{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T07:07:22Z","timestamp":1779001642457,"version":"3.51.4"},"reference-count":82,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Qualitative Nursing Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Research indicates that cultural competence is lacking among registered nurses, and nurses commonly report feeling ill-equipped to care for culturally diverse patients. This qualitative study employed a blended methodological approach informed by narrative inquiry and participatory action research to explore undergraduate nursing students\u2019 development of cultural competence during an international, interprofessional clinical placement. Ten undergraduate nursing students completed a 3-week clinical placement in partnership with preservice teachers from the Faculty of Education. Aligned with participatory action research commitments to democratizing knowledge production, students were engaged as co-authors across multiple stages of the study. This approach recognized students as knowledge holders whose experiential insights shaped the analytic process. Data were generated through semi-structured interviews, and reflexive thematic analysis was undertaken iteratively, emphasizing the co-construction of themes. Five themes were generated: (1) opportunities for personal growth, (2) relationship building to facilitate collaboration, (3) interprofessional teamwork and leadership skills, (4) cultural competence development through immersion, and (5) shifting mindsets and learning from resource-limited settings. Findings underscore how structured reflection and debriefing can deepen equity-oriented learning by enabling students to critically examine assumptions, power, and privilege. These insights support the integration of international and interprofessional placements, alongside reflective pedagogy, into undergraduate nursing curricula.<\/jats:p>","DOI":"10.1177\/23333936261450418","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:08:52Z","timestamp":1778836132000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Becoming Culturally Competent: Transformative Learning in an International, Interprofessional Nursing Placement"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-3318","authenticated-orcid":false,"given":"Rachel A.","family":"Elliott","sequence":"first","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Sweet","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Bownes","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan","family":"Nasra","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Schumacher","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly-Anne","family":"Vanderdoe","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Digesu","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice","family":"Kungu","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Okello","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Crew","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mia","family":"Chauvin","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kendall","family":"Soucie","sequence":"additional","affiliation":[{"name":"University of Windsor, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Andreassen P. Hanssen I. Stokke K. (2025). Exploring cultural competence development through international clinical placements: A scoping review. Nurse Education in Practice 16(9) Article 103645. https:\/\/doi.org\/10.1016\/j.ijnsa.2025.100378","DOI":"10.1016\/j.ijnsa.2025.100378"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Ant\u00f3n-Solanas I. Tambo-Lizalde E. Hamam-Alcober N. Vanceulebroeck V. Dehaes S. Kalkan I. K\u00f6m\u00fcrc\u00fc N. Coelho M. Coelho T. Casa Nova A. Cordeiro R. Sagarra-Romero L. Subir\u00f3n-Valera A. B. Hu\u00e9rcanos-Esparza I. (2021). Nursing students\u2019 experience of learning cultural competence. PLoS One 16(12) Article e0259802. https:\/\/doi.org\/10.1371\/journal.pone.0259802","DOI":"10.1371\/journal.pone.0259802"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"Bagnasco A. Rossi S. Dasso N. Cananzi L. Timmins F. Aleo G. Catania G. Zanini M. Sasso L. (2020). A qualitative descriptive enquiry of nursing students\u2019 perceptions of international clinical placement experiences. Nurse Education in Practice 43 Article 102705. https:\/\/doi.org\/10.1016\/j.nepr.2020.102705","DOI":"10.1016\/j.nepr.2020.102705"},{"key":"e_1_3_4_5_1","doi-asserted-by":"crossref","unstructured":"Banks S. Stanley M. J. Brown S. Matthew W. (2019). Simulation-based interprofessional education: A nursing and social work collaboration. Journal of Nursing Education 58(2) 110\u2013113. https:\/\/doi.org\/10.3928\/01484834-20190122-09","DOI":"10.3928\/01484834-20190122-09"},{"key":"e_1_3_4_6_1","doi-asserted-by":"crossref","unstructured":"Braithwaite T. J. Kelly L. P. Chakanyuka C. (2022). File of uncertainties: Exploring student experience of applying decolonizing knowledge in practice. Quality Advancement in Nursing Education 8(3) Article 5. https:\/\/doi.org\/10.17483\/2368-6669.1351","DOI":"10.17483\/2368-6669.1351"},{"key":"e_1_3_4_7_1","doi-asserted-by":"crossref","unstructured":"Braun V. Clarke V. (2022). Conceptual and design thinking for thematic analysis. Qualitative Psychology 9(1) 3\u201326. https:\/\/doi.org\/10.1037\/qup0000196","DOI":"10.1037\/qup0000196"},{"key":"e_1_3_4_8_1","doi-asserted-by":"crossref","unstructured":"Browne C. A. Fetherston C. M. Sidhu K. (2015). How do culture and context impact student experiences of preceptorship? Nurse Education Today 35(12) e50\u2013e55. https:\/\/doi.org\/10.1016\/j.nedt.2015.07.011","DOI":"10.1016\/j.nedt.2015.05.012"},{"key":"e_1_3_4_9_1","doi-asserted-by":"crossref","unstructured":"Bundala F. A. Kamala B. A. Moshiro R. Guga G. Munishi C. Ismail H. R. Mdoe P. F. Ersdal H. Rettedal S. Salim N. (2025). Availability and functioning of neonatal care units and facility-based neonatal mortality in Tanzania. BMJ Global Health 10 Article e018758. https:\/\/doi.org\/10.1136\/bmjgh-2024-018758","DOI":"10.1136\/bmjgh-2024-018758"},{"key":"e_1_3_4_10_1","doi-asserted-by":"crossref","unstructured":"Byrne D. (2020). Evaluating cultural competence in undergraduate nursing students using standardized patients. Teaching and Learning in Nursing 15(1) 57\u201360. https:\/\/doi.org\/10.1016\/j.teln.2019.08.010","DOI":"10.1016\/j.teln.2019.08.010"},{"key":"e_1_3_4_11_1","doi-asserted-by":"crossref","unstructured":"Caldwell P. Purtzer M. A. (2014). Long-term learning in a short-term study abroad program: \u201cAre we really truly helping the community?\u201d Public Health Nursing 32(5) 577\u2013583. https:\/\/doi.org\/10.1111\/phn.12168","DOI":"10.1111\/phn.12168"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"Campinha-Bacote J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing 13(3) 181\u2013201. https:\/\/doi.org\/10.1177\/10459602013003003","DOI":"10.1177\/10459602013003003"},{"key":"e_1_3_4_13_1","doi-asserted-by":"crossref","unstructured":"Campinha-Bacote J. (2018). Cultural competemility: A paradigm shift in the cultural competence versus cultural humility debate\u2014Part I. Online Journal of Issues in Nursing 24(1). https:\/\/doi.org\/10.3912\/OJIN.Vol24No01PPT20","DOI":"10.3912\/OJIN.Vol24No01PPT20"},{"key":"e_1_3_4_14_1","unstructured":"Campinha-Bacote J. (2023). The process of cultural competemility in the delivery of healthcare services. Transcultural C.A.R.E Associates. https:\/\/transculturalcare.net\/the-process-of-cultural-competence-in-the-delivery-of-healthcare-services\/"},{"key":"e_1_3_4_15_1","unstructured":"Canadian Association of Schools of Nursing. (2025). Cultural humility and cultural safety standards for nursing education. https:\/\/www.casn.ca\/2025\/02\/cultural-humility-and-cultural-safety-standards-for-nursing-education-in-canada\/"},{"key":"e_1_3_4_16_1","doi-asserted-by":"crossref","unstructured":"Cant R. P. Cooper S. J. (2017). Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Education Today 49 63\u201371. https:\/\/doi.org\/10.1016\/j.nedt.2016.11.015","DOI":"10.1016\/j.nedt.2016.11.015"},{"key":"e_1_3_4_17_1","doi-asserted-by":"crossref","unstructured":"\u010cerven\u00fd M. Kratochv\u00edlov\u00e1 I. Hellerov\u00e1 V. T\u00f3thov\u00e1 V. (2022). Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011\u20132021. Frontiers in Psychology 13 Article 936181. https:\/\/doi.org\/10.3389\/fpsyg.2022.936181","DOI":"10.3389\/fpsyg.2022.936181"},{"key":"e_1_3_4_18_1","doi-asserted-by":"crossref","unstructured":"Chung S. Jarvill M. (2019). Improving nursing student cultural competence: Comparing simulation to case-based learning. Journal of Nursing Education and Practice 9(7) Article 128. https:\/\/doi.org\/10.5430\/jnep.v9n7p128","DOI":"10.5430\/jnep.v9n7p128"},{"key":"e_1_3_4_19_1","unstructured":"College of Nurses of Ontario. (2019). Entry to practice competencies for Registered Nurses. https:\/\/www.cno.org\/globalassets\/docs\/reg\/41037-entry-to-practice-competencies-2020.pdf"},{"key":"e_1_3_4_20_1","volume-title":"Shaping a professional identity: Stories of educational practice","author":"Connelly F. M.","year":"1999","unstructured":"Connelly F. M., Clandinin D. J. (1999). Shaping a professional identity: Stories of educational practice. Teachers College Press."},{"key":"e_1_3_4_21_1","doi-asserted-by":"crossref","unstructured":"Costello M. Huddleston J. Atinaja-Faller J. Prelack K. Wood A. Barden J. Adly S. (2017). Simulation as an effective strategy for interprofessional education. Clinical Simulation in Nursing 13(12) 624\u2013627. https:\/\/doi.org\/10.1016\/j.ecns.2017.07.005","DOI":"10.1016\/j.ecns.2017.07.008"},{"key":"e_1_3_4_22_1","doi-asserted-by":"crossref","unstructured":"Cruz E. V. Higginbottom G. O\u2019Brien B. (2017). The impact of international clinical placements on cultural competence and professional development. Nurse Education Today 52 71\u201376. https:\/\/doi.org\/10.1016\/j.nedt.2017.02.019","DOI":"10.1016\/j.nedt.2017.02.019"},{"key":"e_1_3_4_23_1","doi-asserted-by":"crossref","unstructured":"Curtis E. Jones R. Tipene-Leach D. Walker C. Loring B. Paine S.-J. Reid P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health 18 174. https:\/\/doi.org\/10.1186\/s12939-019-1082-3","DOI":"10.1186\/s12939-019-1082-3"},{"key":"e_1_3_4_24_1","doi-asserted-by":"crossref","unstructured":"Curtis E. Loring B. Jones R. Tipene-Leach D. Walker C. Paine S. J. Reid P. (2025). Refining the definitions of cultural safety cultural competency and Indigenous health: Lessons from Aotearoa New Zealand. International Journal for Equity in Health 24(1) Article 130. https:\/\/doi.org\/10.1186\/s12939-025-02478-3","DOI":"10.1186\/s12939-025-02478-3"},{"key":"e_1_3_4_25_1","doi-asserted-by":"crossref","unstructured":"Fadaeinia M. M. Miri S. Azizzadeh Forouzi M. Roy C. Farokhzadian J. (2022). Improving cultural competence and self-efficacy among postgraduate nursing students: Results of an online cultural care training program. Journal of Transcultural Nursing 33(5) 642\u2013651. https:\/\/doi.org\/10.1177\/10436596221101925","DOI":"10.1177\/10436596221101925"},{"key":"e_1_3_4_26_1","doi-asserted-by":"crossref","unstructured":"Farokhzadian J. Nematollahi M. Dehghan Nayeri N. Faramarzpour M. (2022). Using a model to design implement and evaluate a training program for improving cultural competence among undergraduate nursing students: A mixed methods study. BMC Nursing 21(1) Article 85. https:\/\/doi.org\/10.1186\/s12912-022-00849-7","DOI":"10.1186\/s12912-022-00849-7"},{"key":"e_1_3_4_27_1","doi-asserted-by":"crossref","unstructured":"Friedrich S. Straub C. Bode S. F. N. Heinzmann A. (2021). SIESTA: A quick interprofessional learning activity fostering collaboration and communication between paediatric nursing trainees and medical students. BMC Medical Education 21(1) Article 475. https:\/\/doi.org\/10.1186\/s12909-021-02880-9","DOI":"10.1186\/s12909-021-02880-9"},{"key":"e_1_3_4_28_1","doi-asserted-by":"crossref","unstructured":"Foronda C. Baptiste D. L. Reinholdt M. M. Ousman K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing 27(3) 210\u2013217. https:\/\/doi.org\/10.1177\/1043659615592677","DOI":"10.1177\/1043659615592677"},{"key":"e_1_3_4_29_1","doi-asserted-by":"crossref","unstructured":"Fung J. T. Chan S. L. Takemura N. Chiu H. Y. Huang H.-C. Lee J. E. Preechawong S. Hyun M. Y. Sun M. Xia W. Xiao J. Lin C. C. (2023). Virtual simulation and problem-based learning enhance perceived clinical and cultural competence of nursing students in Asia: A randomized controlled cross-over study. Nurse Education Today 123 Article 105721. https:\/\/doi.org\/10.1016\/j.nedt.2023.105721","DOI":"10.1016\/j.nedt.2023.105721"},{"key":"e_1_3_4_30_1","doi-asserted-by":"crossref","unstructured":"Garneau A. B. Pepin J. (2014). Cultural competence. Journal of Transcultural Nursing 26(1) 9\u201315. https:\/\/doi.org\/10.1177\/1043659614541294","DOI":"10.1177\/1043659614541294"},{"key":"e_1_3_4_31_1","doi-asserted-by":"crossref","unstructured":"Gower S. Mulhall M. Russell M. (2023). Global learning and professional growth: Outcomes of international nursing placements. Journal of Clinical Nursing 32(5\u20136) 1125\u20131137. https:\/\/doi.org\/10.1111\/jocn.16532","DOI":"10.1111\/jocn.16532"},{"key":"e_1_3_4_32_1","volume-title":"Participatory qualitative research methodologies in health","author":"Higginbottom G.","year":"2017","unstructured":"Higginbottom G., Liamputtong P. (2017). Participatory qualitative research methodologies in health. Sage Publications."},{"key":"e_1_3_4_33_1","doi-asserted-by":"crossref","unstructured":"Homeyer S. Hoffmann W. Hingst P. Oppermann R. F. Dreier-Wolfgramm A. (2018). Effects of interprofessional education for medical and nursing students: Enablers barriers and expectations for optimizing future interprofessional collaboration\u2014A qualitative study. BMC Nursing 17 1\u201310. https:\/\/doi.org\/10.1186\/s12912-018-0279-x","DOI":"10.1186\/s12912-018-0279-x"},{"key":"e_1_3_4_34_1","doi-asserted-by":"crossref","unstructured":"Hovland O. J. Johannessen B. (2018). Nursing students develop cultural competence during student exchanges in Tanzania. Sykepleien Forskning 13 Article e-73782. https:\/\/doi.org\/10.4220\/sykepleienf.2018.73782en","DOI":"10.4220\/Sykepleienf.2018.73782en"},{"key":"e_1_3_4_35_1","doi-asserted-by":"crossref","unstructured":"James L. Al-Kofahy L. (2020). Cultivating cultural competence through Academic Community Engagement and clinical reflection. Journal of Transcultural Nursing 32(5) 623\u2013629. https:\/\/doi.org\/10.1177\/1043659620971699","DOI":"10.1177\/1043659620971699"},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.1891\/9780826119971"},{"key":"e_1_3_4_37_1","doi-asserted-by":"crossref","unstructured":"Johannessen A. K. Hagen R. Nortvedt P. (2014). The significance of international clinical placements for nursing students: A qualitative study. Nurse Education Today 34(10) 1312\u20131317. https:\/\/doi.org\/10.1016\/j.nedt.2014.04.001","DOI":"10.1016\/j.nedt.2014.04.001"},{"key":"e_1_3_4_38_1","doi-asserted-by":"crossref","unstructured":"Johnston J. McKenna L. Malik G. Reisenhofer S. (2023). Recognizing and adapting to cultural differences: Influence of international educational programs on future nursing and midwifery practice. Journal of Transcultural Nursing 34(6) 423\u2013430. https:\/\/doi.org\/10.1177\/10436596231198276","DOI":"10.1177\/10436596231198276"},{"key":"e_1_3_4_39_1","doi-asserted-by":"crossref","unstructured":"Jongen C. McCalman J. Bainbridge R. (2018). Health workforce cultural competency interventions: A systematic scoping review. BMC Health Services Research 18(1) Article 232. https:\/\/doi.org\/10.1186\/s12913-018-3001-5","DOI":"10.1186\/s12913-018-3001-5"},{"key":"e_1_3_4_40_1","doi-asserted-by":"crossref","unstructured":"Kaihlanen A. M. Hietapakka L. Heponiemi T. (2019). Increasing cultural awareness: Nurses\u2019 perceptions of cultural competence training. BMC Nursing 18(1) Article 38. https:\/\/doi.org\/10.1186\/s12912-019-0363-x","DOI":"10.1186\/s12912-019-0363-x"},{"key":"e_1_3_4_41_1","doi-asserted-by":"crossref","unstructured":"Kelleher S. FitzGerald S. Hegarty J. (2016). Factors that influence nursing and midwifery students\u2019 intentions to study abroad: A qualitative study using the theory of planned behaviour. Nurse Education Today 44 157\u2013164. https:\/\/doi.org\/10.1016\/j.nedt.2016.05.019","DOI":"10.1016\/j.nedt.2016.05.019"},{"key":"e_1_3_4_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-4560-67-2"},{"key":"e_1_3_4_43_1","doi-asserted-by":"crossref","unstructured":"Kessler T. A. Kost G. C. (2021). An innovative approach for using cross-cultural collaborative simulation during Undergraduate Nursing Study Abroad Exchanges. Clinical Simulation in Nursing 61 14\u201322. https:\/\/doi.org\/10.1016\/j.ecns.2021.09.004","DOI":"10.1016\/j.ecns.2021.09.004"},{"key":"e_1_3_4_44_1","doi-asserted-by":"crossref","unstructured":"Kohlbry P. W. (2016). The impact of international service-learning on nursing students\u2019 cultural competency. Journal of Nursing Scholarship 48(3) 303\u2013311. https:\/\/doi.org\/10.1111\/jnu.12209","DOI":"10.1111\/jnu.12209"},{"key":"e_1_3_4_45_1","doi-asserted-by":"crossref","unstructured":"Kokko R. (2011). Future nurses\u2019 cultural competencies: What are their learning experiences during exchange and studies abroad? A systematic literature review. Journal of Nursing Management 19(5) 673\u2013682. https:\/\/doi.org\/10.1111\/j.1365-2834.2011.01221.x","DOI":"10.1111\/j.1365-2834.2011.01221.x"},{"key":"e_1_3_4_46_1","doi-asserted-by":"crossref","unstructured":"Kumwenda B. Royan D. Ringsell P. Dowell J. (2014). The role of language in international medical and nursing placements. Medical Education 48(7) 744\u2013752. https:\/\/doi.org\/10.1111\/medu.12427","DOI":"10.1111\/medu.12477"},{"key":"e_1_3_4_47_1","doi-asserted-by":"crossref","unstructured":"Lekas H.-M. Pahl K. Fuller Lewis C. (2020). Rethinking cultural competence: Shifting to cultural humility. Health Services Insights 13. https:\/\/doi.org\/10.1177\/1178632920970580","DOI":"10.1177\/1178632920970580"},{"key":"e_1_3_4_48_1","doi-asserted-by":"crossref","unstructured":"Louis K. S. White A. Brown A. (2025). Nursing students\u2019 enhanced cultural competence after study abroad: A mixed-methods study. Journal of Nursing Education 64(3) 185\u2013191. https:\/\/doi.org\/10.3928\/01484834-20250108-01","DOI":"10.3928\/01484834-20250108-01"},{"key":"e_1_3_4_49_1","doi-asserted-by":"crossref","unstructured":"Majda A. Bodys-Cupak I. E. Zalewska-Pucha\u0142a J. Barzykowski K. (2021). Cultural competence and cultural intelligence of healthcare professionals providing emergency medical services. International Journal of Environmental Research and Public Health 18(21) Article 11547. https:\/\/doi.org\/10.3390\/ijerph182111547","DOI":"10.3390\/ijerph182111547"},{"key":"e_1_3_4_50_1","doi-asserted-by":"crossref","unstructured":"Markey K. Okantey C. (2019). Nurturing cultural competence in nurse education through a values-based learning approach. Nurse Education in Practice 38 153\u2013156. https:\/\/doi.org\/10.1016\/j.nepr.2019.06.011","DOI":"10.1016\/j.nepr.2019.06.011"},{"key":"e_1_3_4_51_1","doi-asserted-by":"crossref","unstructured":"McAdams D. P. (2001). The psychology of life stories. Review of General Psychology 5(2) 100\u2013122. https:\/\/doi.org\/10.1037\/1089-2680.5.2.100","DOI":"10.1037\/1089-2680.5.2.100"},{"key":"e_1_3_4_52_1","doi-asserted-by":"crossref","unstructured":"McElfish P. A. Moore R. Buron B. Hudson J. Long C. R. Purvis R. S. Schulz T. K. Rowland B. Warmack T. S. (2018). Integrating interprofessional education and cultural competency training to address Health Disparities. Teaching and Learning in Medicine 30(2) 213\u2013222. https:\/\/doi.org\/10.1080\/10401334.2017.1365717","DOI":"10.1080\/10401334.2017.1365717"},{"key":"e_1_3_4_53_1","doi-asserted-by":"crossref","unstructured":"Murray R. (2015). Challenges and learning in global health nursing placements. Nurse Education Today 35(5) 653\u2013658. https:\/\/doi.org\/10.1016\/j.nedt.2015.01.014","DOI":"10.1016\/j.nedt.2015.01.014"},{"key":"e_1_3_4_54_1","doi-asserted-by":"crossref","unstructured":"Nashwan A. J. (2024). Culturally competent care across borders: Implementing culturally responsive teaching for nurses in diverse workforces. International Journal of Nursing Sciences 11(1) 155\u2013157. https:\/\/doi.org\/10.1016\/j.ijnss.2023.09.001","DOI":"10.1016\/j.ijnss.2023.09.001"},{"key":"e_1_3_4_55_1","doi-asserted-by":"crossref","unstructured":"Newton L. Pront L. Giles T. (2018). Supervisors\u2019 perspectives of international clinical placements: Communication and cultural challenges. Journal of Nursing Education 57(9) 543\u2013550. https:\/\/doi.org\/10.3928\/01484834-20180815-06","DOI":"10.3928\/01484834-20180815-06"},{"key":"e_1_3_4_56_1","doi-asserted-by":"crossref","unstructured":"O\u2019Brien E. M. O\u2019 Donnell C. Murphy J. O\u2019 Brien B. Markey K. (2021). Intercultural readiness of nursing students: An integrative review of evidence examining cultural competence educational interventions. Nurse Education in Practice 50 Article 102966. https:\/\/doi.org\/10.1016\/j.nepr.2021.102966","DOI":"10.1016\/j.nepr.2021.102966"},{"key":"e_1_3_4_57_1","doi-asserted-by":"crossref","unstructured":"Oikarainen A. Mikkonen K. Kenny A. Tomietto M. Tuomikoski A.-M. Meril\u00e4inen M. Miettunen J. K\u00e4\u00e4ri\u00e4inen M. (2019). Educational interventions designed to develop nurses\u2019 Cultural Competence: A Systematic Review. International Journal of Nursing Studies 98 75\u201386. https:\/\/doi.org\/10.1016\/j.ijnurstu.2019.06.005","DOI":"10.1016\/j.ijnurstu.2019.06.005"},{"key":"e_1_3_4_58_1","doi-asserted-by":"crossref","unstructured":"Osmancevic S. Steiner L. M. Gro\u00dfsch\u00e4dl F. Lohrmann C. Schoberer D. (2025). The effectiveness of cultural competence interventions in nursing: A systematic review and meta-analysis. International Journal of Nursing Studies 167 Article 105079. https:\/\/doi.org\/10.1016\/j.ijnurstu.2025.105079","DOI":"10.1016\/j.ijnurstu.2025.105079"},{"key":"e_1_3_4_59_1","doi-asserted-by":"crossref","unstructured":"Ozkara San E. (2019). Development of the diverse standardized patient Simulation Cultural Competence Education strategy. Nursing Education Perspectives 40(6) E31\u2013E33. https:\/\/doi.org\/10.1097\/01.nep.0000000000000519","DOI":"10.1097\/01.NEP.0000000000000519"},{"key":"e_1_3_4_60_1","doi-asserted-by":"crossref","unstructured":"Page R. Harper R. Frobenius M. (2013). From small stories to networked narrative: The evolution of personal narratives in Facebook status updates. Narrative Inquiry 23(1) 192\u2013213. https:\/\/doi.org\/10.1075\/ni.23.1.10pag","DOI":"10.1075\/ni.23.1.10pag"},{"key":"e_1_3_4_61_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315560984"},{"key":"e_1_3_4_62_1","doi-asserted-by":"crossref","unstructured":"Patel H. Perry S. Badu E. Mwangi F. Onifade O. Mazurskyy A. Walters J. Tavener M. Noble D. Chidarikire S. Lethbridge L. Jobson L. Carver H. MacLellan A. Govind N. Andrews G. Kerrison-Watkin G. Lun E. Malau-Aduli B. S. & the ACHIEVE Network. (2025). A scoping review of interprofessional education in healthcare: Evaluating competency development educational outcomes and challenges. BMC Medical Education 25 Article 409. https:\/\/doi.org\/10.1186\/s12909-025-06969-3","DOI":"10.1186\/s12909-025-06969-3"},{"key":"e_1_3_4_63_1","doi-asserted-by":"crossref","unstructured":"Qin Y. Chaimongkol N. (2021). Simulation with standardized patients designed as interventions to develop nursing students\u2019 cultural competence: A systematic review. Journal of Transcultural Nursing 32(6) 778\u2013789. https:\/\/doi.org\/10.1177\/10436596211023968","DOI":"10.1177\/10436596211023968"},{"key":"e_1_3_4_64_1","unstructured":"Ramsden I. (2002). Cultural safety and nursing education in Aotearoa and Te Waipounamu [Doctoral dissertation Victoria University of Wellington]."},{"key":"e_1_3_4_65_1","doi-asserted-by":"crossref","unstructured":"Reeves S. Fletcher S. Barr H. Birch I. Boet S. Davies N. McFadyen A. Rivera J. Kitto S. (2016). A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical Teacher 38(7) 656\u2013668. https:\/\/doi.org\/10.3109\/0142159X.2016.1173663","DOI":"10.3109\/0142159X.2016.1173663"},{"key":"e_1_3_4_66_1","doi-asserted-by":"crossref","unstructured":"Reid-Searl K. Dwyer T. Moxham L. Happell B. Sander T. (2011). Rediscovering the essence of nursing: Exploring the impact of in clinical experience in Thailand for undergraduate nursing students from Australia. Nurse Education Today 31(8) 892\u2013897. https:\/\/doi.org\/10.1016\/j.nedt.2010.12.024","DOI":"10.1016\/j.nedt.2010.12.024"},{"key":"e_1_3_4_67_1","doi-asserted-by":"crossref","unstructured":"Shahzad S. Ali N. Younas A. Tayaben J. L. (2021). Challenges and approaches to Transcultural Care: An integrative review of nurses\u2019 and nursing students\u2019 experiences. Journal of Professional Nursing 37(6) 1119\u20131131. https:\/\/doi.org\/10.1016\/j.profnurs.2021.10.001","DOI":"10.1016\/j.profnurs.2021.10.001"},{"key":"e_1_3_4_68_1","doi-asserted-by":"crossref","unstructured":"Sharifi N. Adib-Hajbaghery M. Najafi M. (2019). Cultural competence in nursing: A concept analysis. International Journal of Nursing Studies 99 Article 103386. https:\/\/doi.org\/10.1016\/j.ijnurstu.2019.103386","DOI":"10.1016\/j.ijnurstu.2019.103386"},{"key":"e_1_3_4_69_1","doi-asserted-by":"crossref","unstructured":"Shopo K. D. Nuuyoma V. Chihururu L. (2025). Enhancing Cultural Competence in Undergraduate Nursing Students: An Integrative Literature Review of Strategies for Institutions of Higher Education. Journal of Transcultural Nursing 36(4) 412\u2013428. https:\/\/doi.org\/10.1177\/10436596241301407","DOI":"10.1177\/10436596241301407"},{"key":"e_1_3_4_70_1","doi-asserted-by":"crossref","unstructured":"Sj\u00f6gren Forss K. Persson K. Borglin G. (2019). Nursing students\u2019 experiences of caring for ethnically and culturally diverse patients: A scoping review. Nurse Education in Practice 37 97\u2013104. https:\/\/doi.org\/10.1016\/j.nepr.2019.05.003","DOI":"10.1016\/j.nepr.2019.05.003"},{"key":"e_1_3_4_71_1","doi-asserted-by":"crossref","unstructured":"Stubbe D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus 18(1) 49\u201351. https:\/\/doi.org\/10.1176\/appi.focus.20190041","DOI":"10.1176\/appi.focus.20190041"},{"key":"e_1_3_4_72_1","doi-asserted-by":"crossref","unstructured":"Tervalon M. Murray-Garc\u00eda J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved 9(2) 117\u2013125. https:\/\/doi.org\/10.1353\/hpu.2010.0233","DOI":"10.1353\/hpu.2010.0233"},{"key":"e_1_3_4_73_1","doi-asserted-by":"crossref","unstructured":"Tinkler A. S. Tinkler B. (2016). Enhancing cultural humility through critical service-learning in teacher preparation. Multicultural Perspectives 18(4) 192\u2013201. https:\/\/doi.org\/10.1080\/15210960.2016.1222282","DOI":"10.1080\/15210960.2016.1222282"},{"key":"e_1_3_4_74_1","doi-asserted-by":"crossref","unstructured":"Tosun B. Yava A. Dirgar E. \u015eahin E. B. Y\u0131lmaz E. B. Papp K. T\u00f3thova V. Hellerova V. Prosen M. Licen S. Karnjus I. Tamayo M. D. Leyva-Moral J. M. Claeys A. Tricas-Sauras S. (2021). Addressing the effects of Transcultural Nursing Education on nursing students\u2019 cultural competence: A systematic review. Nurse Education in Practice 55 Article 103171. https:\/\/doi.org\/10.1016\/j.nepr.2021.103171","DOI":"10.1016\/j.nepr.2021.103171"},{"key":"e_1_3_4_75_1","doi-asserted-by":"crossref","unstructured":"Tuckett A. Crompton P. (2013). Qualitative understanding of an international learning experience: What Australian undergraduate nurses and midwives said about a Cambodia placement? International Journal of Nursing Practice 20(2) 135\u2013141. https:\/\/doi.org\/10.1111\/ijn.12142","DOI":"10.1111\/ijn.12142"},{"key":"e_1_3_4_76_1","doi-asserted-by":"crossref","unstructured":"Ulvund I. Mordal E. (2017). Nursing students\u2019 reflections on short-term international placements: A qualitative study. Nurse Education in Practice 24 35\u201340. https:\/\/doi.org\/10.1016\/j.nepr.2017.03.004","DOI":"10.1016\/j.nepr.2017.03.004"},{"key":"e_1_3_4_77_1","doi-asserted-by":"crossref","unstructured":"Ulvund I. Dadi G. B. Sundal H. (2023). Nurses benefit from international clinical placements as nursing students: A qualitative study. Nurse Education in Practice 68 Article 103598. https:\/\/doi.org\/10.1016\/j.nepr.2023.103598","DOI":"10.1016\/j.nedt.2022.105663"},{"key":"e_1_3_4_78_1","doi-asserted-by":"crossref","unstructured":"Unver V. Cakiroglu E. Satilmis A. (2021). Barriers experienced by international nursing students: A systematic review. International Nursing Review 68(3) 394\u2013403. https:\/\/doi.org\/10.1111\/inr.12669","DOI":"10.1111\/inr.12669"},{"key":"e_1_3_4_79_1","doi-asserted-by":"crossref","unstructured":"Visiers-Jim\u00e9nez L. Mart\u00ednez-Gimeno M. L. R\u00edos-D\u00edaz J. Lybrecht-Llinares S. M. Baeza-Monedero M. I. (2025). Cultural competence of nursing students after their first supervised internships: An International Cross-Sectional Study. International Nursing Review 72(3) Article e70068. https:\/\/doi.org\/10.1111\/inr.70068","DOI":"10.1111\/inr.70068"},{"key":"e_1_3_4_80_1","doi-asserted-by":"crossref","unstructured":"Walshe N. Condon C. Gonzales R. A. Burke E. Chian\u00e1in L. N. Thamanam N. Smart A. Jordaan G. Regan P. O. (2022). Cultural simulations authenticity focus and outcomes: A systematic review of the healthcare literature. Clinical Simulation in Nursing 71 65\u201381. https:\/\/doi.org\/10.1016\/j.ecns.2022.05.008","DOI":"10.1016\/j.ecns.2022.05.008"},{"key":"e_1_3_4_81_1","unstructured":"World Bank. (2024). Mortality rate neonatal (per 1 000 live births) \u2013 Tanzania. https:\/\/data.worldbank.org\/indicator\/SH.DYN.NMRT?locations=TZ"},{"key":"e_1_3_4_82_1","unstructured":"World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. https:\/\/www.who.int\/publications\/i\/item\/framework-for-action-on-interprofessional-education-and-collaborative-practice"},{"key":"e_1_3_4_83_1","doi-asserted-by":"crossref","unstructured":"Zenani N. E. Sehularo L. A. Gause G. Chukwuere P. C. (2023). The contribution of interprofessional education in developing competent undergraduate nursing students: An integrative literature review. BMC Nursing 22 Article 315. https:\/\/doi.org\/10.1186\/s12912-023-01482-8","DOI":"10.1186\/s12912-023-01482-8"}],"container-title":["Global Qualitative Nursing Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23333936261450418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23333936261450418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23333936261450418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:46:11Z","timestamp":1779000371000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23333936261450418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":82,"alternative-id":["10.1177\/23333936261450418"],"URL":"https:\/\/doi.org\/10.1177\/23333936261450418","relation":{},"ISSN":["2333-3936","2333-3936"],"issn-type":[{"value":"2333-3936","type":"print"},{"value":"2333-3936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"article-number":"23333936261450418"}}