Assessing cultural competence: a comparison of two measures and their utility in global learning experiences within healthcare education

Abstract

Objectives

The purpose of this study was to investigate the relationship between two measures of cultural competence (CC), one more widely used, the other designed for healthcare students. It was hypothesized that there would be strong correlations allowing educators to forgo one measure for the other based on utility, resources, and sustainability.

Design

Exploratory, cross sectional design

Setting

One US Doctor of Physical Therapy (DPT) academic program.

Participants

145 DPT students.

Main outcome measures

Intercultural Development Inventory® (IDI) and Inventory for Assessing the Process of Cultural Competence-among healthcare professionals-Student Version© (IAPCC-SV).

Results

There were significant (negligible to low, rho = 0.16–0.28; p < 0.05) relationships between the IAPCC-SV total and three constructs with IDI Perceived Orientation scores, and the IAPCCSV total and two constructs with the IDI Developmental Orientation scores. There were significant (negligible to low, rho = 0.18–0.35; p < 0.05) relationships between IAPCC-SV total and construct scores with the IDI Acceptance and Adaptation orientation scores. Students with scores in an IDI DO of Acceptance or Adaptation were significantly more likely to have an IAPCC-SV score in the category of Culturally Competent (X2 = 3.70, p = 0.05).

Conclusions

The discordance of the two measures suggests that the instruments measure unrelated constructs (worldviews, attributes or skills) of cultural competence that are exclusive to each measure and context dependent. Context specific measures may not be generalized to a greater worldview, and visa versa. Multimodal assessment that triangulates data and supports student learning outcomes may be the most effective strategy to capture the impact of curriculum and/or a global learning experience on students’ development of cultural competence.

Contribution of the Paper

  • The IDI and IAPCC-SV measure different aspects of CC and are not strongly related.
  • Any measure of CC specific to the healthcare setting should be used in combination with less contextually dependent measures of CC when learning objectives include skills that are expected to be generalized to a broader community or setting.
  • Triangulation of quantitative data and qualitative analysis of students’ work would result in a deeper understanding of students’ intercultural development across settings, allow students to set personal goals, and provide rich data for student learning outcomes and programmatic assessments.