Graduation Year


Document Type




Degree Granting Department


Major Professor

Barbara A. Redding, RN, Ed. D, CNE

Co-Major Professor

Mary E. Evans, Ph.D., RN, FAAN

Committee Member

Laura Gonzalez, MS, ARNP, Ph.D.

Committee Member

Roger Boothroyd, Ph.D.


Culture, Evaluation, Learning Interventions, Measures, Theory


Cultural competence learning interventions have been suggested to positively improve knowledge, attitudes, and behaviors in both professional nurses and nursing students. A meta-analysis was used to examine the effectiveness of learning interventions designed to increase the cultural competence in professional nurses and nursing students. This is the first known meta-analysis of studies on cultural competence learning interventions in professional nurses and nursing students.

The meta-analysis was done using 13 research studies on cultural competence educational interventions from 1999 to 2010 that were published peer-reviewed literature found in electronic databases. Analyses were computed using a fixed-effect model and effect size data reported in terms of odds-ratio. The Comprehensive Meta-Analysis [Version 2] statistical software was used for the meta-analysis. Results of Orwin's fail-safe N, funnel plot and Duval and Tweedie's Trim and Fill revealed no evidence of publication bias. The meta-analysis demonstrated that seven of the 13 studies' individual educational interventions had a significant positive effect (odds-ratio = 4.2) on improving cultural competency of nursing students and professional nurses.

The study was able to determine from the meta-analysis literature that overall, learning interventions of cultural competence in nurses and nursing students significantly translates to a positive effect on the self-perceived cultural competency of nurses and nursing students in terms of knowledge, skills, attitudes, and self-efficacy regardless of intervention type and contact time. However, there is insufficient empirical evidence to support the argument that education and training in cultural competence translates into culturally competent care or that it leads to improved client health outcomes, particularly in nurses and nursing students. The results of this study should be interpreted with caution. Limitations of the study and recommendations for future research are discussed.