TWELVE

Faculty Advisement and Helpfulness: A Culturally Congruent Approach

Consideration of the student as a whole person demands a culturally congruent approach to advisement and helpfulness.

SNAPSHOT SCENARIO

At a nursing faculty meeting, Professor Glass introduces the topic of “culturally congruent faculty advisement and helpfulness” by sharing a personal experience: “I used to think of myself as being a helpful advisor to all students; however, this opinion changed recently. I realized that I made a cultural mistake with one of my students. This mistake set up obstacles for future communication and caused her obvious stress. I apologized immediately, but later I always felt a gap was present. I realized that the increased number of new immigrant nursing students from diverse countries meant that I could not use the same approach with all students. I was also concerned that I may have offended others unintentionally. The next week in class, I asked students to reflect on their experiences with nursing faculty so far and anonymously write down helpful faculty actions, unhelpful faculty actions, student expectations about faculty advisement and helpfulness, and any cultural customs relevant to faculty–student interactions. Responses were amazing.”

Professor Glass read several student comments that contrasted student perceptions, cultural values and beliefs, and student experiences with faculty.

A: My advisor always stares right into my eyes during the registration advisement session. I get so uncomfortable that I feel as though I can’t even speak.

B: My advisor hardly ever looks me in the eye, so I don’t think she even sees me as a person.

C: When nursing faculty greet me in the hall or library and offer to help me during office hours, it makes me feel like they care.

D: My advisor was right behind me in the cafeteria line and didn’t even acknowledge my greeting or say hello.

E: Every time I see my advisor at the college or during her office hours, she smiles and greets me by name, beginning with some small talk first to get me comfortable and then asking me how I am doing. In my culture, it is considered impolite to get right to the point directly in business. Some other faculty are so direct, short, and businesslike all the time, so I don’t feel comfortable asking questions.

F: My advisor has no clue about time management or what I need. Whenever I see her, she begins with two minutes of small talk or short stories like something new at the college, the weather, a conference, and so on, and I could go on and on. She is not very businesslike and this is a waste of time. I was always taught at home to be direct and businesslike with professors; small talk is a time-waster. This really irritates me and I can’t get beyond this to feel comfortable trusting her responses to career questions.

G: When my advisor changed her office hours to Friday afternoons, she offered to set an alternate meeting time with me instead of making me change advisors. That made me feel as though she really cared about me and respected my religious beliefs.

H: Thank you for asking about our (students’) feelings, experiences, and concerns. Even if you do something other than what I expect, I will now feel as though you are trying to treat us as individuals and respect our cultural values and beliefs.

Other faculty members begin discussing similar experiences and concerns about providing culturally congruent advisement and helpfulness.

Professor Ponder: I never really thought too much about it but I guess sometimes I do feel lost in knowing how to best advise, teach, and interact with students who are culturally different from me. I hope I did not hurt anyone’s feelings by doing the wrong thing.

Professor Numbers: We must be doing something right because we still make the average numbers on the state board licensing exam.

Professor Winger: I just use common sense and wing it, just like I did in the clinical setting with culturally different patients. No one’s complained so far.

Professor Booke: The higher education and nursing literature notes the significant role that faculty advisement can play in students’ decisions to drop out, stop out, or stay in school and graduate. I read that faculty advisement and helpfulness inside and outside the classroom is very influential, especially with minority students in predominantly White universities, first generation college students, and older students. In general, students are considered a vulnerable population and may be hesitant to complain because of feared academic or other penalties. Among many cultures, confronting an advisor or teacher is culturally inappropriate behavior, so complaining would be unheard of. Just because no one complains doesn’t mean students are happy, satisfied, and receiving the best advisement to enhance their academic performance.

Professor Ponder [thinks]: In my advanced practice nursing program, I never took any courses that addressed curriculum, principles of teaching, the advisor role, or cultural issues. How can I become a better advisor for a diverse student population?

Faculty advisement and helpfulness is the active involvement of nursing faculty in student’s academic endeavors, career goals, and professional socialization. It is manifested through faculty actions such as encouraging realistic educational and career goals, promoting positive feelings of self-worth, verbalizing belief in the student’s ability to succeed, listening to problems and concerns, expressing interest in academic progress, showing optimism, offering assistance, and maintaining presence. Presence means caring about the student as a whole person, being available as a resource person, and making appropriate referrals when needed.

Consideration of the student as a whole person demands a culturally congruent approach to advisement and helpfulness. The inclusion of cultural values and beliefs (CVB) in Jeffreys’s Nursing Universal Retention and Success (NURS) model (1–3) recognizes that a student’s CVB unconsciously and consciously guide thinking, decisions, and actions that ultimately affect nursing student retention and success, including optimization of outcomes (see Figure 12.1). (The NURS model presents a globally applicable framework for examining the multidimensional factors that affect undergraduate and graduate nursing student retention and success in order to make a positive difference) (1–3). The NURS model proposes that high levels of cultural congruence will serve as a bridge in promoting positive academic and psychological outcomes, thus enhancing persistence behaviors, retention, optimal outcomes, peak potential, and success (2–4). Cultural congruence is the degree of fit between the student’s values and beliefs and those of his or her surrounding environment, that is, nursing education within the educational institution and the nursing profession. The term cultural congruent nursing care was first coined and defined by Leininger (5) to describe nursing care with clients that is meaningful, beneficial, and satisfying; however, the definition can be adapted to the educational setting. In this book, a culturally congruent approach to faculty advisement and helpfulness refers to those faculty actions that are tailored to fit with the student’s CVB in order to promote, facilitate, or support academic endeavors, career goals, and professional socialization.

A culturally congruent approach to faculty advisement and helpfulness requires faculty commitment and active engagement in the ongoing process of developing cultural congruence and becoming “culturally competent” faculty advisors and helpful teachers. The main purpose of this chapter is to describe the process of developing a culturally congruent approach to faculty advisement and helpfulness. The process includes self-assessment, literature review, consultation and collaboration, student assessment, analysis, plan, communication, and interaction.

FIGURE 12.1 Jeffreys’s Nursing Universal Retention and Success (NURS) Model (2013)

SELF-ASSESSMENT

Because faculty may be “unconsciously incompetent” in providing nursing advisement and help, the first step is self-assessment. According to Purnell (6), one is unconsciously incompetent when one is not aware of cultural differences or when one unknowingly carries out actions that are not culturally congruent. Cultural blindness, cultural imposition, and culturally incongruent actions can cause cultural pain to others. (7). The major aim of self-assessment is raising consciousness and self-awareness.

Here, self-assessment is a process in which the nurse educator systematically appraises various dimensions that can impact upon the achievement of culturally congruent advisement and helpfulness. A systematic assessment can be initiated using the dimensions described in Chapter 7, listed in Table 1.2, and illustrated in Figure 7.2 (see Jeffreys 2016 Toolkit Item 15). 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 approach. In addition to raising consciousness and self-awareness, self-assessment can help identify areas of strengths and weaknesses and should be compared with student’s own self-assessments and expectations.

Although the 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 that unconscious and conscious CVB in nursing education and in one’s own values and belief systems, many of which were developed long before entering the nursing culture, may influence practices, behaviors, and actions. 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.

Awareness of one’s knowledge about different CVB, especially the CVB that most directly affect nursing student retention (through academic and psychological outcomes), must be explored (see Table 1.2). Although Table 1.2 presents a snapshot approach of selected CVB that may impact upon nursing student retention and optimal outcomes, 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 CVB in various cultures that 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 can be a humbling experience but frequently sparks a desire for obtaining cultural knowledge. Cultural awareness, desire, and knowledge are essential for the process of cultural competence (8–10).

Cultural knowledge is a thorough educational foundation about various CVB with the goal of comprehending and empathizing with others’ perspectives. The nurse educator must assess one’s cultural desire or motivation for engaging in the process of becoming culturally competent. Reflecting on the feelings one experiences and the actions taken when a student’s CVB are different from one’s own CVB can further one’s insight. Because the process of cultural competence is ongoing, nurse educators should examine their commitment toward achieving this goal. True commitment requires time, energy, persistence, extra effort to overcome obstacles, and willingness to learn from mistakes. Commitment is essential in achieving positive outcomes in student retention (1, 2, 11, 12).

Nurse educators must appraise the multidimensional factors influencing undergraduate nursing student achievement, retention, and success, or full understanding will not truly be achieved. Furthermore, they need to evaluate how CVB can influence persistence behaviors (1, 2, 13–22). Nurse educators should reflect on the last time an updated review of the literature, workshop, or conference on student retention and success was completed. Again, appraisal of one’s desire for updated knowledge and commitment in relation to other faculty responsibilities and available time should be critically determined.

Similarly, self-expectations of the advisor role and helpfulness toward students should be examined. Faculty often overlook the significant role that their attitudes and behaviors can have on student satisfaction and retention (15, 23–27). Although the developmental advisement approach is strongly supported in the literature as offering the most benefits to enhance student academic and psychological growth and development, not all nursing faculty may value, support, or practice developmental advisement. In a developmental approach, student-faculty relationships encourage open communication, shared responsibility and power, caring, mentoring, total student development, self-direction, active help-seeking behaviors, and decision making. Developmental advisement is more focused on the “process” of learning whereas prescriptive advisement is grade-oriented, focused on the attainment of a prescribed product. Prescriptive advisement views the faculty advisor as the authority person who dispenses information and prescribes the measures needed for students to complete their curriculum requirements (28, 29).

Developmental advisement necessitates a commitment on the part of both faculty member and student; the advisor-advisee relationship changes over the educational process. Although the developmental approach is advocated in the NURS model, students may inwardly view faculty advisement and helpfulness differently. Not all students may value a developmental advisement approach. Often student perceptions and expectations about the faculty advisement role are different from that of the faculty (30–38). Additionally, expectations about “helpfulness” can be different from that of faculty (15, 39). The mismatch between student and faculty expectations and perceptions creates another barrier, whereby students can become disappointed and dissatisfied; poor psychological outcomes for the nursing program increase the risk for attrition. Consequently, faculty members should appraise their knowledge about student expectations and perceptions. Lack of knowledge or limited knowledge in this area identifies targets for further self-development. However, one must have the desire to obtain such knowledge and be committed to its pursuit amid other faculty responsibilities. Finally, self-assessment should conclude with a listing of strengths, weaknesses, gaps in knowledge, goals, commitment, and priorities.

LITERATURE REVIEW

Next, a review of the nursing and higher education literature should be conducted. A review of the literature in psychology, anthropology, and sociology may also prove fruitful. Materials should be reviewed for gathering background information or updating previously gathered information about CVB, cultural competence, student retention, advisement, faculty helpfulness, help-seeking behaviors, and faculty-student interactions. Priority areas, weaknesses, or gaps in knowledge previously identified in the self-assessment can guide the review. Choice of a relevant conceptual framework can be instrumental to an organized review. For example, the NURS model can structure a systematic approach to the review and organization of retention literature. After gathering general background information, it may be appropriate to begin targeting specific student cultural groups, especially those with whom there is frequent interaction. The dimensions targeted in Chapter 1 (Table 1.2), and Figure 7.2 can provide a guide for organizing specific information; however, it is vital to individually appraise each student and avoid stereotypical assumptions.

CONSULTATION AND COLLABORATION

Once sufficient background information has been reviewed and synthesized, collaboration with others should be initiated. Sufficient background knowledge is a precursor for successfully optimizing consultation and collaboration. The nurse educator will now have a mutually shared conceptual and empirical knowledge base with colleagues and experts that will promote deeper dialogue and added benefits. Consultation with experts in specific cultures, cultural competency, advisement, and student retention is helpful. Collaboration with colleagues (other nursing faculty) can help coordinate efforts and avoid unnecessary duplication. Consultation and collaboration can occur formally and informally via conferences, e-mail, webinars, telephone, and meetings.

A major benefit of collaboration among faculty is that nurse educators can become aware of each other’s expertise and interests. Other goals include learning from others, avoiding pitfalls, and gaining insight into special program-specific considerations. Still another plus is broadening information sources and soliciting conceptual and/or instrumental support from others.

STUDENT ASSESSMENT

The ability to gather relevant and valid cultural information is an essential component in the development of cultural competence (8). Moreover, a systematic appraisal of CVB is a precursor to determining the needs and priorities within a cultural context (40). Promoting student self-assessment of cultural values and beliefs must be initiated in a positive supportive environment that embraces diversity. Students will need to feel comfortable exploring their own CVB in the context of the nursing educational setting, and also will need to feel comfortable in sharing CVB with others, especially faculty. The literature suggests that students of different cultural backgrounds than faculty often feel isolated and reluctant to share differences for fear of reprimand, discrimination, or misunderstanding (1, 2, 4, 15, 16, 19, 20, 41–54).

Encouraging students to explore their own CVB concerning such dimensions as listed in Table 1.2 will enhance awareness of cultural similarities and differences with peers, clients, and faculty. This awareness will aid in the development of cultural competence in professional settings with clients, peers, other health care professionals, and ancillary workers. Asking about students’ expectations concerning faculty advisement and helpfulness in the classroom, clinical setting, skills laboratory, simulation center, and informal settings will publicize and emphasize the fact that faculty care and have the desire to help students. Students’ perception that an instructor or advisor is asking about student needs is helpful in itself and creates a caring environment. Perceptions that faculty sincerely care about students and openly apologize for (cultural) mistakes is more important than flawless, superficial, and distant interactions with students.

Student assessment may be done formally through the use of survey tools; however, the development of valid and reliable survey tools that are free of cultural bias and social desirability response bias is a complicated and lengthy process (55). A previous review of literature may reveal already existing survey tools with adequate estimates of reliability and validity that can be used or adapted with permission. Use of a survey tool that has not been tested for validity and reliability not only provides questionable results but can impact adversely on student perceptions, if items are offensive, misinterpreted, unclear, insulting, or culturally inappropriate. Such unwanted outcomes create dissatisfaction and added stress, and negatively influence retention.

Another formalized assessment approach may be the use of focus groups consisting of select small groups of students (56, 57). Dialogue with students, using a set of predetermined questions to guide the discussion and allow for comparison between student groups, will allow for unsolicited comments, solicited comments, and qualitative data that can add richness not achievable via a quantitative or close-ended survey questioning. Focus groups that are guided by peer mentors or faculty who are not in a teaching role may ease fear of penalty or adverse consequences. A systematic assessment can be initiated using the dimensions listed in Table 1.2. Student responses can then be compared with those of faculty.

In the classroom, clinical setting, simulation center, or skills laboratory, a simple technique may be to survey students anonymously on the first day. After an introduction, the instructor can express interest in meeting student needs through advisement and helpfulness and can ask students to write several ways that they believe the instructor can be helpful during the semester. It may also be beneficial to ask students to write anything that they experienced in the past that was not helpful or anything that they would perceive to be inappropriate or not helpful. This strategy can also be adapted to ask questions about faculty helpfulness in an informal setting, as well as for online and other distance education modalities.

Advisement and helpfulness should be developmental, that is, changing over time as student needs and expectations change, and so student assessment should be ongoing throughout the course and throughout the program at regularly scheduled intervals. For example, mid-semester, a classroom instructor may want to ask students to write comments again as before and compare with the group’s previous responses. Over time, common trends or themes may emerge, especially in a particular clinical setting or course component. A systematic program appraisal can provide an overview of successful strategies and outcomes (58).

ANALYSIS

Insight into students’ perceptions is important in meeting the needs of adult learners (59). A systematic analysis of students’ self-assessment should identify realistic versus unrealistic expectations, areas of untapped or underutilized advisement, trends among the students surveyed, group similarities, individual differences, and perceived student needs. A thorough and objective analysis to determine the gap between student and faculty expectations, perceptions of what is important, and level of cultural congruence should be estimated. Mismatches need priority attention. The analysis should list strengths and congruency as well as weaknesses, gaps, and incongruency. Analysis of findings may be enhanced through the review of relevant literature to explain findings, elaborate major points, and offer suggestions.

PLAN

Next, a written action plan is developed. Individual faculty can review student comments for areas of unrealistic or unclear expectations and then plan to address this in a group setting to clarify the advisor and faculty role. Similarly, faculty can verbally and positively respond to realistic, clear, and important expectations in faculty-student interactions. Relevant issues reported in the literature and/or uncovered through consultation and collaboration should be incorporated. Another strategy may be to develop, distribute, and discuss an academic advising guide delineating responsibilities as an advisee and responsibilities of the advisor (32). The advisor guidebook of the National Academic Advising Association (NACADA) can provide some foundational information generalizable to multidisciplinary college students (60).

A plan for a faculty development workshop or series of workshops in enhancing culturally congruent advisement and helpfulness is central to promoting retention through positive psychological outcomes. Inadequate planning of effective advisement strategies appropriate for various students throughout the educational process supports the need for faculty development workshops (12, 15, 20, 31, 32, 46, 51, 61–68). Nursing education goes beyond a single nurse educator. It is the whole nursing educational experience that positively or negatively impacts the minds of students. One experience of cultural pain can do much to undermine the efforts of other faculty members who strongly advocate and consciously implement culturally congruent approaches.

The plan for faculty development should recognize that some faculty may fail to recognize the need for a workshop or may demonstrate reluctance to participate. Even if a workshop or series of workshops is mandatory, this does not necessarily mean that faculty will change values, beliefs, and traditions in favor of culturally congruent advisement and helpfulness. However, it is important to remember that all faculty members and students have CVB that may potentially be congruent or incongruent with each others’ and/or with traditional nursing education values (see Table 1.2). Both faculty and students may belong to multiple cultural groups, and the boundaries between cultural groups and affiliations are often unclear (1, 2, 4, 19, 69). Therefore, formalized educational experiences concerning culture are necessary for all individuals, regardless of age, ethnicity, gender, sexual orientation, lifestyle, religion, socioeconomic status, or geographic location (4, 70–73).

Tables 12.1 and 12.2 provide case examples contrasting culturally incongruent and culturally congruent student–faculty interactions and the resulting outcomes. These case examples can be incorporated into a plan to initiate discussion with faculty and students. Such dialogue may help promote inner reflection or self-awareness of one’s CVB, cultural imposition, ethnocentric tendencies, and potential impact of cultural pain on nursing student retention. Using case examples can point out that despite the intention to help, one’s actions may not always be helpful. In fact, they may be counterproductive, causing pain, conflict, dissatisfaction, and stress for the student. Planning communication strategies to convey faculty commitment and holistic caring about culturally diverse students is necessary to avoid misunderstandings and to enhance the quality of faculty-student interactions.

TABLE 12.1 Examples of Culturally Incongruent and Culturally Congruent Advisement Approaches

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