Biographical Sketch
Dr. Marianne R. Jeffreys' grant-funded research, consultations, publications, and professional development programs encompass the topics of cultural competence, nontraditional students, student retention and achievement, self-efficacy, teaching, curriculum and psychometrics. Her book, Teaching Cultural Competence in Nursing and Health Care: Inquiry, Action, and Innovation (first edition) received the AJN Book of the Year Award. She is also author of Nursing Student Retention: Understanding the Process and Making a Difference and more than 30 articles and book chapters. Her conceptual models and questionnaires have been requested worldwide and in various disciplines.
Dr. Jeffreys is a professor of nursing at The City University of New York (CUNY) College of Staten Island and CUNY Graduate College. She received a BS in nursing from the State University of New York College at Plattsburgh, an MA and MEd in nursing education/professorial role from Teachers College, Columbia University, and an EdD in nursing education/nurse executive from Teachers College, Columbia University. She has been inducted into the Kappa Delti Pi International Honor Society in Education, Sigma Theta Tau International Honor Society in Nursing, Transcultural Nursing Society Scholars, Teachers College NEAA Hall of Fame, and is a Fellow in the New York Academy of Medicine. Her awards include the international Leininger Award for Excellence in Transcultural Nursing, Teachers College Columbia University's Award for Scholarship and Research, and the Mu Upsilon Chapter of Sigma Theta Tau Excellence in Professional Nursing Award. In December, 2007, she was selected as consultant of the month by the National Center for Cultural Competence.
Her career includes more than 20 years teaching experience in ADN, RN-BSN, MSN and/or DNS programs and as an RN in various clinical settings for 9 years, with consultations on all types of degree programs and hospital-employee training programs nationwide. Her expertise has been requested for grant-funded projects (HRSA, Kellogg), as well as for institutional and departmental workshops. She designed and teaches the accredited "Advanced Certificate Program in Cultural Competence," at CUNY, Staten Island: http://www.csi.cuny.edu/culturalcompetence.
Jeffreys' Cultural Competence and Confidence (CCC) Model
A Snapshot Approach to Frequently Asked Questions:
- What is the Cultural Competence and Confidence (CCC) model?
- Who can benefit from using the CCC model?
- Why is the CCC model unique and beneficial in guiding cultural competence education?
- How has the CCC model been validated?
- Where can I find a picture of the CCC model and more information?
- When should I use the CCC model?
1) What is the Cultural Competence and Competence (CCC) model?
Jeffreys' Cultural Competence and Confidence (CCC) model is a user-friendly "understand and apply" resource for developing optimal cultural competence in self and in others. Implementing creative, evidence-based educational activities that promote positive, cultural competence learning outcomes for culturally diverse students and health care professionals continues to be a challenge. A new challenge is to reach beyond competence (a minimum) towards the achievement of optimal cultural competence. This new quest recognizes that all individuals, groups, and organizations have the potential for "more". Optimal cultural competence embraces the diversity of diversity, requires ongoing active learning, fosters multicultural workplace harmony, and promotes the delivery of the highest level of culturally congruent patient care.
The CCC model presents an organizing framework for examining the multidimensional factors involved in the process of learning optimal cultural competence in order to:
- develop diagnostic-prescriptive strategies to facilitate learning
- identify at-risk individuals
- guide innovations in teaching and educational research
- evaluate strategy effectiveness
The CCC model interrelates concepts that explain, describe, influence, and/or predict the phenomenon of learning (developing) cultural competence and incorporates the construct of transcultural self-efficacy (confidence) as a major influencing factor.
Transcultural self-efficacy (TSE) is the perceived confidence for performing or learning general transcultural nursing skills among culturally different clients.
Cultural competence is defined as a multidimensional learning process that integrates transcultural skills in all three educational dimensions (cognitive, practical/psychomotor, and affective), involves TSE (confidence) as a major influencing factor, and aims to achieve cultural congruent care.
The term learning process emphasizes that the cognitive, practical, and affective dimensions of TSE and transcultural skill development can change over time as a result of formalized education and other learning experiences.
Assumptions underlying the CCC Model
- Cultural competence is an ongoing, multidimensional learning process that integrates transcultural skills in all three dimensions (cognitive, practical, and affective), involves TSE (confidence) as a major influencing factor, and aims to achieve cultural congruent care.
- TSE is a dynamic construct that changes over time and is influenced by formalized exposure to culture care concepts (transcultural nursing).*
- The learning of transcultural nursing skills is influenced by self-efficacy perceptions (confidence).**
- The performance of transcultural nursing skill competencies is directly influenced by the adequate learning of such skills and by TSE perceptions.**
- The performance of culturally congruent nursing skills is influenced by self-efficacy perceptions and by formalized educational exposure to transcultural nursing care concepts and skills throughout the educational experience.**
- All students and nurses (regardless of age, ethnicity, gender, sexual orientation, lifestyle, religion, socioeconomic status, geographic location, or race) require formalized educational experiences to meet culture care needs of diverse individuals.*
- The most comprehensive learning involves the integration of cognitive, practical, and affective dimensions.
- Learning in the cognitive, practical, and affective dimensions is paradoxically distinct yet interrelated.*
- Learners are most confident about their attitudes (affective dimension) and least confident about their transcultural nursing knowledge (cognitive dimension).*
- Novice learners will have lower self-efficacy perceptions than advanced learners.*
- Inefficacious individuals are at risk for decreased motivation, lack of commitment, and/or avoidance of cultural considerations when planning and implementing nursing care.
- Supremely efficacious (overly confident) individuals are at risk for inadequate preparation in learning the transcultural nursing skills necessary to provide culturally congruent care.
- Early intervention with at-risk individuals will better prepare nurses to meet cultural competency.**
- The greatest change in TSE perceptions will be detected in individuals with low self-efficacy (low confidence) initially, who have then been exposed to formalized transcultural nursing concepts and experiences.*
* Assumptions supported empirically.
**Assumptions currently under study.
Source: Jeffreys, M.R. (2010). Teaching Cultural Competence in Nursing and Health Care: Inquiry, Action, and Innovation (2nd Edition). New York, Springer, pages 53-54.
http://www.springerpub.com/product/9780826117878
2) Who can benefit from using the CCC model?
Health care practitioners, educators, administrators, researchers, and students including:
- Nurses
- Physicians
- Physician Assistants
- Physical Therapists
- Occupational Therapists
- Social workers
- Psychologists
- Chiropractors
- Dieticians
- Speech Language Pathologists
3) Why is the CCC model unique and beneficial in guiding cultural competence education?
The CCC model is unique and beneficial because it is the only model that is:
- Specifically focused on the multidimensional teaching-learning process involved with the development of optimal cultural competence education of self and others
- Conceptually based on the transcultural nursing literature, Bandura's self-efficacy theory (psychology), and the taxonomy of learning (education)
- Supported by evidenced-based results of numerous research studies in practice and academic settings worldwide investigating the effects of cultural competence education initiatives as measured by the model's corresponding Transcultural Self-Efficacy Tool (TSET).
4) How has the CCC model been validated?
All conceptual models and theories have underlying assumptions; however validation of proposed underlying assumptions via valid quantitative evidence is often missing. Some assumptions cannot be validated; they are merely "assumptions" that one holds true. Other proposed assumptions can be quantitatively measured. Many of CCC model's underlying assumptions (see assumptions listed under #1 above) have been validated via numerous studies in practice and academic settings worldwide using the model's corresponding TSET questionnaire.
To obtain valid research results, researchers must use a valid measurement tool. The TSET is a psychometrically valid questionnaire that was developed using the general and specific conceptual and psychometric guidelines concerning the questionnaire design process. The TSET is a comprehensive tool validated by 6 doctoral prepared experts in transcultural nursing and education. In addition, the TSET has been tested since 1994, with high reports of validity and reliability; thereby lending ongoing support for the CCC model. The CCC model is dynamic; subsequent studies with the TSET and the newly adapted Cultural Competence Clinical Evaluation (CCCET) tool and the Clinical Setting Assessment Tool-Diversity and Disparity (CSAT-DD) will lend additional insights into the model's propositions.
5) Where can I find a picture of the CCC model and more information?
An illustration of the CCC model, the Transcultural Self-Efficacy Pathway, and more information about the CCC model, teaching-learning strategies, and measurement of outcomes via questionnaires and assessment tools may be found in Jeffreys' 2010 book Teaching Cultural Competence in Nursing and Health Care: Inquiry, Action, and Innovation and the accompanying Cultural Competence Education Resource Toolkit described below and available at
http://www.springerpub.com/product/9780826117878. Additional resources and services are listed on Dr. Jeffreys' website at
http://www.mariannejeffreys.com.
6) When should I use the CCC model?
The CCC model can be used to:
- Guide the ongoing self-development of optimal cultural competence
- Facilitate the ongoing development of optimal cultural competence in others
- Apply the 7-step approach of optimal cultural competence development
- Self-assessment
- Active promotion
- Systematic inquiry
- Decisive action
- Innovation
- Measurement
- Evaluation
- Design, implement, and evaluate cultural competence education strategies
- Provide a conceptual framework for research studies and grants
Description
In our multicultural society, nurses and health care providers, educators and administrators, professional association leaders, and researchers must work toward achieving cultural competency. This new edition, along with the digital Cultural Competence Education Resource Toolkit, offers a unique and effective guide to do just that.
Newly updated and revised, this book presents ready-to-use materials for planning, implementing, and evaluating cultural competence strategies and programs. Users will learn to identify the needs of diverse constituents, evaluate outcomes, prevent multicultural-related workplace conflict, and much more. Complete with vignettes, case exemplars, illustrations, and assessment tools, this book is required reading for those working in academic settings, health care institutions, employee education, and nursing and health care organizations and associations.
Key Features:
- Offers a wide selection of educational activities and techniques for diverse learners
- Presents guidelines for helping educators, students, and professionals to maximize strengths, minimize weaknesses, and facilitate success
- Describes toolkit questionnaires for measuring and evaluating cultural learning and performance
- Provides guidelines for employee orientation programs to achieve cultural competence in the workplace
The Digital Cultural Competence Education Resource Toolkit:
The Toolkit consists of three sets of tools and a total of 21 distinct tools. The three sets of tools are:
- Resources for Academic Settings
- Resources for Health Care Institutions
- Resources for Professional Associations
Taken together, the tools provide a comprehensive set of materials for planning, implementing, and evaluating cultural competence education strategies and programs. These tools may be used alone or in conjunction with other tools and will be of use to a broad range of readers at all levels: nurses, educators, administrators, association leaders, managers, researchers, students, and other health care providers. The Tools and this book will enable you to achieve optimal cultural competence.
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