Promoting culturally-based care: Teaching-learning strategies for educating nursing students

The faculty at Duquesne University School of Nursing have collaboratively developed, implemented and required a Transcultural Nursing Course in the undergraduate nursing curriculum.   This course serves as the foundation to increase cultural awareness, knowledge and skills of freshmen nursing students in the hope that they may one day become professional registered nurses with the framework and desire for providing culturally competent care for individuals, families and communities.  The course framework is built around Camphina-Bacote’s Model of Cultural Competence.  The framework includes the following components:  cultural awareness, cultural knowledge, cultural skill building, and cultural encounter.  According to the model the process starts with cultural desire, for without it the process of cultural competence cannot begin.  Therefore, the teaching learning strategies begin with the focus on the student.  Activities center on assisting the student to know and understand the cultural self, (who they are culturally, how their beliefs, values, traditions, etc. inform who they are, where they come from and where their people come from).  Activities include cultural rooting and cultural icons, and how their family views health.  Students are encouraged to talk with their families in completing the various assignments.  Over the years many students have experienced the power and pride from doing such exercises and a renewed sense of cultural self and empowerment. 

Once the student attains an understanding about the cultural self, the course activities shift to increasing their knowledge and understanding people who are culturally different.  Teaching learning strategies are geared toward exploring the cultural beliefs, values, life way patterns, etc. of people that are culturally different than themselves.  This is accomplished through movies, cultural pilgrimage to places that are sacred and significant to people in the community, and class discussions and debriefing with students on campus.  The faculty purposefully steer the students away from the usual plethora of different cultures and discouraging the cookbook approach to cultural knowledge, instead provide the students with the skill-set/processes for investigating people who are culturally different.  In this manner, students are not led to believe that all people in a particular culture are the same (for example believing that all African Americans are religiously Baptist).  In addition, students are educated on how people learn and develop stereotypical behaviors and prejudices.  Exercises are creatively geared to help students work through stereotypes and prejudices in a non threatening manner. 

A powerful teaching learning strategy is the cultural encounter, where students actually engage in an experience that pushes them out of their comfort zone.  The students usually are afraid at first but as faculty take them through reflective thinking and debriefing processes, the students have responded positively to such experiences.  The Transcultural course offers an opportunity whereas students can build upon throughout the rest of their nursing education and future careers.  Duquesne University School of Nursing’s community-based curriculum continues to weave and promote cultural competence throughout.  Duquesne University School of Nursing believes it is developing a graduate that is more flexible and prepared to practice in a diverse health care environment.