ESSENTIAL COMPETENCIES OF PRECEPTORS: A FOCUS ON WORKING WITH APRN STUDENTS

Module 5: Managing Learning Experiences with Culturally and Generationally Diverse Students

The Relationship Between Culture and Learning

"Culture is a mold in which we are all cast and it controls our daily lives in many unsuspected ways……Culture hides more than it reveals, and strangely enough, what it hides, it hides most effectively even from its own participants."
(Hall & Hall, 1990, p. 29).

Need for a Diverse Workforce

Nursing's leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally-competent patient care. According to the U.S. Census Bureau, in 2008, individuals from different ethnic and racial minority groups accounted for more than one-third of the U.S. population (U.S. Census Bureau, 2012). With projections pointing to minority populations becoming the majority by 2043, professional nurses must demonstrate an understanding of a variety of cultures to provide care across multiple settings (AACN, 2015a). Specifically, the United States Census Bureau (2012), projects people from ethnic and racial minority groups— namely Hispanic, Black, Asian, American Indian, Native Hawaiian and Pacific Islander—will together outnumber non-Hispanics over the next four decades (Ayoola, A, 2013).

Based on 2012 health care delivery and staffing patterns and assuming the current RN demand equals the current RN supply of approximately 2.9 million, the demand for RNs is projected to reach 3.5 million in 2025, this reflects an increase of 612,000 RNs. This is due to a growth in disease burden attributable to changing patient demographics, which contributes to an increased demand of 584,000 RNs. Expanded insurance coverage under the Affordable Care Act accounts for an additional demand of 28,000 RNs (Health Resources and Services Administration (HRSA), 2014). This has the potential to impact APRN communities as many institutions look for more effective provision of care as well as a more cost effective model of care.

What is Culture?

Culture is a set of beliefs and behaviors that are learned and shared by members of a group. Each society has its own beliefs and way of life, as well as a way of differing ways of thinking and behaving. These beliefs and behaviors include characteristics such as:

• Age
• Ethnicity
• Gender
• Marital status
• Nationality
• Occupation
• Race
• Religious affiliation
• Sexual orientation

Cultural characteristics have an impact on how students from differing cultures learn, work, think, show emotion, and solve problems (Parish & Linder-VanBershot, 2010). This applies to APRN students as well. Most individuals are aware of different learning styles. Some people are visual learners, others are auditory learners, and still others are experiential learners. However, culture can have an impact on learning, for example, an APRN student who does not make eye contact with a preceptor could be perceived as disinterested, while in the APRN student's culture, this action could reflect a sign of respect. It is often easy to attribute behaviors in others to personality traits rather than cultural differences. As such, sometimes it is easier to make value judgments based on these behaviors rather than to seek clarification on cultural impacts (Parish & Liner-VanBershot, 2010).

Parrish & Linder-VanBerschot (2010) have chosen to represent influences on patterns of thought and behavior in the following interrelated manner (Figure 1):
Hover over the model below for more information.

Cultural Dimensions

Many philosophies of cultural differences exist. Ford, Moore and Milner (2005) extrapolated five primary cultural dimensions from a number of theories to identify cultural variations and learning differences. These dimensions are expressed as a range, with cultures and individuals falling within the extremes of the range. These dimensions are self, responsibility, time, locus of control, and communication style.

RESOURCE

Overview of Leininger's Theory of Culture Care Diversity and Universality was developed by Madeleine Leininger and reflects a theory of transcultural nursing which aims to provide culturally specific care, and can be applied to working with nurses from other cultures.

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