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Measuring advanced-level nursing students’ preparedness to provide cross-cultural care

Purpose: This project investigated graduating nurse practitioner (NP) students’ preparedness to deliver cross-cultural patient care.

Background: Educators are challenged to teach patient-centered approaches in which providers communicate with cultural humility, appreciating the perspective of other’s views, values, and health practices. Integrating cross-cultural patient care into NP education is mandated to prepare future providers to better address patient needs from a wide range of sociocultural backgrounds. Teaching of cross-cultural patient care differs across nursing programs in the U.S., and methods of evaluating that teaching also vary.

Methods: We surveyed schools of nursing across the U.S. to investigate NP students’ educational experiences and their perceptions of preparedness to provide cross-cultural patient care (i.e., patients who are members of a culture different from the perceived predominant culture, including racial/ethnic minorities, LGBTQI+ populations, persons with disabilities, persons from another country, among others). The survey was adapted from previously validated instrument (Park, et al.; Weissman, et al.) that we first piloted at our home College of Nursing and then modified to include current curricular issues. Students indicated their level preparedness to care for 15 types of cross-cultural patient populations by using a scale of very well-prepared, well-prepared, somewhat unprepared, and very unprepared. We also established a cross-cultural survey project website, the central hub for accessing project information and survey results for participating schools. Participating schools may use the survey results to identify strengths and weaknesses in their curricula.

Results: One hundred forty-one NP students across 9 nursing schools participated in the cross-cultural survey. Participants reported feeling most prepared to care for patients in general (87%), who are members of racial and ethnic minorities (89%), who are from cultures different than their own (84%), and who are persons with disabilities (84%). Participants reported feeling least prepared to care for those who are new immigrants (41%), those with limited English proficiency (33%), and persons with health beliefs at odds with Western medicine (32%).

Discussion: Despite NP students’ reporting that they feel well- or very well-prepared to address most cross-cultural populations, particularly in general, racial and ethnic minorities, from cultures different than their own, and persons with disabilities, students reported a lack of perceived preparation to care for certain populations, most of all for new immigrants. This suggests that NP programs should consider enhanced cross-cultural curriculum including patient care of new immigrants.

Significance: This work provides a better understanding of NP students’ preparedness to provide cross-cultural care. Preparing NP students to care for patients from wide ranges of sociocultural backgrounds continues to increase in importance over time. Schools of nursing can use survey to help guide enhancements to their curricula focusing on cross-cultural care.