East Tennessee State University has a variety of international travel opportunities for general education within its undergraduate study abroad program. Some opportunities even exist within specific degree programs. Despite the literature purporting the benefits acquired from clinical experience abroad, the College of Nursing has yet to incorporate an international component to its BSN curriculum. This study explores College of Nursing students' interest in participating in international clinical experiences and the perceived barriers for students who are willing to travel.

Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Mar. 25, 2010). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. 60-66).

The history of the United States is rooted in differences and actions that has culminated in the current reality of culturally incompetent behaviors with a lack of diversity, equity, and inclusion prevailing in organizations and society. Through a cultural competence conceptual framework, this research highlighted an action-oriented approach for organizations seeking to engage in efforts to support and integrate diversity, equity, and inclusion. To conduct this research, I developed a cultural competence conceptual framework with eight types of initiatives derived from the scholarly literature on diversity, equity, inclusion, and cultural competence. The types of initiatives point to organizational efforts to engage in developmental and action-oriented strategies that: facilitate leadership engagement, sensitivity, and responsiveness to diversity, equity, and inclusion; specify strategic and operational goals; incorporate cultural awareness and sensitivity in policies, practices, programs, and procedures; integrate diversity, equity, and inclusion into human resource management to build a diverse and representative workforce; cultivate a supportive, inclusive, and equitable organizational culture/climate; reinforce and sustain a commitment to diversity, equity, and inclusion; employ sensitive and inclusive communications; and implement targeted training and professional development on diversity, equity, and inclusion. The cultural competence framework presented ways for organizations to actively engage in setting action-oriented goals targeting ingrained, systemic, and institutionalized disparities. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

Consumers of mental health services are recognized as experts due to their rich lived experiences. Because of their expert status, they are expected to play a vital role in the re-shaping of mental health systems by determining what culturally competent services look like and how services are provided to culturally diverse populations. Therefore, it is essential that the consumers' voices, choices and roles in transforming the mental health system are included in assessing the cultural competence of mental health counselors (New Freedom Commission, 2003). There is a significant gap in the literature regarding the consumers' unique perspective (Pope-Davis et al., 2002). There is a need for both qualitative studies and studies that focus on consumers to gain a deeper, richer insight of the consumers' perspective (Rubin & Rubin, 1995). A qualitative phenomenological design was used to give voice to three participants regarding their perceptions of cultural competence in the counseling relationship. Phenomenological interviews were used to explore in depth and with diversity the participants' subjective meaning of the lived experience (Denzin & Lincoln, 2003). Constant comparative research methods were used to analyze the data. Four themes naturally emerged from the data. Theme 1) Defining Cultural Competence was discussed as being inclusive of all differences; not focusing solely on race or ethnicity, including more than recognizing obvious differences, and counselors' willingness to raise and engage in the issue of culture. Theme 2) Counselor Attitude participants voiced that counselors' attitude plays a significant role in whether certain topics are broached and how much is shared about the topic. They reported what counselors convey through their attitude and interactions as being more important than what they convey verbally. Theme 3) The Counseling Relationship was discussed in regard to the importance of counseling relationships that fosters an environment of safety where sharing information and teaching and learning is reciprocal between counselor and consumer and Theme 4) Counselor Attributes were found to be more important than counseling techniques and theories. The findings are presented in a discussion of themes with narratives developed about each case. / Ph. D.

Thesis advisor: Eva Garroutte / Thesis advisor: David Karp / In an age in which diversity and healthcare inequalities are prominent issues, culturally competent care has emerged as a popular response. However, there seems to be a gap between this academic interest and the attempts to implement cultural competency in the American healthcare system. The aim of this qualitative research was to explore the link between culture and health and to uncover what cultural competency might mean on a practical level through a case study of the pediatric in-patient units of an urban hospital in Boston, Massachusetts. Through participant observation over the span of two months, as well as 20 semi-structured interviews with 14 healthcare providers and 6 bilingual Latino parents of pediatric patients, I investigated the challenges that these groups face in providing and seeking care, respectively. The results of this project attempt to give voice to the families and their providers, as well as suggest how the hospital can better accommodate the needs of the Latino population. Overall, this project has revealed the complexity of the links between culture and health, and indicated that there is no single model of cultural competence that can adequately capture this complexity. Ultimately, relationships and good communication are at the core of the cross-cultural medical encounter, and may serve to create a more culturally welcoming atmosphere for patients of all backgrounds. / Thesis (BA) — Boston College, 2012. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Sociology Honors Program. / Discipline: Sociology.

Thesis advisor: Usha Tummala-Narra / Immigrants in the United States experience a unique array of mental health stressors related to their experiences of migration and acculturation. For immigrants who are also persons of color, additional obstacles and stressors may compound their experiences. Previous research indicates that while psychologists who work with this population may endorse multicultural competence, they may not actually carry out culturally sensitive practices. Additionally, much of the present literature on therapy with minority clients focuses on aspirational goals. However, analyses of the ways in which these tenets are applied to clinical work are few and far between. What are the barriers to implementing these practices? What resources support clinicians who are working with diverse immigrant populations? The present qualitative study focused on the experience of clinicians who work with minority immigrant clients. Thirteen White psychologists responded to open-ended questions regarding their clinical experience with this population. Interview questions explored positive and negative clinical experiences, issues of power, and the ways in which the therapeutic relationship impacted clinicians' views of themselves. Results of the study indicate that internal and external systemic factors influenced clinicians' expectations for therapy as well as the manner in which they approached problematic relational outcomes. Analyses further highlighted the role of power and systemic influences on the therapeutic relationship. Participating psychologists painted a clear picture of the importance of collaborative, empathic relationships, which further highlights the consequences of neglecting to address underlying tensions. A clear and consistent theme of deeply personal commitment to their work transcended individual interviews. Implications for researchers, clinicians, and training institutions were addressed. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

The purpose of this qualitative study was to gain an understanding of the patients’ perceptions of the lived experience as recipients of culturally competent nursing care related to their cultural values, customs, and health beliefs. A review of the literature revealed that culturally competent nursing care is the basis of providing holistic, individualized care. However, as culturally competent care has gained momentum in recent years, healthcare disparities in the United States remain, particularly among underserved minority and vulnerable groups of multicultural backgrounds. Literature suggests a link between culturally competent nursing care and improved health outcomes. This connection has been the motivation for nursing professionals to embrace culturally competent care and work to close the gap of incongruence of quality healthcare for all individuals. Van Manen’s phenomenological research method was used to reveal the essence of the lived experience of culturally competent nursing care as perceived by participants of Chinese ethnicity. The phenomenon was the experience of being in a hospital receiving nursing care as a patient from diverse cultural background. The context of the phenomenon was healthcare organizations that purport to provide exemplary culturally competent care. Following interviews of nine participants, transcripts were analyzed. Data analysis revealed four themes: (a) nurse’s presence; (b) feeling understood; (c) nice nurse, happy nurse, happy patient related to nurses’ caring behaviors and the impact on one’s perception of their health; and (d) gratitude. The concept of connectedness was an overarching theme within each of the four identified themes, serving as the thread among all interviews and themes. Watson’s Human Caring Science Theory of Nursing provided a framework for the themes and overarching theme. In this qualitative study, participant interviews contributed to building the body of knowledge about culturally competent care that shed light on Chinese participants’ meaningful nursing care experiences.

Creativity often involves combining existing ideas and knowledge in novel ways. As such, individuals’ access to diverse information and knowledge via social networks has been considered an important determinant of creativity. In this dissertation, I propose another factor to explain why some individuals are more likely than others to generate creative ideas: their ability to bridge disconnected cultural frames inside their organization. I draw on the cultural holes argument (Pachucki & Breiger, 2010) that cultural frames are connected through the persons that employ them (DiMaggio, 1987), and disconnections between cultural frames (i.e., cultural holes) can inhibit the exchange of ideas and knowledge among individuals. Thus, I conceptualize organization’s culture as a cultural network where the nodes represent the cultural frames its members use and the connections between two nodes represent the overlap of their users. I argue that while cultural holes inside an organization can present barriers for the exchange of ideas and information for those that do not share cultural referents, they also create opportunities for generating novel ideas for those that can bridge them. Bridging cultural holes, or cultural brokerage, enables individuals to utilize a wider range of information that is available, and recognize opportunities and combinations of information that others may not be able to see. The heart of this dissertation is this notion that individuals’ position in the cultural network and the patterns of cultural frames they use affect the diversity of information and knowledge they can process and as a result, their ability to generate creative ideas. In Chapters 3 and 4, I test this theory in two very different contexts: (1) an e-commerce company located in South Korea; and (2) two executive MBA groups at a U.S. university. I employ novel methods for measuring individuals’ use of culture and map out the cultural networks as well as the cultural holes inside the organizations. In both studies, controlling for social network brokerage and cultural fit, I find that cultural brokerage leads to the generation of creative ideas. More specifically, individuals who use loosely connected cultural frames were more likely to generate creative ideas compared to those that use cultural frames that are cohesively connected. In Chapter 5, I explore the question of who becomes cultural brokers with data collected from the two studies introduced in Chapters 3 and 4. I find both personal and contextual factors that are associated with cultural brokerage. Overall, these findings provide insight into how individuals’ different use of their organization’s culture affect the diversity of information they can utilize inside the organization and as a result, their ability to generate creative ideas.

Multicultural practitioners promote cultural competence among individuals to create awareness and tolerance of others who are culturally different. Yet, current research on cultural competence education primarily focused on practitioners in the traditional school setting instead of individuals in nonschool settings. This basic qualitative study investigated how multicultural practitioners in nonschool settings experience their attempts to develop cultural competence in constituents. Bennett's intercultural sensitivity, Koehn and Rosenau's multicultural competence, and Quappe and Cantatore's cultural awareness models informed the semi-structured interviews with 8 multicultural practitioners obtained via snowball sampling. Data were manually coded and analyzed to develop themes. Results indicated four ways participants conceptualized cultural competency, a five-part approach to cultural competence promotion, seven varying efforts to develop cultural competence, seven challenges that hindered their work, and four areas of success. Future studies might investigate differences in cultural competency efforts used by specific cultural groups and multicultural practitioners' growth as professionals to help to determine professional development programs that warrant implementation. This study will generate interest in developing cultural competence in groups and settings beyond the reach of traditional educational settings, thereby contributing to social change.

Because of its political and philosophical launching ground (Arredondo & Perez, 2006), cultural competence did not begin as an empirical research program, and as a result, there remains disagreement about how to define and measure cultural competence. Although the application of cultural competence remains unclear to some psychologists (Fuertes et al., 2006), it is now common knowledge that the therapeutic alliance is a statistically and clinically significant contributor to effective therapy. This pilot study merges two prominent bodies of literature, cultural competence and therapeutic alliance, with the underlying assumption that a culturally competent counselor will be able to provide effective service through the therapeutic relationship (Pope-Davis et al., 2002). This pilot study was designed to provide information about the relationship between therapists' self-reports and their observed behaviors regarding cultural competence (CC), examine how therapists' CC facilitates the formation of working alliances, and examine the role of CC in predicting parent-child discrepancy in alliance. Participants were family therapists and family members involved in a multi-site clinical trial study (Parent Study) evaluating Brief Strategic Family Therapy (BSFT™; Szapocznik, Hervis, & Schwartz, 2003). A total of 14 therapists from 8 community treatment programs from across the country were included in the rating portion of the study. The Parent Study included African American and Hispanic families with adolescents ages 12-17, mostly referred from the juvenile justice system. Scores from Roysircar's Multicultural Counseling Inventory (MCI; 1994) and Cultural Diversity Observer Rating Scale (CDORS; 2005) were compared. Observed therapeutic alliance was evaluated using the Vanderbilt Therapeutic Alliance Scale-Revised. The associations were evaluated with 3 multilevel univariate linear models using HLM software. Since 6 of 14 therapists (43%) completed the MCI, the pilot study was completed without self-reported competence as a predictor of therapeutic alliance (only CDORS was used). The results of this study failed to provide support for the hypothesized relationships between cultural competence and therapeutic alliance. These results are discussed in light of the methodological limitations of this study and suggestions are made to improve future investigations in this area.