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Abstract: This project sought to improve NPs'ability to provide culturally competent care through training. Measures included client surveys and NP self-assessment. NPs (n=13) completed a Cultural Competence Assessment pre- and post- training using the Purnell Model for Cultural Competence. Clients completed the Clinicians' Cultural Sensitivity Survey pre- and post- NP training. Post-training, there was a significant increase in NPs reporting cultural assessment documentation and decreases in stereotyping. Project duration was insufficient to see quantifiable changes in client perception; however, NPs reported the training was valuable. Cultural competence training for NPs has potential to increase appropriate care and improve client satisfaction.
Key Words: nurse practitioners, primary care, cultural competence, Purnell model for cultural competence
Introduction and Literature Review
As the American population becomes more diverse, skills needed to provide culturally appropriate care for clients are evolving. Primary care nurse practitioners work in diverse communities in underserved areas where clients have unique cultural, economic, and social needs (Matteliano & Street, 2012). As nurse practitioners continue to gain autonomy to practice to the full extent of their training, it is important to assess their ability to care for clients in terms of cultural competence. Cultural competence is an essential component of client care, from establishing rapport to the ability to make accurate diagnoses through an understanding of clients' language related to health and illness (Elminowski, 2015; Engebretson, Mahoney, & Carlson, 2008; Lucas, Michalopoulou, Falzarano, Menon, & Cunningham, 2008). PubMed and CINAHL searches for studies of healthcare providers and cultural competence revealed that the majority of research assessing cultural competency of healthcare providers has focused on physicians. Patient satisfaction surveys found via the database searches used the word "doctor" rather than "healthcare provider" or "nurse practitioner" (Lucas et al., 2008).
In the few studies that assessed nurse practitioners' self-perceived cultural competence, NPs were found to generally perceive themselves as culturally competent (Benkert, Templin, Schim, Doorenbos, & Bell, 2011; Matteliano & Street, 2012; Starr & Wallace, 2009). However, in a search of PubMed and CINAHL, no studies were found that assessed NPs self-perceived cultural competence in conjunction with clients' assessment of NPs cultural competence. Further research is needed to assess clients' perceptions of NP's cultural competence to determine if there is concurrence between clients and NPs on what comprises...