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Editorial

The state of transcultural nursing global leadership and education

Linda J Luna
School of Nursing, University of Phoenix, Nashville TN, United States of America

June Miller
President, School of Nursing, Johns Hopkins University, Baltimore MD, United States of America

Article Text

The scholarly articles presented in this section reflect the current state of global transcultural nursing leadership, as well as the progress made in fostering cultural competence through transcultural nursing education. Transcultural nursing can be traced back to the early years, over a half century ago, when Dr Madeleine Leininger first began exploring the relationship between nursing and anthropology (Leininger 1970). Through her pioneering theoretical work, we first started using the term ‘transcultural', to mean ‘across all world nations'. We have since developed into our own discipline of transcultural nursing, boasting of our unique knowledge base within the discipline of nursing. Leadership has emerged through the years, with the establishment of the Transcultural Nursing Society in the United States in 1975, and the 1994 establishment of the Transcultural Nursing Society in Australia through the Royal College of Nursing, Australia. Both organisations, through collaboration and individual efforts, have provided leadership for the expanding discipline, to include the hosting of annual international conferences, the development of policy and position statements, and the encouragement and showcasing of important research focusing on unique culture care perspectives.

Bryant and colleagues (2008) provide an excellent evolutionary perspective of the role the Royal College of Nursing, Australia (RCNA) has played in supporting the growth and development of transcultural nursing in Australia. The official recognition of transcultural nursing as a distinct society in 1994 firmly established the importance of discovering care from a cultural perspective in a multicultural society such as Australia. The article by Andrews (2008) highlights the global nature of transcultural nursing and identifies many Australian nurse leaders who have been visionaries in establishing culturally relevant nursing practice. As a result of the scholarly work by Australian transcultural nurse leaders, there is now a significant body of knowledge in nursing that is useful in practice, education and research around the globe.

As much as we would like to think all of this progress translates into effective education programs for practicing nurses and faculty, read the contemporary articles before you say otherwise. We are still only beginning to understand how we can provide the critical learning environment for students to grasp the key components of transcultural nursing, and to then evaluate the effectiveness of our programs. Lynette Raymond, of the University of Notre Dame, Sydney Australia (2008), shares with us a detailed BN curriculum approach, including several required courses in TCN, and the introduction of a variety of conceptual models. This very specific curriculum focus, designed from extensive literature review of research relevant to Australia, includes plans for evaluation one year after graduation. We look forward to the results.

On the other hand, we are faced with two research studies that declare we are not finding positive results in many of our attempts to evaluate cultural competency in undergraduate programs in the United States. Mixer (2008) describes a gap in faculty knowledge, and therefore limited ability to provide the context of culture care for student learning. Kardong- Edgren and Camphina-Bacote (2008) present a study indicating that regardless of approach, by graduation many students are not scoring beyond cultural awareness in scales measuring cultural competence. These findings are reminiscent of the situation with measuring critical thinking as an outcome measure of baccalaureate schools of nursing. Like critical thinking, we know that cultural competence is an important outcome of baccalaureate education, but how do we measure it?

It seems that many of us who have made transcultural nursing our life's work, especially exploring theory and research, need now refocus our leadership skills to direct our attention to insuring that students and clinicians are nurtured in culture care principles. We must be creative in designing clinical cultural immersion experiences, faculty workshops, and evaluation tools, both qualitative and quantitative to measure the effectiveness of our cultural competence programs.

The discipline of transcultural nursing is well grounded in our scholarly theoretical work and our extensive worldwide research. Our leaders share important findings with each other through international conferences and scholarly journals. We talk and write extensively about cultural competence for health care professionals. However, the question is whether we are actually successful at disseminating that knowledge into clinical practice. Should we now direct our focus away from the macro worldwide, theoretical stance and toward a micro focus on each individual student nurse, to insure they are provided with opportunities for learning the process of cultural competence?

TCNS International is in the final stages of launching its new certification process, to include an extensive curriculum which will be available to nurses worldwide. Perhaps, combined with intensive cultural immersion experiences and more faculty opportunity for in-depth learning about teaching concepts of TCN, we can move forward. We need to continue our pioneering efforts to expand our leadership in creative ways to answer the important questions raised in the writings of these well known scholars of transcultural nursing. The future of health care depends on the work of those at the bedside in every cultural context.


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References

Andrews MM (2008) Commentary: Global leadership in transcultural practice, education and research, Advances in Contemporary Transcultural Nursing 2nd edn, Contemporary Nurse 28(1-2): 13-16.

Bryant RB, Foley ER and Percival EC (2008) The role of RCNA in promoting transcultural nursing as a discipline of study, research, practice and management in Australia, Advances in Contemporary Transcultural Nursing 2nd edn, Contemporary Nurse special issue 28(1-2): 3-11.

Kardong-Edgren S and Campinha-Bacote J (2008) Cultural competency of graduating US Bachelor of Science nursing students, Advances in Contemporary Transcultural Nursing, 2nd edn, Contemporary Nurse special issue 28(1-2): 37-44.

Leininger M (1970) Nursing and Anthropology: Two worlds to blend. John Wiley & Sons: New York.

Mixer SJ (2008) Use of the culture care theory and ethnonursing method to discover how nursing faculty teach culture care, Advances in Contemporary Transcultural Nursing 2nd edn, Contemporary Nurse special issue 28(1-2): 23-36.

Raymond LM (2008) Exemplar: Developing a new Bachelor of Nursing course responsive to Australia's culturally diverse community, Advances in Contemporary Transcultural Nursing 2nd edn, Contemporary Nurse special issue 28(1-2): 17-22.



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