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Developing, Implementing, and Evaluating Cultural Competency and Equality IN Nurse Training : What A

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Results From an Action Research Project to Mainstream ... and utilising participatory methods of data collection through an action research methodology. ... – PowerPoint PPT presentation

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Title: Developing, Implementing, and Evaluating Cultural Competency and Equality IN Nurse Training : What A


1
Developing, Implementing, and EvaluatingCultural
Competency and Equality IN Nurse Training What
Are We Learning?
  • Results From an Action Research Project to
    Mainstream Cultural Competencies and Equality
    Training in the Nurse Curriculum

2
Objectives
  • Background and purpose of the research.
  • Share findings and lessons learned.
  • Lecturers commitment to teaching cultural
    competencies and equality.
  • Lecturers self efficacy.
  • Curriculum management of teaching cultural
    competencies and equality.
  • Make recommendations for further inquiry.

3
Mainstreaming CulturalCompetency and Equality
Training Using Action Research Methodology
  • As part of an action research project, the school
    of health made a commitment to promote cultural
    competence and equality training across all
    modules through a policy of mainstreaming.
  • The major aim of mainstreaming is to build
    capacity in curriculum provision, through planned
    curriculum development and embedding cultural
    competence and equality training to an agreed
    standard.

4
Our Vision
  • The ability to provide care to patients with
    diverse values, beliefs and behaviours including
    tailoring delivery of care to meet patients
    social, cultural, and linguistic needs.
  • The ultimate goal is a health care system and
    workforce that can deliver the highest quality of
    care to every patient, regardless of race,
    ethnicity, cultural background, or English
    proficiency.
  • The commonwealth fund. New York, NY, 2002.

5
Rationale for Culturally Competent Health Care
  • Responding to demographic changes
  • Eliminating disparities in the health status of
    people of diverse racial, ethnic, cultural
    backgrounds
  • Improving the quality of services outcomes
  • Meeting legislative, regulatory, accreditation
    mandates
  • Gaining a competitive edge in the marketplace
  • Decreasing the likelihood of liability/malpractice
    claims

6
The ASKED Framework
  • A - awareness
  • S - skill
  • K - knowledge
  • E - encounters
  • D - desire
  • Source Campinha-Bacote J. Cultural competence in
    psychiatric nursing

7
Study Design
  • A case analysis of cultural competence and
    equality training.
  • The evaluation adopted a pluralistic design that
    includes both quantitative and qualitative
    strategies and utilising participatory methods of
    data collection through an action research
    methodology.

8
Project included
  • Questionnaire Survey
  • Curriculum mapping
  • Self completion Audit
  • Focus Group Interviews

9
FOCUS
  • The views and perspectives of
  • teaching staff, regarding the status of
  • cultural and equality competence training
  • in the School of Health

10
Instrument
  • On-line questionnaire consisting of five sections
    and 26 items.

11
Likert Scale
  • On-line questionnaire consisting of five sections
    and 26 items.
  • Relative importance within the curriculum,
  • Feelings of self efficacy,
  • Perceptions of behavior to support delivery,
  • Perceived ability with subject management,
  • Teaching opportunities.

12
Respondent Profile
13
Respondent Profile
14
Respondent Profile
15
Respondent Profile
16
Respondent Profile
17
Results
18
Sense of Self-Efficacy
  • 1 inability to practise equal opportunities in
    employment.
  • 2 challenge their personal and professional
    biases.
  • 3 incorporating a clients cultural beliefs into
    practice and treatment.
  • 4 capacity to empathize with their clients.
  • 5 understand the biases in assessment tools and
    diagnostic criteria.

19
Self-reported Promotional Behaviours
  • 1 diffusion model
  • 2 de-prioritisation  of race equality
  • 3 screen books, and other teaching resources for
    negative cultural, racial, age and
    gender-stereotypes.  
  • 4 finding news ways of teaching equality and
    cultural competency.  
  • 5 teaching effort.  

20
Perceived Ability and Comfort With Teaching Skills
  • 1 cultural beliefs, religious practices,
    disabilities and rights of my students.  
  • 2 culturally appropriate teaching techniques.  
  • 3 ability to teach students how to recognise
    oppression and discrimination and promote
    equality  
  • 4 inability to intervene when there is cultural
    insensitivity, gender bias or prejudice.  
  •   5 lack of training and confidence.  

21
Teaching Opportunities
  • 1 critically reflect upon their personal and
    professional cultural biases.
  • 2 understand the barriers that prevent equality
    of access to health care.  .
  • 3 understand disease incidence and prevalence
    among ethnic groups.  .
  • 4 undertake a culturally based health needs
    assessment.  .
  • 5 directly engage in cross cultural interactions
    with clients from diverse cultural groups.  .
  • 6 work with interpreters.  .
  • 7 learn from others as cultural informants.    .

22
Headlines..
  • There was a strong sense of public duty to
    promote equality and commitment to furnish nurses
    with the necessary competencies to meet the needs
    of a diverse society.
  • An integrated approach to equality, and in
    particular, race equality was a priority, but
    less evidence of prioritising the subject above
    other course provision.
  • Board self-assurance to manage cultural
    competence and equality training- responding well
    to the daily challenge of preparing nursing and
    midwifery students to care for multi-ethnic and
    multi-cultural populations.

23
Barriers
  • Lack of time in an already packed curriculum
  • Difficult to allocate time to search out new and
    innovative ways to teach such a sensitive
    subject
  • Lack of information and knowledge of some
    cultures and religions
  • Lack of confidence
  • Large group for teaching
  • Staff attitudes some staff think it is not
    important

24
Caveats..
  • The data suggests that prominence may be given to
    equality issues only in so far as these emanate
    from problem based and situated learning.
  • Lecturers attributes critical to curriculum
    planning and innovation commitment, ownership,
    reflection, action.

25
Sustained Inquiry Key Questions
26
Continuity and Coherence
  • The methods used to raise equality matters.
  • Initiatives and techniques being used to raise
    student awareness of bias in assessment tools.
  • Initiatives and techniques being used to promote
    cultural immersion and insight.
  • The comparability of training opportunities.

27
How Does High Self-efficacy Impact on Training?
  • There is a need to establish
  • Levels of teacher self efficacy using reliable
    and valid measurement scales.
  • Factors contributing to variations in
    self-efficacy.
  • Correlate with audited behaviours and practices.

28
The Positive Actions of Teachers Should Be
Treated As a Resource, Audited and Models of Good
Practice Established.
  • The actions being taken by teachers
  • Address racial harassment within educational.
  • Premises.
  • Help students recognise oppression and.
  • Discrimination.
  • Understanding the cultural beliefs, religious.
  • Practices, disabilities and rights of students.
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