CULTURAL SENSITIVITY TRAINING

Overview

This randomized controlled experimental study aims to determine the effect of a cultural sensitivity training program on nursing students' cultural sensitivity, cultural awareness, and ethnocentrism levels. Fourth-year nursing students at Giresun University Faculty of Health Sciences are randomly assigned to an experimental group or a control group using simple randomization. The experimental group receives a 4-week cultural sensitivity training program (2 hours per week) including interactive lectures, discussions, case studies, video demonstrations, and role-playing activities. The control group continues with the standard nursing curriculum. Data are collected using the Intercultural Sensitivity Scale, Intercultural Awareness Scale, and Ethnocentrism Scale at baseline (pre-test) and after the intervention (post-test). The primary hypothesis is that participants receiving the training will show significant improvements in cultural sensitivity and awareness and a significant decrease in ethnocentrism compared to the control group.

Background: Cultural sensitivity and awareness are essential competencies for nursing professionals providing care to diverse patient populations. Ethnocentrism, the tendency to view one's own culture as superior, can negatively affect patient care quality. Structured educational interventions during undergraduate nursing education may enhance culturally competent care delivery. Study Design: This is a randomized controlled experimental study conducted at Giresun University Faculty of Health Sciences, Nursing Department, during April-May 2025. Fourth-year nursing students were selected because they have accumulated both theoretical knowledge and clinical experience and have interacted with individuals from diverse cultural backgrounds. Sample Size: Power analysis was performed using G\*Power 3.1. Based on the effect size of 0.685 reported by Topcu (2019), with 95% power and 5% significance level, a minimum of 60 participants (30 per group) was required. To account for potential attrition, 71 students were enrolled (35 experimental, 36 control). Three students in the experimental group were excluded due to non-attendance, resulting in a final sample of 67 participants (32 experimental, 35 control). Randomization: Participants were assigned to groups using simple random randomization. An independent biostatistician generated the randomization table using an online calculator (calculatorsoup.com). Groups had only one common class day per week, minimizing cross-contamination risk. Participants were verbally instructed not to share intervention content. Intervention: The experimental group received a 4-week Cultural Sensitivity Training Program delivered in classroom settings every Monday (11:00-13:00) in two 50-minute sessions. The program content included: Week 1 - Culture concepts, cultural elements, and the relationship between society and culture; Week 2 - Health, illness, and culture relationships including cultural factors in health behaviors and nutrition; Week 3 - Cultural sensitivity, cultural awareness, and ethnocentrism concepts with strategies for reducing ethnocentrism; Week 4 - Transcultural nursing and cultural care models including Leininger's Sunrise Model, Giger and Davidhizar's Transcultural Assessment Model, and Purnell's Cultural Competence Model. Teaching methods included interactive lectures with PowerPoint presentations, group discussions, question-and-answer sessions, case studies, video demonstrations, and role-playing scenarios. The training content was validated by field experts using the DISCERN quality assessment tool. Control Group: The control group received no cultural sensitivity intervention during the study period. After post-test data collection, the control group also received the Cultural Sensitivity Training Program for ethical considerations. Outcome Measures: Three validated instruments were used - (1) Intercultural Sensitivity Scale (Chen and Starosta, 2000; Turkish adaptation by Bulduk, Tosun and Ardic, 2010): 24-item, 5-point Likert scale measuring five emotional dimensions of intercultural sensitivity (Cronbach alpha=0.90); (2) Ethnocentrism Scale (Neuliep and McCroskey, 2001; Turkish adaptation by Ustun, 2011): 20-item, 5-point Likert scale (Cronbach alpha=0.92); (3) Intercultural Awareness Scale (Rozaimie et al.; Turkish adaptation by Yakar Karabuga and Alpar, 2017): 9-item, 5-point Likert scale with three sub-dimensions (Cronbach alpha=0.73). A 17-item Descriptive Characteristics Form was also administered. Statistical Analysis: Data were analyzed using SPSS 25.0. Normality was assessed using skewness and kurtosis coefficients (within ±1.5 range). Parametric tests were used including paired samples t-test for within-group comparisons, independent samples t-test for between-group comparisons, and chi-square test (with Fisher's Exact Test when necessary) for demographic homogeneity. Statistical significance was set at p\<0.05. Instrument reliability was assessed using Cronbach's alpha coefficients. Ethics: The study was approved by Karadeniz Technical University Health Sciences Scientific Research Ethics Committee (Decision No: 158, Date: December 12, 2024). Institutional permission was obtained from Giresun University Rectorate (Decision No: E-13301833-100-55965, Date: December 13, 2024). Written informed consent was obtained from all participants.