Educational interventions designed to develop nurses' cultural competence: A systematic review.

BACKGROUND

Due to a steady rise in cultural and linguistic diversity in healthcare settings and evident challenges associated with this diversity, there is an urgent need to address cultural competency of nurses. Ongoing, continuing professional development is needed to ensure nurses can provide culturally congruent nursing care.

OBJECTIVES

The aim of this systematic review was to identify current best evidence on the types of educational interventions that have been developed to improve nurses' self-assessed cultural competence and on the effectiveness of these interventions.

DESIGN

A systematic literature review.

DATA SOURCES

Four electronic databases (PubMed, CINAHL, Medic, Eric) were searched for studies using a quasi-experimental design or randomised controlled trial published between January 2000 and June 2018.

REVIEW METHODS

Guidelines from the Centre for Review and Dissemination and the Joanna Briggs Institute guided the review. Two researchers independently assessed the eligibility of the studies by title, abstract and full-text and the methodological quality of the studies. Data tabulation and narrative analysis of study findings was performed.

RESULTS

Six studies met criteria for inclusion in the review. Studies used a quasi-experimental study design (n = 5) and a randomised controlled trial (n = 1). The participants (n = 334) were mainly nurses and interventions were conducted in various healthcare settings. Cultural competence education was offered through traditional contact teaching (n = 5) or web-based modules (n = 1) and ranged from one to 17 hours in length. Learning was enhanced through lectures, group discussions, case studies, reflective exercises and simulations. In two studies, following cultural competence interventions, participants in the intervention group had statistically significantly increased levels of competence in culture-related outcomes when compared to the control group. The four remaining studies did not include control group comparisons. Effect sizes (Cohen's d) of the studies varied from small (d = 0.22) to very large (d = 1.47).

CONCLUSIONS

There continues to be a need for high quality studies investigating educational interventions to develop nurses' cultural competence. Further research should focus on reporting specific components of interventions that result in an increase in cultural competence.