EBP Abstract
Appraised by: Deeqa Omar, Tamsen O’Berry, & Heather Jesme
Clinical Question:
Does providing cultural competence training to nurses improve their ability to deliver culturally
competent care?
Articles:
Beach, C. M., Price, G. E, Gary, L. K., Robinson, K. A., Gozu, A., Palacio, A., …Cooper, L. A.
(2005). Cultural competence: A systematic review of health care provider education
interventions. Medical Care, 43(4), 356-373.
Delgado, D. A., Ness, S., Ferguson, K., Engstrom, P. L., Gannon, T. M., & Gillett, C. (2013).
Cultural competence training for clinical staff: Measuring the effect of a one-hour class
on cultural competence. Journal of Transcultural Nursing, 24(2), 204-213.
doi:10.1177/1043659612472059
Smith, L.S. (2001). Evaluation of an educational intervention to increase cultural competence
among registered nurses. Journal of Cultural Diversity, 8(2): 50-63.
Synthesis of Evidence:
Beach et al. (2005) conducted a systematic review on provider knowledge, attitude, skills, and
patient satisfaction before and after cultural competency training. The review indicated excellent
evidence that cultural competency training improves knowledge, attitude, and skills of providers,
but there was poor evidence that training impacts patient adherence and outcomes. Delgado et al.
(2013) was a quasi-experimental study that assessed the effect of a one-hour class on cultural
competence by comparing the baseline scores to post intervention scores three and six months
after completion of the class. Scores were divided levels of culturally incompetent, culturally
aware, culturally competent, and culturally proficient. The overall increase in mean scores
demonstrates a statistically significant improvement in cultural awareness, even when failing to
reach the level of competence. Smith (2001) conducted a quasi-experimental study where
subjects were randomly assigned to attend either an eight hour “culture school” or an eight hour
nursing informatics class. Subjects who attended “culture school” had a greater self-reported
cultural self-efficacy and greater cultural knowledge when compared to the subjects who
participated in the nursing informatics class. The study concluded that a cultural education
intervention could significantly increase cultural competence as measured on cultural selfefficacy scales and knowledge based questions. All three studies used good research designs to
answer the research question. The articles indicated positive outcomes on health provider
knowledge, when cultural competency training is provided. Based on the three articles reviewed,
educational interventions deliver results to increase cultural competency within nursing practice.
Bottom Line:
Educational interventions, such as a cultural competency training program, increase health
providers’ knowledge, providing positive results to increase cultural competency within nursing
practice.
Implications for Nursing Practice:
Providing training to nursing staff may increase their ability to provide better care to diverse
populations. Evidence suggests a positive trend between training programs and improved
outcomes, but more research is needed. An intervention that can be put into place would be
mandating cultural competence training to all nurses to improve knowledge and skills needed to
provide culturally sensitive and competent care.