Dr Conor Gilligan

Aims and objectives: To determine the effect of immersive 3D cultural simulation on nursing students' empathy towards culturally and linguistically diverse patients. Background: Accelerated globalisation has seen a significant increase in cultural diversity in most regions of the world over the past forty years. Clinical encounters that do not acknowledge cultural factors contribute to adverse patient outcomes and health care inequities for culturally and linguistically diverse people. Cultural empathy is an antecedent to cultural competence. Thus, appropriate educational strategies are needed to enhance nursing students' cultural empathy and the capacity to deliver culturally competent care. Design: A one-group pretest, post-test design was used for this study. The simulation exposed students to an unfolding scene in a hospital ward of a developing county. Methods: A convenience sample of second-year undergraduate nursing students (n = 460) from a semi-metropolitan university in Australia were recruited for the study. Characteristics of the sample were summarised using descriptive statistics. T-tests were performed to analyse the differences between pre- and post simulation empathy scores using an eight item modified version of the Kiersma-Chen Empathy Scale. Results: Students' empathy towards culturally and linguistically diverse patients significantly improved after exposure to the 3D simulation experience. The mean scores for the Perspective Taking and Valuing Affective Empathy subscales also increased significantly postsimulation. Conclusions: The immersive 3D simulation had a positive impact on nursing students' empathy levels in regards to culturally and linguistically diverse groups. Research with other cohorts and in other contexts is required to further explore the impact of this educational approach. Relevance to clinical practice: Immersive cultural simulation experiences offer opportunities to enhance the cultural empathy of nursing students. This may in turn have a positive impact on their cultural competence and consequently the quality of care they provide to culturally and linguistically diverse patients.

© 2015 Elsevier Ltd.Background: Safe medication practices depend upon, not only on individual responsibilities, but also effective communication and collaboration between members of the medication team. However, measurement of these skills is fraught with conceptual and practical difficulties. Aims: The aims of this study were to explore the utility of a Theory of Planned Behaviour-based questionnaire to predict health professional students' behavioural intentions in relation to medication safety and collaborative practice; and to determine the contribution of attitudes, subjective norms, and perceived control to behavioural intentions. Design: A descriptive cross-sectional survey based upon the Theory of Planned Behaviour was designed and tested. Participants: A convenience sample of 65 undergraduate pharmacy, nursing and medicine students from one semi-metropolitan Australian university were recruited for the study. Methods: Participants' behavioural intentions, attitudes, subjective norms, and perceived control to behavioural intentions in relation to medication safety were measured using an online version of the Theory of Planned Behaviour Medication Safety Questionnaire. Results: The Questionnaire had good internal consistency with a Cronbach's alpha of 0.844. The three predictor variables of attitudes, subjective norms, and perceived control accounted for between 30 and 46% of the variance in behavioural intention; this is a strong prediction in comparison to previous studies using the Theory of Planned Behaviour. Data analysis also indicated that attitude was the most significant predictor of participants' intention to collaborate with other team members to improve medication safety. Conclusion: The results from this study provide preliminary support for the Theory of Planned Behaviour-Medication Safety Questionnaire as a valid instrument for examining health professional students' behavioural intentions in relation to medication safety and collaborative practice.

© 2015 Elsevier Ltd. Decreasing the numbers of adverse health events experienced by people from culturally diverse backgrounds rests, in part, on the ability of education providers to provide quality learning experiences that support nursing students in developing cultural competence, an essential professional attribute. This paper reports on the implementation and evaluation of an immersive 3D cultural empathy simulation.The Satisfaction with Cultural Simulation Experience Scale used in this study was adapted and validated as the first stage of this study. Exploratory factor analysis and confirmatory factor analysis were undertaken to investigate the psychometric properties of the scale using two randomly-split sub-samples. Cronbach's Alpha was used to examine internal consistency reliability. Descriptive statistics were used for analysis of mean satisfaction scores and qualitative comments to open-ended questions were analysed and coded.A purposive sample (n=497) of second of nursing students participated in the study. The overall Cronbach's alpha for the scale was 0.95 and each subscale demonstrated high internal consistency: 0.92; 0.92; 0.72 respectively. The mean satisfaction score was 4.64 (SD 0.51) out of a maximum of 5 indicating a high level of participant satisfaction with the simulation. Three factors emerged from qualitative analysis: "Becoming culturally competent", "Learning from the debrief" and "Reflecting on practice".The cultural simulation was highly regarded by students. Psychometric testing of the Satisfaction with Cultural Simulation Experience Scale demonstrated that it is a reliable instrument. However, there is room for improvement and further testing in other contexts is therefore recommended.

Brief interventions are effective for problem drinking and reductions are known to occur in association with screening and assessment. The present study sought to assess, among participants (N= 202) in a clinical trial, how much change occurred between baseline assessment and a one-session brief intervention (S1), and the predictors of early change. The primary focus was on changes in the Beck Depression Inventory Fast Screen scores and alcohol consumption (standard drinks per week) prior to random allocation to nine further sessions addressing either depression, alcohol, or both problems. There were large and clinically significant reductions between baseline and S1, with the strongest predictors being baseline scores in the relevant domain and change in the other domain. Client engagement was also predictive of early depression changes. Monitoring progress in both domains from first contact, and provision of empathic care, followed by brief intervention appear to be useful for this high prevalence comorbidity. © 2013 Elsevier Inc.

Introduction: Cultural diversity among students in tertiary institutions in Australia and globally has increased rapidly in the last decade, and is continuing to do so. Methods: Focus groups were held at the University of Newcastle, NSW to: (1) examine the specifi c needs of international students in the Master of Pharmacy, Bachelor of Medicine and Bachelor of Nursing programs in relation to language and cultural considerations and (2) to understand the attitudes of domestic students to the cultural issues faced among their peers. Th e project explored these issues with the intention to inform curricula changes to accommodate the needs of culturally and linguistically diverse students. Results: Th e key themes emerging from international students were: diffi culties in spoken language, diff erences in professional roles and expectations, diff erences in methods of learning, inadequate social interaction outside the classroom and acceptance of diff erences in cultural and religious practices. Th e domestic student views reinforced the comments from international students both in regard to social interaction and in regard to participation in class discussions. Although local students were interested in learning from international students about their culture and religious beliefs, there were limited initiatives from both sides. Discussion: Th ere is a need for tertiary institutions that benefi t economically from increasing the numbers of international students to help them to study and live in a new environment. Assistance needs to go beyond learning the English language to helping students understand its use in a professional context (health terminology and slang used by patients), the nuances of the health professional disciplines in a western society, the approach to study and problem-based learning styles and skills to assist with social interaction. Th e results of the present exploration have led to a series of proposed actions for the University of Newcastle. Th ese recommendations are applicable to any 'Western' teaching institution with a large number of international students from developing countries enrolled in their health programs.