Discuss the impact of culture on health and illness. Explore health seeking behaviors of a variety of cultures and explore how clinical nurse can adapt their practice to accommodate the behaviors.
Discuss current thinking on different approaches to addressing diversity/inclusivity in the clinical and classroom environments. Identify a variety of ways in which different cultures perceive the learning experience. Focus on learning styles.
Discuss the impact of culture on health and illnesses. Explore health seeking behaviors of a variety of cultures and explore how clinical nurses can adapt their practices to accommodate the behaviors. .
Complete your discussion with a list of current citations and references.
Please respond to peers discussion and add one different comment to the discussion? Please respond to Irish Culture.
In both the healthcare arena and classroom, the topics of cultural competence and diversity are being discussed more frequently and openly. Cultural competence encompasses the capacity to identify, understand, and respect the values and beliefs of others (Diaz, Clarke & Gatua, 2015). Training on various cultures and their beliefs in regards to healthcare have allowed for individuals to be cared for in their own culturally accepted manner. Each person will perceive and handle their condition in different ways, and will expect and require different approaches to care?culture will undoubtedly play its role in this equation (Mendes, 2015) The clinical nurses must adapt their practices to provide patient-centered care with their cultural beliefs in mind. The nurse should feel comfortable having an open discussion with the patient about their cultural values and beliefs, in order to adhere to and respect those practices, which may be foreign to them.
A person?s faith may affect their treatment decisions and preferences, and importantly, advance care plans for their end-of-life care (Mendes, 2015). For example, a Jehovah?s Witness can sign a Bloodless Advanced Directive and have the ability to choose other means of life-saving products without going against their beliefs and accepting blood. A study in the British Journal of Midwifery discussed the birth plan preferences in Nigerian and Irish women in Ireland. The Irish women were more vocal on wanting an epidural for pain relief, while the Nigerian women did not want to use anything for pain relief in labor. In general, Nigerians appear to view childbirth as a natural, at times lengthy, phenomenon and as such it is not unusual to avoid analgesia and medical intervention, such as cesarean section delivery (Sheridan, Yekinni, Oyeye, Ogunleye, Oluyede, O?Sullivan, & Higgins, 2011). Since the publishing of this study, the healthcare providers in that area of Ireland have tailored their practices to respect the cultural differences and offer other methods of pain relief such as massage therapy, aromatherapy and hydrotherapy; this is a fantastic example of providing culturally competent care.
If the patient?s culture is respected and used in the plan of care, they will be more receptive to adhere to the recommendations and keep up with the regimen. Using culturally competent care encourages help-seeking behaviors among minority populations, because they know they will be cared for in a manner most comfortable and familiar to them. It will also result in earlier diagnoses and increased access to services and treatment; it is important to recognize the cultural identities of all individual [patients] increasing their personal quality of life, and in turn come closer to achieving the type of care provision we would all wish for our own loved ones (Mendes, 2015). Culture has a tremendous impact on health and illness, as stated earlier, it can make or break the patient?s willingness to follow a healthcare regimen. The way to ensure all nurses are prepared to care for diverse patients is through the promotion of diversity in nursing education programs, as well as fostering the development of cultural competence among all levels of nursing students (Diaz, Clarke & Gatua, 2015). This essential practice will prepare student nurses to deliver high quality, patient-centered care.
In nursing education, aside from preparing the students to provide culturally competent care, the educators are tasked with ensuring students from all different cultures, religions, genders, socioeconomic backgrounds, sexual orientation and age ranges are respected and feel included in the educational experience. The American Association of Colleges of Nursing (AACN) estimates approximately 73% of undergraduate nursing students are now considered non-traditional which refers to any student who meets one or more of the following criteria: aged 25 or older, commutes to school, enrolled part time, is male, is a member of an ethnic or racial minority group, speaks English as a second or additional language, has dependent children, and holds a general equivalency diploma (GED) or has required re-medial classes (Bednarz, Schim, & Doorenbos, 2010). Ensuring inclusivity in the classroom for all students should be every educators top priority. If every student feels valued for who they are, a sense of trust lives in the classroom, and that trust allows all students to feel comfortable enough to take intellectual risks (https://www.teachingtolerance.org). An approach to address the issues of diversity in the classroom would be to empower each student to be their best selves and allow for their success both in the classroom and in the healthcare field. Educators are challenged to recognize different learning needs and respect and utilize the knowledge and experiences that students bring to the learning settings (Bradshaw & Lowenstein, 2011). Students come from all different walks of life now, as the saying goes, but their method of learning is still the same: teaching needs to be tailored to the learner?s needs. By using the strengths and originality of diverse students, the final classroom product can be much stronger than the product of an assimilated, cookie cutter one (Bradshaw & Lowenstein, 2011). Each culture experiences learning in their own way and the educator must be aware of this. The students of Asian-American culture are accustomed to not participate or make eye contact when speaking, however, for an educator not aware of this cultural norm, it would mean the student was simply not interested in this class and would result in deduction of points for class participation (Bradshaw & Lowenstein, 2011). Many cultures also value work sharing and helping the whole group to achieve, whereas in the classroom, this practice may not be acceptable, especially when it comes to examinations (Diaz, Clarke & Gatua, 2015). Understanding the learning styles of each student given their diverse backgrounds will help the educator design various teaching methods to allow for the success of the classroom as a whole. Activities such as small group work, case studies, simulations and active discussions are just a few ways in which students can express themselves freely to learn about the material and from each other. A better knowledge and understanding of learning styles allows the educator to teach in a manner that both reaches the greatest number of students and challenges all students to grow as learners (Bradshaw & Lowenstein, 2011). Administering the VARK questionnaire, which determines if you learn best through visual, aural, read/write or kinesthetic method, on the first class meeting will allow for the student and the educator to see how they learn best and help provide the student with the appropriate tool to help them be successful.
Bednarz, H., Schim, S., & Doorenbos, A. (2010). Cultural Diversity in Nursing Education: Perils, Pitfalls, and Pearls. Journal of Nursing Education J Nurs Educ, 49(5), 253-260. Retrieved September 17, 2016.
Bradshaw, M. J., & Lowenstein, A. J. (2011). Innovative teaching strategies in nursing and related health professions (6th ed.). Boston: Jones and Bartlett.
Diaz, C., Clarke, P. N., & Gatua, M. W. (2015). Cultural Competence in Rural Nursing Education: Are We There Yet? Nursing Education Perspectives, 36(1), 22-26. Retrieved September 18, 2016.
Elliott, P. (2015, December 3). How to craft an open classroom. Retrieved September 17, 2016, from file:///Users/jenniferkeller/Desktop/How to Craft an Open Classroom | Teaching Tolerance – Diversity, Equity and Justice.
Mendes, A. (2015). Cultural competence: Part of good personalized dementia care. Nursing and Residential Care, 17(6), 338-341. Retrieved September 18, 2016.
Sheridan, C. P., Yekinni, I., Oyeye, G., Ogunleye, K., Oluyede, G., O?Sullivan, K., & Higgins, J. R. (2011). Comparing birth plan preferences among Irish and Nigerian women. Br J Midwifery British Journal of Midwifery, 19(3), 172-177. Retrieved September 16, 2016.
The VARK Questionnaire. Retrieved September 18, 2016, from https://vark-learn.com/the-vark-questionnaire/
I. Discuss current thinking on different approaches to addressing diversity/inclusivity in the clinical and classroom environment. Identify a variety of ways in which different cultures perceive the learning experience. Focus on the learning style.
Today school is becoming highly complex and culturally diverse and educators face a lot of challenges for students to reach same academic goal and standard. Every classroom is a cultural community reflective of the discipline and perspective studied, the teacher and the student. Successful learning requires an intercultural approach where students are responsible to listen or observe in order to understand various perspectives. Culturally and linguistically diverse students vary in term of their educational background, native language, literacy, socioeconomic status, and cultural tradition (Stephenson, 2014). Cultural intelligence has become one of the key competences of the 21th century. As an educator myself in an LPN program in a multigenerational and culturally diverse group of mostly Hispanics and African Americans, there is an expectation among teachers to acquire expertise in transmitting curriculum and structuring the classroom for optimal learning (Moule 2013). Facing such a challenge, I believe that the given curriculum should emphasize a culturally intelligent curriculum format that provide students with analytical tools to deal with uncertainties and the ability to think critically in a wide variety of communicative contexts.
As an instructor in this type of setting, I have the influence and the obligation to create environment for students? retention and success across the school setting. Research indicates that teaching in diversity and multicultural sensitivity across disciplines can reduce prejudice, transform students?perspectives and is positively correlated with workplace readiness (Enberg et al. 2007, Denson 2009). Curricular and pedagogical practices that enhance cultural intelligence serve all our students by attending to the experiences of differences among and across our student population. (Harper and Hurtado 2007, Museus and Maramb 2011, Museus et al. 2008).
According to Roxanne Amerson (2006), keeping students awake and alert in the nursing classroom can be also a constant struggle. To involve students and create interactive learning opportunities, it is important to design cognitive strategies that attracts the students? learning preferences. Such creativity entails a certain willingness to think outside the box. Educators must be able to develop their teaching strategies beyond the common and expected classroom activities. The important factor to energizing the nursing lecture is to design an environment that urges students to be active participants. It is important to use creativity to create cognitive strategies that appeal to students? learning preferences.
Here are some methods to effectively enhance the students? learning:
1. Development of Cultural Intelligence. What is Cultural Intelligence? Cultural Intelligence is a person’s capability to adapt effectively to new cultural contexts and it has both process and content features (Earley & Ang 2003). Cultural intelligence is a multi-dimensional construct. Cognitive and metacognitive, motivational and behavioural components shape the whole of CQ (Ang, 2006).
2. The use of the Theory of Multiple Intelligence Learning in the classroom. This concept can be incorporated in a classroom setting. With an open mind and a willingness to forego traditional approaches, it can be accomplished. An example that puts this concept into practice involves client education and there are several steps:
a) INTERPERSONAL – begin the lecture by asking students to talk with peers about an instance in which a nurse or doctor taught them something.
b) MATHEMATICAL/LOGICAL and MUSICAL – review some common learning theories and then give students a written assignment. They will have five minutes to compare and contrast the theories and record their own beliefs about learning. Play soft background music during this activity.
c) VISUAL and VERBAL/LINGUISTIC – use a PowerPoint presentation with interactive graphics and fill-in-the-blank statements.
d) KINESTHETIC – randomly distribute to students laminated cards with criteria for a learning objective (i.e., client-centered, measurable, time-limited, realistic). Have students write their criteria on the board, giving examples of how these criteria are used in writing an objective.
e) INTRAPERSONAL – provide a journal article to read independently that focuses on providing effective patient teaching.
Additionally, with a little anticipation and planning, we have to integrate activities that meet the needs of seven of Gardner?s eight types of intelligences. It has been the author?s experience that student evaluations will reflect satisfaction with the willingness of the educator to step outside the normal traditions of the classroom to address a variety of learning preferences. The future task for nurse educators will be to implement these techniques and exhibit efficacy through research.
Thus, nurse educators regularly express their concern about not covering all the material and feeling obligated to complete as much lecture content as possible within a one- to two-hour period of time. The truth is that only certain students will learn when a teaching format is focused to meet the needs of certain types of learners. O?Hare (9) found out that, when nurses were taught new and difficult content through instructional methods that matched their learning style preferences, they scored higher on standardized achievement test scores. By designing short and interactive activities focused on specific intelligence styles that can be interspersed throughout the lecture, the nursing lecture can be interactive and energized.
Supplementing the above findings, academic cultures place great value on independence, from course development and delivery to scholarly honors. Independence is normed on middle class American society, privileging students from that socioeconomic stratum (Stephens, Fryberg, Markus, Johnson & Covarrubias, 2012). Introversion is rewarded through research hours and independent scheduling. On the other hand, collegiality is also not only valued, but required in order for academic gears to mesh and move institutional development forward. Social capital, with extended campus representatives, is essential to achieve college and career success (Becker, Krodel & Tucker, 2009). Of all cognitive abilities, critical thinking is most valued and commended. It is the basis of original thought and the gist of academic discourse. Even at the most basic logistical levels, academia presents unique cultural changes (Conley, 2007). Schedules are a moving target and require high-level tracking skills, self-motivation, and pacing. Self-reliance is essential when family members are not available to intervene or aware of impending deadlines. The learning pace is often a surprise to incoming freshmen, who have cruised through more relaxed standards in high school. Similarly, new college students are generally not prepared for the extent to which they must collaborate with student colleagues, experts in the field, staff members, and other faculty. Students must frequently allow themselves to criticism on paper and in front of the classroom when making presentations, and are expected to defend their viewpoints or integrate corrective feedback.
The ability, therefore, to successfully navigate in a new environment requires a sense of self, sense of others, and awareness about shared and different experiences within each interaction. Values, idiosyncrasies, communication patterns, physical gestures, moral reasoning, and behavioral cues all contribute congruently that influences social meaning within relationships. When incongruent messages dominate social interactions, attention is required to identify, interpret, and adjust to the differences. Under these circumstances, academic learning is compromised because cognitive processes are otherwise overloaded by sorting through the meaning associated with cultural variables. Sternberg?s Interactional Theory suggests that comprehensive intelligence is revealed by a person?s dynamic modifications in response to their environment (Early & Ang, 2003). In this case, however, institutional intelligence, instead of personal intelligence, is needed to generate effective modifications. If academic goals include success for Hispanic, first-generation, and low-income students; colleges and universities must first acknowledge the gap between students? incoming cultural milieus in contrast to the academic culture in which they are expected to succeed and then develop interventions to bridge that gap. In other words, colleges and universities must mediate the environmental transition for culturally diverse students into a different culture. It is only by doing so that we could secure the future of our students that on the one hand they become successful in their own fields, and on the other hand, can be very useful in the society at large.
II. Discuss the impact of culture on health and illness. Explore health seeking behaviors of a variety of cultures and explore how clinical nurse can adapt their practice to accommodate the behaviors.
Culture affects ones perception of health, illness and death. It has a major impact on a person?s belief about causes of disease, approaches to health promotion, and how illness and pain are experienced and expressed, as well as where (or from whom) patients seek help; and the type of treatment thepatient prefers (Canadian Pediatric Society, 2015).
Culture, as described by the Canadian Pediatric Society (2015) is the pattern of ideas, customs and behavior shared by a particular group of people in the society, which determine them from one another. The same organization, additionally, characterized culture as dynamic and evolving, learned and passed from one generation to the other. This is frequently identified through language, manner of dressing, music and behavior and is assimilated into all aspects of an individual?s life.
Interestingly, the United States of America remains a popular destination of the world?s international migrants (Zong and Batalova, 2015), In 2013, approximately 41.3 million immigrants lived in the Unites States totaling to 13% of the total U.S population (Zong nd Batalova, 2015), The significant change in the demographic landscape of America according to Buttaro, 2014, have impacted directly America?s health education, health care delivery and public health. One significant factor that directly affects health is culture (Buttaro, 2014).
A study conducted by Park, Chesla, Rehm and Chun in 2011, entitled Culturally Appropriate Mental Health Care for Asian Americans. It showed that Asian men in general feels pressured to be strong and find it difficult to express their feeling to other members of the family because they are known as the ?head of the family?. This study also showed that Asians prefer indirect communication due to the fact that it is less threatening and confrontational. This view is directly in contrast from the American society?s belief that direct communication is healthy and therapeutic (Park et al., 2011). In this mentioned research the care provider acts as messenger by apologizing to the family members and explaining the experiences that were causing pain and suffering to the patient (Park et al. 2011). By being sensitive to the hierarchical role and relationships within Asian American families, care provider may act as interpreter or mediator so that family members may understand each other while preserving the patient?s position as head of the family (Park, Chesla, Rehm & Chum, 2011). Furthermore, the clinical nurse can be a source of neutral, unbiased and objective information regarding the health of family member/s, whenever information is sought and whenever it is appropriate to be shared. This relieves the members in this particular group of the burden of having to be confrontational or emotional during some of the more pressure-laden conversations. The nurse should, however, best be careful not to sound or appear imposing or intrusive, as the role he/she needs to assume is more of a facilitator of communication and an interpreter where her/his expertise on health is needed or sought.
As a nurse growing up in a tightly knit community or culture or extended family type of setting, our belief system are mostly not to seek treatment in a profession setting i.e. (clinic, hospital or health center). We also preferred to use herbal medicines rather than over the counter medication that are available in the pharmacy. This behavior too is very evident to people living in remote or far flang areas. We tend to do our own health care remedies based on our experiences from our elders or we seek help from the village elder known as ?Albularyo? or also known as ?Quack doctor?. Most of these belief systems are directly influenced by people?s faith/ spiritual belief, experiences and socio-economic status.
As a professional nurse, I can?t say that the above practice is outrightly wrong for people find relief and sometimes alleviation from their maladies. We call it psychological or spiritual but the fact remains that they are cured in some way. But, my learning in this particular field will somehow better explain to them an alternative and may in some sense redirect this particular mind-set. Offering and explaining to them a much better option, which focuses directly on their illness will somehow move them to embrace a better understanding of their wellness. I believe that my enrichment in this particular field of study especially as I take up this course gives me a much better position to understand and enlighten some cultural inappropriateness in dealing with health care. Thus, by enlightening them, they will all the more appreciate their particular cultural practices and at the same time offer them the best possible option to a more life sustaining, prolonged, integrative and wholesome health care.
Stephenson, V (2014). Teaching Strategies to Accommodate Culturally Linguistically Diverse Students in Online Nursing Courses. Master of Arts/Science in Nursing Scholarly Projects. Paper76.
Song, D., & Oh, E. (2011). Learning Style Based on the Different Cultural Background of KFL Learners in Online Learning. Multimedia-Assisted Language Learning, 14(3),133-154.
O?Hare, L. (2002). Effect of traditional versus learning-style presentation of course content in adult health nursing on the achievement and attitudes of baccalaureate nursing students. Unpublished doctoral dissertation, St. John?s University, Queens, NY.
Moule, J. (2015). Cultural Competence: A primer for educators. Wadsworth: Belmont. CA.
Gardner, H. (1999). Intelligence reframed: Multiple intelligence for the 21st Century. New York: Basic Books.
Boykin, A.W., & Noguera, P. (2011). Creating the opportunity to learn. Alexandria, VA: ASCD.
https://2014.wascarc.org/site/default/files/CARTER%20CQ@0Stem%20Carter%20Cianci_0.pdf. Retrieved September 17, 2016.
Buttaro, L. (2014). Cultural Competency: The Effects of Culture Shock and Language Stress in Health Education. International Journal of Business/ Humanities and Technology, 4(5), 27-34
Zong, J., & Batalova, J. (2015, February 26). Frequently Requested Statistics on Immigrants and Immigration in the United States. Retrieved September 15, 2016.
Park, M., Chelsea, C., Rehm, R., & Chum, K. (2011). Working with Culture: Culturally appropriate mental health care for Asian American. Journal of Advanced Nursing. 2373-2382.
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