Competence, Clinical Exposure and Culturally Responsive Healthcare Alignment among Nursing Students

Abstract

Culturally responsive care is essential to equitable nursing practice, particularly in settings where students encounter patients with diverse cultural beliefs, languages, and health practices. This study determined the levels of nursing students’ cultural competence, clinical exposure, and alignment with system-level indicators of culturally responsive healthcare, and examined their relationships and predictors. A quantitative descriptive-correlational design was employed among 197 second-, third-, and fourth-year Bachelor of Science in Nursing students at Central Mindanao University selected through proportionate stratified random sampling. A structured questionnaire assessed cultural awareness, cultural knowledge, cultural skills, curriculum integration, clinical practicum experience, participation in workshops/seminars, patient-centered communication, equity in healthcare delivery, and compliance with national/institutional standards. Data were analyzed using mean, standard deviation, Pearson correlation, and multiple linear regression. Students demonstrated high overall cultural competence (M = 4.382, SD = 0.666), with cultural awareness rated very high (M = 4.673). Clinical exposure was high overall (M = 3.960, SD = 0.853), although participation in workshops/seminars was only moderate (M = 3.182). Healthcare alignment was high (M = 4.461, SD = 0.620), with equity in healthcare delivery receiving the highest rating (M = 4.822). All competence and exposure dimensions were significantly and positively correlated with healthcare alignment (r = .416 to .624, all p < .001). The regression model was significant, F = 30.727, p < .001, explaining 60.8% of the variance in alignment. Clinical practicum experience was the strongest predictor (β = .287), while cultural knowledge was not an independent significant predictor. The findings support strengthening culturally diverse clinical placements, curriculum integration, structured reflection, and continuing cultural competence training in nursing education.