Dr. Alice F. Kuehn:

Preparing Nurses for Culturally Competent Practice: An Immersion Experience with Mexico and Canada

University of Missouri, School of Nursing




The increasing diversification of patient populations in the United States demands a workforce prepared to deliver culturally competent health care. Racial and ethnic disparities in health care access and utilization exist in the United States, often due to a lack of cultural awareness and competency on the part of "mainstream” nurse providers (Clinton, 1996), and culture, race, gender, sexual orientation, and socioeconomic issues have been identified by Meleis, Isenberg, Koerner, & Stern (1995) as key components of "culturally competent care."            The nurse who is culturally competent is not only aware of differences (cultural awareness) but has developed the ability to intervene appropriately and effectively. Cultural competence requires more than simply acquiring knowledge about another ethnic or cultural group. It is a combination of knowledge, attitudes, and skills that enables the nurse to translate cultural awareness into the reality of culturally competent clinical practice.


The changing demographics of populations served in both Missouri and Iowa, with   significantly increasing numbers of immigrants from Mexico, alerted nursing faculty at MU and University of Iowa to the growing need for nurses well prepared in cultural and language diversity.  Joining  with nurse faculty from Canada and Mexico, this project ,  funded by the Fund for the Improvement of Post-Secondary Education (FIPSE North American), Human Resource Department-Canada (HRDC), and Secretaria de Educación Pública - México (SEP), has focused on helping students, faculty  and professional nurses from each of the six partners - Dalhousie University (DalU), University of Prince Edward Island (UPEI), Universidad Autónoma de San Luis Potosí (UASLP), Universidad Autónoma de Nuevo León (UANL), the University of Missouri (MU), and University of Iowa (UI) to be better prepared to deliver culturally competent health care, emphasizing education in cultural diversity, language (Spanish), different health care systems and  how they  relate to the practice of professional nursing within each country.


This paper describes challenges faculty faced together including writing the proposal, Memorandum of Understanding, the shared, web-enhanced course, and planning and executing international and local field experiences. At the University of Missouri-Columbia, a special course in Medical Spanish was offered to nursing, medical, health profession students and registered nurses to better prepare the students and nurses for their international and local field experiences. Course material developed jointly and loaded at the project web site at the University of Missouri–Columbia (www.nursingfutures.org) will be described, noting the five modules addressing history and geography of each country, multicultural awareness, recognition of specific healthcare beliefs and values, and the nurse role within each country’s healthcare system. A description of the international and local cultural immersion experiences will be shared, including the scheduled field experiences at health centers, hospitals, classes, and cultural locations. Those who participated in the exchange to Mexico began with a two-week Spanish immersion course in Cuernevaca. The many lessons learned from our 1st exchange, just completed in June, 2004, are summarized, and evaluations of the impact upon both participants and local host agencies following our first full year of operation discussed.   


Contact Information:


 Alice F. Kuehn, PhD, RN

Associate Professor, Emeritus

Director, North American Mobility in Nursing Project

University of Missouri-Columbia

S322 School of Nursing

Columbia, MO 65211

(573) 882-0232

(573) 884-4544 fax