{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:01:07Z","timestamp":1770894067855,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Erasmus+ Programme of the European Union","award":["2018-I-ES01-KA203-050800"],"award-info":[{"award-number":["2018-I-ES01-KA203-050800"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Background: Within the European higher education context, students and lecturers are encouraged to engage in teaching and learning activities abroad. This frequently involves using a second language and being exposed to students and lecturers from culturally different backgrounds. Objective: To design a model for teaching and learning cultural competence in a multicultural environment (CCMEn). Design: Theory development from empirical experience, research, and scholarly works. Method: This model was developed based on our experience of teaching and learning cultural competence in a multicultural environment in a nursing education context; it rests on three pillars, namely, Coyle\u2019s Content and Language Integrated Learning educational approach, the concept of social and emotional learning, as defined by the Collaborative for Academic, Social and Emotional Learning, and the existing literature surrounding teaching and learning cultural competence in higher education. Results: The CCMEn model is intended to guide the process of teaching and learning cultural competence in a multicultural environment through the use of a second language and has been adapted from existing educational approaches and theory. Conclusion: Teaching and learning in multilingual and multicultural contexts in Europe is becoming more common. Students who learn alongside students and teachers from different cultural backgrounds need to be supported from an academic, linguistic and socioemotional perspective. We believe that the CCMEn model can serve as a guide to enhancing student learning in this context.<\/jats:p>","DOI":"10.3390\/nursrep10020019","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T22:30:52Z","timestamp":1607985052000},"page":"154-163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Teaching and Learning Cultural Competence in a Multicultural Environment (CCMEn) Model"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8206-4803","authenticated-orcid":false,"given":"Isabel","family":"Ant\u00f3n-Solanas","sequence":"first","affiliation":[{"name":"Research Group GENIAPA, Department of Physiatry and Nursing, University of Zaragoza, C\/Domingo Miral s\/n, 50009 Zaragoza, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5334-6895","authenticated-orcid":false,"given":"Margarida","family":"Coelho","sequence":"additional","affiliation":[{"name":"Instituto Polit\u00e9cnico de Portalegre, School of Education and Social Science, Pra\u00e7a do Munic\u00edpio, 77301-110 Portalegre, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7674-0150","authenticated-orcid":false,"given":"Isabel","family":"Hu\u00e9rcanos-Esparza","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad San Jorge, Autov\u00eda A-23. Km 199, 50830 Villanueva de G\u00e1llego, Spain"}]},{"given":"Val\u00e9rie","family":"Vanceulebroeck","sequence":"additional","affiliation":[{"name":"Department of Nursing, AP University College, Lange Nieuwstraat 101, 2000 Antwerpen, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6020-349X","authenticated-orcid":false,"given":"Indrani","family":"Kalkan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Istanbul Aydin University, Sefak\u00f6y-K\u00fc\u00e7\u00fck\u00e7ekmece 38, 34295 Istanbul, Turkey"}]},{"given":"Raul","family":"Cordeiro","sequence":"additional","affiliation":[{"name":"Instituto Polit\u00e9cnico de Portalegre, School of Health Sciences, Pra\u00e7a do Munic\u00edpio, 77301-110 Portalegre, Portugal"}]},{"given":"Nuran","family":"K\u00f6m\u00fcrk\u00fc","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Istanbul Aydin University, Sefak\u00f6y-K\u00fc\u00e7\u00fck\u00e7ekmece 38, 34295 Istanbul, Turkey"}]},{"given":"Teresa","family":"Soares-Coelho","sequence":"additional","affiliation":[{"name":"Instituto Polit\u00e9cnico de Portalegre, School of Education and Social Science, Pra\u00e7a do Munic\u00edpio, 77301-110 Portalegre, Portugal"}]},{"given":"Nadia","family":"Hamam-Alcober","sequence":"additional","affiliation":[{"name":"Servicio Aragon\u00e9s de Salud, Women\u2019s and Children\u2019s Hospital, Paseo Isabel la Cat\u00f3lica, 1-3, 50009 Zaragoza, Spain"}]},{"given":"Shana","family":"Dehaes","sequence":"additional","affiliation":[{"name":"Department of Nursing, AP University College, Lange Nieuwstraat 101, 2000 Antwerpen, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5752-1136","authenticated-orcid":false,"given":"Antonio","family":"Casa-Nova","sequence":"additional","affiliation":[{"name":"Instituto Polit\u00e9cnico de Portalegre, School of Health Sciences, Pra\u00e7a do Munic\u00edpio, 77301-110 Portalegre, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5929-6449","authenticated-orcid":false,"given":"Luc\u00eda","family":"Sagarra-Romero","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad San Jorge, Autov\u00eda A-23. Km 199, 50830 Villanueva de G\u00e1llego, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"ref_1","unstructured":"(2019, February 26). European Commission Social Inclusion. Available online: https:\/\/ec.europa.eu\/europeaid\/sectors\/human-development\/social-inclusion_en."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1177\/1043659605281976","article-title":"Cultural competence in nursing: New meanings","volume":"17","author":"Cowan","year":"2006","journal-title":"J. Transcult. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/j.1466-7657.2009.00744.x","article-title":"Similarities and mutual understanding: Exchange experiences in Malawi for host and guest students","volume":"56","author":"Hagen","year":"2009","journal-title":"Int. Nurs. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.nepr.2013.11.006","article-title":"Student exchange for nursing students: Does it raise cultural awareness\u2019? A descriptive, qualitative study","volume":"14","author":"Bohman","year":"2014","journal-title":"Nurse Educ. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/10459602013003003","article-title":"The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care","volume":"13","year":"2002","journal-title":"J. Transcult. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Jeffreys, M.R. (2015). Teaching Cultural Competence in Nursing and Health Care, Third Edition: Inquiry, Action, and Innovation, Springer Publishing Company. [3rd ed.].","DOI":"10.1891\/9780826119971"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/JNR.0000000000000157","article-title":"The Relationships Among Personality, Intercultural Communication, and Cultural Self-Efficacy in Nursing Students","volume":"24","author":"Chan","year":"2016","journal-title":"J. Nurs. Res."},{"key":"ref_8","unstructured":"Papadopoulos, I., Tilki, M., and Taylor, G. (1998). Transcultural Care: A Guide for Health Care Professionals, Quay Books."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/003172170108300309","article-title":"Diversity within Unity: Essential Principles for Teaching and Learning in a Multicultural Society","volume":"83","author":"Banks","year":"2001","journal-title":"Phi Delta Kappan"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.profnurs.2009.01.010","article-title":"Banks Multicultural Model: A Framework for Integrating Multiculturalism Into Nursing Curricula","volume":"25","author":"Bagnardi","year":"2009","journal-title":"J. Prof. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1046\/j.1365-2702.2003.00717.x","article-title":"International clinical placements for undergraduate students","volume":"12","author":"Grant","year":"2003","journal-title":"J. Clin. Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1440-172X.2004.00470.x","article-title":"Study abroad as a process of learning intercultural competence in nursing","volume":"10","author":"Koskinen","year":"2004","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_13","unstructured":"(2020, December 02). European Commission Transcultural Nursing: A European Priority, a Professional Responsibility. Available online: https:\/\/ec.europa.eu\/programmes\/erasmus-plus\/projects\/eplus-project-details_en."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.nedt.2018.07.011","article-title":"Investigating Malaysian Nurses\u2019 perspectives of intercultural teaching in transnational higher education learning environments","volume":"69","author":"Arunasalam","year":"2018","journal-title":"Nurse Educ. Today"},{"key":"ref_15","first-page":"13","article-title":"Utilising the Hand Model to promote a culturally safe environment for international nursing students","volume":"27","author":"Mackay","year":"2011","journal-title":"Nurs. Prax. N Z"},{"key":"ref_16","unstructured":"Masih, J. (1999). Supporting students in content and language integrated contexts: Planning for effective classrooms. Learning through a Foreign Language\u2014Models, Methods and Outcomes, Centre for Information on Language Teaching and Research (CILT)."},{"key":"ref_17","unstructured":"Durlak, J.A., Domitrovich, C.E., Weissberg, R.P., and Gullotta, T.P. (2016). Handbook of Social and Emotional Learning: Research and Practice, The Guilford Press. Edici\u00f3n: Reprint."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.nedt.2016.11.012","article-title":"The role of language skills and internationalization in nursing degree programmes: A literature review","volume":"49","author":"Garone","year":"2017","journal-title":"Nurse Educ. Today"},{"key":"ref_19","first-page":"1","article-title":"Content and Language Integrated Learning\u2014Motivating Learners and Teachers","volume":"13","author":"Coyle","year":"2006","journal-title":"Scott. Lang. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.58265\/pulso.5002","article-title":"Towards quality-CLIL: Successful planning and teaching strategies","volume":"33","author":"Meyer","year":"2010","journal-title":"Pulso"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Frydenberg, E., Martin, A.J., and Collie, R.J. (2017). Assessing Students\u2019 Social and Emotional Learning: A Review of the Literature on Assessment Tools and Related Issues. Social and Emotional Learning in Australia and the Asia-Pacific: Perspectives, Programs and Approaches, Springer Singapore.","DOI":"10.1007\/978-981-10-3394-0_4"},{"key":"ref_22","unstructured":"O\u2019Conner, R., De Feyter, J., Carr, A., Luo, J.L., and Romm, H. (2017). A Review of the Literature on Social and Emotional Learning for Students Ages 3-8: Characteristics of Effective Social and Emotional Learning Programs (Part 1 of 4). REL 2017-245."},{"key":"ref_23","first-page":"126","article-title":"The importance of developing social and emotional learning (SEL) within the CLIL classroom, with special reference to Spain","volume":"26","author":"Mortimore","year":"2017","journal-title":"Encuentro, Revista de investigaci\u00f3n e Innovaci\u00f3n en la Classe de Idiomas"},{"key":"ref_24","first-page":"344","article-title":"Socio-emotional well-being and academic achievement: Evidence from a multilevel approach","volume":"24","author":"Berger","year":"2011","journal-title":"Psicologia: Reflex\u00e3o e Cr\u00edtica"},{"key":"ref_25","first-page":"279","article-title":"Socio-emotional challenges in international education: Insight into reciprocal understanding and intercultural relational development","volume":"7","author":"Ujitani","year":"2008","journal-title":"J. Res. Intern. Educ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/HNP.0b013e318263f2c9","article-title":"Cultural competency in baccalaureate US nursing education: Hybrid course","volume":"26","author":"Aponte","year":"2012","journal-title":"Holist. Nurs. Pract."},{"key":"ref_27","unstructured":"(2020, November 20). Council of Europe Educational Culture. Available online: https:\/\/www.coe.int\/en\/web\/lang-migrants\/educational-culture-\/-tradition-\/-background."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/1043659619875184","article-title":"A Theory of Cultural Humility","volume":"31","author":"Foronda","year":"2019","journal-title":"J. Transcult. Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.nedt.2012.12.006","article-title":"Development and evaluation of a teaching and learning approach in cross-cultural care and antidiscrimination in university nursing students","volume":"33","author":"Allen","year":"2013","journal-title":"Nurse Educ. Today"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"185","DOI":"10.12968\/bjon.2003.12.3.185","article-title":"Transcultural nursing: How do nurses respond to cultural needs?","volume":"12","author":"Narayanasamy","year":"2003","journal-title":"Br. J. Nurs."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Papadopoulos, I. (2018). Culturally Competent Compassion, Routledge. [1st ed.].","DOI":"10.4324\/9781315560984"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/j.1744-6198.2009.00163.x","article-title":"\u201cLeaving the Comfort of the Familiar\u201d: Fostering Workplace Cultural Awareness Through Short-Term Global Experiences","volume":"45","author":"Leak","year":"2010","journal-title":"Nurs. Forum."},{"key":"ref_33","first-page":"1","article-title":"The development and validation of the intercultural communication sensitivity scale","volume":"3","author":"Chen","year":"2000","journal-title":"Hum. Commun."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"129","DOI":"10.5172\/conu.673.28.1-2.129","article-title":"Cultural competence in action for CAMHS: Development of a cultural competence assessment tool and training programme","volume":"28","author":"Papadopoulos","year":"2008","journal-title":"Contemp. Nurse"},{"key":"ref_35","unstructured":"(2019, October 15). CSI Resources: Professional Learning. Available online: https:\/\/casel.org\/csi-resources-professional-learning\/."},{"key":"ref_36","unstructured":"Biggs, J., and Tang, C. (2007). Teaching for Quality Learning at University, Open University Press. [3rd ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1177\/1043659616632046","article-title":"The Cultural Competence of Graduating Nursing Students","volume":"28","author":"Repo","year":"2017","journal-title":"J. Transcult. Nurs."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1080\/13670050.2014.980778","article-title":"Teacher training needs for bilingual education: In-service teacher perceptions","volume":"19","year":"2016","journal-title":"Int. J. Biling. Educ. Biling."},{"key":"ref_39","unstructured":"Mehisto, P., Marsh, D., and Frigols, M.J. (2008). Uncovering CLIL: Content and Language Integrated Learning in Bilingual and Multilingual Education, Macmillan Education."},{"key":"ref_40","unstructured":"Nursing Council of New Zealand (2011). Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice., Nursing Council of New Zealand."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3928\/01484834-20180102-08","article-title":"Factors Influencing the Development of Cultural Competence in Undergraduate Nursing Students","volume":"57","author":"Chen","year":"2018","journal-title":"J. Nurs. Educ."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kaihlanen, A.-M., Hietapakka, L., and Heponiemi, T. (2019). Increasing cultural awareness: Qualitative study of nurses\u2019 perceptions about cultural competence training. BMC Nurs., 18.","DOI":"10.1186\/s12912-019-0363-x"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lopes, A. (2020). Linking Content and Language-Integrated Learning (CLIL) and Task-based Language Teaching (TBLT) in an effective way: A methodological proposal. Onom\u00e1zein: Revista de ling\u00fc\u00edstica, filolog\u00eda y traducci\u00f3n de la Pontificia Universidad Cat\u00f3lica de Chile, 5\u201322.","DOI":"10.7764\/onomazein.ne6.01"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.sbspro.2015.03.171","article-title":"Beyond the CEFR: Towards Standardization of Language Competence Recognition in Europe","volume":"178","author":"Pastor","year":"2015","journal-title":"Procedia Soc. Behav. Sci."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/10\/2\/19\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:44:56Z","timestamp":1760179496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/10\/2\/19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":44,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["nursrep10020019"],"URL":"https:\/\/doi.org\/10.3390\/nursrep10020019","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,14]]}}}