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The Use of Simulations for the Development of Cultural Competencies in Nursing Education

text of different cultural and ethnic backgrounds in a high-fidelity simulation
(Seckman & Diesel, 13). In the studies examined, the use of a standardized
patient was the most frequently mentioned simulator for the development of
cultural competencies. These competencies were most frequently mentioned
in the context of caring for racially and ethnically diverse patients (Byrne,
; Grossman et al., 1; Hamilton, 16; Ndiwane et al., 14) or patients’
sexual orientation and gender identity (Hickerson et al., 18; Ozkara San,
19; Ozkara San et al., 19). Two studies employed the virtual simulation
method (Altmiller et al., 3; Fung et al., 3), which addressed a range of
topics, including the implementation of culturally appropriate care plans, the
exploration of concepts related to cultural competency, and the assessment
of advanced communication skills. Two studies employed screen-based sim-
ulations to explore cultural, environmental needs and attitudes towards pov-
erty in care (Everson et al., 15; Tiffany & Hoglund, 16). Two further studies
utilised role play as a simulation method (Englund et al., 19; Garrido et al.,
14), with one of these studies focusing on patients’ sexual orientation and
cultural needs. In designing the scenarios, authors most frequently utilized
the Campinha-Bacote model of cultural competence, Jeffreys’ Cultural Com-
petence and Confidence Model, and the Purnell Model for Cultural Compe-
tence. Alongside the selected cultural model, some studies also incorporated
the International Nursing Association for Clinical Simulation and Learning
standards, which were designed to provide evidence-based guidelines for
the practice and development of simulations.

Learning Elements Addressed by Simulations for the Development
of Cultural Competence
In this section, we categorized the studies based on the learning elements
that students aimed to acquire during simulations for the development of
cultural competence (Table 3). The cognitive domain of learning cultural
competence is the learning domain in which the greatest progress was made
by the nursing students. In the studies examined, the cognitive knowledge
component of cross-cultural competence learning was the most developed
among nursing students (Fung et al., 3; Grossman et al., 1; Hamilton,
16; Ndiwane et al., 14; Ozkara San, 19; Ozkara San et al., 19; Phillips et
al., 1; Tiffany & Hoglund, 16). Additionally, Ozkara San (19) and Hicker-
son et al. (18) highlight that simulation experiences afforded students the
chance to cultivate a secure and respectful environment for patients and to
engage in discourse on cultural practices, which proved to be a highly effec-
tive strategy for enhancing their self-esteem.

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