Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

Complementary and alternative medicine practices,traditional healing practices,and cultural competency in pediatric oncology in Hawai'i

OBJECTIVE： Hawai＇i is an ethnically diverse island state with a high rate of both traditional healing （TH） and complementary and alternative medicine （CAM） use. The aim of this project was to assess TH and CAM use within the pediatric oncology population in Honolulu and improve the delivery of culturally competent care. METHODS： A 9-item survey was distributed to all pediatric oncology patients at Kapi＇olani Medical Center for Women and Children for 3 months. The survey inquired about patient ethnicity, TH practices CAM practices and perception of cultural competence of the care received. Descriptive statistics were calculated for the survey items. Qualitative analysis was done with participant comments to identify themes. RESULTS： Sixty-two surveys were completed. TH was used by 39% of the respondents in the home, and 10% in the hospital （top method was traditional foods）. CAM was used by 27% of the respondents in the home, and 68% in the hospital （top method was healing touch）. Ninety-seven percent of the respondents reported receiving culturally competent care. Areas for improvement included language services and dietary choices. CONCLUSION： CAM and TH are used frequently by pediatric oncology patients in Hawai＇i, and the vast majority of patients and families felt that the care they received was culturally competent.

Efficacies of Different Methods of Teaching Transcultural Nursing Practice in China

Purpose： This study assessed the effectiveness of three teaching methods for developing cultural competency based upon Leininger＇s theoretical framework with nursing students in China： case studies, traditional didactic learning, and self-directed learning. These methods were used in tran- scultural nursing teaching practices to identify the method that resulted in the greatest improve- ments in the nursing student＇s understanding and clinical application of transcultural nursing. Methods： The Transcultural Nursing Questionnaire（TNQ） was used for pre-and post-test comparisons of all participants in four areas of cultural knowledge and the Evaluation of Transcultural Nursing Competency（ETNC） was applied via role-play to evaluate the cultural competency of 120 of the 305 participants from three general hospitals in the PuDong New District, Shanghai, China. Individual transcultural nursing courses that focused on case study, traditional didactic or self-di- rected methods persisted for four months in three hospitals. Results： Statistical analyses of the cognitive scores of the participants in the transcultural nursing courses revealed a significant difference（P〈0.01） between scores collected before and after the teaching with the three methods. Comparisons of the three hospitals revealed that the scores for transcultural nursing cognition and simulating service assessment were significantly different（P〈0.01） for the case study nursing students. The scores of the students who were taught with the traditional didactic and self-directed methods were not significantly different across the three hospitals（P〉0.05）. Conclusion： The results revealed that the case study, traditional didactic and self-directed method effectively improved the transcultural nursing cognitive levels of the nursing students. The case study method appeared to be the most effective approach based upon the TNQ pre-and post-tests and the ETNC cultural competency scores.

Strategies for recruiting a sample of adults with type 2 diabetes from primary care clinics in rural Appalachia: Incorporating cultural competence

Background:Recruiting research participants from primary care in rural Appalachia is a major challenge and can be influenced by cultural characteristics,making it critically important to incorporate strategies of cultural competence in the overall design of clinical research.Objectives:The purpose of this paper is to describe culturally competent strategies used for recruitment and data collection with a sample of adults with type 2 diabetes from primary care settings in Appalachia.Design:The Purnell model of cultural competence and relevant literature served as a framework for study design.Four overarching approaches informed the organization of recruitment strategies and development of the data collection plan.Procedures:The approaches included selection of research sites,establishing collaborations,sustaining collaborative relationships,and enhancing understanding of benefits of participation.Four recruitment sites were selected based on potential to enhance diversification of participants;multiple steps were included in each of the three remaining approaches to build relationships and gain participation.A study log was maintained to provide evaluation data.Results:Recruitment took 14 months and a sample of 102 subjects provided consent with 101 participants providing complete data.Demographics were representative of the region except that African American participation was higher(6.9%)compared to current north central Appalachia(3%).Over 72%of participants indicated they would be interested in participating in future studies.Conclusions:These findings emphasize the importance of employing strategies for cultural competence in study design.Use of concepts from the Purnell model led to enhanced representativeness and potential for subsequent generalizability.

A concept analysis of cultural competence

Objectives:To clarify the meaning and reduce ambiguities of the concept cultural competence,and promote consistency in using the concept in nursing dialog,research,and practice.Method:Using Walker and Avant's method of concept analysis.Results:Cultural competence is the gradually developed capacity of nurses to provide safe and quality healthcare to clients of different cultural backgrounds.Its defining attributes are cultural awareness,cultural sensitivity,cultural knowledge,cultural skill,and dynamic process.Antecedents are cultural diversity,cultural encounter,and cultural desire.Consequences involve three beneficiaries,as follows:clients,nurses,and healthcare organizations.Empirical referents are primarily consisted in self-reported tools.Conclusions:The understanding of cultural competence of nurses that emerged in this concept analysis will contribute to the development of a rigorous design of instruments or research.

Cultural competence of nurses in Pudong New Area,Shanghai:a mixed-method study

Objective:Cultural competence has gradually attracted attention from many countries,including China.This study was undertaken to determine the cultural competence of registered nurses in Shanghai,China,and to identify the cultural competence among registered nurses in Pudong New Area,Shanghai.Methods:Qualitative interviews were conducted in combination with a quantitative survey.Fifteen clinical nurses were interviewed,and 1088 clinical nurses were recruited for the survey with cultural competence scale for registered nurses,based on the results of the qualitative and quantitative studies.Results:The overall level of cultural competence among registered nurses in Shanghai's Pudong New Area was moderate.Among the seven dimensions,cultural encounter had the highest score,followed by cultural practice,cultural awareness,cultural desire,cultural skill,cultural experience,and cultural knowledge.Age,level of hospital care,mastery of secondary level,and studying overseas were the influencing factors.Conclusions:Hospitals and universities should be aware of the importance of studying cultural competence.Cultural competencerelated courses should be increased,and various forms of training should be undertaken to enhance the interest of nurses.

Cross-Cultural Competence and English Language Teaching

Language is a part of culture and plays a very important role in it. Learning a language is inseparable from learning its culture.So, we should stick to integrate culture teaching with English teaching and try to improve the student’s cultural awareness so that they can know how to communicate appropriately during the cross cultural communication.

Childhood Development Cross Culturally:Implications for Designing Childhood Obesity Interventions and Providing Culturally Competent Care

United States is experiencing significant growth in its foreign-born population,especially Chinese American population comprising of 1.2%of the U.S.population.Many healthcare providers are challenged in their efforts to provide culturally competent healthcare to this population.To provide culturally competent healthcare,healthcare providers should understand variations in cultural attributes that impact health.One group in which cultural variation holds great influence is that of children.Culture influences a child's behavior,development and health.This article provides a cross-cultural,comparative examination of important cultural influences on child behaviors development and health in China and the U.S.Using the findings about these two populations,interventions for childhood obesity cross culturally are addressed through the analysis of a U.S.based Children's Obesity Program.The author suggests that uniquely different approaches to childhood obesity intervention research are needed based upon the cultural differences identified within this paper.

Person-job fit and work-life balance of female nurses with cultural competence as a mediator: evidence from Nigeria

Objective: This study investigated the mediating effect of cultural competence in the relationship between person-job (P-J) fit and work-life balance among female nurses. Methods: Participants included 216 (mean age = 31.12;SD = 9.16) female nurses that were conveniently selected from two Federal Teaching hospitals in Nigeria. Three questionnaires via the perceived fit scale, cultural competence scale, and work-life balance scale were utilized for data collection. Data were analyzed using both the Pearson Product Moment Correlation and PROCESS macro statistical tools. Results: Results revealed that both P-J fit and cultural competence positively and significantly associated with work-life balance. Also, cultural competence partially mediated the relationship between P-J fit and work-life balance of nurses. Conclusions: The cultural competence enhances the capacity of nurses to balance work and family roles. Therefore, cultural competence training that enhances nurses’ capabilities to handle cultural diversities of patients is essential.

Towards Closing the Language & Culture Gap: A Pedagogical Approach

This paper advances an approach to culture and language instruction through the theoretical construct of the 3Ps (Products, Practices, Perspectives), combined with an inquiry-based approach utilizing the theory on stages of second language acquisition. Culture elements, when embodied in a properly developed and organized curriculum can be systematically implemented all along the different phases of language growth. Mastery of a language is not simply mastery of vocabulary as well as grammar and spelling rules. The most successful language learners learn both culture and language together. The conceptualizations provided by research, although at times conflicting, form a useful foundation for language teaching that provides a deeper and a more enriching human experience. Making culture the core in a language class is akin to asserting the obvious (Furstenberg, 2010);they are two flip sides of the same coin. With its focus on revisiting the role of culture in the FL Classroom, the paper seems to fall into the same category - affirming the tried and true, but like Furstenberg, the author believes there is good reason to re-consider the possibility of closing the language and culture gap.

Turning cross-cultural medical education on its head:Learning about ourselves and developing respectful curiosity

Cross-cultural education is often understood to mean acquiring cultural knowledge about different cultural groups in order to serve people from diverse groups equitably.However,this article argues that to work effectively in cross-cultural situations,we need to learn about our own culture and develop an approach of respectful curiosity.The first goal of cross-cultural education is to understand how culture influences our thoughts,perceptions,biases,and values at an unconscious level.The second goal is to understand the nature of individual cultural identity as a multidimensional and dynamic construct through exploration of our own cultural identity.This exploration helps us understand the limitations of learning about‘others’through learning categorical information and helps us limit the effect of our implicit biases on our interactions.The approach of respectful curiosity is recommended to question our assumptions,understand each unique individual patient,connect with each patient,and build the therapeutic relationship.

Rethinking Cultural Competence Education in the Global Era:Insights from Fei Xiaotong’s Theory of Cultural Self-Awareness

Since humanity entered the 20th century,diversity has become a key feature that manifests itself in all aspects of society.As a venue for people and ideas to meet,universities face ever-increasing challenges in fulfilling their cultural mission.With unprecedented human connectivity,cultural competence is more than a goal.It has become an essential skill for students and a key concern for policymakers and practitioners across the world.Considering the strengths and weaknesses of current approaches to cultural competence education,this article aims to elucidate the significance of the notion of cultural self-awareness proposed by Fei Xiaotong,China’s premier social anthropologist.It explores how Fei’s insights can facilitate universities to rethink their conception and delivery of cultural competence education.By challenging the tendency for cultural competence education to be segregated among a range of disciplines and moving it to the core of the university’s curricular offerings,the article promises an approach whereby all students,regardless of their disciplinary backgrounds,can benefit from the full development of their cultural capability,as can the institution,wider community,and society as a whole.

Understanding cultures beyond medicine

A patient with a terminal illness died of a horrible suicidal attempt and the case provoked deeper learning of how a certain cultural background can lead people to different behaviors.This case study is intended to stimulate more cultural competency-related discussions.

What They Learned Won't Go Away:The Impacts ofan International Exchange Program on Chinese Teacher Candidates' Understanding of and Practice in Science Education

Purpose:The Canadian university where this study took place has established an international exchange program in teacher education with a large Chinese university.This study was designed to examine how the international exchange program influenced Chinese science teacher candidates'understanding of science education and how such learning impacted their teaching in China.Design/Approach/Methods:The study adopted a qualitative research design with interview and reflective journal as the main approaches for data collection.Findings:Participants greatly appreciated the opportunity of exchange.They reported an improved understanding of Canadian school education and its science curriculum and pedagogy,which changed many aspects of their original values about the relationship between the teacher and students,classroom environment,and so on.Although they faced many constraints to implement what they learned from the exchange in Chinese science classrooms,what they learned had never been forgotten.Participants tried to apply them here and there at the level they could control.Originality/Value:There are many reported studies in the literature about Chinese international students on Western campuses.However,research on Chinese students who participate in international exchange programs is very rare.The findings of this study can inform policymakers and education practitioners about student international exchange programs and benefit future exchange participants.