Student Paper
Cultural Competency in Baccalaureate Nursing Education: A Conceptual Analysis
Deborah Byrne, RN, MSN, La Salle University, Villanova University
Abstract
The ability to deliver culturally competent nursing care is an expected competency of
undergraduate nursing education programs. The American Association of Colleges of Nursing
(AACN) and the National League for Nursing (NLN) have developed toolkits that provide nurse
educators with models and teaching strategies to facilitate student learning in cultural
competency. However, the concept of cultural competency varies as does the best method for
integrating and evaluating cultural competency in undergraduate nursing curriculum. With the
growing number of diverse clients, it is imperative that nursing students deliver culturally
competent care. This article explores the current view of the concept of cultural competency from
the standpoint of nursing education and the methods used to evaluate cultural competency in
undergraduate nursing education programs.
Keywords: cultural competency, simulation,
undergraduate nursing education, cultural
awareness, cultural humility
Background and Significance
Health care is increasingly complex, diverse,
and growing in the United States. The United
States Census Bureau (2009) predicts that the
U.S. population of non-European Caucasians will
be equivalent to Caucasian Americans by 2050.
According to Healthy People 2020, there are
significant health disparities among minority
groups. A fundamental goal of Healthy People
2020 is to eliminate health disparities for all
groups (U.S. Department of Health and Human
Services [USDHHS]). The need for culturally
competent health care is essential to reduce
health disparities and ensure positive health
outcomes.
The National League for Nursing (NLN) and
American Association of Colleges of Nursing
(AACN) include culturally appropriate care in their
accreditation standards and have developed
toolkits for nurse educators to assist with
incorporating cultural competency in
undergraduate nursing curricula (NLN, 2009;
AACN, 2008). There is, however, no consensus in
the literature regarding effective ways to teach
cultural competency to undergraduate
baccalaureate nursing students. Most nursing
programs in the United States include the concept
and skill of cultural competency as a program
outcome and attempt to integrate cultural
competency into their curricula. Attempts at
integration have been reported as inadequate in
developing culturally competent nurses (Brennan
& Cotter, 2008). As the diversity of the population
increases, so too must the cultural competency of
nurses in practice. It is imperative that
undergraduate nursing students develop cultural
competency knowledge, awareness, and skills
while experiencing didactic courses, clinical, and
simulation experiences.
Culture is integral to how people view death,
birth, illness, and health (Delgado et al., 2013).
For individuals to seek health care, .
Deactivated
4 posts
Re:Topic 3 DQ 1
"Cultural competency is described as a set of congruent practice skills, behaviors, attitudes and policies that come embedded in a system, agency, or among consumer providers and professionals.*Cultural competency facilitates the ability to carry out tasks effectively in an environment that has cross cultural situations.' Hence, cultural competence is the mastery of skills that provide appropriate awareness and sensitivity to individuals who are in cross cultural situations. Cultural competency is related to diversity and disparity. As Buchbinder and Shanks'" pointed out, diversity has been historically defined by broad categorical markers such as age, sexual orientation religion, and ethnicity, which involves many factors, including economic status and marginalization. Therefore, not only must the prolific numbers of ethnic groups in the United States be taken into account in anticipating care, but also factors that are relevant to a patient's minority status (i.e., whether they are migrants, uninsured, poor, or refugees) which contribute to economic, social, welfare, and psychological despair" (Green& Reinckens, 2013).
If we want better outcomes for our patients it is extremely important to take into consideration the types of culture these patients possess. With that being said as I read this article it made such clear sense to me. Take for instance you have patient that speaks Spanish or another language for their language. Then to add on top of the mix the patient is unable to maintain a high paying job due to his language barrier and lack of funds for education. This them snow balls into the patient is unable to receive the proper health care because he cant afford insurance. This is something other cultures face all the time. However if we as nurses take the time to educate OURSELVES about the different cultures and the barriers they may have, as well as put ourself out in the community and help these patients with opportunities to receive health care with clinics and programs then we might have a strong chance to lessen the amount of poor outcomes that may develop in the end. These patients a every other patient should be treated with equality and respect as we would treat our own family.
References
Green, Z. D., & Reinckens, J. (2013). Cultural Competency in Health Care: What Can Nurses Do?. Maryland Nurse, 14(4), 16.
.
Cultural Competence and PovertyExploring Play Therapists’ AOllieShoresna
Cultural Competence and Poverty:
Exploring Play Therapists’ Attitudes
Lauren Chase and Kristie Opiola
Department of Counseling, University of North Carolina at Charlotte
This article reports the findings of a survey that investigated attitudes toward poverty
among play therapists (N � 390) and its relation to demographic information. Multi-
variate analyses of variance (MANOVA) were used to measure the relationship
between play therapists’ demographics and their attitudes toward poverty, specifically
their structural, personal deficiency, and stigma scores. Results indicated that both
region and age resulted in differing views on poverty. Participants living in the
Northeast held stronger structural views of poverty than participants in the South.
Similarly, participants in the 50 –59 and 60 plus age groups disagreed to strongly
disagree with a personal explanation toward poverty than participants in the 30 –39 age
group. The importance of play therapists’ examining their attitudes toward poverty and
the direct impact on their work is discussed. Finally, implications of the results,
including overall findings, are explained.
Keywords: play therapy, attitudes of poverty, cultural competence
Culturally competent training is an element
of credentialing requirements that ensures men-
tal health providers offer adequate and respon-
sive care to diverse populations. Although the
mental health field has embedded cultural com-
petence in their standards and guidelines, there
are discrepancies in the way the profession as-
sesses and measures competence (Sue et al.,
1996). Researchers have investigated attitudes
toward poverty in the helping professions
(Levin & Schwartz-Tayri, 2017; Noone et al.,
2012; van Heerde & Hudson, 2010; & Wit-
tenauer et al., 2015), but no study has focused
on play therapists’ attitudes toward poverty.
The purpose of this study is to fill a gap in the
literature regarding play therapist’s attitudes to-
ward poverty because awareness and knowl-
edge are key elements to implement culturally
responsive services and skills with diverse chil-
dren in a variety of settings.
Cultural Competence
Cultural competence is an important compo-
nent of professional practice, and practitioners
are expected to develop skills and understand-
ing pertaining to diverse clientele. Researchers
define cultural competence as the set of beliefs,
knowledge, and skills mental health providers
possess in order to deliver effective interven-
tions and services to members of various cul-
tures (Gilbert et al., 2007; Sue, 2006). The New
Freedom Commission on Mental Health (2003)
recognized disparities in mental health delivery
and viewed the lack of cultural competence for
minority populations as a persistent problem.
Culturally competent health care is essential to
providing effective care to all populations. To
aid practitioners in their ability to increase their
cultural competence, leading professional men-
tal health associations have published ...
Discussion 1In today’s society, certain types of cultural barrie.docxcharlieppalmer35273
Discussion 1
In today’s society, certain types of cultural barriers in healthcare have the power to negatively impact outcomes and can lead to expensive consequences for health systems. Cultural competency refers to the ability to interact with people across cultures. When used in healthcare, it focuses on being able to care for patients with diverse values, beliefs, and behaviors. Today, the delivery of healthcare needs to be tailored to patients’ social, cultural and linguistic needs. According to the health care service company Cigna, cultural competency in healthcare can overcome health disparities. Some of these disparities include language barriers, cultural beliefs and practices, medical bias, variations in care access and quality, and low health literacy (Husson University, 2019).
The Purnell Model of Clinical Competence is a mid-range theory that is used for the research examining culture and within the context of culture and values. This theory was created by Larry Purnell and it was developed based on his observations of undergraduate nursing students and how they would interact with patients that are from different cultural backgrounds. In the United States, culturally competency is a key area for nurses and advanced practitioners (Marzilli, 2017).
Having the ability to communicate effectively with patients and their families is key for good patient care. The importance of communicating effectively in cross-cultural encounters is necessary. Cultural competence includes providing effective health care across diverse cultures by working collaboratively and communicating effectively. Advanced practice nurses and physicians who are aware of their own and their patients’ cultural backgrounds, along with the values that are often implicit in current medical models, are better able to achieve mutual understanding within the patient encounter and to focus on culturally appropriate health care interventions (Ladha et al., 2018)
With the Purnell Model, all aspects and domains of this model work by affecting one another, rather than standing alone. With this model there are specific cultural domains that include, heritage, communication, family roles and organization, workforce issues, bicultural ecology, high risk behaviors, nutrition, childbearing, death rituals, spirituality, health care practices and the healthcare practitioner (National Association for School Nurses, 2019).
As nurse practitioners, understanding the impact that cultural competence and interaction with your patients are key in quality patient care and trust. Cultural competency is relevant to healthcare education due to the fact that minorities will constitute 54% of the total United States population by 2050. The Purnell Model helps by evaluating the impact of interventions such as service learning and the change on cultural competence following the specific intervention. Research involving the Purnell Model is used as the theoretical framework for determining the h.
Discussion 1 (Lindsay)
Module 1 Discussion
Cultural competence is having the capability to effectively interact with individuals belonging to different cultures. Being culturally competent is essential in the nursing profession. Specifically, because advanced practice nurses (APN) care for many different cultural groups in the community. Cultural competence plays a significant role in eliminating and decreasing health care disparities. Therefore, APNs must have the ability to communicate appropriately with different cultural backgrounds to effectively treat patient’s health concerns in a manner that is acceptable to the patient.
The Purnell model defines culture as behavioral patterns, beliefs, values, lifestyles, and all other factors that influence the human work and thought characteristics of a group of people that guide their worldview and decision making (Purnell, 2005). The Purnell model was a framework designed to use across all disciples and practice settings to assess different cultures. Every healthcare discipline values communication and must know their patients ethnocultural beliefs. Healthcare providers are more effective in caring for patients when they understand ethnocultural diversity. The model is a circle with three rims, the outlying rim represents global society, a second rim representing community, a third rim representing family, and the inner rim representing the person (Purnell, 2005). The interior of the circle is split into 12 parts representing cultural domains and their concepts. The 12 cultural domains construct the framework of the model. The Purnell model was developed for multiple purposes. These include providing a framework to learn concepts and characteristics of culture; define instances that affect an individual’s worldview; provide a tool that links the most significant relationships of culture; interrelate characteristics of culture that promote congruence to deliver sensitive and competent care; provide a structure for analyzing cultural data; and view individuals, families, and communities within their unique ethnocultural environment (Purnell, 2005). Communicating in a culturally sensitive way can minimize prejudices and biases.
Culturally competent communication means communicating with mindfulness and knowledge of health disparities and understanding that sociocultural influences have important effects on beliefs, behaviors, and the skills used to manage these factors appropriately (Taylor & Lurie, 2004). It is also important to recognize and understand different communication needs and styles. For example, identifying patient language preferences, literacy levels, and level of English proficiency. Promoting culturally competent communication in the health care setting reflects high quality care and a holistic approach. Good patient-provider communication is associated with increased adherence to treatment plans, higher patient satisfaction, and improved health outcomes (Taylor & Lurie, 2004). ...
Deactivated
4 posts
Re:Topic 3 DQ 1
"Cultural competency is described as a set of congruent practice skills, behaviors, attitudes and policies that come embedded in a system, agency, or among consumer providers and professionals.*Cultural competency facilitates the ability to carry out tasks effectively in an environment that has cross cultural situations.' Hence, cultural competence is the mastery of skills that provide appropriate awareness and sensitivity to individuals who are in cross cultural situations. Cultural competency is related to diversity and disparity. As Buchbinder and Shanks'" pointed out, diversity has been historically defined by broad categorical markers such as age, sexual orientation religion, and ethnicity, which involves many factors, including economic status and marginalization. Therefore, not only must the prolific numbers of ethnic groups in the United States be taken into account in anticipating care, but also factors that are relevant to a patient's minority status (i.e., whether they are migrants, uninsured, poor, or refugees) which contribute to economic, social, welfare, and psychological despair" (Green& Reinckens, 2013).
If we want better outcomes for our patients it is extremely important to take into consideration the types of culture these patients possess. With that being said as I read this article it made such clear sense to me. Take for instance you have patient that speaks Spanish or another language for their language. Then to add on top of the mix the patient is unable to maintain a high paying job due to his language barrier and lack of funds for education. This them snow balls into the patient is unable to receive the proper health care because he cant afford insurance. This is something other cultures face all the time. However if we as nurses take the time to educate OURSELVES about the different cultures and the barriers they may have, as well as put ourself out in the community and help these patients with opportunities to receive health care with clinics and programs then we might have a strong chance to lessen the amount of poor outcomes that may develop in the end. These patients a every other patient should be treated with equality and respect as we would treat our own family.
References
Green, Z. D., & Reinckens, J. (2013). Cultural Competency in Health Care: What Can Nurses Do?. Maryland Nurse, 14(4), 16.
.
Cultural Competence and PovertyExploring Play Therapists’ AOllieShoresna
Cultural Competence and Poverty:
Exploring Play Therapists’ Attitudes
Lauren Chase and Kristie Opiola
Department of Counseling, University of North Carolina at Charlotte
This article reports the findings of a survey that investigated attitudes toward poverty
among play therapists (N � 390) and its relation to demographic information. Multi-
variate analyses of variance (MANOVA) were used to measure the relationship
between play therapists’ demographics and their attitudes toward poverty, specifically
their structural, personal deficiency, and stigma scores. Results indicated that both
region and age resulted in differing views on poverty. Participants living in the
Northeast held stronger structural views of poverty than participants in the South.
Similarly, participants in the 50 –59 and 60 plus age groups disagreed to strongly
disagree with a personal explanation toward poverty than participants in the 30 –39 age
group. The importance of play therapists’ examining their attitudes toward poverty and
the direct impact on their work is discussed. Finally, implications of the results,
including overall findings, are explained.
Keywords: play therapy, attitudes of poverty, cultural competence
Culturally competent training is an element
of credentialing requirements that ensures men-
tal health providers offer adequate and respon-
sive care to diverse populations. Although the
mental health field has embedded cultural com-
petence in their standards and guidelines, there
are discrepancies in the way the profession as-
sesses and measures competence (Sue et al.,
1996). Researchers have investigated attitudes
toward poverty in the helping professions
(Levin & Schwartz-Tayri, 2017; Noone et al.,
2012; van Heerde & Hudson, 2010; & Wit-
tenauer et al., 2015), but no study has focused
on play therapists’ attitudes toward poverty.
The purpose of this study is to fill a gap in the
literature regarding play therapist’s attitudes to-
ward poverty because awareness and knowl-
edge are key elements to implement culturally
responsive services and skills with diverse chil-
dren in a variety of settings.
Cultural Competence
Cultural competence is an important compo-
nent of professional practice, and practitioners
are expected to develop skills and understand-
ing pertaining to diverse clientele. Researchers
define cultural competence as the set of beliefs,
knowledge, and skills mental health providers
possess in order to deliver effective interven-
tions and services to members of various cul-
tures (Gilbert et al., 2007; Sue, 2006). The New
Freedom Commission on Mental Health (2003)
recognized disparities in mental health delivery
and viewed the lack of cultural competence for
minority populations as a persistent problem.
Culturally competent health care is essential to
providing effective care to all populations. To
aid practitioners in their ability to increase their
cultural competence, leading professional men-
tal health associations have published ...
Discussion 1In today’s society, certain types of cultural barrie.docxcharlieppalmer35273
Discussion 1
In today’s society, certain types of cultural barriers in healthcare have the power to negatively impact outcomes and can lead to expensive consequences for health systems. Cultural competency refers to the ability to interact with people across cultures. When used in healthcare, it focuses on being able to care for patients with diverse values, beliefs, and behaviors. Today, the delivery of healthcare needs to be tailored to patients’ social, cultural and linguistic needs. According to the health care service company Cigna, cultural competency in healthcare can overcome health disparities. Some of these disparities include language barriers, cultural beliefs and practices, medical bias, variations in care access and quality, and low health literacy (Husson University, 2019).
The Purnell Model of Clinical Competence is a mid-range theory that is used for the research examining culture and within the context of culture and values. This theory was created by Larry Purnell and it was developed based on his observations of undergraduate nursing students and how they would interact with patients that are from different cultural backgrounds. In the United States, culturally competency is a key area for nurses and advanced practitioners (Marzilli, 2017).
Having the ability to communicate effectively with patients and their families is key for good patient care. The importance of communicating effectively in cross-cultural encounters is necessary. Cultural competence includes providing effective health care across diverse cultures by working collaboratively and communicating effectively. Advanced practice nurses and physicians who are aware of their own and their patients’ cultural backgrounds, along with the values that are often implicit in current medical models, are better able to achieve mutual understanding within the patient encounter and to focus on culturally appropriate health care interventions (Ladha et al., 2018)
With the Purnell Model, all aspects and domains of this model work by affecting one another, rather than standing alone. With this model there are specific cultural domains that include, heritage, communication, family roles and organization, workforce issues, bicultural ecology, high risk behaviors, nutrition, childbearing, death rituals, spirituality, health care practices and the healthcare practitioner (National Association for School Nurses, 2019).
As nurse practitioners, understanding the impact that cultural competence and interaction with your patients are key in quality patient care and trust. Cultural competency is relevant to healthcare education due to the fact that minorities will constitute 54% of the total United States population by 2050. The Purnell Model helps by evaluating the impact of interventions such as service learning and the change on cultural competence following the specific intervention. Research involving the Purnell Model is used as the theoretical framework for determining the h.
Discussion 1 (Lindsay)
Module 1 Discussion
Cultural competence is having the capability to effectively interact with individuals belonging to different cultures. Being culturally competent is essential in the nursing profession. Specifically, because advanced practice nurses (APN) care for many different cultural groups in the community. Cultural competence plays a significant role in eliminating and decreasing health care disparities. Therefore, APNs must have the ability to communicate appropriately with different cultural backgrounds to effectively treat patient’s health concerns in a manner that is acceptable to the patient.
The Purnell model defines culture as behavioral patterns, beliefs, values, lifestyles, and all other factors that influence the human work and thought characteristics of a group of people that guide their worldview and decision making (Purnell, 2005). The Purnell model was a framework designed to use across all disciples and practice settings to assess different cultures. Every healthcare discipline values communication and must know their patients ethnocultural beliefs. Healthcare providers are more effective in caring for patients when they understand ethnocultural diversity. The model is a circle with three rims, the outlying rim represents global society, a second rim representing community, a third rim representing family, and the inner rim representing the person (Purnell, 2005). The interior of the circle is split into 12 parts representing cultural domains and their concepts. The 12 cultural domains construct the framework of the model. The Purnell model was developed for multiple purposes. These include providing a framework to learn concepts and characteristics of culture; define instances that affect an individual’s worldview; provide a tool that links the most significant relationships of culture; interrelate characteristics of culture that promote congruence to deliver sensitive and competent care; provide a structure for analyzing cultural data; and view individuals, families, and communities within their unique ethnocultural environment (Purnell, 2005). Communicating in a culturally sensitive way can minimize prejudices and biases.
Culturally competent communication means communicating with mindfulness and knowledge of health disparities and understanding that sociocultural influences have important effects on beliefs, behaviors, and the skills used to manage these factors appropriately (Taylor & Lurie, 2004). It is also important to recognize and understand different communication needs and styles. For example, identifying patient language preferences, literacy levels, and level of English proficiency. Promoting culturally competent communication in the health care setting reflects high quality care and a holistic approach. Good patient-provider communication is associated with increased adherence to treatment plans, higher patient satisfaction, and improved health outcomes (Taylor & Lurie, 2004). ...
Instructions to writer- this is a peer respond- please respond to Gabr.docxhye345678
Instructions to writer: this is a peer respond, please respond to Gabriella and Olga with a minimum of 150 words to each peer and at least 1 academic resource to each peer .
Must meet the following:
I need this in APA Style . Thank you!
This’s Gabriella Discussion Post ↓
The Purnell model for cultural competency is considered a model to improve comprehension on cultural competence for individuals within the healthcare community. The Model’s efficiency has been well-rooted in the globally, informing and bringing awareness, to the client’s culture using assessments, health-care planning, interventions, and evaluations (Purnell, 2013). Members of the healthcare field are acquainted to people from distinct backgrounds, cultures, beliefs, and values daily. The population is growing nationwide and is becoming more assorted. Therefore, nurses and other medical professionals need to become more familiar with cultural diversity or it might have a negative impact on the population. Purnell’s model aims at preventing this from happening by making nurses more culturally knowledgeable and catering to their needs regardless of a patient’s culture and background.
Purnell’s model of cultural competence is an ethnographic model that provides a cultural understanding of people in the process of health protection, development, and coping with diseases (Yalçın Gürsoy, & Tanrıverd, 2020). Purnell’s model is characterized as a model with a focus on four essential concepts which includes person, community, global society, and family. The most outer part of the diagram or model consists of the global society which emphasizes the obligation for healthcare workers to view the world and society as allied and not separate items. The model discusses how globalization and communication skills are effective in the influence of society and the method that individuals depict others based on their cultural background. Nonetheless, the model applies the community as a means of getting healthcare members involved and have the want to explore it as a way of comprehending one’s ethics and viewpoints. The way a certain community is seen, impacts decision making and goals to understand them can provide better care. In communities, family is also very important, as a patient may want a member to be included in any decision-making process. Additionally, professionals within the healthcare community must comprehend that a patient’s cultural tendencies, values and beliefs may revolve around familial connections. Finally, one of the most important concepts of the Purnell model is the person. When a medical professional is providing care to a patient, they must treat them as an individual who has their own morals and values. The four concepts of Purnell’s model, family, person, community, and global society have different ways that an individual interrelates, which may influence the treatment they receive and some of the decisions that are made.
Purnell’s mode.
Running Head TEACHING PLAN2TEACHING PLAN2.docxjeanettehully
Running Head: TEACHING PLAN 2
TEACHING PLAN 2
High-Level Teaching Plan for A Diverse Learning Environment
Student’s Name
Course Code
Institution Affiliation
Date
A Patient Educator in A Hospital
Introduction
Nursing is not all about giving medications or treating patients. It is the responsibility of the nurses to educate patients on how to prevent illnesses and how to manage certain medical conditions. Nurses can do these by interacting and communicating with patients. By doing this, they will help patients understand how to take control of their health care. When patients take part in their health care, they are likely to change their behaviors and do things that are likely to improve their general health.
My role and the environment I will utilize for teaching
According to Burke and Mancuso (2012), learning is very important in any nursing environment. Effective education of patients happens from the time they are admitted at the hospital and goes on until the patients are discharged from the hospital. For out-patients, I will educate them during their waiting time. As a nurse I will take every opportunity I will come across during the patients’ visit to the hospital and throughout their admission in the hospital to educate them about their health care. I will provide patients with instructions to follow on self-care and how to maintain certain problems. Some of the self-care instructions include;
· How to follow the steps of self-care
· How to know early signs of certain illnesses
· How to go about emergency problems
· Who to contact in case of problems
The intended audience
I will educate people of all populations in my education program regardless of their age, culture, illness, ethnicity, and gender. General education will be provided to all patients on how to take care of themselves when they leave the hospital. This important because sometimes patients go home, neglect themselves, resume their unhealthy practices, and forget to manage their medical conditions. For patients suffering from diabetes, I will educate and provide them with instructions on how to inject themselves with insulin. For new mothers, they will learn how to take care of their new born babies and how to bath the infants. I will provide instructions on how to change a colostomy pouching system for the concerned patients.
The Social Cognitive Learning Theory
Key points of the theory
This theory concentrates on the impacts of social factors on a person’s thinking, perception and motivation. According to the social cognition theory, a patient must have different perspectives, approaches, and reactions to situations in the health care environment. The players in the health care setting would be expected to have different perceptions, interpretations, and responses to a situation that are strongly colored by their social and cultural experiences (Braungart, Braungart, & Gramet, 2008).
Why this theory fits the topic, audience, and the context
The ...
The demographic profile of the countries suggests that countries are rapidly becoming heterogeneous, multicultural societies. So it is imperative that nurses develop an understanding about culture and its relevance to competent care. Transcultural nursing represents and reflects the need for respect and acknowledgement of the wholeness of all human beings.
It is essential to remember that regardless of race ethnicity or cultural heritage, every human being is culturally unique. Professional nursing care is culturally sensitive, culturally appropriate and culturally competent
22CHAPTER 2 Cultural CompetencyAchieving cultural .docxrobert345678
22
CHAPTER
2 Cultural Competency
Achieving cultural competence is a learning process that
requires self-awareness, reflective practice, and knowl-
edge of core cultural issues. It involves recognizing one’s
own culture, values, and biases and using effective patient-
centered communication skills. A culturally competent
healthcare provider adapts to the unique needs of patients
of backgrounds and cultures that differ from his or her
own. This adaptability, coupled with a genuine curiosity
about a patient’s beliefs and values, lay the foundation for
a trusting patient-provider relationship.
A Definition of Culture
Culture, in its broadest sense, reflects the whole of human
behavior, including ideas and attitudes, ways of relating to
one another, manners of speaking, and the material products
of physical effort, ingenuity, and imagination. Language is
a part of culture. So, too, are the abstract systems of belief,
etiquette, law, morals, entertainment, and education. Within
the cultural whole, different populations may exist in groups
and subgroups. Each group is identified by a particular
body of shared traits (e.g., a particular art, ethos, or belief;
or a particular behavioral pattern) and is rather dynamic
in its evolving accommodations with internal and external
influences. Any individual may belong to more than one
group or subgroup, such as ethnic origin, religion, gender,
sexual orientation, occupation, and profession.
Distinguishing Physical Characteristics
The use of physical characteristics (e.g., gender or skin
color) to distinguish a cultural group or subgroup is inap-
propriate. There is a significant difference between distin-
guishing cultural characteristics and distinguishing physical
characteristics. Do not confuse the physical with the cultural
or allow the physical to symbolize the cultural. To assume
homogeneity in the beliefs, attitudes, and behaviors of all
individuals in a particular group leads to misunderstandings
about the individual. The stereotype, a fixed image of any
group that denies the potential of originality or individuality
within the group, must be rejected. People can and do
respond differently to the same stimuli. Stereotyping occurs
through two cognitive phases. In the first phase, a stereotype
becomes activated when an individual is categorized into
a social group. When this occurs, the beliefs and feelings
(prejudices) come to mind about what members of that
particular group are like. Over time, this first phase occurs
without effort or awareness. In the second phase, people
use these activated beliefs and feelings when they interact
with the individual, even when they explicitly deny these
stereotypes. Multiple studies have shown that healthcare
providers activate these implicit stereotypes, or unconscious
biases, when communicating with and providing care to
minority patients (Stone and Moskowitz, 2011). With this
in mind, you can begin learning cult.
AbstrActOne of the biggest challenges in nursing educati.docxransayo
AbstrAct
One of the biggest challenges in
nursing education is to develop cul-
turally sensitive graduates. Although
theory and lecture are appropriate to
introduce cultural issues, the applica-
tion of those skills is limited by the
kinds of clinical experiences and pa-
tient populations students may treat.
Literary works are a rich source of
information for nursing. This assign-
ment was created to sensitize the
students to the influence of cultural
diversity. Students were assigned to
read one novel from an approved list
and answer the questions posed on
the Cultural Discovery worksheet.
The only direction that was given re-
garding novel selection was that the
novel had to represent a culture other
than the student’s own. The focus
was to expose students to a different
culture. Classroom discussion, based
on worksheet answers, followed. The
assignment’s good, bad, and ugly out-
comes are discussed. Suggestions for
adaptation of this assignment to an
online format are also provided.
T
he United States is home to
one of the most ethnically and
culturally heterogeneous popu-
lations in the world. There are more
than 150 ethnic groups (U.S. Census
Bureau, 2006) and 430 recognized
tribes of Native Americans in the
United States (Redish & Lewis, 2007),
all with their own diverse practices
and beliefs. Culture and ethnicity of-
ten determine the clients’ perception
of health and illness. This includes
kinds of acceptable treatment, type
of follow up permitted, and who will
make health care decisions. As a cul-
ture defines health and illness, it also
defines health care and treatment
practices. Cultural values determine,
in part, how patients will behave.
The provision of culturally compe-
tent care is a dynamic process that
requires individuals to be aware of
their own values and beliefs, as well
as understand how these affect their
responses to those from cultures dif-
ferent from their own. Leininger
(1991) defined culture as the learned,
shared, and transmitted values, be-
liefs, norms, and life practices of a
particular group that guide their
thinking, decisions, and actions in
patterned ways. Cultural competence
includes the attributes of caring, re-
spect, adaptation, honesty, appropri-
ate body language, and interest and
the ability to develop working rela-
tionships across lines of difference
(Galanti, 2004). This encompasses
self-awareness, cultural knowledge
about illness and health practices, in-
tercultural communication skills, and
behavioral flexibility (Strivastava,
2006). Even the concept of transcul-
tural nursing is relatively new in the
nursing literature. In fact, only in the
past 3 decades have nurses begun to
develop an appreciation for the need
to incorporate culturally appropriate
clinical approaches into the daily rou-
tine of client care (Giger & Davidhi-
zar, 1999). Educators strive to develop
students into sensitive practitioners,
and they are challenged .
1 postsRe Topic 3 DQ 2Community health nurses must be c.docxaulasnilda
1 posts
Re: Topic 3 DQ 2
Community health nurses must be culturally compliant to provide the most adequate and highest level of quality care. Understanding certain feelings and recognizing these is the first step for the nurse to put aside stereotypes and bias. Most of the time, they are learned behaviors prior to nursing. Stereotyping in nursing is a preconceived assumption regarding a certain group of people; this, in turn, leads to various personal feelings built upon that stereotype resulting in being bias. In health care, these feelings can lead to implicit bias feelings we unconsciously display towards patients and can impact patient care (Falkner, 2018). It is challenging for nurses not to be biased against one group or the other due to the fact that medically and scientifically there are certain groups or populations that certain condition/diseases are more prevalent than others, but "jumping the gun" per say could result in false diagnosis or inadequate treatments (Puddifoot, 2019). Community nurses must take into account the scientific and medical data related to each and every individual.
Campinha-Bacote and Munoz (2001) proposed a five-component model for developing cultural competence: Cultural awareness, Cultural knowledge, Cultural skill, Cultural encounters, and Cultural desire. One important way for nurses to achieve cultural competence and promote respect is to challenge our own beliefs and ask better questions regarding our patient populations. For example, nurses should avoid unintentionally stereotyping a patient into a specific cultural or ethnic group based on characteristics like outward appearance, race, country of origin or religious preference. Additionally, many subcultures and variations can exist within a cultural or ethnic group. For instance, the term Asian-American includes cultures such as Chinese, Japanese, Taiwanese, Filipino, Korean and Vietnamese, and within these cultures, there are variations in a geographic region, religion, language, family structure and more.
Using 200-300 APA format with references to support the discussion.
How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue
.
Running head CULTURAL INCOMPETENCE IN NURSING .docxjoellemurphey
Running head: CULTURAL INCOMPETENCE IN NURSING
CULTURAL INCOMPETENCE IN NURSING12
Literature Review: Cultural Incompetence in Nursing
Bettina Vargas
Kaplan University
Literature Review: Cultural Incompetence in NursingComment by Tracy Towne: Use citations to support yoru statements so the reader knows it is not just your opinion
In healthcare, cultural incompetence impedes the delivery of quality care at the global, national and healthcare organizational level. In the United States, the minority disproportionate access of healthcare is mainly due to cultural incompetence in nursing and so are the increasing health issues they face, such as high rates of diseases and deaths. At the practicum site, Coral Gables Nursing and Rehabilitation, the effect of cultural incompetence in reference to the delivering poor quality care to a culturally diverse patient population is evident. With this in mind, the focus of this literature review is to provide insight on the trends of cultural incompetence, explore theories used to examine cultural incompetence, gaps in the pre-existing literature and solutions to cultural incompetence. This will help to contextual cultural incompetence and find lasting solutions for eradicating cultural incompetence and prioritizing cultural competence.
Trends
Cultural incompetence in nursing finds its roots in the nursing education and training. According to Bednarz, Schim, & Doorenbos (2010), as the general population records increased diversity, so do the nursing classroom where the minorities are enrolling in nursing education at a higher rate. This increases the need to focus on diversity in nursing education to nurture cultural competent nursing professionals. However, cultural incompetence among the teaching staff in terms of the inability to counter diversity barriers make it difficult to teach a diverse classroom and impart students with cultural competence. These barriers emerge from values and common attitudes held by nursing education and culture such as avoiding unwanted discrimination and the Golden Rule, which is “do unto others as you would have them do unto you” (para. 9). As Hassouneh (2013) indicate, the effect of such barriers, is “unconscious incompetence” as well intentioned faculties are unable to recognize realities, including the fact that each student is unique and deserves unique treatment, thus generating more barriers towards instilling students with cultural competence. The nursing education and training lacks uniformity in accommodating the needs of diverse students. Lack of efficiency in cross-cultural communication, both in written and spoken form aggravates this. Besides, nursing education has no profound way of bringing the different cultures, jargon and professional languages that the students and the faculty possess together to create coherence and increasingly enable the nurses and the faculty to understand each other. The effect is a learning environme ...
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Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1: Dealing with Diversity in America from Reconstruction through the 1920s
For History 105: Dr. Stansbury’s classes (6 pages here)
Due Week 3 and worth 120 points. The formal deadline is Monday at 9am Eastern time, Jan. 21. But, due to the King holiday, no late penalty will be imposed if submitted by the end of Jan. 22.
[NOTE ON ECREE: The university is adopting a tool, called ecree for doing writing assignments in many classes. We will be using the ecree program for doing our papers in this class. More instructions on this tool will be posted. You are welcome to type your paper in MS-Word as traditionally done—and then to upload that file to ecree to revise and finish it up. Or, as we suggest, you may type your paper directly into ecree. When using ecree, you should use CHROME as your browser. As posted: “Please note that ecree works best in Firefox and Chrome. Please do not use Internet Explorer or mobile devices when using ecree.”]
BACKGROUND FOR THE PAPER: After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Topic and Thesis Statement—in which you can take a pro or con position:
· Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows with the four parts below (see TIPS sheet and TEMPLATE also), handling these issues:
1. The position you choose —or something close to it—will be the thesis statement in your opening paragraph. [usually this is one paragraph with thesis statement being the last sentence of the paragraph.]
2. To support your position, use thre.
Assignment 1 Why are the originalraw data not readily us.docxdeanmtaylor1545
Assignment 1
:
Why are the original/raw data not readily usable by analytics tasks? What are the main data preprocessing steps? List and explain their importance in analytics.
Refer to Chapter 3 in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Discuss the process that generates the power of AI and discuss the differences between machine learning and deep learning.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
Assignment 2
:
What are the privacy issues with data mining? Do you think they are substantiated?
Refer to Chapter 4
in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
.
More Related Content
Similar to Student PaperCultural Competency in Baccalaureate Nursing .docx
Instructions to writer- this is a peer respond- please respond to Gabr.docxhye345678
Instructions to writer: this is a peer respond, please respond to Gabriella and Olga with a minimum of 150 words to each peer and at least 1 academic resource to each peer .
Must meet the following:
I need this in APA Style . Thank you!
This’s Gabriella Discussion Post ↓
The Purnell model for cultural competency is considered a model to improve comprehension on cultural competence for individuals within the healthcare community. The Model’s efficiency has been well-rooted in the globally, informing and bringing awareness, to the client’s culture using assessments, health-care planning, interventions, and evaluations (Purnell, 2013). Members of the healthcare field are acquainted to people from distinct backgrounds, cultures, beliefs, and values daily. The population is growing nationwide and is becoming more assorted. Therefore, nurses and other medical professionals need to become more familiar with cultural diversity or it might have a negative impact on the population. Purnell’s model aims at preventing this from happening by making nurses more culturally knowledgeable and catering to their needs regardless of a patient’s culture and background.
Purnell’s model of cultural competence is an ethnographic model that provides a cultural understanding of people in the process of health protection, development, and coping with diseases (Yalçın Gürsoy, & Tanrıverd, 2020). Purnell’s model is characterized as a model with a focus on four essential concepts which includes person, community, global society, and family. The most outer part of the diagram or model consists of the global society which emphasizes the obligation for healthcare workers to view the world and society as allied and not separate items. The model discusses how globalization and communication skills are effective in the influence of society and the method that individuals depict others based on their cultural background. Nonetheless, the model applies the community as a means of getting healthcare members involved and have the want to explore it as a way of comprehending one’s ethics and viewpoints. The way a certain community is seen, impacts decision making and goals to understand them can provide better care. In communities, family is also very important, as a patient may want a member to be included in any decision-making process. Additionally, professionals within the healthcare community must comprehend that a patient’s cultural tendencies, values and beliefs may revolve around familial connections. Finally, one of the most important concepts of the Purnell model is the person. When a medical professional is providing care to a patient, they must treat them as an individual who has their own morals and values. The four concepts of Purnell’s model, family, person, community, and global society have different ways that an individual interrelates, which may influence the treatment they receive and some of the decisions that are made.
Purnell’s mode.
Running Head TEACHING PLAN2TEACHING PLAN2.docxjeanettehully
Running Head: TEACHING PLAN 2
TEACHING PLAN 2
High-Level Teaching Plan for A Diverse Learning Environment
Student’s Name
Course Code
Institution Affiliation
Date
A Patient Educator in A Hospital
Introduction
Nursing is not all about giving medications or treating patients. It is the responsibility of the nurses to educate patients on how to prevent illnesses and how to manage certain medical conditions. Nurses can do these by interacting and communicating with patients. By doing this, they will help patients understand how to take control of their health care. When patients take part in their health care, they are likely to change their behaviors and do things that are likely to improve their general health.
My role and the environment I will utilize for teaching
According to Burke and Mancuso (2012), learning is very important in any nursing environment. Effective education of patients happens from the time they are admitted at the hospital and goes on until the patients are discharged from the hospital. For out-patients, I will educate them during their waiting time. As a nurse I will take every opportunity I will come across during the patients’ visit to the hospital and throughout their admission in the hospital to educate them about their health care. I will provide patients with instructions to follow on self-care and how to maintain certain problems. Some of the self-care instructions include;
· How to follow the steps of self-care
· How to know early signs of certain illnesses
· How to go about emergency problems
· Who to contact in case of problems
The intended audience
I will educate people of all populations in my education program regardless of their age, culture, illness, ethnicity, and gender. General education will be provided to all patients on how to take care of themselves when they leave the hospital. This important because sometimes patients go home, neglect themselves, resume their unhealthy practices, and forget to manage their medical conditions. For patients suffering from diabetes, I will educate and provide them with instructions on how to inject themselves with insulin. For new mothers, they will learn how to take care of their new born babies and how to bath the infants. I will provide instructions on how to change a colostomy pouching system for the concerned patients.
The Social Cognitive Learning Theory
Key points of the theory
This theory concentrates on the impacts of social factors on a person’s thinking, perception and motivation. According to the social cognition theory, a patient must have different perspectives, approaches, and reactions to situations in the health care environment. The players in the health care setting would be expected to have different perceptions, interpretations, and responses to a situation that are strongly colored by their social and cultural experiences (Braungart, Braungart, & Gramet, 2008).
Why this theory fits the topic, audience, and the context
The ...
The demographic profile of the countries suggests that countries are rapidly becoming heterogeneous, multicultural societies. So it is imperative that nurses develop an understanding about culture and its relevance to competent care. Transcultural nursing represents and reflects the need for respect and acknowledgement of the wholeness of all human beings.
It is essential to remember that regardless of race ethnicity or cultural heritage, every human being is culturally unique. Professional nursing care is culturally sensitive, culturally appropriate and culturally competent
22CHAPTER 2 Cultural CompetencyAchieving cultural .docxrobert345678
22
CHAPTER
2 Cultural Competency
Achieving cultural competence is a learning process that
requires self-awareness, reflective practice, and knowl-
edge of core cultural issues. It involves recognizing one’s
own culture, values, and biases and using effective patient-
centered communication skills. A culturally competent
healthcare provider adapts to the unique needs of patients
of backgrounds and cultures that differ from his or her
own. This adaptability, coupled with a genuine curiosity
about a patient’s beliefs and values, lay the foundation for
a trusting patient-provider relationship.
A Definition of Culture
Culture, in its broadest sense, reflects the whole of human
behavior, including ideas and attitudes, ways of relating to
one another, manners of speaking, and the material products
of physical effort, ingenuity, and imagination. Language is
a part of culture. So, too, are the abstract systems of belief,
etiquette, law, morals, entertainment, and education. Within
the cultural whole, different populations may exist in groups
and subgroups. Each group is identified by a particular
body of shared traits (e.g., a particular art, ethos, or belief;
or a particular behavioral pattern) and is rather dynamic
in its evolving accommodations with internal and external
influences. Any individual may belong to more than one
group or subgroup, such as ethnic origin, religion, gender,
sexual orientation, occupation, and profession.
Distinguishing Physical Characteristics
The use of physical characteristics (e.g., gender or skin
color) to distinguish a cultural group or subgroup is inap-
propriate. There is a significant difference between distin-
guishing cultural characteristics and distinguishing physical
characteristics. Do not confuse the physical with the cultural
or allow the physical to symbolize the cultural. To assume
homogeneity in the beliefs, attitudes, and behaviors of all
individuals in a particular group leads to misunderstandings
about the individual. The stereotype, a fixed image of any
group that denies the potential of originality or individuality
within the group, must be rejected. People can and do
respond differently to the same stimuli. Stereotyping occurs
through two cognitive phases. In the first phase, a stereotype
becomes activated when an individual is categorized into
a social group. When this occurs, the beliefs and feelings
(prejudices) come to mind about what members of that
particular group are like. Over time, this first phase occurs
without effort or awareness. In the second phase, people
use these activated beliefs and feelings when they interact
with the individual, even when they explicitly deny these
stereotypes. Multiple studies have shown that healthcare
providers activate these implicit stereotypes, or unconscious
biases, when communicating with and providing care to
minority patients (Stone and Moskowitz, 2011). With this
in mind, you can begin learning cult.
AbstrActOne of the biggest challenges in nursing educati.docxransayo
AbstrAct
One of the biggest challenges in
nursing education is to develop cul-
turally sensitive graduates. Although
theory and lecture are appropriate to
introduce cultural issues, the applica-
tion of those skills is limited by the
kinds of clinical experiences and pa-
tient populations students may treat.
Literary works are a rich source of
information for nursing. This assign-
ment was created to sensitize the
students to the influence of cultural
diversity. Students were assigned to
read one novel from an approved list
and answer the questions posed on
the Cultural Discovery worksheet.
The only direction that was given re-
garding novel selection was that the
novel had to represent a culture other
than the student’s own. The focus
was to expose students to a different
culture. Classroom discussion, based
on worksheet answers, followed. The
assignment’s good, bad, and ugly out-
comes are discussed. Suggestions for
adaptation of this assignment to an
online format are also provided.
T
he United States is home to
one of the most ethnically and
culturally heterogeneous popu-
lations in the world. There are more
than 150 ethnic groups (U.S. Census
Bureau, 2006) and 430 recognized
tribes of Native Americans in the
United States (Redish & Lewis, 2007),
all with their own diverse practices
and beliefs. Culture and ethnicity of-
ten determine the clients’ perception
of health and illness. This includes
kinds of acceptable treatment, type
of follow up permitted, and who will
make health care decisions. As a cul-
ture defines health and illness, it also
defines health care and treatment
practices. Cultural values determine,
in part, how patients will behave.
The provision of culturally compe-
tent care is a dynamic process that
requires individuals to be aware of
their own values and beliefs, as well
as understand how these affect their
responses to those from cultures dif-
ferent from their own. Leininger
(1991) defined culture as the learned,
shared, and transmitted values, be-
liefs, norms, and life practices of a
particular group that guide their
thinking, decisions, and actions in
patterned ways. Cultural competence
includes the attributes of caring, re-
spect, adaptation, honesty, appropri-
ate body language, and interest and
the ability to develop working rela-
tionships across lines of difference
(Galanti, 2004). This encompasses
self-awareness, cultural knowledge
about illness and health practices, in-
tercultural communication skills, and
behavioral flexibility (Strivastava,
2006). Even the concept of transcul-
tural nursing is relatively new in the
nursing literature. In fact, only in the
past 3 decades have nurses begun to
develop an appreciation for the need
to incorporate culturally appropriate
clinical approaches into the daily rou-
tine of client care (Giger & Davidhi-
zar, 1999). Educators strive to develop
students into sensitive practitioners,
and they are challenged .
1 postsRe Topic 3 DQ 2Community health nurses must be c.docxaulasnilda
1 posts
Re: Topic 3 DQ 2
Community health nurses must be culturally compliant to provide the most adequate and highest level of quality care. Understanding certain feelings and recognizing these is the first step for the nurse to put aside stereotypes and bias. Most of the time, they are learned behaviors prior to nursing. Stereotyping in nursing is a preconceived assumption regarding a certain group of people; this, in turn, leads to various personal feelings built upon that stereotype resulting in being bias. In health care, these feelings can lead to implicit bias feelings we unconsciously display towards patients and can impact patient care (Falkner, 2018). It is challenging for nurses not to be biased against one group or the other due to the fact that medically and scientifically there are certain groups or populations that certain condition/diseases are more prevalent than others, but "jumping the gun" per say could result in false diagnosis or inadequate treatments (Puddifoot, 2019). Community nurses must take into account the scientific and medical data related to each and every individual.
Campinha-Bacote and Munoz (2001) proposed a five-component model for developing cultural competence: Cultural awareness, Cultural knowledge, Cultural skill, Cultural encounters, and Cultural desire. One important way for nurses to achieve cultural competence and promote respect is to challenge our own beliefs and ask better questions regarding our patient populations. For example, nurses should avoid unintentionally stereotyping a patient into a specific cultural or ethnic group based on characteristics like outward appearance, race, country of origin or religious preference. Additionally, many subcultures and variations can exist within a cultural or ethnic group. For instance, the term Asian-American includes cultures such as Chinese, Japanese, Taiwanese, Filipino, Korean and Vietnamese, and within these cultures, there are variations in a geographic region, religion, language, family structure and more.
Using 200-300 APA format with references to support the discussion.
How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue
.
Running head CULTURAL INCOMPETENCE IN NURSING .docxjoellemurphey
Running head: CULTURAL INCOMPETENCE IN NURSING
CULTURAL INCOMPETENCE IN NURSING12
Literature Review: Cultural Incompetence in Nursing
Bettina Vargas
Kaplan University
Literature Review: Cultural Incompetence in NursingComment by Tracy Towne: Use citations to support yoru statements so the reader knows it is not just your opinion
In healthcare, cultural incompetence impedes the delivery of quality care at the global, national and healthcare organizational level. In the United States, the minority disproportionate access of healthcare is mainly due to cultural incompetence in nursing and so are the increasing health issues they face, such as high rates of diseases and deaths. At the practicum site, Coral Gables Nursing and Rehabilitation, the effect of cultural incompetence in reference to the delivering poor quality care to a culturally diverse patient population is evident. With this in mind, the focus of this literature review is to provide insight on the trends of cultural incompetence, explore theories used to examine cultural incompetence, gaps in the pre-existing literature and solutions to cultural incompetence. This will help to contextual cultural incompetence and find lasting solutions for eradicating cultural incompetence and prioritizing cultural competence.
Trends
Cultural incompetence in nursing finds its roots in the nursing education and training. According to Bednarz, Schim, & Doorenbos (2010), as the general population records increased diversity, so do the nursing classroom where the minorities are enrolling in nursing education at a higher rate. This increases the need to focus on diversity in nursing education to nurture cultural competent nursing professionals. However, cultural incompetence among the teaching staff in terms of the inability to counter diversity barriers make it difficult to teach a diverse classroom and impart students with cultural competence. These barriers emerge from values and common attitudes held by nursing education and culture such as avoiding unwanted discrimination and the Golden Rule, which is “do unto others as you would have them do unto you” (para. 9). As Hassouneh (2013) indicate, the effect of such barriers, is “unconscious incompetence” as well intentioned faculties are unable to recognize realities, including the fact that each student is unique and deserves unique treatment, thus generating more barriers towards instilling students with cultural competence. The nursing education and training lacks uniformity in accommodating the needs of diverse students. Lack of efficiency in cross-cultural communication, both in written and spoken form aggravates this. Besides, nursing education has no profound way of bringing the different cultures, jargon and professional languages that the students and the faculty possess together to create coherence and increasingly enable the nurses and the faculty to understand each other. The effect is a learning environme ...
Improve Cultural Competence
Cultural Competence Essay
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Cultural Competency Essay
Essay On Cultural Competence
Cultural Competence Essay
What Is Cultural Competence?
Example Of Cultural Competence
Cultural Competency Paper
My Interview With Cultural Competence Essay
Culture Competence Essay
Examples Of Cultural Competence
Essay on Intercultural Competence
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Essay On Cross-Cultural Competence
Cultural Competence In Education Essay
Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1: Dealing with Diversity in America from Reconstruction through the 1920s
For History 105: Dr. Stansbury’s classes (6 pages here)
Due Week 3 and worth 120 points. The formal deadline is Monday at 9am Eastern time, Jan. 21. But, due to the King holiday, no late penalty will be imposed if submitted by the end of Jan. 22.
[NOTE ON ECREE: The university is adopting a tool, called ecree for doing writing assignments in many classes. We will be using the ecree program for doing our papers in this class. More instructions on this tool will be posted. You are welcome to type your paper in MS-Word as traditionally done—and then to upload that file to ecree to revise and finish it up. Or, as we suggest, you may type your paper directly into ecree. When using ecree, you should use CHROME as your browser. As posted: “Please note that ecree works best in Firefox and Chrome. Please do not use Internet Explorer or mobile devices when using ecree.”]
BACKGROUND FOR THE PAPER: After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Topic and Thesis Statement—in which you can take a pro or con position:
· Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows with the four parts below (see TIPS sheet and TEMPLATE also), handling these issues:
1. The position you choose —or something close to it—will be the thesis statement in your opening paragraph. [usually this is one paragraph with thesis statement being the last sentence of the paragraph.]
2. To support your position, use thre.
Assignment 1 Why are the originalraw data not readily us.docxdeanmtaylor1545
Assignment 1
:
Why are the original/raw data not readily usable by analytics tasks? What are the main data preprocessing steps? List and explain their importance in analytics.
Refer to Chapter 3 in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Discuss the process that generates the power of AI and discuss the differences between machine learning and deep learning.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
Assignment 2
:
What are the privacy issues with data mining? Do you think they are substantiated?
Refer to Chapter 4
in the attached textbook:
Sharda, R., Delen, D., Turban, E. (2020). Analytics, Data Science, & Artificial Intelligence: Systems for Decision Support 11E.
ISBN: 978-0-13-519201-6.
Requirement:
****Separate document for each assignment.****
Minimum 300-350 words. Cover sheet, abstract, graphs, and references does not count.
Add references separately for each assignment question.
Double Spaced and APA 7th Edition Format
No plagiarized content please! Attach a plagiarized report.
Check for spelling and grammar mistakes!
$5 max. Please bid if you agree.
.
Assignment 1 Refer to the attached document and complete the .docxdeanmtaylor1545
Assignment 1
:
Refer to the attached document and complete the following sections from the document (highlighted in yellow):
Policy 1.1
Policy Statement Section Overview
Policy 1.2
Policy Statements Contents
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheets, abstracts, graphs, and references do not count.
·
Add references separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
.
Assignment 1
:
Remote Access Method Evaluation
Learning Objectives and Outcomes
Ø
Explore and assess different remote access solutions.
Assignment Requirements
Discuss which of the two remote access solutions
, virtual private networks (VPNs) or hypertext transport protocol secure (HTTPS),
you will rate as the best.
You need to make a choice between the two remote access solutions based on the following features:
Ø Identification, authentication, and authorization
Ø Cost, scalability, reliability, and interoperability
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
Assignment 2
:
Discuss techniques for combining multiple anomaly detection techniques to improve the identification of anomalous objects. Consider both supervised and unsupervised cases.
Requirement:
·
****Separate word document for each assignment****
· Minimum 300-350 words. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style. Length – 2 to 3 paragraphs.
·
Sources: 2 References to Support your answer
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $5 max. Please bid if you agree.
Assignment 3
:
Refer to the attached “Term Paper for ITS632(1)” for assignment.
Requirements
:
·
****Separate word document for each assignment****
· Minimum 6 pages. Cover sheet, abstract, graphs, and references do not count.
·
Add reference separately for each assignment question.
·
Strictly follow APA style.
·
Sources: 3-5 References
· No plagiarized content please! Attach a plagiarized report.
· Check for spelling and grammar mistakes!
· $30 max. Please bid if you agree.
.
Assignment 1 Inmates Rights and Special CircumstancesCriteria.docxdeanmtaylor1545
Assignment 1: Inmates Rights and Special Circumstances
Criteria
Unacceptable
Below 60% F
Meets Minimum Expectations
60-69% D
Fair
70-79% C
Proficient
80-89% B
Exemplary
90-100% A
1. Analyze the legal mechanisms in which an inmate can challenge his or her confinement. Support or refute the cost of such challenges to the state and / or federal government. Provide a rationale for your response.
Weight: 30%
Did not submit or incompletely analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Did not submit or incompletely supported or refuted the cost of such challenges to the state and / or federal government. Did not submit or incompletely provided a rationale for your response.
Insufficiently analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Insufficiently supported or refuted the cost of such challenges to the state and / or federal government. Insufficiently provided a rationale for your response.
Partially analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Partially supported or refuted the cost of such challenges to the state and / or federal government. Partially provided a rationale for your response.
Satisfactorily analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Satisfactorily supported or refuted the cost of such challenges to the state and / or federal government. Satisfactorily provided a rationale for your response.
Thoroughly analyzed the legal mechanisms in which an inmate can challenge his or her confinement. Thoroughly supported or refuted the cost of such challenges to the state and / or federal government. Thoroughly provided a rationale for your response.
2. Examine the four (4) management issues that arise as a result of inmates with special needs. Prepare one (1) recommendation for each management issue that effectively neutralizes each concern. Provide a rationale for your response.
Weight: 30%
Did not submit or incompletely examined the four (4) management issues that arise as a result of inmates with special needs. Did not submit or incompletely prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Did not submit or incompletely provided a rationale for your response.
Insufficiently examined the four (4) management issues that arise as a result of inmates with special needs. Insufficiently prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Â Insufficiently provided a rationale for your response.
Partially examined the four (4) management issues that arise as a result of inmates with special needs. Partially prepared one (1) recommendation for each management issue that effectively neutralizes each concern. Partially provided a rationale for your response.
Satisfactorily examined the four (4) management issues that arise as a result of inmates with special needs. Satisfactorily prepare.
Assignment 1 Go back through the business press (Fortune, The Ec.docxdeanmtaylor1545
Assignment 1
Go back through the business press (Fortune, The Economist, BusinessWeek, and so forth and any other LIRN- based articles) and find at least three articles related to either downsizing, implementation of a new technology, or a merger or acquisition. In a minimum of four (4) pages in 7th edition APA formatted paper:
What were the key frontline experiences listed in relation to your chosen change?
How do they relate to those listed in Chapter 4?
Did you identify new ones confronting change managers?
How would you prioritize these experiences?
Do any stand out as “deal breakers”? Why?
What new insights into implementing this type of change emerge from this?
Assignment 2
PA2 requires you to identify a current change in an organization with which you are familiar and evaluate a current public issue about which “something must be done.” In relation to the change issue, think about what sense-making changes might need to be enacted and how you would go about doing this. Assess this in terms of the eight (8) elements of the sense-making framework suggested by Helms Mills and as set out in Table 9.7:
Identity construction
Social sense-making
Extracted cues
Ongoing sense-making
Retrospection
Plausibility
Enactment
Projection
Which ones did you believe you might have the most/least control over and why?
What implications does this have for adopting a sense-making approach to organizational change?
minimum of
four (4) pages document for each assignment
.
Assignment 1 Discussion—Environmental FactorsIn this assignment, .docxdeanmtaylor1545
Assignment 1: Discussion—Environmental Factors
In this assignment, you will have a chance to discuss a topic that brings personality theory together with social psychology. Dealing with unhealthy groups like gangs or cults is an important issue in social psychology. However, you cannot fully address this issue if you do not first understand personality development and how one’s personality affects the choices that are made. Specifically, you will look at Skinner’s behavioral perspective on personality development and discuss how that theory can play a role in this issue of unhealthy groups.
Bob is an adolescent who grew up in a gang-infested part of a large city. His parents provided little supervision while he was growing up and left Bob mostly on his own. He developed friendships with several kids in his neighborhood who were involved in gangs, and eventually joined a gang himself. Now crime and gang activities are a way of life for Bob. These have become his way to identify with his peer group and to support himself.
It is relatively easy to see that Bob’s environment has played a large role in his current lifestyle. This coincides with Skinner’s concept of environment being the sole determinant of how personality develops. Skinner believed that if you change someone’s environment and the reinforcements in that environment, you can change their behavior.
Use the Internet, Argosy University library resources, and your textbook to research Skinner’s concept of the environment and answer the following questions:
If you were to create an environment for Bob to change his behavior from that of a gang member to a respectable and law-abiding citizen, what types of environmental changes and positive reinforcements would you suggest and why?
What are some interventions that are used in the field currently? Are there any evidence-based programs that use these environmental and reinforcement interventions?
Write your initial response in 2–3 paragraphs. Apply APA standards to citation of sources.
By
Saturday, March 1, 2014
, post your response to the appropriate
Discussion Area
. Through
Wednesday, March 5, 2014
, review and comment on at least two peers’ responses.
.
Assignment 1 1. Using a Microsoft Word document, please post one.docxdeanmtaylor1545
Assignment 1
1. Using a Microsoft Word document, please post one federal and one state statute utilizing standard legal notation and a hyperlink to each statute.
2. In the same document, please post one federal and one state case using standard legal notation and a hyperlink to each case.
Assignment 2
A. Social media platforms such as Facebook, Twitter, and even Tiktok have become very powerful and influential. Please give your thoughts on whether governments should regulate the content of content on these media. Minimum 250 words.
B. Respond to two classmates' postings. Minimum 100 words per posting.
.
Assignment 1 Dealing with Diversity in America from Reconstructi.docxdeanmtaylor1545
Assignment 1:
Dealing with Diversity in America from Reconstruction through the 1920s
Due Week 3 and worth 120 points
After the Civil War, the United States had to recover from war, handle western expansion, and grapple with very new economic forms. However, its greatest issues would revolve around the legacies of slavery and increasing diversity in the decades after the Civil War. In the South, former slaves now had freedom and new opportunities but, despite the Reconstruction period, faced old prejudices and rapidly forming new barriers. Immigrants from Europe and Asia came in large numbers but then faced political and social restrictions. Women continued to seek rights. Yet, on the whole, America became increasingly diverse by the 1920s. Consider developments, policies, and laws in that period from 1865 to the 1920s. Examine the statement below and drawing from provided sources, present a paper with specific examples and arguments to demonstrate the validity of your position.
Statement—in which you can take a pro or con position:
Political policies and movements in the period from 1865 to the 1920s generally promoted diversity and “the melting pot” despite the strong prejudices of a few. (or you can take the position that they did not). Use specific examples of policies or movements from different decades to support your position.
After giving general consideration to your readings so far and any general research, select one of the positions above as your position—your thesis. (Sometimes after doing more thorough research, you might choose the reverse position. This happens with critical thinking and inquiry. Your final paper might end up taking a different position than you originally envisioned.) Organize your paper as follows, handling these issues:
The position you choose —or something close to it—will be the thesis statement in your opening paragraph.
To support your position, use three (3) specific examples from different decades between 1865 and 1930. You may narrowly focus on race or gender or immigrant status, or you may use examples relevant to all categories.
Explain why the opposing view is weak in comparison to yours.
Consider your life today: In what way does the history you have shown shape or impact issues in your workplace or desired profession?
Length: The paper should be 500-to-750 words in length.
Research and References: You must use a
MINIMUM of three sources
; the Schultz textbook must be one of them. Your other two sources should be drawn from the list provided below. This is guided research, not open-ended Googling.
Source list for Assignment 1:
Some sources are “primary” sources from the time period being studied. Some sources below can be accessed via direct link or through the primary sources links on Blackboard. Each week has a different list of primary sources. For others, they are accessible through the permalink to the source in our online library: Sources below having
libdatab.
Assignment 1 Due Monday 92319 By using linear and nonlinear .docxdeanmtaylor1545
Assignment 1: Due Monday 9/23/19
By using linear and nonlinear methods of listening, the counselor can respond in meaningful ways which can create a healthy therapeutic alliance. During the assessment, the client will often provide a wealth of information. It is the job of the counselor to listen in order to identify needs, resources, strengths and abilities. The counselor may pick up on gaps in the client's story during the assessment. This is likely because the client will tell the conscious part of the story. However, we must also listen to what is NOT being said.
Counselors must consider the unconscious part of the story during the assessment. One way for the counselor to do this is by being mindful of Adverse Childhood Experiences (ACES). How might recognizing ACES:
1) inform the counselor during the assessment?
2) guide goal development for the treatment episode?
3) affect the clients readiness to change?
.
Assignment 1This assignment is due in Module 8. There are many v.docxdeanmtaylor1545
Assignment 1
This assignment is due in Module 8. There are many variations on WebQuests. Please make sure you follow these instructions and not those listed in the textbook. Although, reading the texts and learning another variation will only benefit you in the future. This assignment is worth 100 points.
1. Find a good website in which you can use for the exercise. If you want your students to learn more about zoo animals, then maybe you should locate your local zoo website and use it as a source. Make sure you choose a site that is age appropriate for your students. And please identify which grade and subject level you have chosen in the title.
2. After deciding on a website, create the student instructions for this exercise. Make sure to incorporate aesthetic value (picture). The instructions are very important because you do want your students to be excited about the activity.
3. You will ask the students 10 questions about the site and its information. Be sure the website is clear in its direction and easily navigated so the students can find the information. Create the questions and type them into a Word document with lines for students to use to fill in their answers.
4. After you finish your WebQuest, make sure you include a sheet with the answers to the questions.
5. Save the document as a .doc, .docx, or pdf and submit it via the assignment drop box by clicking on the title of the assignment.
Submission: To submit, choose the Assignment 4: WebQuest link above and use the file attachment feature to browse for and upload your completed document. Remember to choose Submit to complete the submission.
Grading: This assignment is worth 100 points toward your final grade and will be graded using the Webquest Rubric. Please use it as a guide toward successful completion of this assignment.
Assignment 2
This assignment is due in Module 9. The objective of this lesson is to utilize the Internet to help clarify/expand upon your teaching, while creating a field trip environment for your students.
There are times when you will not have the funding to take your class on an actual field trip. With the help of technology, you can now visit various sites without leaving the room. For assignment 4, you are going to plan a virtual field trip for your classroom. Think about the grade level, subject area, possible topics for the curriculum that you teach, and appropriate online communication. You must create an original, virtual field trip. You cannot use someone else's field trip. Remember, you can utilize various software (PowerPoint, Prezi, etc.) to create this field trip, but be careful, it is not a lesson with technology assisted software. The students have to feel like they are truly at the location of the field trip looking at the exhibit, animal, statue, and so forth. There should be no words on the slides because it is not a classroom lesson, it is a field trip.
You will be the tour guide, and everything you plan to say as the guide shoul.
Assignment 1TextbookInformation Systems for Business and Beyond.docxdeanmtaylor1545
Assignment 1
Textbook:Information Systems for Business and Beyond
Please answer the following
From Chapter 1 – Answer Study questions 1-5 and Exercise 3
From Chapter 2 – Answer Study questions 1-10 and Exercise 2 (should be a Power point presentation)
All the above questions should be submitted in one Word document, except for the PowerPoint presentation (Chapter 2 - Exercise 2).
Please understand that Plagiarism will not be tolerated and will result in a zero grade.
Submission Requirements
Font: Times New Roman, size 12, double-space
Citation Style: APA
References: Please use citations and references where appropriate
No Plagiarism
Chapter 1: What Is an
Information System?
Learning Objectives
Upon successful completion of this chapter, you will be
able to:
• define what an information system is by identifying
its major components;
• describe the basic history of information systems;
and
• describe the basic argument behind the article
“Does IT Matter?” by Nicholas Carr.
Introduction
Welcome to the world of information systems, a world that seems to
change almost daily. Over the past few decades information systems
have progressed to being virtually everywhere, even to the point
where you may not realize its existence in many of your daily
activities. Stop and consider how you interface with various
components in information systems every day through different
Chapter 1: What Is an Information
System? | 9
electronic devices. Smartphones, laptop, and personal computers
connect us constantly to a variety of systems including messaging,
banking, online retailing, and academic resources, just to name a
few examples. Information systems are at the center of virtually
every organization, providing users with almost unlimited
resources.
Have you ever considered why businesses invest in technology?
Some purchase computer hardware and software because everyone
else has computers. Some even invest in the same hardware and
software as their business friends even though different technology
might be more appropriate for them. Finally, some businesses do
sufficient research before deciding what best fits their needs. As
you read through this book be sure to evaluate the contents of each
chapter based on how you might someday apply what you have
learned to strengthen the position of the business you work for, or
maybe even your own business. Wise decisions can result in stability
and growth for your future enterprise.
Information systems surround you almost every day. Wi-fi
networks on your university campus, database search services in
the learning resource center, and printers in computer labs are
good examples. Every time you go shopping you are interacting
with an information system that manages inventory and sales. Even
driving to school or work results in an interaction with the
transportation information system, impacting traffic lights,
cameras, etc. V.
ASSIGNMENT 1TASK FORCE COMMITTEE REPORTISSUE AND SOLUTI.docxdeanmtaylor1545
ASSIGNMENT 1
TASK FORCE COMMITTEE REPORT:
ISSUE AND SOLUTIONS
Due Week 4, worth 150 points
Leaders address issues and propose solutions. As a leader, you’ll need to stay
on top of events that may facilitate or hinder productivity. You must create and
implement solutions to address these issues.
This assignment exposes you to complex modern organizational challenges.
The solutions you devise should reflect your learning and research of organiza-
tional and individual influences in the workplace.
PREPARATION
1. Select an organization
Select an organization in which current events have adversely affected
productivity, requiring management to resolve an issue related to:
corporate culture, managing diversity, leading teamwork, and
developing motivational strategies. The organization should be one
with which you are familiar — where you work now or have worked
previously (business, nonprofit, government, or military). You may also
consider other organizations in the news, such as Macy’s for the retail
industry, United for the airline industry, Wells Fargo for the banking
industry, etc. The focus is on finding solutions, but you should be
somewhat familiar with the organization or industry.
2. Plan your research
Use research from the course textbook, company website, business
websites (CNBC, Bloomberg, etc.), resources from the Strayer Library,
or outside resources to develop solutions to the following questions as
they relate to corporate culture, managing diversity, leading teamwork,
and developing motivational strategies to achieve the organization's
goals and objectives. Your recommendations must be fully articulated
and supported with appropriate detail and sources. Note: Wikipedia
and web-based blogs do not qualify as credible resources.
INSTRUCTIONS
Imagine yourself as the task force committee leader at this organization. You
have been tasked with analyzing hindrances to organizational efficiency. You
must propose strategic solutions.
Create a full report in which you do the following:
1. Describe the Organization and the Issue to Resolve
Provide a brief description of the organization you selected. Present
the organizational issue that adversely affected productivity and that
you, the task force leader, will review and resolve.
2. Analyze Current Corporate Culture
How has the current corporate culture facilitated the development of
the current issue? Research the organization, dig into the culture, and
analyze how it contributed to this issue. Hint: Review the mission and
vision statements as well as the corporate website.
3. Identify Areas of Weakness
What are the organization’s areas of weakness? Using your research
on organizational behavior approaches to corporate culture, diversity,
teamwork, and motivational strategies, identify areas of weakness.
4. Propose
Solution
s
What organizational practices would you modify? What solutions
should your task force recommend to management? As the leader of
the task force, ide.
Assignment 1Select one of these three philosophers (Rousseau, Lo.docxdeanmtaylor1545
Assignment 1
Select one of these three philosophers (Rousseau, Locke, Hobbes) and write a 1 page paper in which you analyze the significant ways in which their ideas differ from those at work in modern democracies. What could we gain from following their ideas more closely, and what might be dangerous if we did so?
assignment 2
In the workplace, we may hear a statement, joke, or remark that is unkind or inappropriate. Often the speaker might appear to do so in a way that is not intended to offend, but comes from other experiences or lack of awareness as to how they may be received.
It is up to you as a manager to set the tone for how these comments are countered in order to create an inclusive environment.
Choose
one
of the statements below (clearly identify in your work which statement you chose).
"We don't serve
those
people here." (Reference to lesbian, gay, bisexual, and transgender clients)
"He should go back to his
own country."
(Reference to someone of a different race)
"She just slows us down." (Reference to a disabled worker)
"Why doesn't he retire already!" (Reference to an older employer)
In a 2 page paper, suggest some ways in which you would professionally respond if you heard the comment by your subordinate in the employee lounge. Include how you might approach the employee (immediately, privately etc.). Provide specific comments that you might use in your discussion and consider how the individual might defend their actions. What further conversation might this lead to?
Explain the ethical and legal (if any) implications if statements such as the one you chose would continue. What might be lost in your workplace if the statements are allowed?
Include at least one resource you could use to help your conversation. Identify whether there is a legal guideline to share with your employee.
assignment 3
attached is the case
Review the Sherwood Manufacturing case again, and in a 2 page paper include the following:
Provide two or more detailed alternatives (regarding Miranda not being considered for the promotion) for Bob and Kelly to consider. Compare and contrast the alternatives, identifying the expected outcome of each.
What are the legal guidelines and ethical implications to consider?
What form of discrimination (individual, structural, or institutional), if any, do you believe is taking place at Sherwood Manufacturing?
assignment 4
use the same attached paper for this one also
Review the Sherwood Manufacturing case again and consider what you have learned about organizational cultures respecting diversity. In a 2 page paper:
Describe the elements of an organizational culture and how it might impact an organization to be considered inclusive.
Next, describe what you believe Sherwood's organizational culture is currently.
Finally, consider what you believe would be an "ideal" inclusive organizational culture for Sherwood. Be specific and include as many aspects of the culture as possible.
Include what steps could be taken.
Assignment 1Scenario 1You are developing a Windows auditing pl.docxdeanmtaylor1545
Assignment 1
Scenario 1
You are developing a Windows auditing plan and need to determine which log files to capture and review. You are considering log files that record access to sensitive resources. You know that auditing too many events for too many objects can cause computers to run more slowly and consume more disk space to store the audit log file entries.
Answer the following question(s): (2 References)
If computer performance and disk space were not a concern, what is another reason for not tracking audit information for all events?
Scenario 2
Assume you are a security professional. You are determining which of the following backup strategies will provide the best protection against data loss, whether from disk failure or natural disaster:
· Daily full server backups with hourly incremental backups
· Redundant array of independent disks (RAID) with periodic full backups
· Replicated databases and folders on high-availability alternate servers
Answer the following question(s): (2 References)
Which backup strategy would you adopt? Why?
Assignment 1 Submission Requirements
Format: Microsoft Word (or compatible)
Font: Arial, size 12, double-space
Citation Style: APA
Length: At least 350 words for each question
References: At least 2 credible scholarly references for each question
No plagiarism
Assignment 2: Security Audit Procedure Guide
Scenario
Always Fresh wants to ensure its computers comply with a standard security baseline and are regularly scanned for vulnerabilities. You choose to use the Microsoft Security Compliance Toolkit to assess the basic security for all of your Windows computers and use OpenVAS to perform vulnerability scans.
Tasks
Develop a procedure guide to ensure that a computer adheres to a standard security baseline and has no known vulnerabilities.
For each application, fill in details for the following general steps:
1. Acquire and install the application.
2. Scan computers.
3. Review scan results.
4. Identify issues you need to address.
5. Document the steps to address each issue.
Assignment 2 Submission Requirements
Format: Microsoft Word (or compatible)
Font: Arial, size 12, double-space
Citation Style: APA
Length: At least 3 pages
References: At least 4 credible scholarly references
No plagiarism
Assignment 3: System Restoration Procedure Guide
Scenario
One of the security improvements at Always Fresh is setting up a system recovery procedure for each type of computer. These procedures will guide administrators in recovering a failed computer to a condition as near to the point of failure as possible. The goal is to minimize both downtime and data loss.
You have already implemented the following backup strategies for workstation computers:
· All desktop workstations were originally installed from a single image for Always Fresh standard workstations. The base image is updated with all patches and new software installed on live workstations.
· Desktop workstation computers execute a cloud backup eve.
Assignment 1Research by finding an article or case study discus.docxdeanmtaylor1545
A
ssignment 1:
Research by finding an article or case study discussing ONE of the following laws or legal issues as it relates to computer forensics:
1) Electronic Communications Privacy Act (ECPA)
2) Cable Communications Privacy Act (CCOA)
3) Privacy Protection Act (PPA)
4) USA Patriot Act of 2001
5) Search and seizure requirements of the Fourth Amendment
6) Legal right to search the computer media
7) Legal right to remove the computer media from the scene
8) Availability of privileged material on the computer media for examination
Using at least 500 words - summarize the the article you have chosen. You will be graded on Content/Subject Knowledge, Critical Thinking Skills, Organization of Ideas, and Writing Conventions.
.
Assignment 1Positioning Statement and MottoUse the pro.docxdeanmtaylor1545
Assignment 1
Positioning Statement and Motto
Use the provided information, as well as your own research, to assess one (1) of the stated brands (Alfa Romeo Hewlett Packard, Subway, or Sony) by completing the questions below. At the end of the worksheet, be sure to develop a new positioning statement and motto for the brand you selected. Submit the completed template in the Week 4 assignment submission link.
Name:
Professor’s Name:
Course Title:
Date:
Company/Brand Selected (Alfa Romeo Hewlett Packard, Subway, or Sony):
1. Target Customers/Users
Who are the target customers for the company/brand? Make sure you tell why you selected each item that you did. (NOTE: DO NOT say “ANY, ALL, EVERYONE” you cannot target everyone, you must be specific)
Age Bracket: [Insert response]
Gender: [Insert response]
Income Bracket: [Insert response]
Education Level: [Insert response]
Lifestyle: [Insert response]
Psychographics (Interest, Hobbies, Past-times): [Insert response]
Values (What the customer values overall in life): [Insert response]
Other items you would segment up on: [Insert response]
How does the company currently reach its customers/users? What methods and media does the company use to currently reach the customers/users? What methods and media should the company use to currently reach the customers/users?
[Insert response]
What would grab the customers/users’ attention? Why do you think this will capture their attention?
[Insert response]
What do these target customers’ value from the business and its products? Why do you think they value these items?
[Insert response]
2. Competitors
Who are the brand’s competitors? Provide at least 3 competitors and tell why you selected each competitor.
Competitor 1: [Insert response]
Competitor 2: [Insert response]
Competitor 3: [Insert response]
What product category does the brand fit into? Why have you placed this brand into the product category that you did?
[Insert response]
What frame of reference (frame of mind) will customers use in making a choice to use/purchase this brand/service? What other brands/companies might customers compare this brand to (other than the top three identified above)?
[Insert response]
3. USP (Unique Selling Proposition) Creation
What is the brand’s uniqueness? Why do you think this is a key uniqueness for this business?
[Insert response]
What is the competitive advantage of the brand? How is it different from other competing brands? Why do you consider this a competitive advantage?
[Insert response]
What attributes or benefits does the brand have that dominate competitors? Why do you think they dominate?
[Insert response]
How is this brand/company better than its competitors? What is the brand’s USP (Unique Selling Proposition? Why have you decided upon this USP?
Unique Selling Proposition: [Insert response]
Defense of USP: [Insert response]
4. Positioning Statement & Motto
Develop a new positioning statement and motto for the brand you selected. Below is an.
ASSIGNMENT 1Hearing Versus ListeningDescribe how you le.docxdeanmtaylor1545
ASSIGNMENT 1:
Hearing Versus Listening
Describe how you learned how to listen! Please use between 300-500 words to make a complete description of this learned behavior. Did you learn to listen properly? Do you still listen the same way that you were taught as a child? Why or why not?
“Doctor Aunt”
by Eden, Janine and Jim.
CC-BY
.
A mother takes her four-year-old to the pediatrician reporting she’s worried about the girl’s hearing. The doctor runs through a battery of tests, checks in the girl’s ears to be sure everything looks good, and makes notes in the child’s folder. Then, she takes the mother by the arm. They move together to the far end of the room, behind the girl. The doctor whispers in a low voice to the concerned parent: “Everything looks fine. But, she’s been through a lot of tests today. You might want to take her for ice cream after this as a reward.” The daughter jerks her head around, a huge grin on her face, “Oh, please, Mommy! I love ice cream!” The doctor, speaking now at a regular volume, reports, “As I said, I don’t think there’s any problem with her hearing, but she may not always be choosing to listen.”
Hearing
is something most everyone does without even trying. It is a physiological response to sound waves moving through the air at up to 760 miles per hour. First, we receive the sound in our ears. The wave of sound causes our eardrums to vibrate, which engages our brain to begin processing. The sound is then transformed into nerve impulses so that we can perceive the sound in our brains. Our auditory cortex recognizes a sound has been heard and begins to process the sound by matching it to previously encountered sounds in a process known as
auditory association
.
[1]
Hearing has kept our species alive for centuries. When you are asleep but wake in a panic having heard a noise downstairs, an age-old self-preservation response is kicking in. You were asleep. You weren’t listening for the noise—unless perhaps you are a parent of a teenager out past curfew—but you hear it. Hearing is unintentional, whereas
listening
(by contrast) requires you to pay conscious attention. Our bodies hear, but we need to employ intentional effort to actually listen.
“Hearing Mechanics”
by Zina Deretsky. Public domain.
We regularly engage in several different types of listening. When we are tuning our attention to a song we like, or a poetry reading, or actors in a play, or sitcom antics on television, we are listening for pleasure, also known as
appreciative listening
. When we are listening to a friend or family member, building our relationship with another through offering support and showing empathy for her feelings in the situation she is discussing, we are engaged in
relational listening
. Therapists, counselors, and conflict mediators are trained in another level known as
empathetic or therapeutic listening
. When we are at a political event, attending a debate, or enduring a salesperson touting the benefits of vario.
assignment 1
Essay: Nuclear Proliferation
The proliferation of nuclear weapons is closely monitored by the international community. While the international community formally recognizes only five nuclear powers - the United States, Russia, China, France, and the United Kingdom - it is widely acknowledged that at least four others (India, Israel, North Korea, and Pakistan) currently possess nuclear weapons and one other (Iran) is attempting to develop nuclear weapons capabilities.
Describe the current international regime governing the development of nuclear weapons, including the major agreements and treaties controlling nuclear technology. Explain why the international community generally seeks to prevent the proliferation of nuclear weapons. (500-750 words)
assignment 2
World military spending is nearly $2 trillion every year. If you could redirect these funds, how would you use them? Would such uses be better or worse for the states involved? Do you think there is a realistic chance of redirecting military spending in the way you suggest? (150 words minimum)
assignment 3
Human Rights: A Hollow Promise to the World?
( one paragraph )
.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
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http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
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Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Student PaperCultural Competency in Baccalaureate Nursing .docx
1. Student Paper
Cultural Competency in Baccalaureate Nursing Education: A
Conceptual Analysis
Deborah Byrne, RN, MSN, La Salle University, Villanova
University
Abstract
The ability to deliver culturally competent nursing care is an
expected competency of
undergraduate nursing education programs. The American
Association of Colleges of Nursing
(AACN) and the National League for Nursing (NLN) have
developed toolkits that provide nurse
educators with models and teaching strategies to facilitate
student learning in cultural
competency. However, the concept of cultural competency
varies as does the best method for
integrating and evaluating cultural competency in undergraduate
nursing curriculum. With the
growing number of diverse clients, it is imperative that nursing
students deliver culturally
competent care. This article explores the current view of the
concept of cultural competency from
the standpoint of nursing education and the methods used to
evaluate cultural competency in
undergraduate nursing education programs.
Keywords: cultural competency, simulation,
undergraduate nursing education, cultural
2. awareness, cultural humility
Background and Significance
Health care is increasingly complex, diverse,
and growing in the United States. The United
States Census Bureau (2009) predicts that the
U.S. population of non-European Caucasians will
be equivalent to Caucasian Americans by 2050.
According to Healthy People 2020, there are
significant health disparities among minority
groups. A fundamental goal of Healthy People
2020 is to eliminate health disparities for all
groups (U.S. Department of Health and Human
Services [USDHHS]). The need for culturally
competent health care is essential to reduce
health disparities and ensure positive health
outcomes.
The National League for Nursing (NLN) and
American Association of Colleges of Nursing
(AACN) include culturally appropriate care in their
accreditation standards and have developed
toolkits for nurse educators to assist with
incorporating cultural competency in
undergraduate nursing curricula (NLN, 2009;
AACN, 2008). There is, however, no consensus in
the literature regarding effective ways to teach
cultural competency to undergraduate
baccalaureate nursing students. Most nursing
programs in the United States include the concept
and skill of cultural competency as a program
outcome and attempt to integrate cultural
competency into their curricula. Attempts at
integration have been reported as inadequate in
developing culturally competent nurses (Brennan
3. & Cotter, 2008). As the diversity of the population
increases, so too must the cultural competency of
nurses in practice. It is imperative that
undergraduate nursing students develop cultural
competency knowledge, awareness, and skills
while experiencing didactic courses, clinical, and
simulation experiences.
Culture is integral to how people view death,
birth, illness, and health (Delgado et al., 2013).
For individuals to seek health care, they need to
feel safe and secure with their providers. Health
care providers need to understand client culture
and deliver culturally sensitive and competent
care to achieve the best patient outcomes. For
health care providers to deliver culturally
competent care, they must be aware of their own
biases about the culture they are serving to
prevent poor patient outcomes (Campinha-
Bacote, 2007).
In nursing education, interaction with culturally
diverse clients, families, and communities is
essential for student development of cultural
competence (Campinha-Bacote, 2003).
Integration of cultural nursing skills, knowledge,
and attitudes will produce the best outcomes.
Cultural knowledge is the basis of cultural
competence, but it is the application of knowledge
in clinical, simulation, and immersion experiences
that will develop culturally competent nurses
(Campinha-Bacote, 2003). The concept analysis
model by Walker and Avant (1988) clarifies
understanding of the various attributes of the term
cultural competence. This method provides a
systematic process by which a concept can be
4. clarified further by identifying the attributes,
antecedents, and consequences of the concept.
In order to deliver quality care to a diverse
population, it is imperative that nurse faculty
incorporate cultural competency skills in
undergraduate nursing programs.
Background of Concept
Culture is defined as a pattern of traditions,
beliefs, values, norms, symbols, and meanings
among a group of people (Campinha-Bacote,
2007). Competency refers to performing, ‘‘in a
manner that is satisfactory to the demand of the
situation, to interact effectively with the
environment’’ (Thomas, 1993, p. 429). The
definition of the concept cultural competence
varies, but a commonly used definition of cultural
competency is ‘‘the ongoing process in which the
healthcare professional continuously strives to
achieve the ability and availability to work
effectively within the cultural context of the patient
(individual, family, community)’’ (Campinha-
Bacote, 2003, p. 5). Cultural competency is
embedded in various fields of study, including
social and behavioral sciences, law, and nursing.
All three disciplines profess the same definition of
culture but apply the term cultural competency
based on relevance to their respective fields
(Singer, 2012; Gould & Martindale, 2013;
Leininger & McFarland, 2002).
Numerous definitions of culture are based in
the social and behavioral sciences; however,
there are four basic concepts that the social and
5. behavioral sciences use in their definitions
(Singer, 2012). The first concept describes culture
as learned through the process of socialization
from birth. This concept is incorporated in many
psychological interpretations of culture. The
second concept is that all members of the same
group share the same cultural values and beliefs.
This concept is broad and does not include
subgroups of larger cultural groups. For example,
in the Jewish faith there are multiple subgroups
with shared values and beliefs; each has some
variation from the larger group (IJS Israel &
Judaism Studies, n.d.). The third concept of
culture is the adaptability of a cultural group to
social and environmental conditions, and the
fourth concept states that culture is an ever-
changing process (Singer, 2012). The third and
fourth concepts appear crucial to delivering
culturally competent care. Each generation
presents with new circumstances that affect the
care they receive. An older Hispanic client may
believe in folklore to treat illnesses, but a younger
Hispanic client may prefer technology and
modern medicine.
In the legal field, cultural competency and
sensitivity are increasingly important when
performing child custody evaluations (Gould &
Martindale, 2013). The authors define culture as a
‘‘pattern of traditions, beliefs, values, norms,
symbols, and meanings’’ (Gould & Martindale,
2013, p. 3.). More than half the U.S. population
are from immigrant families, and many of the
families are experiencing separation or divorce. In
the field of matrimonial law, it is understood that
cultural competence has three broad dimensions.
6. Attorneys and child evaluators need to have an
awareness of their own beliefs toward different
cultures and an awareness of the expectations of
their clients. They also need to utilize culturally
appropriate assessment tools when conducting
evaluations with culturally diverse people. The
International Journal for Human Caring114
attorneys and evaluators are aware of the
importance of delivering culturally competent
assessments to properly arrange the best custody
arrangement for children. Gould and Martindale
(2013) noted the lack of literature providing
guidance on how to address cultural issues in
child custody assessments.
There are several components to integrating
cultural competency into a child custody
evaluation: interviews, psychological testing,
direct parent-child observations, record review,
expert opinions, cultural relativism, and
responsible opinion formulation. Cultural
sensitivity and awareness must be integrated into
all of these components. The evaluator should
retain professional interpreters when necessary
when interviewing a parent or child. The evaluator
should also be cognizant of the family’s beliefs,
customs, and attitudes when evaluating direct
parent-children observations, psychological
testing, and record review. Experts engaged in
the case should also be familiar with the cultural
background of the child and parents.
7. In nursing, culture has been defined as by
Leininger and McFarland (2002) as, ‘‘the learned
and shared beliefs, values, and lifeways of a
designated or particular group that are generally
transmitted intergenerationally and influence
one’s thinking and action modes’’ (p. 9). This
definition has been central in transcultural nursing
and allows for a holistic approach to delivering
culturally congruent nursing care. Both definitions
and their concepts guide nurses delivering care to
diverse groups of clients.
There have been numerous studies regarding
cultural competency in nursing (Jeffreys & Dogan,
2013; Jeffreys & Dogan, 2012; Kardong-Edgren
et al., 2010; Kardong-Edgren & Campinha-
Bacote, 2008; Krainovich-Miller et al., 2008;
Noble, Nuszen, Rom, & Noble, 2014; Caffrey,
Neander, Markle, & Stewart, 2005; Reyes,
Hadley, & Davenport, 2013). In nine studies,
students measured the cultural awareness level
based on self-perception reports. These studies
all had cultural competency as a program
outcome in a nursing curriculum and tested
various teaching methods and interventions to
increase cultural competency. The studies also
showed a positive outcome when cultural
competency was integrated throughout the
curriculum.
The application of cultural competence in
social and behavioral sciences, law, and nursing
is closely related and shares similar concepts. In
social and behavioral science, law, and nursing,
cultural competence is needed to ensure positive
and fair outcomes. In social and behavioral
8. sciences, cultural competency is implemented in
many fields including psychology. A psychologist
needs to be culturally competent to deliver best
practices. If psychologists are not aware of client
culture, they can cause undue harm. In law, a
child custody evaluator needs to deliver culturally
competent care in order to ensure the optimal
custody arrangement is made for the child. In
nursing, a nurse needs to practice culturally
congruent care in order to ensure positive health
outcomes and reduce health disparities.
Significance of the Concept for Nursing
There are several cultural competency
theories and models in the literature related to
nursing. Campinha-Bacote’s Cultural Competence
Model (2007) has been widely documented in
global nursing research studies. Her model has
five interdependent constructs: cultural
awareness, cultural knowledge, cultural skill,
cultural encounters, and cultural desire.
Campinha-Bacote (2007) contends that as
individuals move toward cultural competence,
they must experience all of these constructs. A
pilot study by Delgado et al. (2013) evaluated the
effectiveness of implementing a 1-hour class on
cultural competence at a large Midwestern
medical center. In this study, the Inventory for
Assessing the Process of Cultural Competence
Among Healthcare Professionals–Revised
(IAPCC-R) was administered to participants to
assess baseline cultural competence prior to an
intervention, and then another assessment was
given at 3 and 6 months post training. This
9. instrument was developed by Campinha-Bacote
based on her cultural competency conceptual
model and integrates five cultural competency
constructs. The intervention was a 1-hour class to
promote cultural competency and show the
impact of cultural competency on quality of care.
The intervention included participants examining
their own ethnic heritage, issues related to health
care, and implications for health care providers.
Participants included registered nurses, patient
care assistants, and unit secretaries. Results
showed a statistically significant difference (p¼
.02) in cultural awareness over time (Delgado et
al., 2013). Kardong-Edgren et al. (2010)
evaluated cultural competency in graduating
baccalaureate nursing students. The investigators
evaluated six nursing program outcomes with
different methodologies for teaching cultural
competence. They used the IAPCC-R to measure
cultural competency in graduating nursing
students. All the participating nursing programs
integrated Campinha-Bacote’s cultural care model
into the nursing curriculum except for Program 1,
which did not integrate any specific cultural care
model in the curriculum. The results showed an
increase in all five constructs by implementing this
conceptual model in the undergraduate nursing
programs (Kardong-Edgren et al., 2010).
Jeffreys (2009) also developed a conceptual
model, the Cultural Competency and Confidence
model (CCC). In a study by Jeffreys and Dogan
(2013), an instrument was administered to
evaluate culturally specific care provided for a
diverse population. The Clinical Cultural
10. Competency Evaluation Tool (CCCET) was based
on the CCC model. In the model, Jeffreys defines
cultural competence as a ‘‘multi-dimensional
learning process that integrates transcultural skills
in all three education learning domains (cognitive,
practical, and affective), involves transcultural
self-efficacy (TSE), and aims to achieve culturally
congruent care’’ (Jeffreys & Dogan, 2013, p.
189). The CCCET has three subcategories
including provision of cultural-specific care,
cultural assessment, and cultural sensitivity. The
instrument was administered to second-semester
students at the end of their medical-surgical
course. The findings in this study suggest that
educational interventions in the clinical setting
move nursing students from a passive role to an
active role (Jeffreys & Dogan, 2013).
In all three studies, cultural competency
conceptual models framed the research. Some
authors agree that cultural competency models
are needed to guide teaching cultural
competence; however, disagreements center on
the best way to integrate the models into the
curriculum. The literature supports the proposition
that delivering culturally congruent care can
decrease health disparities.
Attributes of the Concept
There are several characteristics of the
concept of cultural competence in the literature:
(a) cultural awareness, (b) cultural knowledge, (c)
cultural skill, (d) cultural encounters, (e) cultural
desire, (f) cultural sensitivity, and (g) cultural
humility. Cultural awareness is the self-evaluation
11. of our personal biases and prejudices about
individuals from a culture different than our own
and requires individuals to explore their own
cultural heritage (Campinha-Bacote, 2007). Since
biases are ingrained in the mind and not easily
recognized, cultural competence is difficult to
accomplish. Van Ryn and Burke (2000)
investigated 193 physician-patient interactions.
Findings revealed that physicians rated African-
American patients as less intelligent, less
educated, less likely to comply with medical
advice, and more likely to abuse drugs (van Ryn
& Burke, 2000).
Cultural knowledge is the process of acquiring
a strong educational base about culturally diverse
groups. This construct includes the common
knowledge of health-related beliefs, disease
incidence and prevalence, treatment efficacy, and
diagnostic clarity (Campinha-Bacote, 2007). For
example, the genetic disease Tay-Sachs is more
prevalent in the Jewish-American community
(National Tay-Sachs & Allied Diseases, n.d.).
Nurses who practice culturally competent care
possess the knowledge and skills to identify at-
risk Jewish patients for genetic screening.
Cultural skill is the ability to perform culturally
competent care, including collecting relevant
2016, Vol. 20, No. 2 115
Student Paper
cultural data and performing a culturally sensitive
12. health assessment. Several assessment
instruments are available on cultural assessment,
which health care providers can employ to ensure
accurate assessment is obtained from an
individual, group, or community.
Cultural encounters are interactions with
patients from diverse backgrounds (Campinha-
Bacote, 2007). The purpose of cultural
encounters is to improve verbal and nonverbal
communication with different cultures. The
exposure to diverse cultures will assist in
obtaining effective communication skills and
increasing awareness of other cultures.
Additionally, cultural desire is the motivation of an
individual to participate in the process of
becoming culturally competent (Campinha-
Bacote, 2007). The motivation of the individual
must be genuine for the process to be successful.
To achieve this construct, the individual has to
possess the characteristics of caring, sacrifice,
commitment to social justice, and humility.
The concept of caring is fundamental to the
construct of cultural desire and is based on a
humanistic view of caring (Campinha-Bacote,
2007). Cultural sensitivity is the acceptance and
understanding of cultural differences. The
implementation of cultural sensitivity produces
better health outcomes because the practitioner is
sensitive to the beliefs, values, and attitudes of a
different culture (Burnard, 2005). For example, a
culturally sensitive, female, registered nurse
would possess the cultural knowledge to refrain
from shaking hands with a male Muslim patient.
Cultural humility is the ability of individuals to be
13. humble and think less of themselves. This
concept translates into the realization that one’s
own culture is not paramount (Schuessler, Wilder,
& Byrd, 2012). Schuessler et al. (2012) used
reflective journaling to evaluate undergraduate
nursing students’ level of cultural humility. Results
showed novice nursing students began to
understand cultural humility by interacting with
patients from different cultures. Students stated
they began to be aware of how other cultures
interacted with each other and with health care
practitioners.
Model Case
Kate, a community health registered nurse,
cares for Mary, an elderly client who lives alone in
an inner city housing complex. Mary is an 85-
year-old African-American woman with several
chronic conditions including diabetes,
hypertension, peripheral vascular disease (PVD),
obesity, and transient ischemic attacks. Mary has
been hospitalized several times in the past year
for exacerbation of her chronic conditions. Upon
arriving at Mary’s home, Kate notices the
unhealthy food on Mary’s kitchen counter, lack of
assistive devices, and swelling in Mary’s lower
extremities.
Kate has been working in this community for
several years and is aware of the beliefs, values,
behaviors, and past experiences of this African-
American community. As a result, Kate
understands the importance and value of religion
in this community. The church in this community
serves not only as a place of worship but also as
14. a community of support. Therefore, Kate has
developed a relationship with the church leaders
in this community. She also has an open line of
communication with various social programs in
this community.
Upon assessing Mary, Kate is aware of Mary’s
mistrust of health care providers based on past
encounters. In addition, Mary has a reluctance to
ask for help and likes to eat good ‘‘home
cooking.’’ Mary is on a fixed income and believes
she cannot afford to eat healthier. Mary has
missed several doctor’s appointments owing to
her lack of transportation.
Kate acknowledged and was sensitive to
Mary’s mistrust of health care professionals and
worked to develop a trust-based relationship with
Mary. Kate developed a comprehensive care
plan, in collaboration with Mary, to reduce her
frequent hospital admissions. Kate was sensitive
to the importance of religion to Mary and
contacted the minister of her church to see if they
had any programs to assist seniors with running
errands and transportation to medical
appointments. In addition, Kate contacted a local
senior group to see if they had social gatherings
to help combat Mary’s loneliness. Kate found a
food cooperative (co-op) that was not far from
Mary’s apartment.
Within 6 months of implementing this
comprehensive plan of care, Mary did not have
any hospital admissions, started to enjoy outings
with people from the senior center, and received
rides from church volunteers to visit her
15. physicians. Mary started going with a friend to the
food co-op to begin eating healthier. Mary
expressed feeling respect and understanding
from Kate, and they continue to work together.
Overall, Mary’s health has improved, and she
feels she is a participant in her health.
This model case demonstrates positive health
outcomes when culturally competent care is
delivered. This client represents an underserved
minority group that faces health disparities at an
alarming rate (USDHHS, 2010). The registered
nurse is aware of the culture of the group that she
serves and has developed the knowledge, skills,
and attitude needed to deliver culturally
competent care. The registered nurse also
demonstrated a cultural desire and sensitivity to
customs and beliefs held by the cultural group.
The client responded positively to the nurse’s
recommendations because she said she felt the
nurse listened and respected her beliefs and
feelings.
Borderline Case
Joseph is a registered nurse with 20 years
experience caring for a largely Hispanic
population. Through his work experience, Joseph
has learned a few key Spanish terms in order to
communicate with his patients. He feels confident
interacting with patients in the Hispanic
community. He is aware that many Hispanic
patients use complementary medicine and
implement healing traditions different from
American culture. Joseph is caring for an elderly
Hispanic woman named Maria who presents with
16. shortness of breath. Joseph uses his limited
Spanish to communicate with Maria and her
family. The family speaks limited English, but
through hand gestures and some Spanish,
Joseph asks Maria and her family if they take any
over-the-counter herbal supplements or practice
any healing rituals.
About 4 hours into his shift, Joseph notices
Maria’s shortness of breath is increasing despite
breathing treatments and administration of
steroids. The attending physician contacts Maria’s
family physician and learns she has chronic
obstructive pulmonary disease (COPD) and just
finished a course of steroids. The dose of steroids
Maria is currently receiving is too low to explain
increased shortness of breath. Maria’s
medications are adjusted and within 2 hours her
shortness of breath decreased.
Upon reviewing this case with his nurse
manager, Joseph realized that although he
showed awareness toward this patient from a
different culture, he still did not have the cultural
knowledge and skill to call for a professional
interpreter. Joseph and the nurse manager
developed an in-service program to educate the
staff on the benefits of using a professional
interpreter.
This borderline case demonstrates the need to
develop cultural competency skills continually.
The nurse in this case had the self-efficacy
desire, awareness, and knowledge to perform a
culturally sensitive assessment on his patient but
did not have the knowledge or skill to utilize a
17. professional interpreter. Not using an interpreter
could have led to further harm of the patient.
Contrary Case
Lisa, a registered nurse, works on a busy
telemetry floor at a small community hospital with
a predominantly white population. She has had
little experience with people from a different
culture and does not think it is an important part of
her job. Lisa received a report on a 22-year-old,
African-American male patient named Anthony,
with a diagnosis of exacerbation of sickle cell
anemia. Lisa notes in her report that the patient is
requesting a stronger dose of hydromorphone for
increased pain. Lisa comments to the reporting
nurse, ‘‘Of course, I get the drug addict. This is
going to be a long shift.’’ Lisa enters Anthony’s
International Journal for Human Caring116
Student Paper
room and proceeds to perform a brief
assessment. Anthony appears in distress and
rates his pain as a 10 out of 10 on the pain scale.
He begs the nurse for more pain medication. Lisa
calls the attending physician and states, ‘‘The
patient, Anthony, in room 383, is complaining of
pain. He is getting plenty of pain medication and
is just drug seeking. I recommend we discontinue
his narcotics and give him ibuprofen. He will want
to go home quicker if we stop feeding his
addiction.’’ The physician discontinues the
18. hydromorphone, and Lisa gives Anthony
ibuprofen with a lecture about abusing narcotics.
Anthony remains in pain for the rest of Lisa’s shift.
Upon discharge, Anthony feels dissatisfied with
the care he received, and he develops a distrust
of physicians and nurses.
This case demonstrates a complete lack of
cultural competency of the nurse and physician.
The nurse did not demonstrate cultural
knowledge, skills, awareness, desire, sensitivity,
or humility. The nurse works with a predominantly
white population and lacked knowledge of sickle
cell anemia. However, if Lisa had the cultural
awareness, desire, and humility, she would have
educated herself about the disease. She would
have been culturally sensitive to the pain caused
by sickle cell anemia. She did not have the
cultural awareness of her own biases and
stereotypes of cultural humility to know that each
culture is different, which resulted in harm to the
patient.
Assumptions for the Concept
There are several assumptions about the
cultural competency model:
� Cultural competence is a life-long process.
� Cultural competence is a fundamental
component in delivering culturally congruent
care.
� Cultural awareness is essential for cultural
competence to occur.
19. � Rendering culturally competent care will
reduce health disparities.
These assumptions are based on experiential
knowledge and the literature (Campinha-Bacote,
2007; Jeffreys & Dogan, 2012).
Antecedents and Consequences
Prior to the development of cultural
competence, certain behaviors, attitudes, and
ideas must occur. The following are cultural
competency antecedents based on the literature:
� Self-awareness: Practitioners must be aware
of their own biases, stereotypes, and
attitudes toward other cultures. They must
also be aware of their own cultural heritage.
� Encounters: Practitioners’ past cultural
encounters can affect their interactions with
other cultures.
� Attitude: Practitioners’ attitudes must be
open, flexible, and sensitive to others.
� Communication: Practitioners’ level of
communication skills must be high in order
to effectively interact with other cultures.
� Knowledge: Practitioners should have a
basic knowledge of the prominent culture in
which they are delivering care.
� Self-efficacy: Practitioners should have the
confidence to deliver culturally competent
20. care.
When cultural competence has been
demonstrated, the consequences of those
behaviors and events result in improved health
outcomes. Behaviors represent the actions of
healthcare providers. If those actions or behaviors
are culturally competent, improved health
outcomes may follow for the patient. Events are
the actual interactions between healthcare
provider and patient. The following are cultural
competency consequences based on the
literature:
� Culturally competent registered nurses
deliver culturally congruent care to all
patients.
� Clients become active participants in their
health care.
� Clients have decreased fear of the health
care system and health care practitioners.
� Clients have increased satisfaction with
health care services.
Figure 1
A Cultural Competency Conceptual Model
2016, Vol. 20, No. 2 117
Student Paper
21. � Decreased health disparities are reported.
� Better health outcomes result by increasing
health promotion and preventive care.
� Nurse educators support culturally
competent practices in undergraduate
nursing students.
� Health status of ethnic, racial, and low-
income groups improves.
Conceptual Model
The conceptual model in Figure 1 illustrates
the cyclical direction of attaining cultural
competency. The antecedents need to exist in
order for the nurse to attain the characteristics
needed to reach cultural competency. If cultural
competency is reached, the consequences
demonstrate a benefit to the individual,
community, and nation.
Discussion of Concept
The concept of cultural competency is integral
to giving the best care possible to individuals,
families, and communities. It is imperative that
nursing students receive cultural competency
education in the classroom, and in clinical and
simulation settings. The literature establishes the
effectiveness of cultural competency education in
the classroom and study abroad. However, study
abroad and immersion experiences are expensive
and only available to a select few. The research
conducted on simulation (Jeffries, 2009; Miller,
22. 2010; Shin, Park, & Kim, 2015) demonstrates the
effectiveness of using simulation to bridge the gap
between the classroom and practice.
The literature illustrates the effectiveness of
students engaging with patients of a different
culture in study abroad or immersion experiences.
Reeves and Fogg (2006) gathered data on the
perceptions of undergraduate nursing students
regarding their life experiences with cultural
diversity. The authors noted several themes
during the analysis of the interviews. One
unexpected theme emerged—defining life
experience—and is the only one discussed in this
study. The authors elaborated on this theme with
direct quotes from the participants. The quotes
from the students highlighted the lack of cultural
exposure in the nursing curriculum and how
various exposures outside of nursing helped them
become culturally aware. Participants in the study
reported unique cultural experiences that shaped
how they viewed different cultures. One
participant spoke about attending camp as a
counselor where the majority of the staff were
lesbians. The participant had never been exposed
to a homosexual culture and had a difficult time
with adjustment. At the end of the summer,
however, she acknowledged it was an exceptional
educational experience and had changed her
views. The experience reinforced the need for
cultural awareness and exposure during nursing
education programs (Reeves & Fogg, 2006).
Reeves and Fogg (2006) illustrated the
importance of exposing undergraduate
baccalaureate students to other cultures.
23. Exposures help to cultivate cultural awareness in
nursing students so that they can continue to
develop cultural competency knowledge and
skills. Specific cultural skills emphasized in the
literature are culturally appropriate assessment
tools, diagnosis, planning, interventions, and
evaluation methods. Cultural competency affects
how patients interact with nurses in the hospital
setting. With the implementation of the Patient
Protection and Affordable Care Act (2010) and an
aging population, health care is moving from the
acute care setting to the community. In public and
community health, culturally appropriate attitudes,
skills, knowledge, awareness, humility, and
sensitivity are essential to delivering culturally
congruent care. In ethnic minority communities,
there are many barriers to attaining quality health
care, including language barriers, distrust of the
medical profession, immigration status, and lack
of preventive care and health promotion. By
delivering culturally congruent care in the
community setting, health disparities and health
outcomes of a community can be improved.
Conclusion
The delivery of culturally competent care is a
benefit to society. The need for culturally
competent care is evident in the literature without
a clear consensus as to best methods. With a
growing, diverse population, health disparities will
increase unless health care professionals educate
students and clinicians to provide culturally
competent care. A review of nursing education
literature reveals various methods to integrating
cultural competency in the curriculum. In order to
24. meet the needs of the population, consensus is
needed to ensure all nursing students are given
the same cultural competency knowledge and
application in practice.
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Author Note
Deborah Byrne, RN, MSN, is Assistant
Professor at the School of Nursing and Health
Sciences, La Salle University, Philadelphia,
Pennsylvania, and a doctoral student in nursing at
the College of Nursing, Villanova University,
29. Villanova, Pennsylvania.
Correspondence concerning this article should
be addressed to Deborah Byrne, School of
Nursing and Health Sciences, La Salle University,
1900 West Olney Avenue, Philadelphia, PA
19141, USA. E-mail may be sent to
[email protected]
2016, Vol. 20, No. 2 119
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The client-oriented model of cultural competence in healthcare
organizations
Giovanni Di Stefano , Eleonora Cataldo and Chiara Laghetti
Dipartimento di Scienze Psicologiche, Pedagogiche e della
Formazione, Università degli Studi di Palermo , Palermo, Italy
ABSTRACT
The paper aims to propose a new model of cultural competence
in health organizations based
on the paradigm of client orientation. Starting from a literature
30. review, this study takes
inspiration from dimensions that characterize the cultural
competence of health
organizations, and re-articulates them in more detail by
applying a client orientation view.
The resulting framework is articulated into six dimensions
(formal references; procedures and
practices; cultural competences of human resources; cultural
orientation toward client;
partnership with community; and self-assessment) that define
the ability of a health
organization to achieve its mission, acknowledging,
understanding, and valorizing cultural
differences of internal clients (staff) and external clients
(consumers). This study makes an
effort to address the paucity of studies linking approaches to
managing cultural diversity in
health organizations with cultural competence within the
framework of client orientation.
ARTICLE HISTORY
Received 30 March 2017
Accepted 3 October 2017
KEYWORDS
Cultural competence; health
organizations; client-oriented
model
Introduction
Globalization has deeply changed the profile of both
the workforce and the users of organizations in the
societies of the new millennium. One important ques-
tion is how to deal with growing cultural diversity in
such a way that it may produce positive results – in
31. terms of productivity and service quality, well-being
and satisfaction – for organizational systems and for
people, both workers and users.
The Diversity Management (DM) approach aims to
accomplish such a result by adopting a heterogeneous
viewpoint in order to lever cultural differences and
treat them as an added value rather than an obstacle.
In fact, the premise for managing diversity is the recog-
nition of differences as positive attributes of an organ-
ization, rather than as problems to be solved [1]. In this
way, diversity may become a source of competitive
advantage, increase the quality of organizational life
and ultimately be advantageous for business [2]. The
point is not, therefore, the acceptance of differences,
but the creation of an inclusive environment and the
commitment to valuing them. This can be made poss-
ible through a culture of inclusion that creates a work
environment nurturing teamwork, participation, and
cohesiveness. However, many organizations do not
see the advantages that cultural diversity could bring
to them and how well-managed cultural diversity
may achieve a competitive edge in the market.
The topics of cultural differences and disparities that
may result from them have been already described in
healthcare organizations, since the emerging challenges
of providing health services in a growing multi-ethnic
world [3,4]; within these organizations, the approach
of intercultural DM and the cultural competence are
considered a priority. In particular, cultural compe-
tence is a powerful instrument for managing cultural
diversity in multicultural settings, since it improves
quality and eliminates racial/ethnic disparities in
organizations. The goal of cultural competence is to
33. INTERNATIONAL JOURNAL OF HEALTHCARE
MANAGEMENT
2019, VOL. 12, NO. 3, 189–196
https://doi.org/10.1080/20479700.2017.1389476
http://crossmark.crossref.org/dialog/?doi=10.1080/20479700.20
17.1389476&domain=pdf
http://orcid.org/0000-0001-7276-549X
mailto:[email protected]
http://www.tandfonline.com
organization within the framework of client orien-
tation. EBSCO, MEDLINE, Scopus, and Web of
Science databases were searched for relevant peer-
reviewed articles regarding the organizational cultural
competence and client orientation in healthcare.
Toward a definition of cultural competence
for health organizations
Since the 1980s, several scholars have paid attention to
the construct of cultural competence, focusing on stu-
dents [5–7], research [8], policy organizations [9],
counseling services [10–12], and above all, the
human service sector – social work and healthcare
[3,4,13–24]. With specific reference to healthcare
organizations, the concept of cultural competence
was used not only in reference to the individual’s ability
to provide care in a culturally appropriate way but also
in relation to systems and organizations.
Cultural competence has been defined variously in
the literature. For example, Green [20] first defined it
as the ability to conduct professional work in a way
that is consistent with the expectations, which mem-
34. bers of a distinctive culture regard as appropriate
among themselves. This definition emphasizes the
worker’s ability to adapt professional tasks and work
styles to the cultural values and preferences of clients.
According to Cross et al., cultural competence is a set
of congruent behaviors, attitudes, and policies that
come together in a system, agency, or among pro-
fessionals and enable that system, agency, or those pro-
fessionals to work effectively in cross-cultural situation
[25],p.1. Sue defines cultural competence as the ability
to engage in actions or create conditions that maximize
the optimal development of client and client systems
[11],p.817. According to the National Quality Forum,
cultural competence is the ongoing capacity of health-
care systems, organizations, and professionals to pro-
vide for diverse patient populations high-quality care
that is safe, patient- and family centered, evidence
based and equitable [26],p.2. Last but not least, Betan-
court et al. [3] define cultural competence as the ability
of systems to provide care to patients with diverse
values, beliefs, and behaviors, including tailoring deliv-
ery to meet patients’ social, cultural, and linguistic
needs.
Despite these differences, authors seem to agree that
cultural competence is an active and developmental
process that is ongoing and never reaches an endpoint.
Cultural competence develops over time through train-
ing, experience, guidance, and self-evaluation [4,14,25].
In connection to such a general statement, Campinha-
Bacote views cultural competence in the specific field of
healthcare as the ongoing process in which the health-
care provider continuously strives to achieve the ability
to effectively work within the cultural context of the cli-
ent (individual, family, community) [4],p.181. Scholars
35. tend to consider cultural competence as increasingly
important for healthcare quality [13,14,15,22], and
believe that there is a link between cultural competence
and reducing or eliminating racial and ethnic dispar-
ities in health care [7,16,27].
Although the centrality of cultural competence in
health practice appears to be a widely accepted concept
[3,13,14], still exists a scarce research on the effects and
the outcomes of developing culturally competent
healthcare organizations [16,28]. Nevertheless, there
is some evidence that the implementation of cultural
competence models improves the ability of health sys-
tems and their workers to provide services to culturally
diverse patient groups, reducing disparities in quality
of health care [13,15,16].
Main models of cultural competence
Several models of cultural competence have been
developed in the last two decades; in them, the dimen-
sions of this construct were delineated with particular
attention to individuals and organizations.
Cross et al. [25], focusing on systems of care, pro-
pose a continuum that ranges from cultural destructive-
ness, that is destructive attitudes, policies, and practices
toward diverse cultures and individuals within a cul-
ture to cultural proficiency or advanced cultural compe-
tence, i.e. attitudes, policies, and practices that hold
culture in high esteem, with the intermediate stages
of cultural incapacity, in which the organization not
intentionally seeks to be culturally destructive, but
rather is not able to help minority clients, cultural
blindness, that is believing that all people are the
same and that approaches used by a dominant culture
36. are universally applicable, cultural pre-competence,
namely realizing weaknesses in serving minorities
and attempting to improve service for a specific part
of the population, and cultural competence, i.e. adapt-
ing a service model to the needs of minorities, expand-
ing cultural knowledge and resources, conducting
cultural self-evaluation continuously. In order to assess
at which of these stages a given organization is, one
may evaluate the entity of five essential elements that
contribute to a system’s ability to become more cultu-
rally competent: (1) the propensity to valuing diversity,
that is the awareness, acceptance, and respect of differ-
ences in lifestyle, communication, behaviors, values,
and attitudes; (2) the cultural self-assessment, specifi-
cally the ability of the system to assess itself and have
a sense of its own culture; (3) the dynamics of differ-
ence, or the ability of the organization to manage mis-
interpretation and misjudgment when a member of
one culture interacts with other from a different one;
(4) the institutionalization of cultural knowledge,
namely how much organization provides cultural
knowledge to their workers about family system,
values, history, and etiquette of specific populations;
190 G. D. STEFANO ET AL.
and, finally, (5) the adaption to diversity, i.e. the sensi-
bility of the organization to adapt its approaches in
order to create a better fit between the needs of min-
ority groups and services available.
Rodgers’ model, instead, focuses on the identifi-
cation of attributes of cultural competence rather
than the development of a definition of the concept.
37. Rodgers [29] identifies seven attributes of cultural
competence: cultural awareness, i.e. developing con-
sciousness of culture and the ways in which culture
shapes values and beliefs; cultural knowledge, that is a
continued acquisition of information about different
cultures and an essential underpinning of cultural
understanding; cultural understanding, specifically the
ongoing development of insights related to the influ-
ence of culture on the beliefs, values, and behaviors
of diverse groups of people by which one can begin
to address problems such as marginalization and sub-
jection that may be the result of beliefs and values of
one culture differing from those of the dominant cul-
ture; cultural sensitivity that develops as one comes to
appreciate, respect, and value cultural diversity and,
in so doing, one also comes to realize how one’s own
personal and professional cultural identity influences
practice; cultural interaction, namely the personal con-
tact, communication, and exchanges that occur
between individuals of different cultures; cultural
skill, or the ability to communicate effectively with
those from other cultures, including the incorporation
of the client’s beliefs, values, and practices into the pro-
vision and planning of care and also varying pro-
cedures and techniques to accommodate cultural
beliefs; cultural proficiency, that is the commitment to
change through some activities as the sharing of
information.
A different model is proposed by Purnell [23]. It is
based on the assumption that cultural competence is
not a linear process in which a healthcare provider –
or any organization – progresses from unconscious
incompetence, a condition in which it is unaware that
is lacking knowledge about another culture, to con-
scious incompetence, to one in which is aware, and
38. from this to a state in which it has a conscious compe-
tence, learning about the client’s culture and providing
culturally specific interventions, to the optimal con-
dition in which it automatically provides congruent
care to clients of diverse cultures, namely it holds an
unconscious competence.
Finally, Campinha-Bacote’s model views cultural
competence as the ongoing process whereby the
healthcare provider continuously strives to achieve
the ability to effectively work within the cultural con-
text of the client (individual, family, and community)
[4]. Campinha-Bacote’s model is composed of five
major constructs that have an interdependent relation-
ship with each other: cultural awareness, that is the self-
examination and exploration of one’s cultural and
professional background; cultural knowledge, i.e. the
pursuit and achievement of a sound educational foun-
dation about diverse cultural and ethnic groups; cul-
tural skill, namely the ability to collect relevant
cultural data regarding the client’s presenting problem,
to conduct cultural assessments and culturally based
physical assessments; cultural encounters, or the pro-
cess that encourages the cross-cultural interactions
between healthcare provider and clients from culturally
diverse background; and, finally, the cultural desire,
that is the motivation of the healthcare provider to
want to become culturally aware, knowledgeable and
skillful, and familiar with cultural encounters.
Although all the models presented so far have had
some success and have been implemented in a wide
variety of programs in medical schools, the concept
of culture competence must go beyond the traditional
notion of ‘competency’, involving the fostering of a
39. critical consciousness of the self, others, and the
world and a commitment to addressing issues of
societal relevance in health care [30]; also, they seem
to consider cultural competence only as a means to
provide a culturally specific service for users of differ-
ent ethnicities.
The model here proposed, which we call the Client-
Oriented Model of Cultural Competence, is instead
designed mainly as a tool for the management and
development of human resources from different cul-
tural backgrounds. In our proposal, a culturally compe-
tent organization aims to promote positive
intercultural encounters among colleagues, then
between providers and consumers. The organization
must be culturally competent with regard to internal
customers to dispense a culturally competent service
to external customers.
The client-oriented model of cultural
competence
The Client-Oriented Model of Cultural Competence
can be considered as a model that, inspired by the
DM approach, aims to link the task of managing cul-
tural diversity in health organizations with cultural
competence, within the framework of client orien-
tation. In this model, the cultural competence is
defined as the ability of a healthcare organization to
achieve its mission (service delivery), acknowledging,
understanding, and valorizing cultural differences of
internal clients (staff) and external clients (consumers).
Within the proposed model, we posit that the client
orientation view may be considered a specific key
element for healthcare organizations. In fact, the
40. focus on provider–client relationship may give added
value to healthcare services: for example, when health-
care providers either do not speak the client’s language
or are insensitive to cultural differences, the quality of
health care can be compromised [13]. Under this point
INTERNATIONAL JOURNAL OF HEALTHCARE
MANAGEMENT 191
of view, a client-oriented healthcare organization is a
system that responds effectively to language, and in a
more general sense, to psycho-social needs of their cli-
ents. Also, the respect, the sensitivity, and the under-
standing for clients’ culture and values appear to be
related to the ability of healthcare providers to offer
provisions of health services [3,4,13].
It is articulated into the following six dimensions:
(1) Formal references related to cultural competence;
(2) Procedures and practices;
(3) Cultural competences of human resources;
(4) Cultural orientation toward clients;
(5) Partnership with community;
(6) Self-assessment.
These dimensions are described below in detail.
Formal references
The first dimension of the Client-Oriented Model of
Cultural Competence regards written formal organiz-
ational statements about mission, values and prin-
ciples, goals and policies, beneficiaries, and vision. In
41. a culturally competent organization, formal references
explicitly stress the importance of cultural competence,
consider the cultural diversity of staff members as a
resource to be valuable, and include members of differ-
ent cultures as beneficiaries of the service. A culturally
competent governance establishes policies and goals
that help ensuring the delivery of the service in a cultu-
rally responsible way, by involving various groups in
the decision-making process [27]. The organizational
statements must be communicated to staff and consu-
mers, and the language in the formal references must
acknowledge the cultural diversity of personnel and
population served. In other terms, an organization is
culturally competent when, even before delivering its
services to implement the provision of services, it
defines its own primary task in a culturally sensitive
way, taking care to distribute its own purposes, prin-
ciples, and values within the system and in the whole
territory and encouraging the sharing of the same
goals and principles among staff and users.
Procedures and practices
The second dimension regards the practices of man-
agement and development of human resources. In
relation to service delivery procedures, in agreement
with Hernandez et al. [27], we believe that cultural
competence in service ensures ad hoc services that
reflect the needs of consumers. A healthcare organiz-
ation should have a database containing information
about each user’s clinical history, culture of origin,
and reported impact ensuing the first encounter with
the organization, to ensure a culturally competent
service. This database, continuously updated, will be
a guide for health providers, who will be able to provide
42. the most appropriate service, in timely fashion and in
the most appropriate way, to the specific patient. In
relation to management and development of human
resources practices, efforts should be made to recruit,
select, and hire multicultural administrative staff and
medical personnel, who should be representative of
the cultures existing in the community and able to
speak the languages of the populations served [31,32].
Racial/ethnic diversity in the healthcare leadership
and workforce has been clearly connected with the
delivery of quality care to diverse patient populations
[3].
So conceived, procedures and practices serve the
more general objective to render a healthcare organiz-
ation a culturally competent system; this, in turn,
should allow to create a multicultural environment,
which is a setting ready to receive people, both consu-
mers and staff, of different cultures. In other words, a
culturally competent organization, which has designed
and created through its procedures and practices a
physical and symbolic multicultural environment,
ensures users’ open access to services through the elim-
ination of socio-cultural barriers see [3,27]. First, the
absence of language barriers, i.e. multilingual bro-
chures, documents/information materials allows effec-
tive communication between providers and
consumers. The organization will monitor consumers’
needs on-site through such devices as anonymous
questionnaires on the services offered.
As a customer-oriented system, the organization
will offer the opportunity to provide feedback also to
the staff, who will be able thus to report problematic
issues encountered in the workplace and provide sug-
gestions to improve the service. Thus, the organization
43. creates, maintains, and improves a work environment
that is conducive to the well-being and development
of all employees [17,33]. Such devices will increase
the sense of belonging in the workplace (affective com-
mitment) and employees will identify with the organiz-
ation and its values. The physical–spatial structure with
its premises and furnishings is nothing more than the
expression of the organization’s system of values
based on acceptance, respect, and appreciation of cul-
tural differences. The culture of an organization, in
fact, is primarily inferred from the observation of its
visible and tangible aspects, along with the public
actions of its members.
Cultural competences of human resources
The third dimension focuses on attitudes and skills of
personnel required to provide culturally acceptable
care, developed through training, which are: awareness
of own beliefs and bias; knowledge, acknowledgment
of, and respect for, beliefs and values of other cultures;
192 G. D. STEFANO ET AL.
relational skills in intercultural encounters with co-
workers and consumers; appropriate language and
effective communication; multicultural team-working
skills. A large part of the literature suggests some of
these beliefs/attitudes and skills are components of cul-
tural competence [11,12,18,21,24,25]. In particular, Sue
et al. [12] list some of the culturally competent counse-
lor’s attitudes and skills, namely: valuing and respect-
ing differences in beliefs, values, language, and
helping practices; awareness and knowledge of own
44. and clients’ cultural heritage and experiences, attitudes,
values, biases, and stereotypes; ability to engage in a
variety of verbal and nonverbal helping responses.
In our opinion, it is of primary importance that
employees of multicultural organizations be aware of
the cultural basis of their behaviors, in such a way that
they may realize that their beliefs do bear consequences
on their actions in the workplace, possibly leading them
to commit errors of assessment. It is also important that
they know, accept, and respect the different cultures of
co-workers and users. In fact, if staff members are not
willing to accept co-workers culturally different from
themselves, they will always have difficulties welcoming
external customers, which are carriers of culturally
specific needs, and this attitude of closure shall affect
the delivery of an efficient service. Relational, communi-
cation, and team-working skills are necessary to work in
a multicultural context. In general, with the acquisition
of relational skills, employees become capable of mana-
ging intercultural encounters with colleagues and users,
listening to others different from themselves, under-
standing their needs, and managing their own behaviors
on the basis of their cultural characteristics.
Culturally competent organizations aim to reduce
the difficulty of interaction (i.e. misunderstanding,
conflicts, and differences of views) between individuals
of different cultures. To achieve this, it is also necessary
to obtain specific multicultural team-working skills,
which allow members to cooperate, share information,
share their views, communicate effectively, and reach
an agreement on the various clinical issues. Communi-
cation skills seem to be essential to interact and work in
multi-ethnic groups. In order for the team’s goal to be
achieved and the environment to be positive, the com-
45. munication must be clear and transparent, fluid and
open, welcoming of others without judging, censor-
ship, or misunderstandings.
Upon meeting a culturally different customer, it is
important the staff adapt their communication style
and pay attention also to nonverbal communication.
As claimed by Campinha-Bacote [4], nonverbal com-
munication techniques must take into consideration
the client’s use of eye contact, facial expressions, body
language, touch, and space. Nonverbal language and
paraverbal language are the first channels of interaction
and affect the transmission of the message more greatly
than the spoken word. Communication with the user is
effective if there is correspondence between the verbal
and the nonverbal channels. Therefore, our model
puts special emphasis on communication skills and
improves relationships among colleagues and between
providers and users.
The organizations need to render all employees
more sensitive to cultural issues through diversity edu-
cation and cultural competence training, teaching them
culturally adapted models of care or types of interven-
tions [31], and developing their attitudes and skills
necessary to deliver service in a culturally responsible
manner. Staff members will be involved in group dis-
cussions, i.e. case method and self-case method and
exercises, such as simulations, role-playing which
refer to their multicultural working environments, as
well as outdoor training sessions centered on the rela-
tional and communication skills and multicultural
team-working skills development.
The importance of diversity and cultural compe-
46. tence training and education is highlighted by a large
part of the literature [3,5,7,11,15,17,18,25,30,32,34–
36], because cultural competence is mediated through
the behavior of all human resources that act on both
upper and lower levels of an organization. In this
way, cultural competence does not stay a mere abstract
concept, but rather it becomes a reflection of the skills,
abilities, and actions of every resource.
In general, the organization must focus on the devel-
opment of such interpersonal skills in order to be cus-
tomer-oriented from a cultural standpoint. If the
organization grants its employees a chance to acquire
and exercise these competences in their workplace
relationships, they will also become able to deal with
users belonging to any ethnic group in a culturally sen-
sitive and responsible way.
Cultural orientation toward clients
The fourth dimension is the one that best qualifies the
Client-oriented Model of Cultural Competence. It is
the analysis of user and staff needs and it regards also
the knowledge of their cultural characteristics. Accord-
ing to our definition, culturally competent organiz-
ations are culturally client-oriented, insofar as they
proactively look to meet the cultural needs of both
internal and external users. Hernandez et al. [27] and
Siegel et al. [32] have already stressed the importance
of knowing the needs and cultural characteristics of
the local population that constitutes most of the organ-
ization’s user pool.
In our model, we take into consideration external
customers; we are aware that cultural competence is
an integral component of patient-centered care, but we
47. plan to extend the analysis of needs and the knowledge
of the cultural characteristics also to internal customers,
because we consider an organization’s care for its staff
an essential element within the construct of cultural
INTERNATIONAL JOURNAL OF HEALTHCARE
MANAGEMENT 193
competence. We also believe that the cultural character-
istics of staff affect not only the interaction with multi-
cultural clients – and, therefore, the quality of service,
but also the interpersonal relationships among col-
leagues. The quality of the latter must be guaranteed
by the organization, through the promotion of effective
communication styles and a positive emotional environ-
ment. These aspects of working life promote employee
satisfaction, which will impact customer satisfaction in
the assessment of Total Quality Management. Accord-
ing to this approach, in fact, the treatment of internal
customer is transferred to the external customer. In
other words, only if the organization is culturally com-
petent with regard to staff, will it also be toward users.
The ultimate goal is to provide quality service to multi-
cultural users, but in order for an organization to be
defined culturally competent, that organization must
ensure a positive work environment for its own multi-
cultural staff.
Partnership with community
Culturally competent healthcare organizations collab-
orate with community partners, such as other public,
private, or no-profit organizations that help minority
groups. From such collaboration, useful feedback
48. may emerge regarding the analysis of the needs and
cultural characteristics of ethnic groups served, upon
which the organization sets its own targets for inter-
vention. The community partners are, therefore, con-
sidered bridges, which bring together the providers
and the consumers even before the latter start using
the former’s services [13,19].
Preliminary meetings, during social events, orga-
nized periodically (i.e. friendly soccer matches in
which healthcare professionals and users of different
ethnicity play on the same team), permit the establish-
ment of a relationship of trust, which will make the
members of minority groups likely to turn to the
organization for need of care. In other words, through
this continuous dialogue with the territory, the organ-
ization makes culturally competent marketing, foster-
ing relationships with potential multicultural users
and making the service known to them, in a mutually
advantageous process. With respect to minority com-
munities’ users, such a process increases their ability
to manage their own health needs more autonomously
and use services more responsibly and with the aware-
ness that, once within the organization, they will find a
welcoming environment.
Broadly speaking, healthcare organizations should
develop collaborative partnerships with communities
and use a variety of mechanisms, both formal and
informal, to facilitate community and patient or consu-
mer involvement in designing and implementing cul-
turally and linguistically appropriate services-related
activities [13].
Self-assessment
49. Cross et al. [25] argue that the organization’s self-
assessment is essential to the development of its cul-
tural competence. On the basis of the literature
[6,9,25], we highlight the importance of self-assessment
on the part of a healthcare organization (qualitative
and quantitative instruments), with particular atten-
tion to service quality, consumer satisfaction, and per-
sonnel well-being. These three aspects are closely
related and the evaluation of each of them is inter-
twined with the evaluation of the other two. The self-
assessment is useful for the organization to continu-
ously adapt its strategies. It is constituted as a continu-
ous monitoring action, oriented to reviewing service
delivery procedures, management practices, and
human resources development, with the ultimate goal
of developing the most appropriate strategies for a cul-
turally competent system. It is also useful to assess the
quality of the service provided, in terms of process and
product quality, from an intercultural standpoint.
It is useful to evaluate users’ satisfaction, through the
collection of their perceptions and opinions, by means
of an on-site desk collecting questions and complaints
as well as questionnaires submitted by users during
their stay, with a constant focus on addressing the
needs of different cultural groups. The on-site desk
also allows internal clients to evaluate their own organ-
ization, expressing their opinions and suggestions to
improve service. In this regard, meetings will be called
periodically in order to analyze the data collected from
various multicultural sources, discuss, and give guide-
lines to staff on how to provide those services in a cul-
turally competent manner.
Even the community partners play an important
role in the evaluation process and in the examination
50. of the results of service delivery procedures. By acting
as representatives of particular ethnic groups present
in the territory in which the services are provided,
community partners report those groups’ needs to
the organization. For example, an association repre-
senting the territory’s Tamil community could bring
up a specific need for this clinic ethnic group, the
organization would take note and, on this basis,
become able to develop culturally competent prac-
tices. In this self-assessment process, it is important
for the organization to evaluate the welfare of its
own multicultural staff. Even in this case, it is desir-
able to develop qualitative/quantitative questionnaires
and focus groups.
Finally, the product evaluation aims to assess whether
the organization’s clinical and economic results have
been achieved. There is no doubt that the self-assess-
ment process will have positive repercussions on all eth-
nically diverse systems: leadership, on staff and users.
Thanks to this self-assessment, it will be possible to deli-
ver a high-quality service in a culturally competent
194 G. D. STEFANO ET AL.
manner, managing to keep costs reduced and enhance
the contribution of each human resource involved.
Conclusion
The six dimensions of the Client-Oriented Model of
Cultural Competence interact with each other, accord-
ing to a principle of circularity (see Figure 1). Even
though, thanks to such circularity, each dimension
51. naturally ensues the previous one, the sequence cannot
be considered too strictly in the study of an organiz-
ation that is meant to assess whether it is culturally
appropriate.
The theoretical model described here places pre-
vious conceptualizations of cultural competence
under the paradigm of client orientation. By doing
so, the success of efforts to develop a culturally compe-
tent healthcare organization may be meaningfully
influenced by the ability of the organization and their
practitioners to recognize, value, and respond to the
needs of the specific clients being served, not only
those who belong to racial and ethnic minority groups;
in this sense, the model considers a set of dimensions
that have a pervasive influence in determining clients’
healthcare experience. From this point of view,
although the Client-Oriented Model of Cultural Com-
petence identifies measurable dimensions associated
with culturally competent organization, further
research is needed to determine the best approaches
and methods to measuring these factors. For example,
the model may constitute the basis to develop a specific
checklist to assist organizations to develop policies and
structures that support a cultural competence specifi-
cally framed within the client orientation. Owing to
the multifaceted nature of the model, various indicators
across multiple domains are required in order to obtain
valuable and accurate information, but their identifi-
cation goes beyond the purpose of this work.
An obvious broad implication of the adoption of the
model here represented is, of course, that increased
cultural competence can reduce disparities in pro-
vision of healthcare services. Conversely, at a more
52. focused level, it is important to distinguish between
the cultural competence of individual practitioners
of healthcare and cultural competence at the organiz-
ational level. At the individual level, some com-
ponents of client-oriented cultural competence may
be identified, for example, in the sensitivity and
understanding of one’s own cultural identity, in
having knowledge of other cultures’ beliefs, values and
practices, and having the skills to interact effectively
with clients’ diverse (sub)cultures. At the organiz-
ational level, client-oriented cultural competence
refers to a set of congruent policies, and structures
that come together in a system: for example, creating
structures for clients’ commitment, in order to involve
them in the design and implementation of services
they receive, or developing partnerships that acknowl-
edge strengths and build upon a networks of support
within diverse communities, taking into careful con-
sideration the values and principles that underpin
community engagement.
We believe that an organization is provided with
cultural competence from the very moment in which
it is created, insofar as its creation revolves around
specific cultural values. These values will be acted
upon through the organization’s own practices and
procedures, the development of specific skills within
its staff and the consequent creation of a multicultural
environment. In this model, the organization is also
open to dialoguing with its territory and is willing to
constantly self-evaluate its own actions.
All dimensions must be addressed in the cultural
competence development process. To assess whether
an organization is culturally competent, we posit that
it is not necessary, however, to follow the order of
53. dimensions suggested here. Therefore, in our circular
model, it is possible to start from any dimension to pro-
ceed to the evaluation of any other one. For instance, if
an organization is deemed culturally competent for the
dimensions ‘Procedures and Practices’ and ‘Partnerships
with community’, but it is not competent in regard to
any other dimension, it is still possible to use those
two successful dimensions to devise strategies to achieve
competence in the others. When the tools are given to
develop competence in all dimensions, the organization
will have an orderly system and may operate indepen-
dently in order to remain culturally competent.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes on contributors
Giovanni Di Stefano, PhD, is Assistant Professor of Work
and Organizational Psychology at the University of Palermo,
Italy. His research interests include the impact of organizational
Figure 1. The client-oriented model of cultural competence
diagram.
INTERNATIONAL JOURNAL OF HEALTHCARE
MANAGEMENT 195
culture on human resource management practices, with
particular emphasis on managing deviance and diversities,
the organizational well-being, and the attachment to the
workplace.
54. Eleonora Cataldo, psychologist,is an independent consultant
and researcher based in Palermo, Italy. Specialist in person-
nel selection, her research interests include the effectiveness
of diversity management strategies.
Chiara Laghetti, psychologist,is an independent consultant
and researcher based in Palermo, Italy. Her work and
research interests include the multicultural diversity man-
agement practices.
ORCID
Giovanni Di Stefano http://orcid.org/0000-0001-7276-549X
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196 G. D. STEFANO ET AL.
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AbstractIntroductionToward a definition of cultural competence
for health organizationsMain models of cultural competenceThe
client-oriented model of cultural competenceFormal
59. referencesProcedures and practicesCultural competences of
human resourcesCultural orientation toward clientsPartnership
with communitySelf-assessmentConclusionDisclosure
statementNotes on contributorsORCIDReferences