Inquiry into the cultural consciousness of nursing students during a one-week cultural immersion service learning experience within an American Indian community

Abstract

Cultural consciousness is a central element of purposeful and appropriate health care delivery that integrates knowledge, sensitivity and understanding (Korton & Sahtouris, 2001). The preponderance of research across a variety of disciplines suggests that cultural consciousness and awareness is strengthened through self-reflection (Axtell, Avery & Westra, 2010; Danielewicz, 2001; Furlong & Wright, 2011; Gay & Kirkland, 2003; Rew, 2014), dialogue about race (Murray-Garcia, Harrell, Garcia, Gizzi, & Simms-Mackey , 2014), and experience within other cultures (Fredericks, 2006; Kozub,2013; Peaz, Allen, Carson & Cooper, 2008; Stone, et.al., 2014). The purpose of this study was to examine nursing students' perceptions of cultural consciousness pertaining to American Indian culture developed during a one-week cultural immersion service learning (CISL) experience. Specifically, The overarching research question central to the focus of this study was: How do nursing students at this university describe their CISL experience? Three sub questions were posed to inform the main research question. An intrinsic single case study design bounded by the students' perceptions of a cultural immersion service learning experience within an American Indian community was used to answer the research questions. Thirty participants were selected from two cohorts of nursing students enrolled in Nursing Care of Children and Family, a required junior-level course participated in a one-week CISL experience. Data included instructor observations and two sets of student reflections. The data were analyzed using the constant-comparative method (Strauss, 1987). Evidence from clinical reflections demonstrated most students wrestled a mismatch between their initial expectations and the reality of the situation, but several weeks afterward two-thirds of the students integrated the CISL experience into a coherent whole in which cultural consciousness emerged in their reflections. The findings from this study suggest that incorporating CISL experiences into undergraduate nursing curricula may facilitate the development of cultural consciousness and the skills needed for culturally competent care in student nurses. Also, there appeared to be a link between students' ability to recognize their societal privilege, the close proximity of healthcare disparities, and cultural consciousness. Additionally, recommendations were provided for developing a CISL experience within an undergraduate nursing program.