dr. john kachurick. the problem “…many students lack the basic understanding of cultural...

Dr. John Kachurick

The problem“…many students lack the basic

understanding of cultural pluralism needed to maximize competency with ethnically and racially diverse clients”

(Varricchio, 1987, p. 57).

Cultural Competency?Definitions of cultural competency abound.

One of the earliest definitions sees cultural competency as a “…set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals enabling them to work effectively in cross-cultural situations”

(Cross, Bazron, Dennis, & Isaacs, 1989: iv–v).

Cultural Competency? (2)Duke University defines cultural

competency as “an experiential understanding and acceptance of the beliefs, values, and ethics of others as well as the demonstrated skills necessary to work with and serve diverse individuals and groups.”

Cultural CompetencyFor this presentation, the definition

of Cross et al. is the operation definition since it is succinct, clear and the building block upon which the other definitions are constructed.

Cultural IntelligenceEarley & Mosakowski (2003) contend that

cultural competence starts with one’s cultural intelligence, that is, one’s ability to operate in a variety of situations that involve cross-culture functionality.

This ability includes four elements:Behavioral intelligenceCognitive intelligenceMotivational intelligenceMetacognitive intelligence

Metacognitive IntelligenceThe ability to acquire cultural knowledge,

recognize cultural assumptions, understand cultural norms, and perceive others' cultural preferences before and during interactions.

(Ang, Dyne, Koh, Ng, Templer, Tay, & Chandrasekar)

Cognitive IntelligenceKnowledge of economic, legal, values, and

social systems in different cultures and subcultures. (Ang, Dyne, Koh, Ng, Templer, Tay, & Chandrasekar)

Motivational IntelligenceThe desire to learn about and function in

situations involving cultural differences, based on intrinsic interest and confidence in one's ability to deal with them.

(Ang, Dyne, Koh, Ng, Templer, Tay, & Chandrasekar)

Behavioral IntelligenceThe ability to exhibit situationally appropriate

verbal and nonverbal actions, including words, tone, gestures and facial expressions, when interacting with people from different cultures. (Ang, Dyne, Koh, Ng, Templer, Tay, & Chandrasekar)

Dimensions of CulturalHofstede’s (1980, 1991, 2001) framework of

cultural values is the most cited work in regarding cultural variation, although others have expanded upon his work.

Hofsted’s (2001) dimensions are:Individualism/CollectivismUncertainty AvoidancePower Distance, and Masculinity/FemininityLong-term Orientation

CultureHall (1990) defines culture as a set of

behavioral rules gained during the socialization process that determine how a person sees her environment and her use of verbal and non-verbal communication.

Hall seeks to provide tools to decipher messages from other cultures.

He notes three dimensions to messaging: Multi-tasking vs mono-taskingThe distance individuals maintain

between each other in social interactionHigh or low cultural context for

communications

Enhancing the ModelsTrompenaars (1994) enhances the paradigms

of Hoftede and Hall, using a seven-dimension model for analysis: universalism – particularism, sequential time –synchronic time, specific - diffuse, acheived status – ascribed status, outer directed – inner directed , affectivity – neutrality, individualism - collectivism

Cultural Immersion“The desired professional outcome of

transcultural immersion experiences is cultural sensitiv(ity)…in practice”….

“…once a student has had the chance to become immersed in another worldview, one may see differences as well as similarities resulting in a more culturally sensitive approach”

(Ryan & Twibell, 2002, p.38).

Misericordia UniversitySmall, liberal arts, Catholic universityVery homogenous (Caucasian) populationLimited student exposure to those from other

cultures, races, and ethnicities

University Ties to Cultural CompetencyThe university developed a strategic plan that

addresses a goal for diversity that states:

“We will provide for our students to graduate with cultural competency and our employees to gain needed knowledge, awareness and skills”

(Misericordia Strategic Plan)

Strategic-initiative GrantTwo faculty from the business department

and one faculty from the nursing department received an $8,000 university strategic-initiative reserve grant.

The goal of the grant was to facilitate the development of a pilot international, cross-cultural, immersion course to provide students with an opportunity to develop cultural competency and to study in an international setting.

The ProposalThe three faculty members developed a multi-

disciplinary course in cultural competency.Undergraduate and graduate students from

all programs were encouraged to apply.Twelve students (9 graduate, 3

undergraduate) applied and were accepted for the course.

The faculty obtained IRB approval to conduct a research study.

Hypothesis A statistically significant relationship exists

between a student’s development of cultural competency and an international, multi-disciplinary, cultural-immersion experience.

Guyana, SAThe course involved the 12 students and

the three faculty members traveling to Guyana, one of the poorest nations in South America.

Pre-immersion ActivitiesPrior to departure for Guyana, the 12

students who registered for the course attended six on-campus class sessions designed for diversity training and trip preparation.

The faculty administered the Discovering Diversity Profile to all students as a pre-test at the final meeting.

DDP Test (2)The Discovering Diversity Profile is a

cultural competency test that explores diversity in four key areas:Knowledge: Stereotypes and information are

assessed Understanding: Awareness and empathy are

measured Acceptance: Tolerance and respect are examined Behavior: Self-awareness and interpersonal skills

are measured and insights are provided into actions and attitudes

DDP (3)The DDP aligns well with the concepts

outlined by Hofstede, Hall and Trompenaars and is a good proxy for these concepts.

The instrument meets validity and reliability requirements.

Student Immersion PlanStudents were matched with preceptors related to

their respective fields of study (nursing, organizational management, social work, and occupational therapy) for a two week period.

Each student spent approximately two weeks working in a variety of organizations within Guyana.

During this time, students wrote reflection papers and participated in group learning sessions.

Students also engaged in a variety of cultural experiences such as field trips, tours and leisure outings over the two-week period.

The Students’ Background5 Graduate Organizational Management

Students4 Graduate Nursing Students1 Undergraduate Social Work Student1 Undergraduate Nursing Student1 Undergraduate Physical Therapy Student

Placement Goals 1. Matching placements to the abilities, skills

and knowledge of the students.2. Determining the appropriate organizations.3. Securing commitment of organizations to

allow foreign students to participate in their workplaces.Contact within the organizationsVisiting the organizations to give student

backgrounds.

Placements (1)Matching placements to the abilities, skills

and knowledge of the students.ResumesInterviewsTranscripts

Placements (2)Determining the appropriate organizations.

SafetyInteraction with employeesAppropriate position within the organization

Placements (3)Securing commitment of organizations to

allow foreign students to participate in their workplaces.Contact within the organizationVisiting the organization to:

develop a relationship with the contact and any managers involved

give it students’ backgrounds observe conditions

Our AdvantagesThe official language of Guyana is EnglishThe three professors have prior experiences

within Guyana on rganizational, university and individual levels.

The three professors are familiar with the culture.

The three professors have contacts in the right places within Guyana.

The Participating OrganizationsGuySuCoDemerara DistilleriesMercy WingsSt. Joseph Mercy Hospital Georgetown Public Hospital

GuySuCoOne student spent four days at East Demerara

Estates, a sugar processing plantation, observing the production of sugar products from the harvested sugar cane.

The second GuySuCo placement involved putting a student into the IT environment of this major Guyanese corporation so he could observe and interact with the employees of the department on a professional and personal level.

Demerara DistilleriesThis placement shadowed a marketing

representative for this world-renowned distiller of rum and other sugar-based products, including visiting a variety of establishments that sold the firm’s products.

Mercy WingsThe two students, one a graduate student

and the other a social work student, were placed at Mercy Wings, a facility operated that is an innovative vocational-technical training program for adolescents who have not completed traditional schooling.

Our students interacted with faculty and students at Mercy Wings

St. Joseph Mercy Hospital The four graduate nurses and the

undergraduate nurse reworked the charting system at the hospital and provided other valuable assistance and education to the Guyanese nurses.

One OM graduate student worked with the CEO to develop a marketing plan for the private, non-profit hospital.

Georgetown Public HospitalThe physical therapy student spent part of

her time at the Georgetown Public Hospital and the other part at St. Joseph Hospital working in her discipline with practitioners at both institutions.

Post-test AdministrationOn the return flight to the United States, the

faculty administered to all students the Discovering Diversity Profile as a cultural competency post-test.

Quantitative Data AnalysisAnalysis of the data using SPSS to generate

descriptive statistics and Wilcoxon Signed Ranks Test showed:No statistically significant differences between

the pre- and post-tests were apparent.

Quantitative Analysis (2)Probable reasons for this result include:

The pre-test scores were extremely high75% of the students were at the graduate level.The n was extremely low (12).The immersion may have been too short.

Since the data was non-parametric, the descriptive statistics provided little usable information.

Wilcoxon Signed Ranks Test

a. Binomial distribution used p = .05 (.006 Bonferroni correction)

b. Sign Test

kstrtyp2 - kstrtyp1

kinfo2 - kinfo1

uaware2 - uaware1

uempthy2 - uempthy1

Z -.983a -1.077a -1.131a -.448a

Asymp. Sig. (2-tailed)

.325 .282 .258 .654

arecept2 - arecept1

arespct2 - arespct1

bslfawr2 - bslfawr1

bintpsk2 - bintpsk1

-.715a -2.405a -1.260a -1.029a

.475 .016 .208 .303

Qualitative Data AnalysisData excerpted from in-country class

discussions and student reflection papers following the international study experience indicate the students enhanced their cultural intelligence.

The following excerpts from student papers point to an emerging pattern of enhanced cultural intelligence.

Qualitative Data Analysis (1)“A look at other cultures is an experience you

can only read about - but to travel to other countries is the best way to understand and learn. It was beyond what I expected, a real chance to have a true look at another culture.”

Qualitative Data Analysis (2)“A look at other cultures is an experience you

can only read about - but to travel to other countries is the best way to understand and learn. It was beyond what I expected, a real chance to have a true look at another culture.”

Qualitative Data Analysis (3)“We were immersed in the culture and the

community. It allowed us to see first hand what the needs were.”

“The opportunity to study in this wonderful country allowed me to learn things that could not be taught in a classroom. This experience taught me not only about culture and diversity; it taught me more about the person I want to be.”

Qualitative Data Analysis (4)“Their (Guyanese) reason was plain and

simple—they did not want to leave their homes and their families behind. The Guyanese people are very close and very relying on the bonds and relationships they have with their families and I believe this is one of the greatest factors that separate the Guyanese from the Americans.”

Qualitative Data Analysis (4)“I truly believe all of us returned to the

United States with a greater appreciation for what we have at home….Furthermore, we obtained an even greater appreciation for another world culture.”

Qualitative Data Analysis (5)“… it is clearly a course that students can

compare a culture to what they experience in their own group. I personally was made aware, obtained knowledge, and realized that diversity has very genuine effects on behavior and work outcomes.”

LimitationsThreats to external validity

Convenience sampleSelf-selected group of highly motivated

students Small n Limited generalizability of findings.

ConclusionsBased on our analysis of pre-test/ post- test metrics, we found no statistically significant relationship exists between a students’ development of cultural competency and an international, multi-disciplinary, cultural-immersion experience.

ConclusionsHowever, we did find an emerging pattern of enhancement of students’ cultural competencies through the insights contained in student papers, in both formal and informal discussions with students and in faculty observations of student behaviors and language usage.

ConclusionsBased on these findings, we conclude:

the use of a multi-disciplinary, immersion learning experience may prove an effective tool in assisting students to enhance their awareness and understanding of their roles as professionals within a global community.

Questions for future study1. Does the setting for the immersion experience

impact on the students’ development of cultural competency (industrialized versus developing country)?

2. Should there be differences in strategies for undergraduate versus graduate students to facilitate the development of cultural competency?

3. What types of on-campus activities most enhance the students’ acquisition of cultural competency?

4. Does the length of the immersion impact enhancement of cultural competency? What is the ideal length?

ReferencesAng, S., Dyne, L. V., Koh, C., Ng, K., Templer, K. J., Tay, C., & Chandrasekar, N. A. (2007).

Cultural intelligence: Its measurement and effects on cultural judgment and decision making, cultural adaptation, and task performance. Singapore: Nanyang Technological University.

Center for Disease Control, (2002). “Racial and Ethnic populations”. Available online, Retrieved June 10, 2004 from http://www.cdc.gov/omh/Populations/populations.htm

 Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of

care, volume I. Washington, DC: Georgetown University Center for Child and Human Development.

 Earley, P. C., & Ang, S. (Eds.). (2003). Cultural intelligence: Individual interactions across

cultures. Stanford, CA: Stanford University. Earley, P. C., & Mosakowski, E. (2004). Cultural intelligence. Harvard Business Review, 82(10):

1–9. Hofstede, G. (1980). Culture's consequences: International differences in work-related values.

Thousand Oaks, CA: Sage. Hofstede, G. 1991. Cultures and organizations: Software of the mind. New York: McGraw-Hil

References (2)Hofstede, G. (1991). Cultures and organizations: Software of the mind. New York: McGraw-

Hill.

Hofstede, G. (2001). Cultures consequences: Comparing values, behaviors, institutions and organizations across nations. Thousand Oaks, CA: Sage

Inscape Publishing, Inc. (1994). Discovering the diversity profile® research report.

Randall-David, E. (1994). Culturally competent HIV counseling and education. Rockville: Maternal and Child Health Bureau, U.S. Department of Health and Human Services.

Ryan, M. & Twibell, R.S. (2002). Outcomes of a transcultural nursing immersion experience: confirmation of a dimensional matrix. Journal of Transcultural Nursing, 13

(1), 30-39.

Trompenaars, F. (1994). Riding the waves of culture: Understanding diversity in global business. New York: Irwin.

Varricchio, C. (1987). Cultural and ethnic dimensions of cancer nursing care. Oncology Nursing Forum, 14 (3),57-58.