Relationship Between Nurse Educators' Cultural Competence and Ethnic Minority Nursing Students' Recruitment and Graduation
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East Tennessee State University Digital Commons @ East Tennessee State University Electronic Theses and Dissertations Student Works 12-2008 Relationship Between Nurse Educators' Cultural Competence and Ethnic Minority Nursing Students' Recruitment and Graduation. Pearl Ngozika Ume-Nwagbo East Tennessee State University Follow this and additional works at: https://dc.etsu.edu/etd Part of the Educational Sociology Commons, and the Race and Ethnicity Commons Recommended Citation Ume-Nwagbo, Pearl Ngozika, "Relationship Between Nurse Educators' Cultural Competence and Ethnic Minority Nursing Students' Recruitment and Graduation." (2008). Electronic Theses and Dissertations. Paper 2018. https://dc.etsu.edu/etd/2018 This Dissertation - Open Access is brought to you for free and open access by the Student Works at Digital Commons @ East Tennessee State University. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ East Tennessee State University. For more information, please contact [email protected]. Relationship Between Nurse Educators’ Cultural Competence and Ethnic Minority Nursing Students’ Recruitment and Graduation ________________________ A dissertation presented to the faculty of the College of Nursing East Tennessee State University In partial fulfillment of the requirements for the degree Doctor of Philosophy _____________________ by Pearl N. Ume-Nwagbo December 2008 ___________________ Joy E. Wachs, PhD, RN, PHCNS, BC, FAAOHN, Chair Lee Glenn, PhD Susan Grover, PhD, RN Henry Antkiewicz, PhD Keywords: Ethnic Minorities, Cultural Competence, Nurse Educators, Nursing Students, Under-Representation ABSTRACT Relationship Between Nurse Educators’ Cultural Competence and Ethnic Minority Nursing Students’ Recruitment and Graduation by Pearl N. Ume-Nwagbo The purpose of this exploratory study was to measure the cultural competence of nurse educators in accredited baccalaureate (BSN) nursing programs in Tennessee (TN) and investigate the relationship, if any, between nurse educators’ cultural competence and the percentage of minority nursing students recruited into and graduated from these schools in the previous 5 years. With the rapid rise of the minority population in the United States, more minority healthcare providers, including nurses, are needed to provide culturally congruent care in underserved communities. Literature has implied that nurse educators’ lack of cultural competence and sensitivity regarding minority nursing students’ educational needs could be a contributing factor to minority nurses’ underrepresentation. Nurse educators in 9 accredited colleges of nursing in TN completed the “Cultural Diversity Questionnaire for Nurse Educators.” Some of the participating schools and the American Association of Colleges of Nursing Research Data Center provided the percentage of students recruited and graduated in each school by ethnicity. 2 The findings revealed that the majority of respondents were at least moderately culturally competent. There was no correlation between Tennessee schools' mean cultural competence scores and their percentages of minority students recruited into BSN programs in the past 5 years. But there was a significant statistical correlation between Tennessee schools' mean cultural competence scores and their percentages of minority students graduated from BSN programs in the past 5 years (p = .015). There was a statistically significant difference between the mean cultural competence score of respondents who had lived in a culture different from the United States and those who had not (p = .01). There was also a statistically significant difference between the mean cultural competence score of respondents who had attended multicultural education seminars in the past 5 years and those who had not (p = .0005). The researcher recommended that nursing faculty engage in activities that would increase their cultural competence, enabling them assist students from diverse cultural backgrounds stay in school and graduate. 3 DEDICATION To my husband Ebele and our children, Nwabundo, Osita, and Ndubisi 4 ACKNOWLEDGEMENTS First and foremost, all glory and honor be to God for all the many blessings He has bestowed on my family and me. Some have started their doctoral programs, but for various reasons did not complete. God in His infinite mercies has enabled me to both start and complete this journey. It is not possible to mention all individuals who were instrumental in getting me through this doctoral program. I want to thank everybody who prayed for me and encouraged me throughout this rigorous process. I am grateful to all my professors who taught, helped, and encouraged me through my course work. I thank Dr. Sally Blowers for her mentoring and advising through the course work. Many thanks go to Dr. Lois Lowry for all her help and for providing me the opportunity to be published. Immense gratitude goes to my committee members for their guidance, support, and understanding and for the tremendous patience they demonstrated in reading through the many versions of this work. I am most grateful to my dissertation chair, Dr. Joy Wachs, who has been a pillar of support right from the beginning of this writing. She was always there to pick me up when I became discouraged. I thank her for her expert editing, attention to details, encouragement, and wise corrections. I thank my statistician, Dr Lee Glenn, for his brilliant guidance through the data collection and analyses phases of this writing. Much gratitude also goes to Drs. Susan Grover and Henry Antkiewicz for their valued suggestions and guidance. I also want to thank Ms. Barbara Knight who patiently guided me through creating a web site, loading the survey questions, and collecting data through the Internet. I was very anxious about Internet data collection, but Ms. Knight calmly guided me through it. 5 Also very special thanks go to the deans and directors of the various Colleges of Nursing who participated in this study and who gave me permission to solicit their faculty as respondents. Similarly, I thank Dr. Edwards and Ms. Debie Pfortmiller for directing me to helpful sources for data collection. Likewise, I extend a big thank you to my students in the graduate Women’s Health seminar and the staff of the ETSU Student Health Clinic who helped with pilot-testing the instrument and to all those who took time to complete my study questionnaire. Without you, there would have been no data to analyze. I must not forget to extend my gratitude to D. Lorinda Sealey, PhD, Assistant Professor at Southeastern Louisiana University School of Nursing, the author of the instrument, “Cultural Diversity Questionnaire for Nurse Educators,” used in collecting data for this study. I would also like to thank the three librarians at the Johnson City Medical Center, Bobbi Kahan, Lila Apgar, and Lora Musich, for their relentless efforts in securing needed articles for me throughout my course work and dissertation process. I finally want to thank my husband Ebele and our children Nwabundo, Osita, and Ndubisi for all their prayers, encouragement, and moral, financial, and intellectual support without which I would never have started this program, let alone finished it. 6 CONTENTS ABSTRACT…………………………………………………………………………………... 2 DEDICATION………………………………………………………………………………... 4 ACKNOWLEDGEMENTS…………………………………………………………………... 5 LIST OF TABLES.…………………………………………………………………………… 11 LIST OF FIGURES…………………………………………………………………………… 12 Chapter 1. INTRODUCTION………………………………………………………………… 13 Shift in Minority Population……………………………………………………. 14 Health of the Minority Population……………………………………………… 15 Improving Minority Health……………………………………………………... 16 Barriers to Minority Healthcare Access………………………………………… 17 Language Difficulty and Healthcare………………………………………… 17 Race Concordance and Healthcare………………………………………….. 19 Lack of Trust in Healthcare…………………………………………………. 20 Underrepresentation of Minority Nurses………………………………………. 21 Underrepresentation of Minority Nursing Students……………………………. 24 Significance of the Study………………………………………………………. 26 Statement of the Problem………………………………………………………. 27 Study Variables………………………………………………………………… 29 Research Questions…………………………………………………………….. 29 Hypotheses……………………………………………………………………... 30 7 Assumptions……………………………………………………………………. 31 Summary………………………………………………………………………… 31 2. LITERATURE REVIEW…………………………………………………………. 33 Culture………………………………………………………………………….. 33 Effects of Cultural Blindness…………………………………………………… 34 Cultural Differences…………………………………………………………. 34 Cultural Competence in Health Care and Other Disciplines…………………… 36 Cultural Competence in the Nursing Profession………………………………. 43 Cultural Competence and Nurse Educators……………………………………. 44 Factors Affecting Recruitment and Retention of Minority Nursing Students…. 47 Faculty Role Models…………………………………………………………. 47 Increasing Cultural Awareness, Sensitivity, and Competence………………. 48 Short International Immersion Experiences…………………………………. 49 Cultural Interventions………………………………………………………… 50 Cultural Projects……………………………………………………………… 51 Living, Studying, and Practicing Abroad……………………………………. 52 Cultural Diversity Training and Higher Education…………………………… 52 Cultural Competent Model…………………………………………………… 53 Cultural Diversity Courses…………………………………………………… 54 Summary……………………………………………………………………….. 54 3. METHODOLOGY ……………………………………………………………….. 56 Research Design ……………………………………………………………….. 56 Population, Sample, and Setting……………………………………………….. 57 8 Ethical Considerations………………………………………………………….