SEVEN

Academic Settings: General Overview, Faculty Self-Assessment, and Curriculum Evaluation

with contributions from Phyllis D. Barham, Richardean Benjamin, Patricia Burrell, Phyllis M. Eaton, Grace Hoyer, Kay Palmer, Carolyn M. Rutledge, Joanne K. Singleton, Jason T. Slyer, and Lynn Wiles

All full-time and part-time faculty should be cognizant of the intricate connections, interpersonal dynamics, shared responsibilities, commitment, and ongoing collaborative work necessary to achieve an optimally functioning coordinated curriculum, necessitating a holistic approach.

SNAPSHOT SCENARIO

Professor Cube: We’re in pretty good shape for the shape we’re in.

Professor Past: Yes, we don’t need to change anything in the curriculum now because we just passed accreditation.

Professor Cave: What could be so new to add?

Professor Newton: There’s tons of new information, teaching strategies, technology, cultural groups. Now is the time right after accreditation to try all these new ideas in the existing curriculum and also create one or two new programs.

Professor Pace: I think we should pace ourselves and see where we are in the curricular process for each program and set priorities based on empirical evidence concerning curriculum, cultural competence education, and future projected needs in an increasingly diverse, fast-paced, technologically expanding global society and multicultural workplace.

Professor Mini: Maybe we can just check out the minimum requirements from the accrediting agencies for academia and hospital settings and include it as some self-study learning modules about four select cultures, with some optional modules about other cultures.

Professor Maxwell: Focus on minimal standards may meet the benchmark or expected level of achievement (ELA), but only minimally, and any borderline endeavor will yield borderline results. Sometimes minimal benchmarks or goals will be achieved, sometimes not. And this is usually a short-term fix. We should aim to go beyond the minimum and instill in our faculty and students a goal for maximizing outcomes aiming for optimal cultural competence. We should want to do things well and maximize learning outcomes to instill ongoing, lifelong commitment to cultural competence. Meeting the needs of the present misses the future. Our graduates must be prepared to work in a future that may be 30 or more years in their entry level or advanced practice nursing role. Our diverse students must learn to meet general transcultural skills relevant for assessing and addressing the needs of many diverse populations.

Professor Piece: Well, I’m just a part-time adjunct. I only play a small part. I’ve followed the course syllabus for my clinical piece as best as possible without making any changes over the past 8 years. It’s not my place to evaluate or change curriculum. I’m just hired for my 8-hour clinical days with my undergraduate students. Besides, my piece is clinical; I never had any education or curriculum courses. I’m a clinical expert and proud of it. If the students pass my clinical course component, they’re going to eventually be good nurses. Without my piece, they wouldn’t last for 1 week in a new graduate nurse employee orientation.

Professor Panorama: Every faculty member has a big part in the curriculum. It’s valuable to step back to look at the big picture and not just at a snapshot or a close-up view.

Professor Midway: Well, maybe we should systematically appraise our existing curriculum for cultural competence concepts, content, and teaching–learning strategies and then prioritize our next focus based on our strengths, weaknesses, gaps, resources, and literature recommendations. We shouldn’t do everything all at once. We should focus on quality rather than quantity.

Professor Maxwell: The literature substantiates that maximizing learning outcomes requires well-planned, coordinated strategies and courses that complement each other, build upon prior learning, create realistic scaffolded learning at appropriate levels, and strategically weave together multidimensional strategies aimed at positively influencing cognitive, psychomotor/practical, and affective learning.

Professor Numbers: The literature also recommends implementing evidence-based best practices. Unfortunately, many educators neglect planning for measurement and evaluation at the onset of designing and implementing new curricular and/or course initiatives. We should be sure to examine the validity of existing questionnaires and studies reporting statistically significant changes prior to and after educational intervention.

Professor Light: I recently attended a conference where several interdisciplinary presenters shared their educational study results guided by a conceptual model and a psychometrically strong corresponding questionnaire. Their results demonstrated statistically significant changes in each of the three learning domains.

Professor Cave: We don’t need to look at the unknown outside yet. We’ve got plenty of students enrolled. Let’s just stay here with our current curriculum. We don’t need to venture to new places outside our existing curricula.

Professor Pandora: Once we start examining our curriculum, we are opening up a box that may require a lot of work and change.

Professor Franklin: Nothing ventured, nothing gained. Curriculum is a process. Examining it may be uncomfortable but it’s got to be done.

Professor Change: Curriculum is a process. It’s not stagnant. It requires ongoing evaluation and modification at every stage. The present becomes the past instantly. Change with an eye towards the future and thinking outside the box is critical. Being boxed in to the present without thinking outside the box leaves one with a narrow focus. We shouldn’t change everything at once but critically plan where we are and where we should be going.

Professor Pause: I suggest we pause and systematically appraise where we are and where we want to go.

Professor Ponder: This is all confusing. Where are we now and where should we be going? How can we figure this all out? Do we have time for this in a busy academic life and nursing faculty shortage? Is there some kind of map to help us find out where we are and where we should be going?

Any educational setting can provide numerous opportunities for promoting cultural competence; however, the academic setting can make the greatest impact here. This is true primarily because the main function of the academic setting is “education”—and for the student, “learning”—which can be maximized through a well-planned, coordinated approach (see Figure 7.1). Leininger (1) proposed four approaches for effectively integrating transcultural nursing within the academic setting: (a) transcultural concepts, skills, and principles integrated within an existing curriculum; (b) select culture care modules incorporated within a curriculum; (c) a series of coordinated, substantive transcultural nursing courses with field experiences; and (d) a major degree program or track in transcultural nursing (graduate level).

In this chapter, emphasis is given to the first approach because it has the broadest and most immediate application across academic settings and degree programs. In addition, an integrated approach has the potential to positively affect the greatest number of “future” nurses. Without an initial, formalized exposure to transcultural nursing, how will nursing students even know of its existence, realize its significance, and develop the beginning knowledge, skills, values, and confidence necessary for learning and performing culturally congruent nursing care? Furthermore, how will students be aware of the vast possibilities for ongoing learning in cultural competence development or advanced degree options? Early, stimulated interest in transcultural nursing may later prompt pursuit of a specialized degree program or track in transcultural nursing; however, careful sequencing of meaningful, multidimensional teaching–learning experiences throughout curricula heightens the potential for optimal cultural competence development (and resultant immediate benefits within the workplace and in health care).

FIGURE 7.1 Academic Settings

As lifelong, ongoing cultural competence development is an essential professional expectation, it is extremely urgent that initial education emphasizes cultural competence. Transcultural nursing scholars and other scholars have long advocated for substantive integration of evidence-based transcultural concepts, skills, theory, principles, research, and practice throughout all levels and disciplines of health care professions aimed at providing culturally competent health care to diverse populations, reducing health and health care disparities, and enhancing health professions’ workforce diversity. More recently, professional association and accreditation agency mandates and expectations for initial and ongoing cultural competence education and practice not only brought increased attention to cultural competence overall, but also shifted a somewhat casual and/or distant awareness of culture into everyday professional standards for quality and safety (2–9). Consequently, legal and ethical accountability further jolted educators, practitioners, and administrators to take definitive, immediate, and evidence-based actions toward cultural competence throughout professional education and practice. Entry-level education offers the greatest possibilities, particularly the first nursing “fundamentals” course, because it provides the foundation for all future nursing courses and nursing practice. Optimally, a required prerequisite or co-requisite transcultural nursing course will further enhance the possibility for a stronger foundation for cultural competence development; however, an additional course may not be feasible, especially with the time and credit constraints of associate degree nursing programs (see Chapter 10 for an innovative strategy). Numerically, entry-level education has the potential to make enormous strides in cultural competence development because enrollment in such programs is greater than in any other degree programs. This educational and professional goal can only occur with well-qualified, committed nursing faculty and through the use of culturally congruent teaching–learning strategies that address students’ diverse cultural values and beliefs (CVB).

Nurse educators are empowered to make a tremendous difference by introducing, fostering, and nurturing cultural competence development. Each individual faculty member is empowered to make a positive difference; however, the greatest impact will be achieved through a coordinated, holistic group effort that thoughtfully weaves together nursing course components, nursing curriculum, and supplementary resources. Certain factors within the academic setting may support cultural competence development, while yet other factors may restrict its development. This chapter aims to: (a) uncover, discover, and explore educational opportunities (within academia) for promoting cultural competency; (b) describe action-focused strategies for educational innovation; and (c) present ideas for evaluation (and reevaluation) of educational innovation implementation. Figures, tables, “Innovation in Cultural Competence” exhibits, TSET Research Exhibits, and the “Educator-in-Action” vignette provide supplementary information to expand upon narrative text features. Major emphasis is placed on faculty self-assessment and systematic inquiry at the curricular level via a holistic, team approach. Course-level appraisal and innovations are introduced in Chapters 8 and 9 with spotlights on combination and multidimensional approaches in Chapters 10, 11, and 12.

FACULTY SELF-ASSESSMENT

Promoting cultural competency in academia requires considerable, sincere effort that begins with self-assessment, in which the nurse educator systematically appraises the various dimensions that can impact upon the educational process and on the achievement of educational outcomes (10). A systematic assessment can be initiated using the cultural dimensions listed in Table 1.2, and illustrated in Figure 7.2. (A user-friendly Self-Assessment Tool–Academic [SAT–A] is available in the Cultural Competence Education Resource Toolkit [Jeffreys, 2016]) (11). The SAT–A may be used individually and/or in groups (see instructions in the Preface). The realization that there are multidimensional variables influencing student-faculty interaction is overwhelming; yet, it is essential to evaluate these variables before developing a culturally congruent educational approach. Sometimes nurse educators may be “unconsciously incompetent” in their educational approach with culturally diverse (different) students. According to Purnell (12), an educator is unconsciously incompetent when she or he is not aware of cultural differences or when she or he, unknowingly, carries out actions that are not culturally congruent. Behaviors such as cultural blindness, cultural imposition, and culturally incongruent actions can cause cultural pain to others (13–15). Whether intentional or unintentional, cultural pain hurts and can adversely impact learning, academic performance, persistence, retention, self-efficacy, motivation, and satisfaction. Consciously attempting to implement culturally congruent behaviors and avoiding incompetence is a key component in facilitating cultural competence development among culturally diverse learners.

FIGURE 7.2 Faculty Self-Assessment

First, self-awareness of one’s own CVB is essential. Although the nursing faculty member may be immersed within the “culture” of nursing education and be familiar with long-held nursing education CVB, it is important to be aware of the unconscious and conscious CVB that exist in nursing education and in one’s own values and belief systems. Faculty must be aware that their own CVB, held long before entering into the nursing culture, may influence values, beliefs, practices, behaviors, and actions consciously and unconsciously. For example, a nursing faculty member whose traditional cultural values favor direct eye contact for all communication and who views lack of eye contact suspiciously will need to be consciously aware of his or her underlying values and beliefs and aim to consciously avoid distrusting students based solely on this nonverbal cue (10, 16) (see Chapter 12, Snapshot Scenario).

Second, awareness of one’s knowledge about different CVB, especially the CVB that most directly affect the teaching–learning process and cultural competence development, must be explored (see Figure 7.2). Although Table 1.2 presents only a snapshot approach of selected CVB that may impact upon the educational experience, it does allow for a quick comparison of different CVB. One benefit of this approach is that it evokes the awareness that there may be other CVB in various cultures which the nurse educator is unaware of. The realization that one is not and cannot be “culturally competent” all of the time is often a powerful awakening. Becoming conscious of one’s incompetence is often a humbling experience but often sparks a desire for obtaining cultural knowledge. Awareness of differences and similarities between values and beliefs espoused in higher education, nursing education, and individual student CVB can also lend new insight into why conflicts, misunderstandings, and alternate priorities predominate. Such raised awareness can help determine whether specific factors are supportive or restrictive in the goal of developing cultural competence among culturally diverse students who can guide culture-specific educational interventions. Added within this mix of diversity are academically underprepared students, foreign-trained physicians entering nursing programs, and second-career individuals (10, 17–28).

Embedded in this self-assessment is the appraisal of one’s understanding about the multidimensional factors influencing nursing student learning, achievement, retention, success, and cultural competence development. Educational views, policy, learning styles, and values about education differ across cultures (10, 12, 15, 27, 29–49) and impact upon learning, achievement, and persistence (10, 24, 25, 27, 46, 50–58). Unless nurse educators conduct a systematic appraisal of all of the multidimensional components, a full understanding will not truly be achieved. Nurse educators should reflect on the last time a thorough, updated review of the literature on cultural competence, the teaching–learning process, and diverse students was conducted. Appraisal of one’s desire for updated knowledge and commitment should be critically determined. Evaluating one’s knowledge about student expectations and perceptions should be appraised. Lack of knowledge or limited knowledge in this area identifies areas for further self-development; however, one must have the desire to obtain knowledge and be committed to the pursuit of such an endeavor or knowledge quest. Finally, self-assessment should conclude with a listing of strengths, weaknesses, gaps in knowledge, goals, commitment, and priorities.

The nurse educator must assess one’s cultural desire or motivation for engaging in the process of becoming culturally competent. Within this construct of cultural desire is the concept of caring for others (59, 60). Cultural knowledge is the process of searching and obtaining a thorough educational foundation about various CVB in an attempt to comprehend and empathize with others’ perspectives. Along with awareness, cultural desire and cultural knowledge are essential steps toward becoming culturally competent (59, 60). Thoroughly reflecting on the feelings experienced and actions taken when students’ CVB are different from one’s own CVB can further one’s insight. Because the process of cultural competence is ongoing, the nurse educator should examine one’s commitment toward achieving this goal. True commitment necessitates time, energy, persistence, extra effort to overcome obstacles, and willingness to learn from mistakes.

Comprehensive understanding, skills, and desire are essential but not enough to effectively make a positive difference in cultural competence development. The author believes that resilient transcultural self-efficacy (TSE) (confidence) is the integral component necessary in the process of cultural competence development (of self and in others). TSE is the mediating factor that enhances persistence in cultural competence development despite obstacles, hardships, or stressors. Resilient TSE perceptions embrace lifelong learning in the quest to become more culturally competent and in the quest to assist others (learners) to become more culturally competent. Educators with resilient TSE perceptions persist in their endeavors to be active transcultural advocates or promoters of cultural competence in all dimensions of the educational setting and professional practice.

Faculty self-assessment as “active promoter of cultural competence development” is a necessary precursor for successful strategy development. Table 7.1 provides a guide for appraising values, beliefs, and actions and for determining whether or not one is an active role model in cultural competence development. It is proposed that the “actions taken to promote cultural competence development” is what makes one an active role model. Table 7.1 can also provide a guide for organizational self-assessment to determine if schools of nursing, educational institutions, and organizations are “active promoters” or if there are factors restricting cultural competence development. (A user-friendly Active Promoter Assessment Tool–Academic [APAT–A] is available in the Cultural Competence Education Resource Toolkit [Jeffreys, 2016]) (11). The APAT–A may be used individually and/or in groups (see instructions in Preface).

Participation in cultural competence conferences, workshops, events, meetings, and relevant professional memberships exemplify a professional commitment to lifelong learning and cultural competence development that can be motivating and uplifting to students. Professional nurses serve as role models through their commitment to learning and the nursing profession. Because students have most exposure to the nursing profession through faculty guidance, nurse educators exert a powerful influence on students. If faculty do not value cultural competence activities for their own professional development, then it is hard to imagine that they would have a positive impact on encouraging students’ active development. Similarly, if nurse educators are actively involved in cultural competence activities, yet do not actively publicize their views, involvement, participation, and contribution, positive professional role modeling will not be evident to students. Vicarious learning through role modeling and forms of persuasion (encouragement) are powerful influences on self-efficacy appraisal, motivation, and persistence behaviors (61).

After self-assessment, nurse educators who have not optimally shared positive views, values, beliefs, and experiences with students should make a concerted effort to do so. It is, however, not enough to profess values and beliefs to students; nurse educators must be sincerely committed and take positive actions in order to “make a difference” and enhance cultural competence development. To do this, nurse educators must recognize actual and potential barriers hindering the student’s cultural competence development, propose innovative solutions, take action, initiate strategies, evaluate educational innovations, and create new innovations based on evaluative data.

TABLE 7.1 Nurse Educator’s Self-Assessment: Active Promoter of Cultural Competence Development

*Active promoter/facilitator actions are indicated by italics.

SYSTEMATIC INQUIRY: CURRICULUM

As students, educators, administrators, and health care consumers become more astute collectively in recognizing that culturally congruent health care is a right, and not a privilege, it becomes increasingly urgent to closely examine how visible (or invisible) cultural competency development is in the academic setting (9, 40, 49, 62–68). More recently, campaigns to improve the number of graduates, institutional accountability, lawsuits, and competition for qualified candidates amid economically challenging times of fluctuating job markets, decreasing scholarships and financial aid, and increasing tuition costs emphasize a systematic, ongoing appraisal of the curriculum from a panoramic (big picture) view as well as from a more close-up view across all stages of the curriculum process. Accordingly, numerous accrediting agencies help keep faculty and college administrators focused on evaluation and evidence-based teaching–learning and have emphasized substantive inclusion of cultural competence education at all levels (6–8).

In the undergraduate and graduate setting, examination at the curricular, program, school, and course level requires courage, commitment, time, energy, and a systematic plan. A systematic evaluative inquiry can be guided by two additional questions: (1) to what degree cultural competence is an integral component; and (2) how all the cultural components fit together (see Figure 7.3). A thorough evaluation serves as a valuable precursor to informed decisions, responsible actions, and new diagnostic-prescriptive educational innovations toward the overall goal of achieving optimal cultural competence. Systematic curriculum evaluation via quantitative and qualitative methods helps identify program strengths, weaknesses, inconsistencies, and gaps. Jeffreys Toolkit (2016) Item 20 (Systematic Inquiry–Academic [SI–A]) offers a user-friendly quantitative and qualitative approach for systematic appraisal decisions, corresponding actions, notations/reflections, prioritization, and future planning (11).

Reflective self-appraisal at an individual level and at a program level is necessary for enhancing the scholarship of teaching (19, 22, 26, 41, 47, 48, 69–79). For faculty who have not been formally prepared in teaching, curriculum, and the administrative and scholarship role of the nurse educator (e.g., many part-time adjuncts and faculty with clinical doctorates), it may be a challenge to shift from thinking of curriculum as a process rather than as a product (or list/menu of courses). Yet, all faculty need to be actively engaged, accountable, and take ownership for their part in the process.

FIGURE 7.3 Systematic Inquiry for Decision, Action, and Innovation: Academic Setting

Conceptualizing the Curriculum Process and Optimal Cultural Competence

Although it is beyond the scope of this chapter to detail all of the components in a comprehensive active engagement of the curriculum process, certain features are highlighted. Conceptualization of the curriculum process (Figure 7.4), familiarity with key terms, and linkage with the Cultural Competence and Confidence (CCC) model (Chapter 3) provide additional background necessary for comprehensive curricular appraisal. As components of Figure 7.4 are described in the following sections, readers should note that optimal cultural competence belongs at all stages. Readers are asked to imagine that the circular arrows are three-dimensional, in constant motion, spiraling, and represent the optimal cultural competence illustration depicted in the CCC model (Figure 3.1), incorporating cognitive, practical/experiential or psychomotor, and affective learning substantively, visibly, and consistently in the curriculum. By integrating all learning domains throughout all aspects of the curriculum in a complementary, scaffolded way, the result is an “O” representing optimal outcomes (in this case, optimal cultural competence). Scaffolding involves a carefully planned sequence of teaching–learning strategies, topics, and concepts aimed at greater depth of learning (values, skills, and knowledge) and greater autonomy/independence (self-directed learning). In addition, the seven steps essential for optimal cultural competence (self-assessment, active promotion, systematic inquiry, decisive action, innovation, measurement, and evaluation) must be thoughtfully applied. All areas of the curriculum process are action-oriented; however, stage 3 indicates when the curriculum is functioning with students enrolled and faculty assigned to teach.

Concept-mapping that focuses on cultural competence as a concept helps trace the concept through the curriculum. On close scrutiny, curricular threads of culture and cultural competency should be equally and substantially evident throughout the program’s mission, vision, philosophy, conceptual framework, program objectives, program outcomes, courses, and all course components. In addition, the consistent use and application of key concepts must be appraised. Appropriately developed at the directive stage, a user-friendly and accessible glossary of terms that blends key concepts of the discipline and fits well with the program and university’s mission and philosophy becomes a valuable guide for full-time and part-time faculty, new nurse educators, and students. Curricular examination may be aided by differentiating between horizontal and vertical threads. For example, horizontal threads are interested in the “process” of learning; therefore, horizontal threads must be introduced early, integrated purposely, and intricately woven throughout the curriculum to create a durable fabric that provides long-lasting learning and desirable outcomes.

FIGURE 7.4 Conceptualization of the Curriculum Process

From Torres and Stanton, Curriculum Process in Nursing: A Guide to Curriculum Development (1st ed.), © 1982, p. 25. Adapted by permission of Pearson Education, Inc., Upper Saddle River, NJ.

In contrast, vertical threads are “content” oriented; they build from simple foundational content to more complex content. For example, moving from nursing care of the individual to family and then community demonstrates movement from simple dimensions to more complex dimensions. Applying “content” to care of the individual, care of the family, and care of the community should consider culture-specific measures within the plan of care. For example, the “content” of breast cancer screening should address culturally congruent measures to optimize screening by reaching out to culturally diverse individuals, families, and communities. Curricular vertical and horizontal threads should be complementary, consistent, and appropriate for each educational level. Appropriate selection and sequencing of courses should be justified with a clear rationale. Foundational prerequisite courses, co-requisite courses, and subsequent courses must fit together and build upon each other.

The literature is crowded with terms concerning curriculum development and evaluation of nursing programs (76, 78, 79). “Threads” are chosen here because it fits best with the metaphor of creating an evident pattern and a strong fabric. Visual metaphors are powerful tools for paradoxically condensing and expanding conceptual learning and insights that would otherwise take much longer to comprehend, value, and integrate via other learning modalities/modes (80, 81). Although some contemporary publications in nursing education introduced some new terms, phrases or analogies, the meanings behind them are similar. For example, the phrase “characteristics of the graduate” may have been changed to program outcomes or program student learning outcomes; however, the goal of adequately preparing a nursing professional within a designated role (entry level or advanced degree) remains. Therefore, whatever one chooses to call it, programs aim to produce graduates who learned specified knowledge, skills, and values that can then be transformed into the workplace (and by becoming productive citizens, contributing positively within a global society). Optimal cultural competence fits within this context. Whether faculty are actively considering developing a new curriculum or program (stage 1, directive stage) or focused on the process of evaluating a curriculum in preparation for an upcoming accreditation visit (stage 4, evaluative stage), faculty should consider the connection within and between various curricula and existing, beginning, or developing programs within the institution. Connecting the dots (or weaving the fabric) requires a concentrated effort to find detail but necessitates stepping back to look at the big picture that may be forming or not forming. For example, jumping ahead to connect dots out of sequence can create an abstract picture that looks very different to different viewers. In contrast, connecting the dots with rationalized sequencing results in a clear picture that all viewers can instantly glance at, recognizing the significance of each component in a particular place. Students (and faculty) should not need to guess at where, why, how, when, or what various components of the curriculum (specifically here, cultural competence) contribute in creating the overall picture of the desired graduate.

Using the thread analogy, weak threads often result in holes later. Fixing fabric or mending holes requires specialized skill and not everyone can do it without still noticing the tell-tale signs of a darned curriculum. Frequently, mended fabrics develop the same holes or new holes in other places. Similarly, a snag at any phase can create a weakness, imbalance, or distress (or stress). For example, putting the burden on a single or small group of courses, course components, and/or particular instructors creates distress. Distressed fabric looks and feels displeasing, creates wrinkles to the overall design, and frequently will be abandoned. However, distressed areas can also come from overuse in one area and not enough use in another, thereby necessitating updates and consistent care according to recommendations of experts (i.e., ongoing evidence-based education and evaluation). In contrast, a thread (concept) that is easily distinguishable (such as cultural competence) adds a strong, distinguishing characteristic to the fabric (curriculum) that is not easily forgotten. It is visible; has meaning, strength, and significance; and would not be the same without it.

This author contends that whatever terms are fashionable or chosen in the past, present, or future, curriculum is a process with various identifiable stages, components, challenges, and tasks, all aimed at producing excellent outcomes (graduates who are marketable and can swiftly enter the workforce competently and equipped to handle future unpredictable challenges). This requires focus on optimization rather than on minimum competencies (i.e., preparing nurses who are equipped to creatively handle and proactively meet future challenges in optimal ways within an increasingly global, multicultural society and amid technological advances in education and travel). The nurse of the future must be prepared to think beyond global and be visionary (24, 25), requiring faculty’s active engagement in the curriculum process to update and meet changing times (26, 41, 78, 79). Cultural competence will never go out of style and will be even more needed in the future (as Leininger predicted) (14, 82).

All full-time and part-time faculty should be cognizant of the intricate connections, interpersonal dynamics, shared responsibilities, commitment, and ongoing collaborative work necessary to achieve an optimally functioning coordinated curriculum, necessitating a holistic approach. Detailing expectations and responsibilities for part-time faculty is particularly important, especially in an era where the number of part-time faculty greatly outnumber full-time faculty. Similarly, preceptors and other key contacts at student experiential and/or observational learning sites should receive relevant information about the curriculum, highlighting details of their role, students’ roles, and expected student learning outcomes in relation to the whole curriculum. The development of cultural competence throughout the curriculum must be emphasized and visibly evident to all key participants in the learning process, including students.

The HOLISTIC acronym is presented to assist faculty and administrators in remembering key components of the curriculum process: holistic, ongoing, logically systematic, interdependent, spiraled, teamwork, individualized, comprehensively connected. A brief description of each component is listed here:

Strategy-Mapping

Although less discussed in the nursing literature, strategy-mapping throughout the curriculum is another important evaluative method. Strategy-mapping traces various student-centered learning approaches, thereby assessing another necessary curricular dimension. Because diverse learners have diverse learning needs, strengths, values, and beliefs, weaving in different multidimensional active learning activities throughout the course and curriculum will be most beneficial (10, 15, 26, 27, 31, 40, 41, 64, 66, 70, 71, 77–79, 83–89) (see Table 7.2). Students’ CVB will influence how various strategies are valued, interpreted, and used; therefore, nurse educators should take this into consideration while planning, implementing, and evaluating activities. Students need to understand and appreciate the conditions under which specific learning strategies may be more or less effective, rather than assuming that certain ones are best (90). Explaining the value of different teaching–learning activities may be indicated to optimally facilitate learning among culturally diverse and academically diverse learners.

Specific activities have advantages and disadvantages. Pairing students eliminates the potential for an audience and enhances the potential for in-depth quality student interactions that can foster cognitive and affective growth (91). Groups, however, provide greater opportunities for diverse thinking. Outcome benefits can be maximized with clear directions, group rules, well-matched group composition, effective leadership, immediate feedback and guidance, reflection, and adequate time allocation (92). Storytelling with reflection is another effective strategy, especially among culturally diverse learners (10, 26, 46, 93–94). For many students, gaming, debates, and role-play provide an effective mechanism for active, fun learning that results in cognitive, psychomotor, and/or affective outcomes (41, 95–103); yet, individual competitiveness may be contrary to some students’ CVB. The Internet (web-based, hybrid, and online courses) provides opportunities for interactive learning in pairs, small groups, and large groups via individual e-mail, group e-mails, course chat rooms, course discussion boards, and wiki (14, 41, 64, 77, 103–115). More recently, webcasting permits audio and visual presentations via the Internet, including live class participation via personal computers (22, 41, 64, 103, 113–116). Other technology, such as podcasting, permits various options that can enhance learning, especially among nontraditional students such as learners with dyslexia and/or other learning disabilities, and/or multiple role responsibilities, as well as non-native speakers of the language used in the academic setting (22, 117). Virtual learning platforms offer students a unique opportunity to transfer and apply knowledge and skills within a wide range of culturally diverse virtual patients (41, 118–120). The virtual learning platform creates a “safe” learning environment whereby students get exposed to cultures and situations that they may not ever experience and/or have limited experience with, within the school’s clinical agencies (see Exhibit 7.1). Students must be computer-literate, confident, and motivated if computer-based strategies are to be effective. The simulation lab also offers a variety of opportunities to enhance cultural competence learning and experiences with diverse clients and families (see Chapter 9). Nurse educators have many learner-centered student interactive strategies from which to choose; however, the educator must be adequately prepared, knowledgeable of student variables, committed, and caring if strategies are to be successful (10, 16, 24, 25). Exhibit 7.2 presents an overview of learner characteristics helpful in developing a profile of learner characteristics. Course-specific interventions are discussed in Chapters 8 to 12.

TABLE 7.2 Acronym for Meeting the Needs of Diverse Learners

Stay updated, free articles. Join our Telegram channel

Join