Improving the cultural competence of nursing students: results of integrating cultural content in the curriculum and an international immersion experience.

The purposes of this study were to evaluate the effect of integrating cultural content (ICC) in an undergraduate nursing curriculum on students' self-perceived cultural competence, and to determine whether a 5-week clinical immersion in international nursing (ICC Plus) had any additional effect on students' self-perceived cultural competence. Cultural competence was measured using a 28-item scale regarding students' self-perceived knowledge, self-awareness, and comfort with skills of cultural competence. Pretest scores from admission into the program were matched with posttest scores obtained just prior to graduation for 32 students, 7 of whom also participated in a 5-week immersion experience in Guatemala. Results, expressed in effect sizes, showed small to moderate gains for the 25 students in the ICC group, and very large gains for the 7 students in the ICC Plus group, related to perceived cultural competence. These results are consistent with the two-phase (cognitive and affective) development of cultural competence proposed by Wells.