Community of Support Issue - October 2024

How have you implemented innovative and effective clinical experiences and/or partnerships?

ACEN’s Standard 4 advises nursing educators to prepare students to understand and identify social determinants of health. By recognizing individuals with varied life experiences and cultural beliefs educators can teach the competencies necessary to be culturally responsive in the workforce. Traditionally, biomedical aspects of human health have been the major focus of clinical nursing training. However, the growth in our diverse population requires that our profession become more culturally responsive to render proficient and compassionate healthcare.

A culturally responsive nurse understands and respects differences. When individuals’ identities are respected, they feel understood and valued. This includes teachers, students, patients, and all those we encounter. This effort can be practiced and realized through simulation-based clinical nursing training, which will help to lessen the anxiety students may feel. Coping skills should be weaved into the curriculum to reduce anxiety when working in High-Fidelity Simulation (HFS) Centers. This highly evolved training offers students realistic scenarios that enhance communication skills and decision-making abilities in a safe learning environment.

Simulation centers focus on the delivery of quality care in a safe, non-judgmental learning environment. Upon arrival, a brief introduction should take place, and students are reminded they are intelligent, should always be kind, they are capable and that we all remain on a continuum to improve. Then a pre-briefing is explained where a scenario unfolds.

Students can learn effectively when offered the opportunity to practice and make mistakes without fear of failure. While most nursing disciplines have case studies readily available, there is a lack of clinical pediatric scenarios for nursing instructors in the literature. There are even fewer where culture is mentioned. As a Family Nurse Practitioner with over 35 years of clinical and teaching experience, I have engaged the use of Artificial Intelligence (AI) to bridge this gap.

Last semester, I precepted a graduate nursing student and we developed several culturally responsive pediatric case studies. We created immersive simulation scenarios that involved actors portraying patients from various cultural backgrounds, complete with distinct health beliefs, communication styles, and family dynamics. During these simulations, students were able to practice culturally tailored assessments, engaged in therapeutic communication that respected cultural nuances, and navigated ethical dilemmas related to cultural practices, such as dietary restrictions or end-of-life decision-making. The debriefing sessions that followed encouraged students to explore their biases, enhanced their empathy, and develop strategies for effective patient interactions.  

I have always been fascinated with people I meet from all over the world. I am intrigued by their stories and have gained insight into cultures where social seclusion and conservatism let very few even share a glimpse. It has become apparent that to better understand our students, we need to embrace those who are willing to share their stories while respecting those who prefer not to. When carefully prompted, AI can generate relevant scenarios in real time incorporating multicultural norms. AI can set the scene and provide objectives to guide the students’ actions. Patient care scenarios can be designed to offer a variety of ways for the objectives to be met. AI can also be prompted to offer hints about what to focus on to deliver culturally relevant content.

It is not enough to simply ask what religion a patient observes. It is essential to explore a patients’ cultural norms and beliefs. We must respect individuals’ customs and traditions to gain understanding of how to achieve optimal health for every patient we encounter. There is also a great opportunity to gain knowledge from our students from various backgrounds. Some of our students may be unfamiliar with western influence, and nursing educators should take the time to explain how and why we practice our system of healthcare delivery and should engage students by comparing and learning their healthcare customs to create a harmonious experience.

By incorporating students’ cultural health practices into simulation-based training, nursing educators will learn students’ customs and practices. AI provides access to an endless bank of information to create biomedical features of medical conditions while developing cultural elements. Immersing students in culturally rich environments fosters critical thinking and improves decision-making skills. Students learn to navigate potential conflicts between their own values and those of their patients. Simulation gives access to high-quality clinical experiences, a key best practice in nursing education.

There are inherent risks while engaging AI. To assist in mitigating these risks, it is advised to experiment with the prompts to gain an understanding of how various AI models react to instructions. When accessing AI exercises, ongoing instructor involvement, feedback, and oversight are crucial to maintain integrity.