A CULTURAL COMPETENCE CURRICULUM MODEL
Sheryl Ness, MA, RN
Deborah Jefferson, MSN, RN
Sandra Leinonen, MA, RN
Kathy Ferguson, MS, RN
Theresa Gannon, BSN, RN
Mayo Clinic
Rochester, Minnesota
This poster depicts a cultural competence curriculum model for nursing staff in a large
medical center. In an environment of changing demographics and healthcare
disparities, it is essential that nurses continue to develop competence in providing care
across cultures. It is recognized that nurses are at different levels on their journey of
becoming culturally competent. An extensive literature search supports that education
can enhance the level of competence.
The curriculum was designed to provide nursing staff with knowledge, skills, and tools to
provide culturally and linguistically appropriate healthcare. We define cultural
competence as the acquisition and integration of awareness, knowledge, and skills of
cultural beliefs, values, and behaviors needed to provide individualized patient care.
Expected outcomes include:
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Awareness of one’s own cultural background and nursing practice implications
Recognition of the importance that culture plays in health promotion and
treatment of illness
Acquisition of skills to communicate with patients with diverse language and
cultural backgrounds
Knowledge and skills to complete a comprehensive cultural assessment
Identification of resources to provide culturally and linguistically appropriate care
The curriculum focuses on self awareness, culture general, and culture specific content.
A variety of teaching strategies address the affective, cognitive, and psychomotor
learning domains. The curriculum was implemented in 2007 with classes offered
quarterly and content integrated into existing staff development.
Outcome evaluation methodologies include:
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A pre and post assessment tool to determine the level of cultural competence
A competency to demonstrate the effective use of an interpreter
Cultural assessment chart audits
Monitor use of the transcultural resources website
Community-based focus groups assessing perceptions on the provision of
culturally appropriate care
This cultural competence curriculum model may be readily modified to address the
learning needs in other healthcare institutions. This education initiative is supported by
members of the Mayo Clinic Transcultural Patient Care Subcommittee - Education
Workgroup.
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Elements of the Cultural Competence Curriculum
Student Characteristics or Intended Audience- Department of Nursing Staff at Mayo
Clinic in Rochester, MN. Department of Nursing includes the role of primary RN,
Nursing Education Specialists, Clinical Nurse Specialists, Nurse Researchers, Nursing
Assistants and Unit Secretaries.
Description of Program- The purposes of this program are to expand the participant’s
a) definition of culture, b) knowledge and acquisition of skills to perform a cultural
assessment, c) awareness of tools available to assist in providing culturally competent
care to all patients, and d) use of the institution’s language department services in the
provision of care.
Overview of Program- Learning gained in this program will contribute to excellence and
quality in nursing practice and patient care in all areas and departments. In this
program, participants will explore the meaning of culture in a variety of contexts,
including presentations, video and web-based modules, group discussions, simulation
exercises, case presentations and dialogue regarding current clinical practice and
institutional standards and resources. This program contains four core sessions (units of
study) of one hour each. The entire program can be taken during the period of a year
during staff development time or as a four hour block in a half-day session. It is
recommended that nurses attend class module 1 first and then sequence in order of
module numbers. The first module contains core elements of learning about culture and
health care along with definitions that will be utilized in the other three courses.
Program ObjectivesBy the end of this program, the learner will be able to do the following:
1.
Define culture.
2.
Identify techniques to overcome cultural barriers related to patient care.
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3.
Describe how to utilize the institution’s transcultural resources and language
services.
4.
Perform a cultural assessment as part of the patient plan of care.
Syllabus Information
Class Module 1
Title: What’s Culture Got to Do with It?
Goal: To promote the understanding of cultural competence and demonstrate impact on
quality of care.
Summary: Culture is an essential part of who we are and shapes our beliefs, practices,
and traditions. Participants will explore their own cultural heritage, issues related to
health disparities, and implications for health care providers.
Objectives:
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Identify how health beliefs are formed
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Recognize how assumptions may hinder development of a culturally based plan
of care
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Identify one’s own culture
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Give examples of health disparities
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State three reasons why a health care provider needs to be culturally competent
Teaching Strategies: A variety of teaching methodologies will be used in this class to
address all learning domains (cognitive, affective and psychomotor). Role playing,
lecture with discussion, as well as a short cultural simulation will be featured in this
class.
Evaluation:
Participants will provide feedback after session is completed on general satisfaction.
Class participation in role playing, simulation and group discussion will show evidence of
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objective completion. A self-report survey three months after the class evaluates
application of knowledge into practice. These questions are measured on a likert scale
with opportunities to enter qualitative feedback as well.
Class Module 2
Title: Use of Mayo Intranet Resources for Providing Culturally Competent Care.
Goal: To promote awareness of the resources and tools available to nurses working
with patients within the Mayo healthcare system.
Summary: This class is an online interactive tutorial designed to focus on how to locate
and use information on the Mayo internet related to providing care across cultures.
Objectives:
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Participants will identify key location within the Mayo internet where transcultural
resources are located
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Demonstrate appropriate use of transcultural resources related to the care of
patients within the institution
Teaching Strategies: This class is an online tutorial designed with interactive teaching
strategies including case studies and examples of actual patient scenarios along with the
use of Mayo resources.
Evaluation: Participants provide feedback after session is completed on general
satisfaction within the online tutorial. Quarterly monitoring of the use of the Mayo
Transcultural Resources website is reported and measured.
Class Module 3
Title: Effective Use of Medical Interpreter
Goal: To provide information and knowledge on how to effectively utilize the medical
interpreter services at Mayo.
Summary: In order to provide culturally appropriate care, health care providers need to
be able to communicate effectively across cultures. Discussions will include when to call
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an interpreter and how to use interpreter when communicating with non-English
speaking, limited English speaking, and deaf and hard of hearing patients.
Objectives:
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Participant will identify key resources that assist accessing medical interpreter
services
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Discuss rationale for appropriate use of medical interpreter services within the
health care setting
Teaching Strategies: This class is taught in the classroom and includes lecture with
case studies and group discussion. It is taught in partnership with an actual medical
interpreter who will provide case examples and be available for participant questions.
Evaluation: Participants provide feedback after session is completed on general
satisfaction within the class. Class participation in case studies and group discussion
will show evidence of objective completion. Quarterly monitoring of the actual use of
medical interpreters is be reported and measured.
Class Module 4
Title: Cultural Assessment: Use of Storytelling Technique
Goal: To promote the key elements for completing a cultural assessment as part of the
initial patient assessment while accessing healthcare at Mayo.
Summary: To address the needs of individual patients, nurses need to be able to
complete a cultural assessment identifying the beliefs, values and practices specific to
their culture. Elements of a cultural assessment will be reviewed along with the
documentation process for the patient record.
Objectives:
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Identify three key elements within a cultural assessment.
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Discuss how individual beliefs and values can influence individual health
practices.
Teaching Strategies: This class is taught through storytelling technique. A video of a
patient scenario is viewed with group discussion following. Key elements of the
assessment process are outlined with actual time for input into the patient chart.
Evaluation: Participants provide feedback after session is completed on general
satisfaction within the class. Class participation in group discussion and assessment
process will show evidence of objective completion. Quarterly monitoring of the
completion of the components of the cultural assessment (percentage completed) is
reported and measured for all inpatient units.
Summary of Teaching Strategies
The four class modules for this course are designed to provide and enhance
learning in all domains, including cognitive, affective and psychomotor. An emphasis
was placed on active learning methods through a variety of strategies.
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Cultural simulation- promotes active learning strategies.
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Role playing- integrates knowledge and critical thinking skills.
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Storytelling – integrates imagery with a patient situation to support assessment
and practical experiences.
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Lecture with group discussion – teaches new knowledge along with opportunities
to learn and share with others.
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Reference List
American Organization of Nurse Executives (September, 2005). Position
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Campinha-Bacote, J. (2007). The Process of Cultural Competence in the
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http://www.transculturalcare.net/Cultural_Competence_Model.htm
Cooper Brathwaite, A. (2006). Influence of nurse characteristics on the
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Leineinger, M. (1995). Transcultural Nursing: Concepts, Theories, Research
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Mayo Clinic (2007). Mission and Vision Statement. Retrieved November 22,
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National Center for Cultural Competence, (2005). Retrieved November 12, 2007
from: http://www11.georgetown.edu/research/gucchd/nccc/
Taylor, R. (2005). Addressing barriers to cultural competence. Journal for
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