There is a low representation of Black American women (BAW) in health care senior leadership. With the high level of health problems found among the Black community, diversifying the executive leadership with BAW may be instrumental in increasing provider trust and reducing discriminatory action. Using critical race theory as the conceptual framework, this study examined the experiences, perceptions, and influential or deterrent factors inhibiting advancement of BAW in the health care field. Inquiry centered on factors related to lack of advancement, experiences at different stages of career progression, and strategies impacting career advancement. A qualitative research design using a transcendental phenomenological approach was the chosen method. Seven BAW who met the criteria for inclusion were selected by purposive sampling. Data were collected from semi-structured, audio-recorded, interviews using a newly created protocol. Data analysis included open coding; line-by-line data review; and the use of NVivo to search for frequencies of themes, coding, and text queries. Emergent themes were identified that provided comprehensive descriptions of the participants' experiences. According to study findings, perceived and experienced racial issues were apparent in hiring and work relations. Disparate practices were evident through a lack of inclusion in succession planning, being overlooked despite qualifications, and stereotyping. These findings may stimulate social change by helping those BAW aspiring for senior healthcare leadership to be more successful and by improving health outcomes for BAW through enhanced trust.

Obesity is an increasingly prevalent health issue, especially among children who live in high poverty, low income, and low education areas that lack needed resources and health care to promote quality of life. African American youth have a higher rate of obesity than other populations. The purpose of this project was to address an identified gap in practice by improving health care professionals' ability to provide culturally competent care to African American youth. An educational intervention framed by the Purnell model for cultural competence was developed to address the question, Will cultural competency staff education improve knowledge to prevent and manage childhood obesity among African American youth ages 2 to 19? Health care professionals (n = 10) in 5 community clinics completed the 17-item, 5-point Likert response Cultural Competence Assessment before and after an online education module. The higher the sum of the scores on the items, the higher the self-assessed cultural competence. Using Cohen's d statistic to calculate effect size, a small effect size was found on 1 item, a medium effect size was found on 1 item, and a large effect size was found on 15 items, indicating an increase in self-assessment of cultural competency after the education intervention. The findings demonstrate that education can increase health care professionals' knowledge about how to provide culturally competent management of African American childhood obesity. Practicing culturally competent preventive care in ethnic communities can reduce the gap in practice, which may bring about positive social change in society by decreasing chronic health care comorbidities and disparities in ethnic populations. The project may be of particular interest to nurse providers in primary care and community settings.

INTRODUCTION: According to current census projections, by the year 2050 racial and ethnic minority groups will make up over half of the United States population. With the rise of a more multicultural and diverse population, there has been growing concern with regards to the health disparities and how healthcare professionals can increase positive healthcare outcomes. In an effort to contend with the growing population, the subsequent disparities that will be faced by a more diverse population, and the difficulties many healthcare practitioner’s will encounter while communicating and working with this population group, many healthcare educators have turned their attention to training and educating the next generation of healthcare providers on the practice of cultural competence. For many institutions, however, there is still uncertainty over the most effective means for teaching cultural competence throughout the healthcare curriculum. Data collected from a 2017-2020 study conducted at Boston University in the M.S. in Oral Health Sciences Program, a credential enhancing program for predental students with the aim of providing students with admission into an accredited dental institution, evaluates an effective mechanism for training healthcare professionals in cultural competence skills. This study hypothesizes that one effective and powerful tool for teaching the next generation of health professionals to be culturally competent providers is through role-playing, case-based, simulated exercises which emphasize the importance of the provider patient relationship, holistic approaches to healthcare, and compassion when working with patients. METHODS: A course session was created in an Evidence Based Dentistry Course within the M.S. in Oral Health Sciences Program. From 2017-2019 the course session was composed of three parts: a role-playing enactment of two patient case-based encounters, a real-time class group discussion following both patient encounters, and a PowerPoint presentation emphasizing the key take-away points from the role-playing exercise. At the conclusion of the session, students were asked to participate in a post-session survey regarding the student’s feelings about the session. In 2020, due to the COVID-19 pandemic, a switch in course session modality in the Evidence Based Dentistry course to an online format, prompted a change in the session format. In 2020, students were asked to read both patient encounters on their own, reflect, discuss, and comment on the learning platform Blackboard Learn discussion board on their takeaways from the case, and participate in PowerPoint presentation presented by facilitators. At the conclusion of the 2020 session, students were asked to complete a post-session survey on the effectiveness of the session. In addition to qualitative data obtained from the post-session surveys, in 2020, student discussion board posts were coded and analyzed qualitatively using the coding software NVivo 12 to determine whether students understood the important takeaways from the discussion board portion of the session. RESULTS: According to results from the course session implemented from 2017-2019, overall, the role-playing exercise significantly improved participants understanding of key components of cultural competence. From 2017-2019 students were strongly able to identify the importance of communication in patient encounters, were able to understand the strategies such as communication and compassion in patient encounters, were better able to identify the importance of building a trusting patient -physician relationship, and most importantly, students were able to recognize their own cultural biases when treating patients. Results from 2020, revealed that even with a change in course modality and format to a discussion board format, students were still able to understand the key take-aways of cultural competence from the session. DISCUSSION: This study reveals that students were able to understand cultural competence after completion of both iterations of the course session from 2017-2019 & 2020 and that this session can be an effective method for training the next generation of healthcare professionals the practice of cultural competence. While this study provides insight into the future of cultural competence training, it is important to recognize that more studies must be conducted to provide additional answers to several questions about the most effective mechanism for teaching cultural competence, what to teach in cultural competence education, and when to begin training students the practice of cultural competence.

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Syftet med den här studien var att undersöka och beskriva kuratorers arbete med döva och hörselskadade klienter. Frågeställningar som undersöktes var:-Hur beskriver kuratorerna sitt arbete med döva och hörselskadade klienter?-Vilka arbetsmetoder används av kuratorerna i arbetet med döva och hörselskadade klienter?-Vad innebär en kulturkompetens och en bikulturell kompetens enligt kuratorerna?Författaren ville belysa ämnet utifrån ett perspektiv där den professionella är teckenspråkig då hon anser att detta perspektiv saknas i litteraturen. Semistrukturerade intervjuer genomfördes med tre kuratorer som är teckenspråkiga och verksamma inom dövområdet. Resultatet visar att kuratorernas arbete består av praktiska åtgärder och stödsamtal. De har ett eklektiskt förhållningssätt i tillämpningen av arbetsmetoder, t.ex. att arbetet kan vara systematiskt med kognitiva inslag. Kuratorerna ansåg att det var viktigt att vara teckenspråkig och ha särskilda kunskaper om döva (kulturkompetens) för att kunna bemöta och bedriva behandlingsarbete med döva klienter. De ansåg också att kunskaper om den hörande världen och det svenska språket var betydelsefullt för att kunna ge information till hörande och döva om varandra (bikulturell kompetens). Resultatet visar också att kuratorerna uppfattade att annan typ av kommunikation än den teckenspråkiga var viktig att vara medveten om och reflektera över, så som den icke verbala kommunikationen. / The purpose of this study was to explore and describe the counselors’ work with deaf and hard of hearing clients. The issues examined were: -How do the counselors describe their work with deaf and hard of hearing clients?-What are the working methods used by the counselors at work with deaf and hard of hearing clients? -What does a cultural competence and a bicultural competence means according to the counselors? The author wanted to illustrate the subject form a perspective in which the professional can communicate in sign language since she believes that this perspective is lacking in the literature. Semi-structured interviews were conducted with three counselors who know sign language and work in the deaf area. The results show that the counselors’ work consists of practical measures and counseling. They have an eclectic approach in the application of the methods, for example that the work can be systematically with cognitive elements. The counselors thought it was important to know sign language and have specific knowledge about the deaf (cultural competence) in order to meet and engage in treatment with deaf clients. They also thought knowledge of the hearing world and the Swedish language was important in order to provide information to the hearing and deaf about one another (bicultural competence). The results also show that the counselors understood that other types of communication than the sign language communication was important to be aware of and to consider, as the non-verbal communication.

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