A Bi-national Simulation Study to Improve Cultural Awareness in Nursing Students

Document Type


Publication Date



A School of Nursing in North America and one in Norway collaborated in examining student cultural awareness using simulation technology. Students practiced skills including cultural assessment using simulated scenarios. Scenarios were developed by project faculty, and depicted one patient with respiratory failure and the other with a systemic infectious process. While both schools used the same scenarios, the Norwegians specifically tailored their scenario around Muslim and Somalian patients/families while the Americans focused on Muslim and Italian/Catholic patients/families. Presimulation, both groups had the lowest score with perceived skill in obtaining cultural data. Individual paired t tests found statistically significantly improved scores in cultural awareness using The Transcultural Self-Efficacy Tool after practicing with simulation scenarios focused on cultural differences. Students perceived increased practice with simulated patients improved confidence in cultural awareness. The two cohorts in this study showed an improvement in their cultural awareness after participation in a simulation experience. This finding suggests that simulation may be a useful teaching methodology for use in American and international nursing schools. A Cultural Assessment Checklist was developed to assist students in collecting cultural assessment data on their simulated and real patients. Collaboration between the faculties of the two countries continues and will focus on graduate student education including simulation pedagogy in the future.


Copyright 2011 Elsevier

A link to full text has been provided for authorized users

Publication Title

Clinical Simulation in Nursing Journal

Published Citation

Grossman, S., Mager, D., Opheim, H., & Torbjornsen, A. (2011). A Bi-national Simulation Study to Improve Cultural Awareness in Nursing Students. Clinical Simulation in Nursing Journal, 6 (3), e2114 - 2117. doi:10.1016/j.ecns.2011.01.004.



Peer Reviewed