Final Reflection

Learning Outcomes:•

• Describe strategies of learning to cope with new social/cultural expectations through immersion experiences such as BaFa BaFa and personal experience.
• Analyze experiences of dealing with diversity through personal assessment using the Intercultural Development Instrument
• Create ways to foster of diversity in professional life/classes/student services/student groups

After attending and participating in activities this academic year I feel I definitely meet the learning outcomes. Each session was exceptionally planned by facilitators to make you think, explore, and be open to the experience. The textbook provided a spring board to realize the potential of activities and how to incorporate those not only in classroom with students but also be able to use the activities with faculty at meetings in committee work to bring department to embrace diversity and inclusion. I have grown in how I think and approach different situations. I would not have had this growth if I would have gone just through the motions of attending sessions. I put in significant time to think about how to be more inclusive, how to make activities work to bring department together and what changes we can make to the curriculum to prepare our future student nurses. The pre and post survey assisting in measuring that growth and progress. I strongly feel that for health care workers to provide the best patient care and promote positive patient outcomes we as nurse educators need to provide tools in pre-licensure curriculum. I particular liked the exercise of finding activities to use in classroom. For nursing adding it to all courses and through program will be more beneficial then a one time activity with students. When we add activities throughout the curriculum it will across the entire lifespan and health care communities and care facilities. As we look to increase diversity in healthcare to be more in line with patients we care for we should draw on our program strengths as we are quite diverse in our student population. In the last 3-4 years the nursing program exceeds the national statistics for men in nursing. Which is a great advantage to be able to graduate male nurses. As faculty retirements are expected in next few years we have the opportunity to deliberately and purposefully recruit a more diverse nursing faculty. Historically it has been predominantly female and Caucasian. We can and should do more in this area. Making a more inclusive and diverse student population, faculty and staff will not happen overnight but with dedication and foresight we will be on the right track.

Outside Experience

Activity: The purpose of this activity is to highlight and explore our own feelings of different and be explicit about our strategies for dealing with adapting to new situations.

For this activity I choose a recent visit to the Hamilton County Court in Cincinnati OH. Never having visited this particular site I was unsure of what to expect, who I would encounter, and how I would feel once present. I tried to prepare myself by visiting the website to get a feel of the building, its layout and knowing where to go. I was hoping having this information would act as a ‘security blanket’ while there. Nothing could have prepared me for the experience as this place encounters different people on any given day and it was obvious the minute I stepped foot in the door that activity changes from day to day depending on cases being heard in the courthouse. First encounter was with security officers, who like at the airport scrutinize anything you bring in the building. Next was going to the waiting area. A large room with multiple seating areas and people nervous all around me. In a strange way that was comforting, knowing that the majority had no idea what they would encounter in judge’s chamber it kind of forms a bond. I did not feel comfortable talking to anyone and quietly observed the interactions going on around me. Even though I was told to be present at a certain time I learned that does not mean you are called at the time of appointment. I did not want to be anxious, insecure, disoriented or confused about surroundings and tried to think of why people where there today and what it must have felt for them. I tried to sympathize with men and women about to face a judge who was most likely going to impact their lives, positive or negative; Giving people who made eye contact, very few did, a reassuring smile. It made me think of how students feel when they enter the classroom or clinical for the first time. How unnerving or anxious that must be.

Diversity Activity

Part 1. Activity: Describe your activity, present its design, procedures, goals, and facilitation plan.

I decided to focus on finding an activity to be used with student nurses.

Background: Cultural competent care has become a priority to address for health care organizations. Due to continued changing demographics of our population, we have become a growing multicultural world with increasing health disparities. Understanding what it means to practice in a culturally competent manner is imperative. Health care professionals need to understand the effects of a patient’s culture on the interaction with the health care system. We, nurse educators, have an opportunity to address this with student nurses in the nursing program. Ideally infusing this into the entire curriculum versus a stand alone activity.

After reading several activities in the textbook, I was drawn to examples of activities focusing on ‘understanding differences’, ‘exploring cultural values’ and ‘challenging situations’. While using the internet as another resource to make these activities applicable to health care  I came across the following website: http://support.mchtraining.net/national_ccce/index.html

The site provides interactive learning modules covering core concepts of cross cultural healthcare by means of case studies. It covers scenarios across lifespan while addressing health beliefs, social factors, self-awareness of healthcare provider that are central to providing cultural competent care. It covers how health care provider beliefs impacts the provision of health care. Each concept starts with introduction, followed by case study, short lecture and key concepts and learning activities.

My goal would be to provide activities throughout the 2 year curriculum. For example use the pediatric case study when students are in pediatric course, use case study about non- english speaking  immigrants and the use of interpreters in fundamentals course. Have students complete introduction and read about case prior to class and complete the learning activities in class. There are 3 activities with each case study and would be completed in small groups. Act 1. enables students to gain insight into cultural perspectives and thoughts of individuals. Act 2. students will analyze the various conditions and predict possible consequences those conditions may have on individual, family, and health care provider. Act. 3 focuses on understanding big picture of health beliefs and culture. Students are asked to formalize questions to elicit information from individual and/or family. Ultimately preparing a mutually acceptable, beneficial treatment plan that is a cultural congruent nursing care plan.

case study 1. chronic health issue addressing social, emotional cultural factors related to treatment recommendations.

case study 2. non english speaking immigrants addressing access to schools and health care. Discussion on federal laws related to ESL, legal ramifications, medical interpretations, including use of qualified medical interpreters.

case study 3. child with health issues addressing religious factors and how they affect medical decision making and disease management. What if families health care practices are not congruent with scientific medical model.

case study 4. health disparities as it relates to differences in quality of care, socioeconomic status, race, and ethnicity.

case study 5. four year old child and family’s decision to pursue complementary and alternative medicine and how folk and health beliefs can affect health care experience.

Part 2. What difficulty do you foresee participants having with this activity? How might you address those difficulties through a) design of the activity and b) facilitation of the activity?

If students would not complete prep work full engagement during class would be difficult. I would want to have some ground rules about respecting each other’s opinions when discussing pros and cons in care of patients.  I am not anticipating any major concerns otherwise.

Intercultural facilitation at UCBA

The National League for Nursing released an article regarding need for diversity and cultural competence in Nursing Education. A statement in the article referred to ‘inclusive excellence’ and where to start. We can’t expect it to just happen but need to work on it by design, not default, and measure what we do. Just exposing nursing students in clinical to diversity won’t necessarily lead to better patient outcomes. As educators we need to make an effort how we select textbooks, to how we present different cultural views, to what educational teaching strategies we select. In every course we need to see opportunity that reflect the community we are a part of, we need to have ‘courageous dialogues’ and explore classroom and clinical dynamics.

BaFa experience

In this activity we were divided in two groups by facilitators. No choice was given to us as in what group to join. Made me wonder what thought process was used to divide the participants? I do not think it was random.

I was placed in the Anvaya group.This was immediately uncomfortable upon hearing that this group required us to be in close proximity and touching arms and shoulders. I always need time to get comfortable and get to know people before I would get close with someone. It placed me immediately out of my comfort zone. The activity itself ( to play role) was not difficult. I think in order to adapt to a culture you need to be open and understanding. I do not think when you join a culture, move to another country, they should have to adapt to you. For example, if I moved to a country with a foreign language I feel it is my responsibility to learn that language not for others to adapt to my language.

I also had opportunity to observe the other culture during the activity and report back to my group. Adgantri seemed totally opposite from Anvaya, as in task oriented without feelings but with a competitive edge. For me this was easier to get comfortable with. The rules were more concrete, easier to get accustomed to than my group. I did not feel out of place observing or interacting with this group during the activity

Building Cultural Competence

Over the next few months I am taking a journey to explore opportunities to enhance my cultural competence. The insight received from taking the Intercultural Development Inventory survey will guide my development, along with input from facilitators and peers during our monthly meetings. I look …