A constructivist theoretical proposition of cultural competence development in nursing

Area of Science:

• Nursing Education
• Healthcare Quality
• Cultural Competence

Background:

• Cultural competence is vital for equitable healthcare, yet current models lack developmental levels and a constructivist approach.
• Existing models are criticized for essentialist views of culture and limited application in competency-based programs.

Purpose of the Study:

• To develop a theoretical proposition of cultural competence development in nursing from a constructivist perspective.
• To address the gap in understanding the processes of cultural competence development among nurses and student nurses.

Main Methods:

• Grounded theory design was employed to study cultural competence development.
• Data were collected through participant observation and semi-structured interviews with 24 nurses and student nurses.
• Inductive qualitative data analysis was used to construct a core category and model.

Main Results:

• The core category identified was 'learning to bring the different realities together to provide effective care in a culturally diverse context'.
• Three dimensions of cultural competence emerged: 'building a relationship with the other', 'working outside the usual practice framework', and 'reinventing practice in action'.
• A model was developed describing the concurrent evolution of these dimensions at three developmental levels, influenced by clinical experience and environmental interactions.

Conclusions:

• The developed theoretical proposition offers a new framework for understanding and fostering cultural competence in nursing.
• This model can guide initial and continuing nursing education to enhance care quality in culturally diverse environments.
• Clinical experience and environmental interactions are crucial drivers of cultural competence development in nursing practice.