title: Culture and Cultural Competence in Nursing Education and Practice: The State of the Art.
abstract: OBJECTIVE
  The concept of cultural competency has developed a substantial presence in nursing education and practice since first attracting widespread attention in the 1990s. While several theories and corresponding measures of cultural competency have been advanced and tried, much work remains, as many nursing professionals continue to call for greater evidence-based research and attention to patient perspectives and outcomes.
  
  
  METHODS
  Using a method provided by Hawker et al. to appraise articles, this paper compares nine recent (2008-2013) studies (including two composite studies) related to cultural competency, undergraduate curricula, and teaching strategies in nursing to assess the state of the art in this important area of care.
  
  
  RESULTS
  The studies applied phenomenological, study abroad, online, and service learning strategies, four of which relied on some version of Campinha-Bacote's IAPCC© model. These studies reported a general improvement in competency among students, though generally only to a level of cultural awareness, and admitted being constrained by several common limitations.
  
  
  CONCLUSIONS
  Improved results and more realistic expectations in this area may require a closer understanding of the nature of the "culture" that underlies cultural competence. Harkess Kaddoura.
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Linda
authors.initials: L
authors.lastname: Harkess
authors.affiliation: Duke University, Durham, NC.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Kaddoura
mesh_terms: D000884:Anthropology, Cultural / Q000379:methods; D054521:Cultural Competency / Q000193:education*; D003479:Curriculum / Q000592:standards*; D004508:Education, Nursing, Baccalaureate / Q000379:methods* / Q000592:standards; D006801:Humans
keywords: Cultural competence; cultural diversity; education; nursing research