Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Committee Chair

Jennifer Bail

Committee Member

Rebecca Davis (Co-chair)

Committee Member

Vivian Yates

Committee Member

Abby Horton

Committee Member

Susan Welch

Research Advisor

Jennifer Bail

Subject(s)

Cultural competence--Nurses--Education, Nurse educators--Alabama, Cultural competence--Alabama--Nurses

Abstract

Cultural competence is a vital skill in nursing practice and nursing education. Nurse educators must be able to teach this concept and prepare students to provide culturally competent care to patients. This study examined the cultural competence of Alabama pre-licensure nurse educators in associate degree nursing (ADN) and baccalaureate (BSN) programs and explored their perceptions of cultural competence's role in nursing education. An explanatory sequential mixed-methods design was employed, guided by Campinha-Bacote's Process of Cultural Competence in the Delivery of Health Care Services Model. In Phase I, 51 nurse educators completed the Cultural Diversity Questionnaire for Nurse Educators-Revised (CDQNE-R) and a sociodemographic survey. Participants were predominantly middle-aged, white, female, doctorate-prepared educators employed full-time in BSN programs. Results indicated nurse educators were "proficient" in cultural awareness, knowledge, skills, and desire, but only "competent" in cultural encounters. In Phase II, 18 participants from the quantitative sample were purposively selected for in-depth, semi-structured interviews. Deductive thematic analysis was conducted using the five predetermined themes aligned with the theoretical framework: 1) cultural awareness, 2) cultural knowledge, 3) cultural skills, 4) cultural encounters, and 5) cultural desire. Educators demonstrated a strong commitment to modeling cultural competence and treating all individuals with dignity and respect. They emphasized developing students' awareness through discussion, case studies, and simulations; understanding the social determinants of health; and using culturally respectful communication. However, gaps emerged in knowledge of immigration terminology, pharmacogenomics, disease origins by country, and opportunities for direct cultural encounters. Integration of findings revealed that while Alabama nurse educators value cultural competence and possess strong foundational knowledge, limited engagement with diverse populations and knowledge gaps in specific areas suggest opportunities for targeted professional development. Current political challenges to diversity, equity, and inclusion initiatives further complicate efforts to enhance cultural competence. Findings underscore the need for intentional cultural immersion experiences, formal cultural competence training, and ongoing professional development to prepare nurse educators to effectively teach and mentor increasingly diverse student populations and cultivate a culturally competent nursing workforce.

Comments

Submitted ... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the joint Nursing Science Ph.D. Program ...

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