A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students

Objectives: Increasing professional nurses' and nursing students cultural competence has been identified as one way to decrease the disparity of care for vulnerable and minority groups, but effectiveness of training programs to increase competence remains equivocal. The purpose of this project is to synthesize educational interventions designed to increase cultural competence in professional nurses and nursing students. Design: A systematic review and meta-analysis was conducted to synthesize all existing studies on increasing cultural competence. Data sources: A comprehensive search and screen procedures was conducted to locate all cultural competence interventions implemented with professional nurses and nursing students. Review methods: Two independent researchers screened and coded the included studies. Effect sizes were calculated for each study and a random-effects meta-analysis was conducted. Results: A total of 25 studies were included in the review. Two independent syntheses were conducted given the disparate nature of the effect size metrics. For the synthesis of treatment-control designed studies, the results revealed a non-statistically significant increase in cultural competence ((g) over bar = .38, 95% CI: -.05, .79, p = .08). Moderator analyses indicated significant variation as a function of the measurements, participant types, and funding source. The pretest-posttest effect size synthesis revealed a significant increase in overall cultural competence ((g) over tilde = .45, 95% CI:.24, .66, p < .01). Moderator analyses indicated, however, that the effect sizes varied as functions of the measurement, funding source, and publication type. Conclusions: Interventions to increase cultural competence have shown varied effectiveness. Greater research is required to improve these interventions and promote cultural competence. (C) 2014 Elsevier Ltd. All rights reserved.