The evaluation of service-learning as an innovative strategy to enhance BSN students' transcultural self-efficacy

Abstract

<p>Leaders in nursing education have been challenged to make curricula changes to prepare students to provide culturally competent nursing care. The need to prepare culturally competent nurses has become even more critical because the United States nursing workforce is not as diverse as the population that it serves. Various teaching strategies have been used to evaluate the effectiveness of increasing cultural competence in nursing education. Service-learning has become an increasing more popular teaching strategy to increase students&rsquo; cultural competence. The review of the literature revealed educators who practice servant leadership have assisted students to become engaged citizens while also meeting the needs of the community.</p> <p>The purpose of this non-equivalent, multiple year, quasi-experimental study was to evaluate service-learning as an innovative teaching strategy to change pre-licensure baccalaureate nursing students&rsquo; perceived transcultural self-efficacy (TSE) in providing culturally competent nursing care to diverse populations. The Transcultural Self-Efficacy Tool (TSET) (Jeffreys, 2006) was administered prior to and at the conclusion of the following interventions: service-learning (n = 42) and cultural interview with client from another culture (n = 69). Descriptive statistics revealed the study participants were predominately under age 30 and White, spoke English as a first language, had previous healthcare experience as either a licensed practical nurse or other healthcare provider, and had taken a previous college-level diversity course. Correlation and variety of univariate and multivariate analysis of variance statistical tests were conducted via IBM SPSS 19.0. Results revealed (1) participants&rsquo; perceptions of TSE changed significantly in the affective, cognitive, and practical subscales and for weighted average of the composite of the three subscales after a cultural educational intervention; (2) high correlations existed between the cognitive and practical self-efficacy strength (SEST) post-test scores; (3) pre-test scores were significantly higher for participants who did not speak English as their first language and who were non-White; (4) the highest post-test scores in all three subscales and in the weighted composite and the greatest mean difference in two of three subscales were found in the service-learning group, reflecting positive patterns of TSE change for this intervention group; however, due to the relatively small size of the study sample, a significant difference in the amount of change in perceived TSE as a result of a service-learning intervention was not revealed at this time; (5) White participants had a significantly greater increase in SEST scores in the affective and practical subscales as a result of an intervention; and (6) the changes in the composite SEST scores were significantly greater for the White race group and the English as a first language group.</p> <p>These findings add to the existing body of knowledge on TSE and fill a gap in the literature concerning the influence of language and race on nursing students&rsquo; TSE. Recommendations for future research include conducting similar studies with a larger target population, including a qualitative research method, increasing the length of time between the cultural intervention and the measurement of the participants&rsquo; TSE, and adding a valid and reliable service-learning evaluation tool to determine if service-learning is an innovative strategy to change nursing students&rsquo; TSE. Results of this study should inspire servant leaders in higher education and communities to work collaboratively to develop service-learning cultural immersions for nursing students to address health disparities, render culturally competent nursing care to diverse populations, demonstrate health education and promotion skills, and become engaged citizens in their communities.</p>