Amy J. Witt

Date of Award

January 2016

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Glenda Lindseth


Introduction: By the year 2050 it is expected more than fifty percent of the American population will be of non-European descent (United States Census Bureau, 2011). Racial and ethnic minorities in the United States (U.S.) have more limited access to health care and a poorer quality of health care received, regardless of insurance coverage. Nursing education must provide a means for acquiring cultural competence by nursing students to help combat the growing health disparities. While many different methodologies can be found in nursing curricula, the cultural encounter during the nursing program may prove to be a promising means of acquiring competence. There is however, a gap in the literature addressing the effectiveness of this kind of face-to-face, or hands-on approach.

Methods: Dr. Campinha-Bacote’s model “The Process of Cultural Competence in the Delivery of Healthcare Services” was the framework used to guide this study. A convenience sample included baccalaureate students from three nursing programs in the Midwest. The enrolled were sophomore or senior students in good standing. A total of 245 sophomores and 208 seniors participated. Students completed a demographic questionnaire and the self-report Inventory Assessing the Process of Cultural Competence for Healthcare Providers-Student Version (IAPCC-SV), which examined their level of cultural competence. Pearson product-moment correlation coefficient, t-tests, and one-way analysis of variance (ANOVA) were utilized to determine the association of the five cultural competence construct mean scores, the overall cultural competence mean score, the year in school, and academic program.

Results: There were statistically significant differences in the cultural competence mean scores when compared to the following demographic variables: had taken a previous course on culture (p = <. 001), had a previous college degree (p = < .01), had traveled outside of the United States (p = < .01), and had lived outside of the United States (p = <. 001). At the three schools of nursing, there were statistically significant differences in the mean scores from sophomore to senior year for cultural awareness t(453) = -3.67, p = .000; cultural knowledge t(453) = -7.94, p = .000; and cultural encounter t(453) = -3.11, p = .01. The overall cultural competence mean score difference was statistically significant from sophomore to senior year at all three schools of nursing (t(453) = -4.71, p = 001). However, the overall cultural competence mean scores between the three schools of nursing were not significantly different (F (2, 450) = 1.23, p = .28).

Implications: The results of this dissertation study indicated that the cultural encounter had an impact on the cultural competence of the baccalaureate nursing students in the study; the self-reported cultural competence scores increased from sophomore to senior nursing students as a result. This is important for nursing educators as they investigate how to improve their curriculum through integration of culture, and help their students acquire the cultural competence that is needed to combat the growing health disparities in the U.S. Future studies can expand the current study by researching multiple nursing schools and their curriculum, particularly comparing cultural encounters against other methodologies such as didactic content or simulation experiences, which would shed more light into the impact cultural encounter may or may not have on cultural competence development.