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Learning about Culture
Learning about Culture

Characteristics of Culture

This includes gender, race, ethnicity, sexuality identity, age, physical ability, social circumstances, and religion.

With cultural diversity come identifiable differences in language, communication, dress, behavior, and socialization among groups.

Bonder offer the following points

about culture

  • 1. Culture is learned and transmitted from one generation to another

  • 2. Culture is localized and is created through specific interactions with specific individuals

  • 3. Culture is patterned. These patterns emerge from the repetition of specific behaviors.

  • 4. Culture is evaluative. Values are the central components of culture and reflected in individual behaviors. Values also reflect shared belief that facilitate social interaction with others.

  • 5. Culture has continuity, with change. In general, cultural identity is stable but one’s cultural knowledge changes over the course of life as one encounter new objects, situations, and ideas in the environment.

Promoting Cultural Knowledge
Promoting Cultural Knowledge

3 Main Approaches to promoting cultural knowledge and

competency for healthcare providers and nurse educators

  • 1. fact-centered approach

provides information about the health belief and behaviors of specific ethnic groups. The starting place for interactions with one individual. The focus is factual


  • 1. Attitude-centered

Emphasizing the importance of valuing and respecting all cultures. The acknowledgement of the

culture and fostering of positive attitudes .

The focus is cultural sensitivity

  • 2. Ethnographic to cultural competence

offers a practical strategy of learning how to ask. The focus is on inquiry, reflection, and analysis as a means of getting to know an individual.

Cultural Competence cross cultural situation. The ability to work effectively in a Campinha-Bacote (1998) as the

Cultural Competence

cross cultural situation.

The ability to work effectively in a

Campinha-Bacote (1998) as the

process in which the healthcare provider continuously strives to achieve the ability to effectively work within the cultural context of a client, individual, family or community.

This model allows nurses to see

themselves as becoming culturally competent, rather than

being culturally competent.

Cultural Knowledge.

Obtaining factual knowledge about different culture

Cultural Skill.

Collecting relevant cultural data about a client’s health history and

accurately performing culturally specific physical assessment.

Cultural Encounter.

Engaging in cross cultural encounters with people from other culture.

Cultural Awareness.

Becoming respectful and appreciative of anothers culture.

Cultural Desire

Wanting to engage in learning cultural competence



Cultural Awareness It is the process whereby the nurse becomes respectful, appreciative and sensitive to the
Cultural Awareness It is the process whereby the nurse becomes respectful, appreciative and sensitive to the
Cultural Awareness It is the process whereby the nurse becomes respectful, appreciative and sensitive to the

It is the process whereby the nurse becomes respectful, appreciative and sensitive to the values, beliefs, practices, and problem-solving strategies

of the client’s culture.

It involves self-examination of one’s

own prejudices and bias about other cultures, in addition to an in-depth exploration of one’s own cultural background. It ranges from ethnocentrism to


Behavior is a behavior in which a person is totally

unaware of other’s cultural beliefs and values.

The ethnocentric individuals assumes that his/her values, beliefs and practices are the only corrected perceptions.

Leininger emphasized that if you are not aware of the influence of your own cultural values, there is a risk that you may engage in

cultural imposition, which is the tendency to impose your own beliefs,values practices and patterns of behavior upon another. This

lead to non compliance with health care regimens.



(1998) reports that











nurse failure to provide culturally

responsive care that incorporates







This reflects an attitude of nurses who value respect, and integrate cultural differences into their practices.

This reflects an attitude of nurses who

value respect, and integrate cultural differences into

their practices. They are aware of their cultural backgrounds, along with prejudices and biases about other culture. This awareness alone does not ensure

culturally responsive interventions. Nurses must develop other needed components of cultural competence.

Cultural Knowledge

This involves the process of seeking and obtaining factual information about different culture.

Campinha-Bacote (1998) 4 stages of obtaining cultural knowledge

Unconscious incompetence

Individual’s being unaware that he/she lacks cultural knowledge

Conscious incompetence

The awareness that he/she lacks knowledge about another culture and is willing to seek and obtain the knowledge

Conscious competence

Act of learning about a client’s culture, verifying generalizations and providing culturally responsive

nursing intervention

Unconscious competence

The ability to automatically apply knowledge and culturally congruent care to clients from diverse cultural backgrounds. The nurse who has unconscious competence interacts naturally and easily with clients from diverse culture.

Cultural Encounter

The process whereby a nurse

engages directly in cross-cultural interactions with clients from culturally diverse backgrounds.

The purpose is to refine or modify

one’s belief about those groups to prvent

possible stereotyping.

Cultural Skill

The ability to collect relevant cultural

data about a client’s health history and health

problems, as well as to accurately perform culturally specific physical assessment.

Leininger (1978) defined a cultural assessment as

Systematic appraisal or examination of individuals, groups

and communities as to their cultural beliefs, values and practices to determine explicit needs and intervention practices within the context of the people to be evaluated.

The nurse’s motivation to engage in the process of cultural competence. Nurses need to want to



motivation to engage in the process of

cultural competence. Nurses need to






competence as they provide individualized and safe care to clients.

1. Discomfort caused by lack of knowledge, skills or exposure to group member 2. Discomfort caused
1. Discomfort caused by lack of knowledge, skills or exposure to group member 2. Discomfort caused
  • 1. Discomfort caused by lack of knowledge, skills or exposure to group member

  • 2. Discomfort caused by disapproval or negative attitudes toward group member.

  • 3. Discomfort as a result of feeling threatened by group members

  • 4. Discomfort caused by feelings of guilt, sympathy or pity toward group members

The Culture of Teacher and Learner
The Culture of Teacher and Learner

Most nurse ducator are from the dominant culture and never examined their own culture.

They tend to be more homogenous.

Some authors reported that differences in

interactions between teachers and students are attributable to

race, ethnicity, or gender and the differences are reflected in students perfromance.

Variables found to promote successful student

learning and acjievemnt include faculty commitment and advisement, prompt and individualized attention to students and satisfaying relaationship with faculty staff and peers.

Nurse educators who work with

multicultural students should consider

the following:

Become self-aware of your own cultural values, norms and beliefs and the influence they have on your view of life, family of life and relationship.

Develop and maintain an attitude of respect for the broad

range of cultural differences and their importance to

individuals. Identify and value the strengths in different cultural values and beliefs rather than becoming critical to them.

Develop a strategy for continuing education about

predominant culture in a given community or institution

Consider the use of other professionals and members of other cultures to learn more about their culture.

Assessing the culturally diverse learner
Assessing the culturally diverse learner
  • 7 factors in assessing differences

between people in cultural groups


Biological Variations

Environmental Control Space

Social Organization




The means by which

culture is transmitted and preserved through the


Cultural pattern consisting of verbal and non verbal

expression of each cultural group affect

the way the group expresses ideas and feelings, the way they make decisions the way they communicate

Example: native americans may value more nonverbal and passive approaches while european americans value more verbal and active


An individual’s level of comfort is related to

personal space or distance and discomfort is experienced

when one personal space is invaded.

Personal space is an individual matter and

varies with the situation. The proximity of the comfort

zone also varies from culture to culture.

Example: Puerto ricans and african americans communicate with closer proximity from european backgrounds

Social Organization

Cultural behavior or how one acts

in certain situations, is socially acquired and learned.

Patterns of cultural behavior are important to the teacher because they provide explanations for people behavior.

Individuals are not generally conscious of their cultural


Example: european american nursing with core values of individualism, honesty, truthfulness, straightforwardness, self-assuredness self-confidence and self-motivation.


Temporal orientation refers to

how time is viewed. It includes the ordering of

past, present and future in terms of behavior and outlook.

In education, getting assignment done in a specific timw frame is more important for a learner who is present of future oriented.

Environmental control
Environmental control

This refers to the

persons ability to plan activities that

control nature. It also refers to the

persons perception of his or her ability to direct factors in the environment

Biological Variations
Biological Variations

Educators should know that learners from different backgrounds have

genetic biologica differences that may

affect their classroom performance. One

such difference maybe susceptible to


It is a model that helps a culturally

different patient or client to explain his or her viewpoint or perspective on health and illness. It has relevance for asessing clients, planning care and teaching clinicians to deliver culturally appropriate care.

Kleinman (1980) reported that explanatory models contains any one or all five parts of an illness.

  • Etiology

  • Time of onset of symptoms

  • Pathophysiology

  • Course of sickness

  • Treatment

Teaching and Learning Process
Teaching and Learning Process

It begins with assessment.

Assessment provides the nurse educator with

information about the knowledge and skills needed as well as the

learners characteristics within the context of ethnic and cultural consideration.

Development of teaching plan

Teaching plan is a blueprint for action to achieve the goal and the objectives that have been agreed upon by the educator and the learner.

It is also a carefully organized written presentation of what

the learner needs to learn and how the nurse educator is going to

provide the teaching.

Three reasons for constructing a

teaching plan

To force the reader to examine the relationship among the

steps of the teaching process

To communicate in writing and in an outline format exactly

what is being taught,how it will be taught and evaluated.

To legally document that an individual plan for each learner is in place and is being properly implemented.

8 basic elements of Teaching Plan
8 basic elements of Teaching Plan


Statement of the overall goal

List of objectives and subobjectives

An outline of the related content

The instructional methods for instruction Time alloted

Instructional resources

Methods of evaluations


Elements of Teaching Plan

PURPOSE: GOAL: Objectives and Content Method of Time Resources Method of subobjectives Outline instruction Allotted Evaluation
Objectives and
Method of
Method of

Sample Teaching Plan

PURPOSE: To provide patient with information necessary for self-administration of insulin as prescribed GOAL: The patient will be able to perform insulin injections independently according to treatment regimen

Sample Teaching Plan PURPOSE: To provide patient with information necessary for self-administration of insulin as prescribed


Content outline

Method of

Time allotted


Method of




Following a 20 minute teaching session, the patient will be able to:

Identify the five sites for insulin injection with 100% accuracy


Demonstrate proper techniques according to procedure for drawing up insulin from a multidose vial (psychomotor)

Express any concern about self administration of insulin (affective)

Location of five


1:1 instruction

  • 2 Anatomical chart



anatomical sites rotation of sites



Demonstration Return demo

  • 5 Alcohol Sponges

Observation of return demo

according to

Sterile SQ needle


and insulin syringesmultidose vial of sterile water



  • 3 min

Video written

Question and

common concerns Explorations of feelings



Other teaching approaches have been found to be

effective with culturally and ethnically diverse learners

Negotiations of learning

Providing for immediate application and learning to

help reinforce newly learned content

Creating opportunities for learners to test their own

ideas and be creative. These activities ehnace self-


Cross-Cultural Issues in Computer

based Learning

Morgan (2000) reports that cross cultural

consideration can be a major influence in the successful

understanding of educational and instructional concepts. Therefore, interactive learner designers need to be address cross cultural consideration in software development as follows:


stereotyping Sounds human voices Directional Flow Selection of words and phrases Words, sounds and mistranslation


Selection of





Care should be taken with the use of symbols or icons in the presentation of simulations.


Symbol for the human or animal eye can be disturbing to many

cultures as a symbol of evil.


The use of sound within a system adds life and interest to the learning situation.


The cries of some animals can denote evil to some cultures

Directional Flow

The designer should be aware of the national directional flow that language takes in the users cultures


Asian writes from right to left

Selection of words and Phrases

The tone and use of language has a major impact on the effect

of communication and on the interactiv elearning environment.


The words kill and abort are highly emotive words and can be

replaced with descriptive words end and cancel.

Words, sound and mistranslation

Caution should be used when making direct translations of

words and also to the meaning of the sounds used within the


Selection of human voices

An increasing number of simulations include human voices to add impact and realism to the interactive learning environment.


Female voice would not be as effective of female

Behavior stereotyping

One in which individual of certain gender age occuppation, religion or ethnic background are consistently shown to behave or dress in a particular way.


Certain colors are associated with death in certain culture.


White is associated with death in some asian countries


In some culture a nod can be taken as a sign of a negative response. A sole of the feet can be highly offending in some middle eastern countries


In some culture, passing or touching items using the left hand can be highly offensive.

Communication Issues

Cross-Cultural Communication with Nursing Students

Cross cultural Communications and In service Education

5 areas of concern when recruiting and hiring international nurses

  • 1. Releiving psychological stress

  • 2. Overcoming the language barriers

  • 3. Accepting US nursing practice

  • 4. Incorporating the styles of US Problem solving strategies

  • 5. Implementing the styles of US interpersonal re;ationship

Cross Cultural Communication with Patients and Clients

Gender Differences in Communication

Mulac (1998) 2 abiding truth with uneasy agreement

  • 1. Men and women speak the same language

  • 2. Men and women speak that language differently

Mulac, Bradac and Gibbons (2001) defined culture as the social system that reinforces

behavioral expectation for group members wether

they are national, ethnic or gender groups.

Gudykunst and Ting-Toomey (1998) 4 stylistic modes of verbal

communication between gender


The dimension represents the degree to which speakers show their intention through explicit verbal communications.

DIRECT STYLE is characterized by openness, straightforwardness and honesty

INDIRECT STYLE is more ambiguous,tactful and concern with saving face of the individual in the interest of the harmony.

Male style is characterized by relatively direct and female style are relatively indirect

Male Its good to write this down Female Im not sure what do you think

Succinct VS Elaborate style
Succinct VS Elaborate style

This dimension addresses the quantity of talk that is

valued in different culture. Salient silence and

understatement often mark the succinct styles.


Male uses elliptical setences Great Picture

Descriptive metaphor and similes and flowery words the

elaborate style that is more characteristic of women.

The elaborative style potentially protects relational

harmony. Which is especially important for a women.

Personal VS Contextual style
Personal VS Contextual style

The personal style is individual centered language and

enhances I identity.

The contextual is role centered language and enhances

role identity.

The personal style stresses equality, whereas the

contextual style stresses the speaker and hearer positions

within a hierarchy,

Men are more contextual female personal

Instrumental vs affective style
Instrumental vs affective style

Male use of the instrumental continuum is seen

references to quantity (below 32 D Farenht) and locatives in the center of the pictures

Women use the affective end of the continuum,

referring more often to emotions (She’ll feel

terrible and focusing on peoples feeling.

Thanks For Listening

I would like to thank my sponsors:

Mainstreet for my pants

Daniel Hecter for my sleeves

Darlington for my socks

Mario de boro for my shoes

Sansan for my make-up