. Discuss the variety of cultures in your professional practice.

. Discuss the variety of cultures in your professional practice.

Identify your own cultural beliefs and values.2. Discuss the variety of cultures in your professional practice.3. Reflect on your cultural journey. What do you consider as obstacles to achieving cultural competence? What strategies can be employed to overcome the barriers?
Developing and Implementing a Cultural Awareness Workshop for Nurse PractitionersProblem Recognition In the United States, as the general population is becoming more culturally diverse, the interest in cross- cultural education training among medical providers has increased. The purpose of this study is to investigate the effectiveness of a 3-hour cultural education training workshop and its impact on the participants’ cultural knowledge and cultural competency when presented to a group of Western New York nurse practitioners and nurse practitioner students. The population in the United States continues to diversify which increases the need for outreach and cultural training to serve these populations. There are mandates put forward by the Rehabilitation Act of 1993 that ensures that health care agencies who provide care to the underserved elderly population with disabilities living in independent centers and nursing homes promote strategies that will increase service proficiency. The Rehabilitation Act identifies standards and assurances for independent living centers receiving federal funds. Title VII, section 725, Sub-section C, item 10 states that an agency will provide “satisfactory assurance that: aggressive outreach regarding services provided through the center will be conducted in an effort to reach populations of individuals with severe disabilities that are underserved by programs under this title” (Rehabilitation Services Administration, 1993, p. 161). According to the Center for Immigration Studies (as cited in Renshon, 2007), there were 37.9 million immigrants living in the United States in 2007. At some point most of these individuals will seek the services of a professional health care provider. Culture and cultural differences are increasingly recognized as important facNerfis Sanchez Elminowski, DNP, ANP-BC, Buffalo, New York.Journal of Cultural Diversity Vol. 22, No. 3tors that affect successful outcomes in health services. The outcome of those encounters will depend largely on the health care provider’s knowledge, sldlls, and understanding of culturally competent care (Renshon, 2007). In view of these statistics, there is a greater chance that independent living center staff and nursing home staff who provide care to the elder population will eventually provide care services to a person with a disability from a different culture, thus making culture competency skills of great importance. Culture competency training is therefore necessary for nurse practitioners who provide care to this underserved elder population. Nurse practitioners care for patients from a wide variety of cultural backgrounds, and in order to deliver high quality primary care that is meaningful, effective, and cost effective, these providers must develop a greater understanding and appreciation of the social-cultural background of clients, their families, and the environment in which they live. The National Standards on Culturally and Linguistically Appropriate Services established mandates, guidelines, and recommendations regarding culturally appropriate services to all people from diverse backgrounds and staff training to serve those groups (United States Department of Health and Human Services, Office of Minority Health [USDHHS OMH], 2001). The mandates are related to current federal requirements for all providers and health care organizations who are recipients of federal funds such as Medicare payments. All Medicare Part A certified providers are required to adhere to the National Standards on Culturally and Linguistically Appropriate Services (USDHHS, OMH, 2001). Cultural competence has gained attention as a potential strategy to improve quality and reduce or eliminate disparities in health care. Although there are no requirements under the current federal laws, Executive OrderFall 2015Number 13,166, mandates that each agency receiving federal financial assistance through programs, including Medicare, examine the services it provides, then develop and implement a system by which limited English proficient persons can meaningfully access these services (Executive Order No. 13,166, 2000). Agencies which fall under this executive include hospitals, nursing homes, long term care facilities, home health agencies, and managed care organizations. Healthy People 2020, a comprehensive nationwide agenda that provides science-based 10-year national objectives for improving the health of all Americans, established the goal to eliminate health disparities among population groups (Healthypeople.gov, 2011). One of Healthy People 2020’s proposed objectives is education and community- based programs, which encourage employers to offer more comprehensive learning initiatives at the work site. Therefore, the strategy to develop and present a workshop in the workplace of a health care agency that will increase its staff’s knowledge base of cultural awareness and competency, is supported by Healthy People 2020 health care initiatives.Needs Assessment A needs assessment survey was developed and distributed through two different organizations. These organizations include an elder health care services organization which employs a large number of nurse practitioners and a nurse practitioner owned continuous education company newsletter. The needs assessment was anonymous and distributed utilizing online survey services. The results indicated that nurse practitioners want additional education on culture and cultural competency. When participants were asked, “Do you feel you would benefit from additional education on the topic of cultural competence?” 93.1% overall answered yes (87.5% local and 100% National). When asked, “Would you be willing to attend training(s) on cultural competence and cultural awareness?” 89.7% overall answered yes (87.5% local and 92.3% National).Types of Trainings There were many responses with regard to the types of trainings preferred by the nurse practitioners. The top three picks for achieving learning goals were on-line computer program, conference, and workshop. Most nurse practitioners preferred to train at work during work hours (55.2%) or at a place other than work (27.6%), and only 17.2% would prefer to train at work but not during work hours. Although the sample size was small, the needs assessment results did substantiate and validate the need for cultural education training in this population. Some nurse practitioners said that their cultural competence was only “fair,” most said that it was only “good,” and very few claimed to have “excellent” cultural competency; all participants agreed that they would benefit from additional education on the topic of cultural competence. As a result of these survey findings an educational workshop designed to increase cultural knowledge and competence was developed.Research Question For a group of Western New York nurse practitioners, is a 3-hour workshop on cultural education training effectivein increasing the participants’ cultural knowledge and their cultural competency resulting from the application of that knowledge?Purpose and Goal The main purpose of this study is to investigate the effectiveness of a 3-hour cultural education training workshop and its impact on the participants’ cultural knowledge and cultural competency resulting from the application of that knowledge when presented to a group of WNY nurse practitioners and nurse practitioner students. The goal of the study is to increase the participants’ level of cultural knowledge.Theoretical Framework Leininger’s (2008) theory of culture care diversity and universality was used as the theoretical framework to guide this study. She developed her theory to provide a substantial base of knowledge for the discipline of nursing. The major premise of Leininger’s theory is that there are differences and similarities in healthcare that await discovery so as to establish a body of knowledge relevant to transcultural nursing that will then guide nursing practice. The purpose of the culture care theory is to discover knowledge that could be used to provide culturally congruent care that is meaningful, safe, and beneficial to people of similar or diverse cultures worldwide.Participants and Setting For the purpose of this study, nonprobability convenience sampling was used as the sampling method. A health care organization in WNY and a local college in WNY provided participants for this study. The study sample consisted of 18 nurse practitioners employed by a single health care organization and 45 nurse practitioner students. The setting for this project was the conference room in one WNY health care organization and the lecture room of a local college in WNY.Procedures A needs assessment survey was developed by this researcher and posted locally in a health care organization of WNY’s company e-mail and nationally in a nurse practitioner owned continuous education company newsletter. The needs assessment was anonymous and was distributed utilizing online survey services. The results indicated that nurse practitioners want additional education on culture and cultural competency. Additionally, participants listed conference and workshop as the top two preferred methods of learning. A workshop on cultural awareness and cultural competency was subsequently developed in an attempt to meet this learning need for nurse practitioners. The workshop included a variety of teaching-learning methods and incorporated a self-assessment tool that assists participants in exploring their cultural beliefs along with a case study that illustrates how language barriers and racial bias can have a direct effect on patient care and influence clinical outcomes. In planning for the actual development of the presentation, this researcher then collaborated with a master’s prepared nurse with a concentration in transcultural community health. Further collaboration was then completed with both a national Doctorate of Nursing Practice expert on workshop delivery and a physician with a practice inclusive of a large immigrant and refugee community.Journal of Cultural Diversity Vol. 22, No. 3 Fall 2015Workshop topics include basic definitions, steps to culturally competent care, steps to build cultural competence, cultural considerations in health care, core health beliefs, techniques that lead to better patient adherence, communication barriers, and use of interpreters. Kleinman’s Patient Explanatory Model of Illness and components of a cultural assessment were also presented to the participants. During the workshop pre and post-test that contained the same items were distributed to all participants. All participants were provided with an instructional form one week prior to the workshop to describe the nature of their participation and read out loud to all participants the same day they were distributed one week prior to the workshop. The workshop and opportunity to participate in the study was offered to all nurse practitioners employed at a health care organization in WNY and to nurse practitioner students enrolled in a required course at a WNY college. Participation in the workshop and research study was purely voluntary. The Associate Director of Nursing of this local health care organization e-mailed the instructional form to all of their employed nurse practitioners one week prior to the workshop. The instructional form was read aloud to potential attendees at the beginning of a scheduled Thursday staff meeting and at the beginning of the actual workshop. For the nurse practitioner student group, the same instructional form was verbally reviewed to the student at the beginning of the actual workshop presentation and read aloud to them at the beginning of the actual workshop. The instructional form was written in age appropriate and understandable language, and emphasized that participants do not have to submit any response in order to partake in the workshop. Participants were told that their participation in the workshop was voluntary. Both practicing nurse practitioners and nurse practitioner students were also given a Cultural Competence Self- Assessment Tool to read on their own one week prior to the workshop. The Cultural Competence Self-Assessment Tool was distributed to the participants the same day the instructional form was distributed. The participants were asked to discuss and relate some of the questions on the Cultural Competence Self-Assessment Tool while the workshop was being presented. The questions on the Cultural Competence Self-Assessment Tool and the responses were designed to help the participant build a foundation of self-awareness that may be used in examining the impact of their cultural backgrounds on their relations with others. Permission to use and adapt the Cultural Competence Self-Assessment Tool was granted by Advocates for Youth (1994), Washington, DC. At the end of the workshop, participants completed a post-test questionnaire. Both the pre- and post-tests contained the same items. The results of the pre- and post-test were then placed in a designated yellow envelope marked pre- and post-test. Both pre- and post-tests were numbered so that the correct pre- and post-test scores could be accurately compared at a later time. The participants completed an evaluation form at the end of the workshop and placed those forms in a designated envelope marked evaluation forms. Two months after the workshop (December 2011), nurse practitioner participants were asked to complete a follow-up assessment form questionnaire designed to capture their clinical experiences following workshop participation. Prior to the workshop the follow-up assessment form questionnaire and survey were collected.Consent was implied by completion of the above process. No signatures were obtained. The responses were kept confidential and no personally identifying information was requested. Participation was voluntary and all participates were given the option of withdrawing at any time.DATA ANALYSIS Colaizzi (1978) begins his data analysis process by identifying phenomenon as people experience it. For example, in this study, this researcher strived to understand the phenomenon of the participants’ experience during the time they attended the workshop. To start with, data were gathered from the participants’ descriptions of their experience during the workshop. This was accomplished by posing questions that would elicit this data. After collecting the participants’ descriptive responses, data were then analyzed using Colaizzi’s six-step framework for analyzing qualitative data and then placed into Excel. The numerical responses were entered and averaged and the comments were transcribed. The comments would be employed in the evaluation phase of the study. Pre- and postexam scores were analyzed using the correlation coefficient or Pearson’s r correlation which identifies the magnitude and direction of the association between two variables that are on an interval or ratio data. In addition, a f-test was performed to determine the statistical significance of the data gathered. The correlation coefficient analysis test is an appropriate statistical assessment for this study because it measures the correlation between the independent and dependent variables and shows the impact the workshop had on the dependent variable. In addition to the preliminary and post workshop tests to measure knowledge gained, a follow-up survey, conducted approximately two months after the workshop, was distributed to determine how the workshop impacted the clinical practice of the participants. Likert scale responses were used to gather data for analysis regarding feedback of how the participants perceived the effectiveness of this educational experience. Data were analyzed using descriptive statistics. Categories and themes were identified as appropriate utilizing free text space on the evaluation form(s). Once the quantitative data were collected, each packet was sorted by the number associated with the packet and then manually inputted into Excel by packet number. This allowed for pre- and post-tests to be compared individually and in aggregate form. A formula was used to label each correct answer as a “1” and any incorrect or unanswered question as a “0” and then totaled to find the amount of correct answers. The pre- and post-tests were then compared by percent of increase or decrease in correct answers. Each packet was then subject to the f-test to assess the P-value as well as the calculation of the correlation coefficient. The total was then subject to percent increase, f-test, and correlation coefficient to demonstrate the overall impact of the workshop on the population. Strategies utilized to establish trustworthiness and rigor were maintained throughout the study to ensure independence and credibility.STUDY RESULTS The qualitative and quantitative analysis was completed with the exact same workshop presented to two different audiences. The workshop was designed for practicing nurse practitioners, but was also given to nurse practitionerJournal of Cultural Diversity Vol. 22, No. 3 Fall 2015students to gain a greater understanding of its effectiveness. Following Colaizzi’s (1978) data analysis, the following themes were identified: those with experience identified most positive responses than those without clinical experience as a nurse practitioner; those with more experience in the nursing field appreciated the workshop more; the learning material was too advanced for nurse practitioner students; both nurse practitioners and nurse practitioner students believed that the workshop is useful; and the lecture should be offered as a separate more in-depth class at the college. In summary, the qualitative analysis of responses from nurse practitioners and nurse practitioner students indicated that the nurse practitioners appeared to comprehend a greater understanding of the workshop content, though there was an expressed need for additional educational sessions on this topic.Workshop – Nurse Practitioners The delivery of the workshop for the nurse practitioners was implemented successfully. Out of 18 nurse practitioners, 96% found the workshop tremendously helpful and there was on average a 12% increase in cultural competence. Some of the positive comments about the workshop included, “Presentation was excellent, good information. I appreciate the handouts, they will be a good resource” and “I felt this was extremely enlightening for me as I work in inner city homes and have multicultural patients!” Through a (-test analysis of knowledge scores, the data proved to be statistically significant (0.00), indicating that the workshop had a positive impact on the knowledge of the nurse practitioners. The correlation coefficient was .83, which is close to 1.0, suggesting that the workshop positively influenced the nurse practitioner’s knowledge scores.Table 1. Decrease in Correct Answers of the Nurse Practitioners after the Workshop Question Number Question Decrease % Decrease 13 Which of the following statements is NOT TRUE: (a) Friendly (non-sexual) physical contact is an important part of communication for many Latin American people (b) Many Asian people think it is disrespectful to ask questions of a health provider (c) Most African people are either Christian or follow a traditional religion (correct answer) (d) Eastern Europeans are highly diverse in terms of customs, language, and reliqion. 7 16% 3 Cross-cultural misunderstandings between providers and patients are unlikely to have an impact on objectively measured clinical outcomes. (a) true (b) false (correct answer) 5 11% 7 During a medical interview with a patient from a different cultural background, which is the LEAST useful technique? (a) Asking questions about what the patient believes about her or his illness, what caused the illness, how severe it is, and what type of treatment is needed (b) Gently explaining which beliefs about the illness are not correct (c) Explain the Western or American beliefs about the patients illness (correct answer) (d) Discussinq differences in beliefs without beinq judqmental. 4 9% 6 When a provider believes/expects that a patient will understand a condition and follow a recommended treatment plan, the patient is more likely to do so than if the provider has doubts about the patient. (a) true (correct answer) (b) false 1 2% 11 If a family member speaks English as well as the patients native language, and is willing to act as interpreter, this is the best possible solution to the problem of interpreting. (a) true (b) false (correct answer) 1 2% 14 A motivated health provider can eliminate his or her own prejudices or negative assumptions about certain types of patients. (a) true (b) false (correct answer) 1 2% 15 Because Hispanics have a lower incidence of certain cancers than the majority of the U.S. population, their mortality rate from these diseases is correspondingly lower. (a) true (b) false (correct answer) 1 2%Journal of Cultural Diversity Vol. 22, No. 3 Fall 2015The largest increase in correct responses was a 50% increase (nine more correct answers) to question 2, “Which of the following is NOT a step for building cultural competence in order to work more effectively and respectfully with individuals from a variety of backgrounds.” The choices were: (a) Learning about your own culture through a process of self-assessment, (b) Learning as much as possible about important aspects of cultural backgrounds, (c) Learning about the assumptions and value judgments of individuals in your community, and (d) Learning about individuals in your community. Answer “c”, learning about the assumptions and value judgments of individuals in your community, is the correct answer because decisions or actions should never be made assumptions. Question two encompassed the main goal of the workshop; to increase cultural awareness by learning strategies to deal with cultural diversity. The question 20, “Which of the following statements is NOT TRUE?” , which offered detailed statements pertaining to various cultures, had a decrease of three correct answers (17%) and questions 6 and 22 “When a provider believes / expects that a patient will understand a conditionand follow a recommended treatment plan, the patient is more likely to do so than if the provider has doubts about the patient” and “Which of the following is NOT TRUE of an organization that values cultural competence” had a decrease of one correct answer (6%) and should be reviewed for clarification and content (see Table 1). Overall, the data indicate that the workshop is valuable to the nurse practitioner field and should be used to enlighten nurse practitioners on the cultural barriers associated with their patients.Workshop – Nurse Practitioner Students The workshop was implemented as planned with 45 out of 60 nurse practitioner students completing the workshop. Out of those who attended, 92% of the students found the workshop very useful. Some of the positive comments about the workshop included, “This lecture should be offered as a separate, more in-depth class at the college!” and “Great presentation and very happy this topic is being discussed. It is an important aspect in patient care.” Additional comments attributed to the content being at a higher level than the class’s education level, that the preTable 2.Greatest Outcome:Question NumberQuestion Positive Response 3 1 have a better understanding between the difference of cultural care and cultural competency 94.74% 4 1 am better able to understand and accept that health is defined differently by different cultures 94.74% 8 Would you recommend this workshop to other providers? 94.74%The Outcome:Question NumberQuestion Positive Response 1 I am better able to define and understand culture, cultural competence, and cultural awareness 93.68% 2 I am better able to recognize and understand the impact of culture on communication 93.68% 3 I have a better understanding between the difference of cultural care and cultural competency 94.74% 4 I am better able to understand and accept that health is defined differently by different cultures 94.74% 5 Were you able to identify and decrease barriers to communication, health, wellness, and adherence to treatment? 90.53% 6 Were you able to incorporate the communication techniques learned in the workshop to your day-to-day practice and if so did it lead to positive outcomes in the following areas: 6A Communication techniques 88.42% 6B Positive outcomes in: 6B1 Decrease ER Visits 78.95% 6B2 Decrease hospital 81.05% 6B3 Less diagnostic testing 82.11% 6B4 Provider/patient relationship 85.26% 7 I have been able to interpret the concepts presented in the workshop and apply them to my own practice 92.22% 8 Would you recommend this workshop to other providers? 94.74%; 9 Overall, attending the workshop was beneficial for me personally and professionally 92.63%Journal of Cultural Diversity Vol. 22, No. 3 Fall 2015test and post-test was rushed, and the students could not concentrate on the pre-test because the lecture had already started. These comments were accurate and proper and precaution is needed to properly plan for a student-based workshop. In the future, the workshop needs to be adjusted to the student level and the timing needs to be adjusted to fit into a single classroom period to enhance the number of successful student completions of the workshop, instead of only 45 out of 60. Through using the f-test on the pre-and post-test knowledge scores, the data proved to be statistically significant (0.004), indicating that the workshop had a positive impact on the knowledge of the students. The correlation coefficient is .755, which is not as high as the nurse practitioners, but is still close to 1.0, suggesting that there is a positive correlation between the workshop influencing the students and an increase in correct answers on the quiz. The largest increase in correct responses was a 44% increase to question 2, “Which of the following is NOT a step for building cultural competence in order to work more effectively and respectfully with individuals from a variety of backgrounds.” The choices were: (a) Learning about your own culture through a process of self-assessment, (b) Learning as much as possible about important aspects of cultural backgrounds, (c) Learning about the assumptions and value judgments of individuals in your community, and (d) Learning about individuals in your community. Answer “c”, learning about the assumptions and value judgments of individuals in your community, is the correct answer. As mentioned under workshop nurse practitioner results, the nurse practitioner group had a 50% increase, demonstrating that this question was answered completely and comprehensively during the workshop. There were some questions that had a decrease in correct responses after the workshop. The difficulty with identifying the correct responses could be because the content of the workshop was too advanced for the nurse practitioner students, as the students could have benefited from clinical experience with patients before participating in the workshop. The questions that the nurse practitioner students and the nurse practitioners answered incorrectly do not correlate (see Figures 1 and 2). This may have been due to the fact that the questions should be worded differently for each group or the topic was not covered in as much detail in each workshop respectively. Overall, the data highly suggests that the workshop is valuable to nurse practitioner students and should be used to inform the students on the cultural competence. The students will benefit more from this workshop after they have some clinical experience in the nurse practitioner role. The results of this study demonstrated that cross-cultural training provided through workshops is an effective learning method. Both nurse practitioner group and nurse practitioner students scored significantly higher than their initial test scores. Other studies have been conducted with similar results which validate the hypothesis that learning through interactive workshops is an effective way to learn. Sanner, Baldwin, Cannella, Charles, and Parker (2010) conducted a similar study using a workshop method for learning. Their study involved measuring the impact of cultural diversity forum on students’ openness to diversity. The results showed that the students’ post-test scores were significantly higher than their preliminary test scores; therefore, the students had more cultural sensitivity after the workshop and were more open to diversity. Ina study conducted by Leiper, Van Horn, Hu, and Upad- hyaya (2008), seminars and workshops were evaluated to determine their effectiveness in increasing knowledge in cultural awareness. The study concluded that the workshops improved interdepartmental dialogue among faculty and doctoral students, facilitated understanding of cultural diversity, provided the promotion of attitudinal and behavior changes, and increased cultural awareness and knowledge. The findings from this study are similar to the findings of other comparable studies (Baroffio, Nendaz, Perrier, Layat, & Vermeulen, 2006; Happell, 2006; Lazaro & Um- phred, 2007) and help to confirm and demonstrate that providing cross-cultural education via workshops is an effective systematic approach to promoting cultural awareness and increasing cultural knowledge.Follow-Up Survey Form Questionnaire The data for the follow-up survey was collected during a scheduled work meeting. The nurse practitioners filled out the surveys anonymously. The nurse practitioner students were not given a follow-up survey because they could not rate how the survey affected their professional practice. The nurse practitioners then placed the surveys in an envelope marked “Follow Up Survey.” The data were then inputted into Excel and the mean, median, mode, and percentages were calculated based on positive versus negative responses as well as the comments transcribed and common trends identified. The follow-up survey yielded interesting results (see Table 2). Eighteen out of 19 (92.63%) participants thought that this workshop was beneficial personally and professionally. The overall theme or suggestions for this specific workshop or future workshops of this type is that the workshops should be held at least yearly and / or have specific workshops that focus on different cultures. While the respondents indicated beneficial results from all items on the questionnaire, the item pertaining to emergency room (ER) visits had the least percent of all items asked. This may be because ER visits could not be determined within the time frame of 60 days. Findings of the study were consistent with previous research studies that have shown that workshops are effective in improving cultural diversity awareness of the participants. In their study, Lazaro and Umphred (2007) focused on developing an instrument to assess cultural diversity awareness and developing an educational workshop to improve cultural diversity awareness of physical therapy, academic, and clinical educators. Results indicated that the workshop was effective in improving cultural diversity awareness of the participants. Moffat and Tung (2004) completed a study that evaluated the effectiveness of culture brokering training to enhance cultural competence of independent living center staff. The majority of participants increased their knowledge scores after the workshop and increased their cultural competence scores. More than half of the items were increased with statistical significance and 71% of participants increased their total scores after the workshop. Also consistent with the literature review was the finding of improved communication skills. According to the participants’ responses in this study (88.2%), there was a positive impact on provider-patient communication. Other investigators reported similar finding. Castro and Ruiz (2009) explored the relationship between the degrees of cultural competence in nurse practitioners and measuredJournal of Cultural Diversity Vol. 22, No. 3 Fall 2015Figure 1.
Nurse Practitioner Outcome for Pre- and Post-Test on Cultural Competence
Question NumberFigure 2.Nurse Practitioner Student Outcome for Pre- andPost-Test on Cultural CompetenceQuestion NumberJournal of Cultural Diversity Vol. 22, No. 3Fall 2015the patient satisfaction among Latinas. The study results revealed that the provision of culturally competent care leads to negotiation, mutual exchange of information, increased compliance, and improved patient-provider communication.LIMITATIONS OF THE STUDY The study has several limitations to consider in the inter pretation of the findings. The participants’ interest in the workshop and their scores on the pre- and post-test may have been influenced by their personal experience and years of clinical experience. The differing educational level between the nurse practitioner and nurse practitioner students may have accounted for differences in effectiveness of the workshop. The sample size may not be representative of the population. Part of the sample size was generated from a group of professional nurse practitioners that work with people of diverse backgrounds and there may have been a greater motivation to learn and improve cultural competence skills among this group as compared to the nurse practitioner student group.IMPLICATIONS OF FINDINGS FOR ADVANCE NURSING PRACTICE Advanced health care providers are beginning to recognize that identifying and addressing cultural uniqueness of individuals is essential to positive outcomes. It is vital to any partnership that health care professionals provide culturally sensitive care. To provide this unique form of care, the health care professional is obligated to have cultural awareness and sensitivity along with knowledge of the cultural dimensions of health and illness. Being a culturally competent provider involves understanding and working with people of different cultural backgrounds and developing effective skills that will promote positive outcomes. Nurse practitioners are consistently being challenged to become sensitive to the impact of culture on their patient’s health and well-being. Not having a good understanding of cultural issues can lead to barriers to social and cultural understanding, thus having a negative impact on the provider-patient relation and outcomes. Cultural assessment refers to a “systematic appraisal or examination of individuals, groups, and communities as to their cultural beliefs, values, and practices to determine… needs and intervention practices within the cultural context of the people being evaluated” (Andrews & Boyle, 1999, p. 24). In addition, cultural assessment encompasses both the process of gathering data and the actual content of the gathered information. A workshop that incorporates cultural competency skills and the steps to building cultural competence, such as the one developed for this study, can help facilitate communication and cooperation, promote cultural competence, and improve communication between the patient and the provider, all of which lead to better patient health outcomes.RECOMMENDATIONS FOR FURTHER RESEARCH Research should be continued in order to gain a better understanding of cultural competence and education among nurse practitioner providers. Based on the findings, this specific workshop should be presented to practicing nurse practitioners with clinical experience and those that deal with multicultural patients on a daily basis. Students and those that have limited exposure to multicultural patients should have an altered workshop that takes moretime to explain the background knowledge that is most acquired through work experience. The specific approach should incorporate assessment of the education level of the students before the workshop and consulting with experts to assess the best way to portray cultural diversity without specific multicultural exposure. Further research should be conducted on the continuing education of these workshops. Multicultural workshops could be developed to target specific cultural groups in a more in-depth fashion. The workshop right now is a general educational tool for cultural diversity. Creating and expanding the scope through more cultural workshops may make a greater and more thorough impact on the participants. There are limited studies conducted on cultural barriers and emergency room visits. Research is needed in this area to see if there is any correlation between emergency room visits and cultural barriers. Also, future research in the area of cultural competence and patient outcome measurements should be considered. Many participants expressed that this workshop or future workshops of this type should be held at least yearly and/or have specific workshops that focus on different cultures. Therefore, employers of health care organizations should work on developing strategies that will allow there staff to receive education on cultural awareness and competency in the workplace. Additional research should be conducted on the effectiveness of continuing education or annual workshops on cultural competence. Multicultural workshops could be developed to target specific cultural groups in a more in-depth fashion. Expanding the scope of the workshop may have a more widespread impact on the participants.DISCUSSION AND CONCLUSION This workshop designed to increase cultural awareness and cultural competency, can be considered successful based on the assessments of the participants. The findings from this study suggest that cultural workshops have a positive and long lasting effect for everyone involved. Interactive workshops have been shown to lead to more effective learning (Castro & Ruiz, 2009; Hoellein, Griffith, Linberry, Wilson, & Haist, 2009; Sanner et al., 2010; Wilson, Sanner, & McAllister, 2010), however little exists in the literature to support their effectiveness and application of knowledge into practice. Few studies have gone beyond participant satisfaction by incorporating a follow up survey to assess outcomes. In this study, in addition to measuring pre- and post-test scores and satisfaction of the workshop, this researcher attempted to assess whether participants were able to incorporate the knowledge attained in the workshop into their day-to-day practice by measuring their own perception of change. Two months following the workshop, the practicing nurse practitioner group indicated a decrease in their patient workload emergency room visits, hospitalizations, provider-patient relationship, and diagnostic testing. Research shows that the cultural differences existing between patients and a health care provider are contributing factors to the lower health status of certain cultural groups. Cultural education workshops may manifest acceptance and understanding for those patients living in long term care facilities. This study demonstrated that a cultural educational workshop is an effective way to deliver essential cultural education and training to providers, increaseJournal of Cultural Diversity Vol. 22, No. 3 Fall 2015provider know ledge attainm ent, and im pact providers’ perceived cultural competency from that knowledge obtained.REFERENCES Adapted from A Youth Leader’s Guide to Cultural Competence. Advocates for Youth, Washington, DC. www.advocatesfo- ryouth.org. Andrews, M. M., & Boyle, J. S. (1999). Transcultural concepts in nursing care. Philadelphia, PA: Lippincott. Baroffio, A., Nendaz, M. R., Perrier, A., Layat, C., & Vermeulen, B. (2006). Effect of teaching context and tutor workshop on tutorial skills. Medical Teacher, 28(4), 112-119. Castro, A., & Ruiz, E. (2009). The effects of nurse practitioner cultural competence of Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21(5), 278-286. Colaizzi, P. (1978). Psychological research as the phenomenologist views it. In R. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48-71). New York, NY: Oxford University Press. Executive Order No. 13,166, 3 C.F.R. 65, 159 (2000 comp.). Retrieved from https://www.justice.gov/crt/about/cor/Pubs/ eolep.php Happell, B. (2006). The training and development workshops: Promoting cultural change within mental health nursing. The International Journal of Psychiatric Nursing Research, 11(3), 1299-1309. Healthypeople.gov. (2011). About healthy people. Retrieved from http: / / www.healthypeople.gov / 2020 / about / default.aspx Hoellein, A. R., Griffith, C. H., Linberry, M. J., Wilson, J. E., & Haist, S. A. (2009). A complementary and alternative medicine workshop using standardized patients improves knowledge and clinical skills of medical students. Alternative Therapies, 15(6), 30-34. Lazaro, R. T., & Umphred, D. A. (2007). Improving cultural diversity awareness of physical therapy educators. Journal of Cultural Diversity, 14(3), 121-125. Leininger, M. (2008). Overview of Leininger’s theory of culture care diversity and universality. Retrieved from https://w w w . madeleine-leininger.com Leiper, J., Van Horn, E. R., Hu, J., & Upadhyaya, R. C. (2008). Promoting cultural awareness and knowledge among faculty and doctoral students. Nursing Education Perspectives, 29(3), 161-164. Moffat, J., & Tung, J.-Y. (2004). Evaluating the effectiveness of culture brokering training to enhance cultural competence of independent living center staff. Journal of Vocational Rehabilitation, 20(1), 59-69. Rehabilitation Services Administration. (1993). U.S. Department of Education. The Rehabilitation Act of 1973 As Amended by the Rehabilitation Act of 1993. Washington, DC: U.S. Department of Education. Renshon, S. (2007). Becoming American: The hidden core of the immigration debate. Retrieved from https://www.cis.org/ articles / 2007/ backl07.html Sanner, S., Baldwin, D., Cannella, K. A. S., Charles, J., & Parker, L. (2010). The impact of cultural diversity forum on students’ openness to diversity. Journal of Cultural Diversity, 17(2), 56-61. United States Department of Health and Human Services, Office of Minority Health. (2001). National standards for culturally and linguistically appropriate services in health care: Final report. Retrieved from http: / /minorityhealth.hhs.gov/assets/pdf/ checked / finalreport.pdf Wilson, A. H., Sanner, S., & McAllister, L. E. (2010). A longitudinal study of cultural competence among health science faculty. Journal of Cultural Diversity, 17(2), 68-72.Journal of Cultural Diversity Vol. 22, No. 3 Fall 2015Copyright of Journal of Cultural Diversity is the property of Tucker Publications, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder’s express written permission. However, users may print, download, or email.
Stewart, J. G. & Denisco, S. M. (2015). Role development for the nurse practitioner. Burlington: Jones and Bartlett.
American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, D.C.: Author.
Recommended Textbooks:Buppert, C. (2015). Nurse practitioners business practice and legal guide (5th ed.). Burlington: Jones and Bartlett.
Joel, L. A. (2013). Advanced practice nursing (3rd ed.). Philadelphia: F. A. Davis.

"You need a similar assignment done from scratch? Our qualified writers will help you with a guaranteed AI-free & plagiarism-free A+ quality paper, Confidentiality, Timely delivery & Livechat/phone Support.

Discount Code: CIPD30

Click ORDER NOW..