervisor thought
things were working out well until he
talked to the professor in charge of the lab. The professor said
things were not going well. He
also felt he would have to let Mary go because there had been a
lot of interpersonal problems
since her arrival.

20. A woman who was new to Canada was placed in a teaching
assistant position at a junior
high school. One of the tasks she was asked to do was to mark a
sex education assignment in
which students had to categorize behaviors as sexual intimacy
or not. The teaching assistant
had to approach her cooperating teacher and explain that she
could not mark the assignment
without being given some benchmarks to go by because the
standards for sexual behavioral
norms are very different in this culture.
21. I have a lot of resistance to learning English because I
didn’t really choose to be here. I had
to leave my home because my life was being threatened and my
family’s life was being
threatened. I never really wanted to leave, but I had to because I
was doing an investigation into
some people who had gone missing. I can’t help feeling
resistant to being here; I feel like I am
losing my identity. I am a mathematics professor, but here I can
barely express simple thoughts
in English. I feel stupid. All I want to do is teach math again. In
class I like to translate new
words into Spanish—it feels comfortable, but my teacher gets
annoyed when I do that. It is so
frustrating to feel like I am starting all over again from nothing.
I just want to speak my language
and teach math.
INCA SURVEY

Please answer honestly what you think or would do. There is no
“correct” answer.
Afterwards, use the INCA Survey key to calculate your scores.
Part 1 (Questions 1-7)
Choose:
Never
Sometimes
Frequently or always
1. In restaurants I often eat dishes with ingredients that I don’t
know.
2. I often seek contact with other people in order to learn as
much as possible about their culture.
3. When other people don’t feel comfortable in my presence, I
notice it.
4. I find it easy to adapt to people from diverse origins.
5. I am comfortable with not understanding things if I am in a
strange place or foreign country.
6. When there are colleagues in my work area who constitute an
ethnic minority, I try to involve them in the majority group.
7. When colleagues or superiors from different cultures criticize
my work, I consider changing my work habits accordingly.
Part 2 – Scenarios (Questions 8 – 12)
You have been selected to take part in an international work
project with an associate European company. This will involve
you spending 3–4 months in a country which you have not
visited before (although it is possible that you learnt some of
the language at school).
8. What kind of information do you think you would need

before departure?
I don’t know, I would wait until I got there.
I would use a guide book or other sources to find information
about housing, healthcare, travel.
I would learn or review the language and look for official
sources on history and culture
You have been appointed to a placement in another country for
training purposes. Early in your placement, you discover that
the system of hierarchy is totally different from that practiced
in your own country. For example, you are used to people
dressing informally, using first names, eating in the same
canteen. Here there is much more formality, rules and
regulations, and people don’t even speak the same way to each
other. It is very strange and you cannot help feeling that your
own way is much better.
9. What are some things you might do?
Make an effort to maintain familiar practices, Try and change
things, Explain that our ways are better
Admit homesickness, Look for positive side, even though own
way is best
Seek explanation from superiors in order to understand reasons,
Make an effort to be patient, tolerant, Try out a different way of
behaving to fit in, co-operate, adapt self to others
A young person from a different country comes to work at your
firm for 6 months. You are aware that he is rather isolated and
you consider the idea of inviting him to join you and your

friends. The problem is that your group of friends have known
each other for a long time and a stranger would find it difficult
to fit in.
10. What would you probably do?
Ask friends whether they would welcome a stranger before
taking action, Find out from conversation whether the person
would have similar interests, Invite if interests are similar
Invite even if interests are different, Tell friends that you are
bringing a stranger and explain why, Find out whether the
person would like to join your group of friends, Invite because
you would like to be invited if you were in the same position.
Mention the problem to a colleague, Wait to see whether the
person suggests meeting
You have been working in a foreign country for six months and
you speak the language well enough for everyday needs. At
work, difficult procedures are explained to you in your own
language, so there are no problems here. However, it is almost
impossible to understand your colleagues when they talk to each
other as they talk quickly about situations you do not
understand. It is also difficult to understand jokes and casual
remarks where people seem to speak in a local dialect.
Therefore you often feel out of your depth and confused.
11. How do you feel?
I would feel unhappy, I would feel very left out, I couldn’t deal
with that
I would talk only to fellow nationals

As long as I wasn’t being deliberately excluded it would be OK
12. How would you describe a familiar but complicated task
involving the use of a piece of machinery as if to a foreigner
who did not speak the language very well?
Speak slowly and loudly
Use gestures
Have him/her demonstrate understanding at the end
Part Three : Roleplay (Questions 13-18)
Mr Parker, a department director of a company in Southern
England, has traveled to China in order to conduct negotiations.
He is welcomed by the Managing Director of the Chinese
company. But Mr Parker is not satisfied with the way the
negotiations are going…
For three days Mr Parker has been negotiating with Mr Li, Mr
Wang’s department director. These negotiations have been quite
difficult and tiring. So Mr Parker is looking forward to this
meeting and wants to seize the opportunity to clarify a few
issues face to face with the director of the company.
Parker: I am delighted to meet you.
Wang/Interpreter: (takes his business card and hands it over to
Mr Parker) Here is Mr Wang’s business card.
Parker: (takes Mr Wang’s card and puts it in his pocket) And
here is mine. (he hands Mr Wang his card)
Wang/Interpreter: (Wang reads the card very attentively) Oh,
you have even got Chinese characters on your visiting card!
That's most kind of you. We have a saying in China: ‘When a

friend has come from very far away, then that is a very joyful
event.’ Mr Wang is therefore very glad to be able to welcome
you here today.
Mr Parker, what would you like to drink? Tea or coffee?
Parker: Coffee please.
Wang/Interpreter: Mr Wang would like to know how you have
spent the past few days in Shanghai. Have you been able to
settle in and get used to the climate? Parker: Thank you for
asking. I do have a few problems with my hotel. The air
conditioning doesn’t really work, so I’ve caught a cold. And
also there are … some problems with the negotiations with your
company…
Wang/Interpreter: Mr Parker, if you should have any problems
whatsoever, please let Mr Wang know. We will do our best.
Parker: Thank you very much.
Mr Parker is interrupted in his description of the problem:
Wang/Interpreter: Mr Parker, if you should have any problems
whatsoever, please let Mr Wang know. We will do our best.
Wang/Interpreter: Mr Parker, are you married?
Parker: (slightly surprised) Yes.
Wang/Interpreter: Have you any children yet?
Parker: No, I don’t have any children yet … You know, with all
this travelling I have to do … (forces a smile)
Wang/Interpreter: Mr Parker, Mr Wang has been reading your
business card. And he has noticed that you are sales director,
and you are still so very young. There is, as we say in China, a
bright future lying ahead of you.
Therefore Mr Wang hopes that our … that the negotiations will
take place on the basis of mutual trust and that they will be
fruitful as a result of our joint efforts.
Parker: So do I. You know that our company has a high level of
expertise in technological products. Since we are convinced that
our Chinese partners will appreciate this, I hope that we will be
able to conclude our negotiations successfully and soon.

Wang: (laughs)
Parker: What I would particularly like to know, Mr Wang, is
how your company performs on delivery dates? Will you
manage to keep to deadlines?
Wang/Interpreter: Oh, Mr Parker, there is your coffee. It is
getting cold.
Parker: Thank you. (drinks) But what about the delivery dates?
Wang/Interpreter: You are welcome to discuss these questions
tomorrow with Mr Li in more detail.
Wang/Interpreter: Mr Wang would like to know why you have
not brought your wife with you this time?
Parker: Well, my wife is not all that interested in my business,
and then she doesn’t really like long journeys.
Wang/Interpreter: Mr Wang thinks that is a pity, since Shanghai
is a very nice city. There are many beautiful sights in the
Shanghai area. So you really must bring your wife next time.
Parker: I will try to convince her. But that is going to be very
difficult.
Wang/Interpreter: Mr Parker, have you had a chance to get to
know the Chinese culture in more detail yet?
Parker: No, I'm afraid not. But I am not here on holiday. This is
strictly a business visit.
Wang/Interpreter: Mr Parker, I am sure you have heard that the
Chinese have a very long cultural tradition. So Mr Wang will
tell Mr Li to take you to the 'Yuyuan’ tomorrow for a visit.
There you will find also many shops that sell objects of cultural
interest.
Parker: (growing rather impatient) Thank you very much, Mr
Wang. But … perhaps we can return to that later?
Wang/Interpreter: Mr Wang has been very glad to welcome you
here today. He hopes that our co-operation will be fruitful. The
car that we have ordered for you has just arrived. Mr Wang
would like to show you out.
Parker: Now, that’s a bit sudden. We haven't talked about
business yet.

Wang/Interpreter: As Mr Wang just said, you will be able to
talk business with Mr Li tomorrow.
Parker: (disappointed) All right.
Wang: Mr Parker, if you should have any problems whatsoever,
please let Mr Wang know. We will do our best.
What could Mr Wang mean by this ?
a. Mr Wang will talk to Mr Li about the problems, but doesn't
think they need to be discussed at executive level. If the
problems persist, Mr Parker should get back to Mr Wang as
soon as possible
b. Mr Wang doesn't think this meeting is the place to talk
business. He only wants to get to know Mr Parker, but doesn't
take him seriously as a negotiation partner.
c. Mr Wang can't really help with the hotel problems, but he is
being polite with his guest. So Mr Parker should not discuss his
problems further.
14)Comment on Mr Wang's question: ‘Have you any
children yet?’
a. Mr Wang is just being curious.
b. Perhaps a man's status is higher in China if he has children.
c. He wants to get to know Mr Parker better because that makes
business easier.
In the conversation the following dialogue occurs:
Wang: Therefore Mr Wang hopes that our … that the
negotiations will take place on the basis of mutual trust and that
they will be fruitful due to our joint efforts. Parker: So do I.
You know that our company has a high level of expertise in
technological products. Since we are convinced that our Chinese
partners will appreciate this, I hope that we will be able to
conclude our negotiations successfully and soon.

Why does Mr Wang laugh when Mr Parker makes this
remark?
a. Mr Wang is embarrassed because Mr Parker is so eager to
conclude a deal.
b. Mr Wang is hiding his irritation that Mr Parker may think his
company can't keep to deadlines.
c. Perhaps Mr Wang is nervous because he may not be able to
keep to deadlines.
Mr Wang and Mr Parker briefly discuss cultural activities:
Wang: Mr Parker, have you had a chance to get to know the
Chinese culture in more detail yet ? Parker: No, I'm afraid not.
But I am not here on holiday. This is strictly a business visit.
Which statement best describes this situation in your
opinion?
a. Mr Wang is just trying to keep the conversation going, but he
knows that Mr Parker has no time for cultural activities on such
a short business trip.
b. Mr Parker knows that culture is important to the Chinese, but
he is under pressure. He would like to discuss Chinese culture,
but only after the deal has been concluded.
c. Neither Mr Wang nor Mr Parker are aware that they have
completely different expectations. The meeting would be more
successful if each of them tried to adapt to the other's priorities.
17) Why does Mr Wang repeatedly tell the English manager to
discuss business issues with Mr Li?
a. Mr Wang isn't aware of the details of the contract. Mr Parker
should give Mr Wang more information and ask him to make the
most important decisions. The details can then be worked out
with Mr Li.
b. Mr Wang expects Mr Parker to negotiate with a Chinese
colleague of his own status, as is customary in China. Mr Parker
should not feel offended, but accept it and negotiate with Mr Li.
c. Mr Wang has delegated the negotiations to Mr Li and does

not want undermine Mr Li by discussing the contract with Mr
Parker. Mr Parker should respect this and try to solve any
problems with Mr Li.
18) What statement best expressed the difficulties between Mr
Parker and Mr Wang?
a. Mr Parker acted as you would normally act in a business
meeting, and he expected Mr Wang to do the same. But the
Chinese don't say what they mean, and it's hard to read between
the lines if you don't speak Chinese.
b. Mr Parker and Mr Wang each followed the rules of their own
culture. Mr Parker should have explained himself better and
asked Mr Wang to say more clearly what he means.
c. The different cultures are not a problem, but Mr Wang and
Mr Parker should have known that communication works
differently in each culture. They should have tried to talk about
these differences instead of trying to talk business.
Intercultural competence
INCA questions for each Intercultural Competence
Score
Add your results for the 3 questions from the INCA survey
Based on your score, enter "Basic", "Intermediate" or "Full"
Intercultural competence

INCA questions for each Intercultural Competence
Score
Add your results for the 3 questions from the INCA survey
Based on your score, enter "Basic", "Intermediate" or "Full"
3-4 indicates basic level
5-7 indicates intermediate level
8-9 indicates full level
Communicative awareness
Questions 3, 12 and 18
Knowledge discovery
Questions 2, 8, 14
Respect for otherness
Questions 4,9, 16
Empathy
Questions 10-12
Tolerance of ambiguity
Questions 5,11, 15
Behavioural flexibility
Questions
1,7, 17

Interpreting your INCA survey scores:
Using the results from your INCA survey, complete the table
above. You may wish to make a copy of the table by
downloading the document or recreate the table in another
program.
The goal is to determine your level for each of the 6
Intercultural Competencies. Note that a total score for the INCA
survey is not important for the purpose of this assignment.
When you are done, read the information below to help you
interpret your results.
Intercultural competence – what does it mean?
Intercultural competence enables you to interact both
effectively and in a way that is acceptable to others when you
are working in a group whose members have different cultural
backgrounds. The group may consist of two or more people
including yourself. ‘Cultural’ may denote all manner of
features, including the values and beliefs you have grown up
with, your national, regional and local customs and, in
particular, attitudes and practices that affect the way you work.
Three strands of cultural competences include:

• Openness
• Knowledge
• Adaptability
Openness includes respect for otherness and tolerance of
ambiguity. > To be open means to be open to the other and to
situations in which something is done differently. You can
tolerate your partner as being different and doing things
differently.
Knowledge includes knowledge discovery as well as empathy. >
You not only want to know the ‘hard facts’ about a situation or
about a certain culture, but you also want to know, or you know
something about, the feelings of the other person. You also
know how your interlocutor feels.
Adaptability includes behavioral flexibility and communicative
awareness. > You are able to adapt your behavior AND your
style of communication
Intercultural competence – what does it consist of?
It has been observed how people in groups of mixed cultural
background recognise and deal with the differences that emerge
as the group works together. From such observations, it has
been possible to identify a number of ‘elements’ of competence
that people bring to bear on the situation. These elements are
not definitive. Intercultural competence can include other
‘elements’ of competence, but the INCA project ‘elements’
provide a snapshot, useful as an assessment tool, to provide a
baseline to inform training programmes. If you are

interculturally competent, you may demonstrate the following
characteristics:
‘Tolerance of ambiguity’ Tolerance of ambiguity is understood
as the ability to accept lack of clarity and ambiguity and to be
able to deal with it constructively. In other words, you find the
unexpected and unfamiliar an enjoyable challenge and want to
help resolve possible problems in ways that appeal to as many
other group members as possible.
‘Behavioural flexibility’ Behavioural flexibility is the ability to
adapt one’s own behaviour to different requirements and
situations. In other words, you adapt the way you work with
others to avoid unnecessary conflicts of procedure and
expectation. You will tend to adopt other people’s customs and
courtesies where this is likely to be appreciated, accept less
familiar working procedures where this will raise the level of
goodwill, and so on.
‘Communicative awareness’ The ability in intercultural
communication to establish relationships between linguistic
expressions and cultural contents, to identify, and consciously
work with, various communicative conventions of foreign
partners, and to modify correspondingly one’s own linguistic
forms of expression. In other words, you are alert to the many
ways in which misunderstanding might arise through differences
in speech, gestures and body language. You may, where this
helps, be prepared to adopt less familiar conventions. To be
effective, you will always be ready to seek clarification and
may need, on occasion, to ask other members of the group to
agree on how they will use certain expressions or specialised
terms.
‘Knowledge discovery’ The ability to acquire new knowledge of
a culture and cultural practices and the ability to act using that

knowledge, those attitudes and those skills under the constraints
of real-time communication and interaction. In other words, you
are willing both to research in advance and to learn from
intercultural encounters. You will take the trouble to find out
about the likely values, customs and practices of those you are
going to work with, and will note carefully, as you interact with
them, any additional points that might influence the way you
choose to work with them.
‘Respect for otherness’ Curiosity and openness, readiness to
suspend disbelief about other cultures and belief about one’s
own. In other words, you are ready to regard other people’s
values, customs and practices as worthwhile in their own right
and not merely as different from the norm. While you may not
share these values, customs and practices, you feel strongly that
others are entitled to them and should not lose respect on
account of them. You may sometimes need to adopt a firm but
diplomatic stance over points of principle on which you
disagree.
‘Empathy’ The ability to intuitively understand what other
people think and how they feel in concrete situations. Empathic
persons are able to deal appropriately with the feelings, wishes
and ways of thinking of other persons. In other words, you are
able to get inside other people’s thoughts and feelings and see
and feel a situation through their eyes. While this competence
often draws on knowledge of how you would expect others to
feel, it goes beyond awareness of facts. It often shows itself in a
concern not to hurt others’ feelings or infringe their system of
values.
Each intercultural competence framework has three levels.
These levels are related to your INCA survey results.
Level 1 – Basic Competence

You are already willing to interact successfully with people of
other cultures. You tend to pick things up and learn from them
as you go along, but you haven’t yet got the experience to work
out any system of dealing with intercultural situations in
general. You respond to events, rather than planning for them.
At this stage you are reasonably tolerant of other values,
customs and practices although you may find them odd or
surprising and approve or disapprove.
Level 2 – Intermediate Competence
As a result of experience and/or training, you are beginning to
view more coherently some of the aspects of intercultural
encounters you used to deal with in a ‘one-off’ way. You have a
mental ‘map’ or ‘checklists’ of the sort of situations you are
likely to need to deal with and are developing your skills to
cope with them. This means that you are more prepared for the
need to respond and adapt to the demands of unfamiliar
situations. You are quicker to see patterns in the various
experiences you have and you are beginning to draw
conclusions without having to seek advice. You find it easier to
respond in a neutral way to difference, rather than approving or
disapproving.
Level 3 – Full Competence
Many of the competences you developed consciously at level 2
have become intuitive. You are constantly ready for situations
and encounters in which you will exercise your knowledge,
judgement and skills and have a large repertoire of strategies
for dealing with differences in values, customs and practices
among members of the intercultural group. You not only accept
that people can see things from widely varying perspectives and

are entitled to do so, but you are also able to put yourself in
their place and avoid behaviour you sense would be hurtful or
offensive. At this level of operation you are able to intercede
when difficulties arise and tactfully support other members of
the group in understanding each other. You are confident
enough of your position to take a polite stand over issues,
despite your respect for the viewpoint of others.
How to complete your assignment, part 1:
Write a 1 page reflection of your INCA Survey results. You are
encouraged to include additional resources to support your
reflection. Answer the following questions in your reflection:
1. Describe your results for each of the 6 Intercultural
competencies.
2. What does the data tell you?
3. Do you agree with the results? Why/ why not? Explain your
answer in detail.
There are six categories in this survey which correspond to six
dimensions of cultural competence.
BF = Behavioral Flexibility
KD = Knowledge Discovery
CA = Communicative Awareness
RO = Respect for others
TA = Tolerance for ambiguity
E = Empathy

Part 1
For questions 1 – 7 score yourself in the following way:
Never (1 pt)
Sometimes (2 pts)
Frequently or always (3 pts)
1. In restaurants I often eat dishes with ingredients that I don’t
know. BF
2. I often seek contact with other people in order to learn as
much as possible about their culture. KD
3. When other people don’t feel comfortable in my presence, I
notice it. CA
4. I find it easy to adapt to people from diverse origins. RO
5. I am comfortable with not understanding things if I am in a
strange place or foreign country. TA
6. When there are colleagues in my work area who constitute an
ethnic minority, I try to involve them in the majority group. E
7. When colleagues or superiors from different cultures criticize
my work, I consider changing my work habits accordingly. BF
Part 2
For questions 8-12 score yourself using the number of points
beside the option you chose. The highlighted initials represent
which dimension those scores go into.
You have been selected to take part in an international work
project with an associate European company. This will involve
you spending 3–4 months in a country which you have not
visited before (although it is possible that you learnt some of
the language at school).
KD
8. What kind of information do you think you would need

before departure?
I don’t know, I would wait until I got there. (1)
I would use a guide book or other sources to find information
about housing, healthcare, travel.(2)
I would learn or review the language and look for official
sources on history and culture (3)
You have been appointed to a placement in another country for
training purposes. Early in your placement, you discover that
the system of hierarchy is totally different from that practiced
in your own country. For example, you are used to people
dressing informally, using first names, eating in the same
canteen. Here there is much more formality, rules and
regulations, and people don’t even speak the same way to each
other. It is very strange and you cannot help feeling that your
own way is much better.
9. What are some things you might do? (RO)
Make an effort to maintain familiar practices, Try and change
things, Explain that our ways are better (1)
Admit homesickness, Look for positive side, even though own
way is best (2)
Seek explanation from superiors in order to understand reasons,
Make an effort to be patient, tolerant, Try out a different way of
behaving to fit in, co-operate, adapt self to others (3)
A young person from a different country comes to work at your

firm for 6 months. You are aware that he is rather isolated and
you consider the idea of inviting him to join you and your
friends. The problem is that your group of friends have known
each other for a long time and a stranger would find it difficult
to fit in. (E)
10. What would you probably do?
Ask friends whether they would welcome a stranger before
taking action, Find out from conversation whether the person
would have similar interests, Invite if interests are similar (2)
Invite even if interests are different, Tell friends that you are
bringing a stranger and explain why, Find out whether the
person would like to join your group of friends, Invite because
you would like to be invited if you were in the same position.
(3)
Mention the problem to a colleague, Wait to see whether the
person suggests meeting (1)
You have been working in a foreign country for six months and
you speak the language well enough for everyday needs. At
work, difficult procedures are explained to you in your own
language, so there are no problems here. However, it is almost
impossible to understand your colleagues when they talk to each
other as they talk quickly about situations you do not
understand. It is also difficult to understand jokes and casual
remarks where people seem to speak in a local dialect.
Therefore you often feel out of your depth and confused.
11. How do you feel? (TA)
I would feel unhappy, I would feel very left out, I couldn’t deal

with that (1)
I would talk only to fellow nationals (2)
As long as I wasn’t being deliberately excluded it would be OK
(3)
12. How would you describe a familiar but complicated task
involving the use of a piece of machinery as if to a foreigner
who did not speak the language very well? (CA)
Speak slowly and loudly (1)
Use gestures (2)
Have him/her demonstrate understanding at the end (3)
Part 3
For questions 13 – 16 score yourself using the number of points
beside the option you chose, just like you did for part 2. The
highlighted initials represent which dimension those scores go
into.
Question EM (Empathy)
Wang: Mr Parker, if you should have any problems whatsoever,
please let Mr Wang know. We will do our best.
What could Mr Wang mean by this ?
a. Mr Wang will talk to Mr Li about the problems, but doesn't
think they need to be discussed at executive level. If the
problems persist, Mr Parker should get back to Mr Wang as
soon as possible (1)
b. Mr Wang doesn't think this meeting is the place to talk

business. He only wants to get to know Mr Parker, but doesn't
take him seriously as a negotiation partner. (3)
c. Mr Wang can't really help with the hotel problems, but he is
being polite with his guest. So Mr Parker should not discuss his
problems further. (2)
Question KD (Knowledge discovery)
14) ) Comment on Mr Wang's question: ‘Have you any children
yet?’
a. Mr Wang is just being curious. (1)
b. Perhaps a man's status is higher in China if he has children.
(2)
c. He wants to get to know Mr Parker better because that makes
business easier. (3)
Question AT (Tolerance for Ambiguity)
In the conversation the following dialogue occurs:
Wang: Therefore Mr Wang hopes that our … that the
negotiations will take place on the basis of mutual trust and that
they will be fruitful due to our joint efforts. Parker: So do I.
You know that our company has a high level of expertise in
technological products. Since we are convinced that our Chinese
partners will appreciate this, I hope that we will be able to
conclude our negotiations successfully and soon.
15) Why does Mr Wang laugh when Mr Parker makes this
remark?
a. Mr Wang is embarrassed because Mr Parker is so eager to
conclude a deal. (3)
b. Mr Wang is hiding his irritation that Mr Parker may think his
company can't keep to deadlines. (2)
c. Perhaps Mr Wang is nervous because he may not be able to
keep to deadlines. (1)
Question RO (Respect for otherness)
Mr Wang and Mr Parker briefly discuss cultural activities:

Wang: Mr Parker, have you had a chance to get to know the
Chinese culture in more detail yet ? Parker: No, I'm afraid not.
But I am not here on holiday. This is strictly a business visit.
16) Which statement best describes this situation in your
opinion?
a. Mr Wang is just trying to keep the conversation going, but he
knows that Mr Parker has no time for cultural activities on such
a short business trip. (1)
b. Mr Parker knows that culture is important to the Chinese, but
he is under pressure. He would like to discuss Chinese culture,
but only after the deal has been concluded. (2)
c. Neither Mr Wang nor Mr Parker are aware that they have
completely different expectations. The meeting would be more
successful if each of them tried to adapt to the other's priorities.
(3)
Question BF (Behavioral flexibility)
17) Why does Mr Wang repeatedly tell the English manager to
discuss business issues with Mr Li?
a. Mr Wang isn't aware of the details of the contract. Mr Parker
should give Mr Wang more information and ask him to make the
most important decisions. The details can then be worked out
with Mr Li. (1)
b. Mr Wang expects Mr Parker to negotiate with a Chinese
colleague of his own status, as is customary in China. Mr Parker
should not feel offended, but accept it and negotiate with Mr Li.
(2)
c. Mr Wang has delegated the negotiations to Mr Li and does
not want undermine Mr Li by discussing the contract with Mr
Parker. Mr Parker should respect this and try to solve any
problems with Mr Li. (3)
Question CA (Communicative awareness)
18) What statement best expressed the difficulties between Mr
Parker and Mr Wang?
a. Mr Parker acted as you would normally act in a business

meeting, and he expected Mr Wang to do the same. But the
Chinese don't say what they mean, and it's hard to read between
the lines if you don't speak Chinese. (1)
b. Mr Parker and Mr Wang each followed the rules of their own
culture. Mr Parker should have explained himself better and
asked Mr Wang to say more clearly what he means. (2)
c. The different cultures are not a problem, but Mr Wang and
Mr Parker should have known that communication works
differently in each culture. They should have tried to talk about
these differences instead of trying to talk business. (3)

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