Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Rozina Bhimani


Doctor of Nursing Practice


In the United States there is an ever-increasing diversity of the populations receiving health care service. The newly graduated nurse needs to be prepared to step into a variety of roles quickly, armed with the understanding of what is needed to provide effective care, including cultural awareness. Nursing education programs must provide the education that students require to be equipped to effectively meet the needs of patients related to their diverse characteristics.

Understanding of the nature and process of human learning is critical to the development of educational curricula. The purpose of this systems change project was to better understand how nursing students develop cultural awareness that will enhance the delivery of nursing care to diverse patients and populations.

The college and nursing program site for this systems change project was a small, faith-based campus in Midwestern United States, with a unique faith-based mission and focus. A nursing program goal, that supports an institutional goal, is that graduates will be able to implement biblically-based professional nursing care and leadership for culturally and ethnically diverse individuals and communities. In order to understand how to measure and what measurements would best demonstrate this outcome, it is incumbent upon the program to attempt to qualify and quantify how students develop and demonstrate growth in cultural awareness. A convenience sample of eleven students enrolled in the junior-year transcultural nursing course were assigned three unique lesson modules created for the project. Utilizing a test-retest (a pre and post-test) intervention methodology, participants provided answers to questions about their understanding of the concept of culture and caring for diverse patients. Content analysis

was performed to describe the themes and growth in participant’s cultural awareness following completion of the course modules.

Content analysis revealed three themes: culture is a mosaic that gives meaning to human experience, culture evokes conflicting emotions, and cultural awareness is experiential. Descriptive statistics demonstrated small changes in the percentage of participants’ movement towards understanding of the complexities of culture and caring across cultures. Perceptions and understanding were measured over a relatively short time-frame of five weeks. Results suggest that the process of cultural awareness occurs slowly over time. Participants also indicated that their Christian faith should inform their desire to care for diverse patients, though it was not as simple as first assumed.

The results of this project pointed to the importance of appreciating the process of nursing students’ growing cultural awareness. For the nursing program, there is now more information that will assist in establishing measurable outcome criteria for student achievement of the program goal of being able to care for culturally and ethnically diverse individuals and communities.