2025 Theses Doctoral

Comparison of Two Teaching Strategies in Simulation on Cultural Humility and Cultural Competence Among Baccalaureate Nursing Students

Kaur, Navninder

Background
With growing diversity in the US population, nurses grapple with health care disparities leading to negative patient outcomes. It is crucial to prepare nursing students for how to understand and address cultural differences by instilling cultural humility and cultural competence in nursing curricula. One way to teach cultural humility and cultural competence in nursing education is through simulation. The primary objective of this study was to compare the effect of standardized patients versus high-fidelity manikins on cultural humility and cultural competence in baccalaureate nursing students.

Methods
A longitudinal, quasi experimental pretest posttest comparison design was used. A convenience, non-random sample of 97 baccalaureate nursing students from one university participated in this study. Out of 97 participants, 39 were in their second year and 58 were in their fourth year of the nursing program. The intervention group (n = 48) attended a culturally immersive simulation with a standardized patient and the comparison group (n = 49) attended cultural simulation with a high-fidelity manikin. Participants from both groups completed Foronda’s Cultural Humility Scale (CHS) and Caffrey’s Cultural Competence in Healthcare Scale (CCCHS) before and after participating in the simulation, along with a demographic questionnaire. Eighty-five students completed a second posttest a few weeks after the intervention. Two theoretical frameworks guided the study: Foronda’s Theory of Cultural Humility, and Purnell’s Model for Cultural Competence.

Results
A mixed analysis of variance (ANOVA) with repeated measures showed a statistically significant difference within groups from pretest to posttest 1 and from pretest to posttest 2, in both cultural humility (p < .001) and cultural competence (p < .001). However, there was no difference in cultural humility (p = .265) or cultural competence (p = .743) when teaching strategies (standardized patient versus manikin) or year in the nursing program (second versus fourth) were considered.

Conclusion
Findings suggest that simulation, whether using a standardized patient or high-fidelity manikin, can be effective in enhancing cultural humility and cultural competence in baccalaureate nursing students.