Development and evaluation of a teaching and learning approach in cross-cultural care and antidiscrimination in university nursing students

Background:
Cross-cultural care and antidiscrimination are vital to ethical effective health systems. Nurses require quality educational preparation in cross-cultural care and antidiscrimination. Limited evidence-based research is available to guide teachers.

Objectives:
To develop, implement and evaluate an evidence-based teaching and learning approach in cross-cultural care and antidiscrimination for undergraduate nursing students.

Design:
A quantitative design using pre- and post-survey measures was used to evaluate the teaching and learning approach.

Settings:
The Bachelor of Nursing program in an Australian university.

Participants:
Academics and second year undergraduate nursing students.

Methods:
A literature review and consultation with academics informed the development of the teaching and learning approach. Thirty-three students completed a survey at pre-measures and following participation in the teaching and learning approach at post-measures about their confidence to practice cross-cultural nursing (Transcultural Self-efficacy Tool) and about their discriminatory attitudes (Quick Discrimination Index).

Results:
The literature review found that educational approaches that solely focus on culture might not be sufficient in addressing discrimination and racism. During consultation, academics emphasised the importance of situating cross-cultural nursing and antidiscrimination as social determinants of health. Therefore, cross-cultural nursing was contextualised within primary health care and emphasised care for culturally diverse communities. Survey findings supported the effectiveness of this strategy in promoting students' confidence regarding knowledge about cross-cultural nursing. There was no reported change in discriminatory attitudes. The teaching and learning approach was modified to include stronger experiential learning and role playing.

Conclusions:
Nursing education should emphasise cross-cultural nursing and antidiscrimination. The study describes an evaluated teaching and learning approach and demonstrates how evaluation research can be used to develop cross-cultural nursing education interventions.

Cross-cultural adaption of the Health Educaiton Impact Questionnaire: experimental study showed expert committee, not back-translation, added value

Objectives
To assess the contribution of back-translation and expert committee to the content and psychometric properties of a translated multidimensional questionnaire.

Study Design and Setting
Recommendations for questionnaire translation include back-translation and expert committee, but their contribution to measurement properties is unknown. Four English to French translations of the Health Education Impact Questionnaire were generated with and without committee or back-translation. Face validity, acceptability, and structural properties were compared after random assignment to people with rheumatoid arthritis (N = 1,168), chronic renal failure (N = 2,368), and diabetes (N = 538). For face validity, 15 bilingual people compared translations quality with the original. Psychometric properties were examined using confirmatory factor analysis (metric and scalar invariance) and item response theory.

Results
Qualitatively, there were five types of translation errors: style, intensity, frequency/time frame, breadth, and meaning. Bilingual assessors ranked best the translations with committee (P = 0.0026). All translations had good structural properties (root mean square error of approximation <0.05; comparative fit index [CFI], ≥0.899; and Tucker–Lewis index, ≥0.889). Full measurement invariance was observed between translations (ΔCFI ≤ 0.01) with metric invariance between translations and original (lowest ΔCFI = 0.022 between fully constrained models and models with free intercepts). Item characteristic curve analyses revealed no significant differences.

Conclusion
This is the first experimental evidence that back-translation has moderate impact, whereas expert committee helps to ensure accurate content.

The impact of cultural and climatic background on thermal sensation votes

The increasing number of migration and the creation of multicultural cities have generated a new challenge for urban designers. The design of shared, welcoming and well utilised urban open places is important in order to promote inclusion, interaction, belonging, and diversity within cities. Thermal comfort is directly related to the users' attitude and behaviour in outdoor places. Fulfilling the comfort needs for users having a variety of cultural and climatic backgrounds needs therefore to be taken into consideration. Microclimatic parameters strongly affect thermal sensation, however, physical, physiological and psychological adaptation have also proven to have significant influence. The satisfaction with the thermal environment does not only depend on the place, but also on personal variables people bring to that place with them. The paper investigates the role of the culture and climatic background of users' in the complex relationships between microclimate, thermal adaptation factors and human behaviour in open public places. The paper aims to understand the influence of users' cultural and climatic background variations on their thermal needs and usage of the outdoor places. Climatic measurements, surveys and observations were carried out in Federation square in Melbourne along the year to examine thermal comfort and patterns of behaviours of users having different cultural origins. Quantitative analysis is used to examine the influence of culture and climatic background of the users' on thermal sensations and adaptation factors. The findings contribute to guiding the design of outdoor public places in multicultural cities.

The experience of Singapore in raising awareness of natural and cultural resources

The city-state of Singapore has a major role in the urban development. Majority of the innovative projects are initiated by the government agencies. For this paper, I would like to highlight the two distinct themes of innovation that, I believe preoccupied the authority for its urban issues, they are innovation which concern nature and culture. Land in Singapore is scarce. Natural resources are strictly protected. At the same time they are challenged to return the maximum benefit to their own population. The water catchment area and the prime forest on the whole island is the most valuable natural resources to be preserved. The paper will demonstrate how Singapore challenges with its own resources (water and greenery) in which the holistic planning around these themes become more than just spaces of protection but integrated with the public space system and turned into more valuable spaces for the well being of its population. The second theme is the issue related to culture. Singapore's economy is the most advance compare to other Southeast Asian countries, however when it comes to culture and identity, the city state struggles with the over constructed image of branding Singapore's culture. The paper will discuss several examples around the theme of arts and culture, how the city state bench-mark itself with the world class cities. It is one of the most challenging topic in urban planning and policy making. It is worth discussing on its success and failure. We can learn form Singapore that innovation at the level of policy maker can be achieved in some urban aspects such as the management of natural resources and urban design projects related to it. However when it comes to the issue related to art and culture, the top down policy alone cannot assure the achievement of city's identity as it aspired. Tracing the historical development of the environmental and cultural policies of Singapore the paper intends to study and analyze various case studies reflecting these attempts of natural and cultural instillation. In the process of comparison of these two drastically contrasting actors and approaches, the paper will argue that it has mostly been driven by economic aims, and careful thought. The results have been limited and restrictive. Further arguing that 'creativity' is the essential factor of arts and culture, it evaluates the authenticity and the ultimate implications on cultural spirit.

Dynamics of cultural heritage development in Sarawak

This paper discusses contestation and legitimization in the heritage process in the Malaysian state of Sarawak. Since 2011 the authors have assisted the Rurum Kelabit Sarawak (RKS) to plan a community museum. The museum is envisaged as an anchor for the preservation and representation of the Kelabit culture. In particular, through consultation and capacity building, the project is seeking to incorporate heritage values into development and cultural tourism plans. The paper considers the roles of historical and contemporary agents in the awakening of heritage consciousness in this community. This process has facilitated questions about priorities including, heritage, tourism, representation and the expression of identity through contemporary design, which this paper will contextualize within the discourse of cultural heritage and development in South East Asia. Apart from the RKS and their range of partners, important agents include the Sarawak Government, with jurisdiction over native customs; the Sarawak Museum Department, an official custodian of cultural heritage; UNESCO, through its promotion of the rights of indigenous people and the integration of culture and development; and the WWF, assisting with the Heart of Borneo conservation project. The authors see this case study of a community museum development process as an opportunity to reflect on the interrelated and contested roles and responsibilities of local, national and trans-national agents in a heritage project that contributes to an understanding of cultural politics and heritage-making.

Enhancing and assessing group and team learning in architecture and related design contexts

EXECUTIVE SUMMARYTeamwork skills are essential in the design industry where practitioners negotiate often-conflicting design options in multi-disciplinary teams. Indeed, many of the bodies that accredit design courses explicitly list teamwork skills as essential attributes of design graduates e.g., the Australian Institute of Architects (AIA), Royal Institute of British Architects (RIBA), the National Council of Architectural Registration Boards (NCARB) of the United States and the Institution of Engineers, Australia (IEAust). In addition to the need to meet the demands of the accrediting bodies, there are many reasons for the ubiquitous use of teamwork assignments in design schools. For instance, teamwork learning is seen as being representative of work in practice where design is nearly always a collaborative activity. Learning and teaching in teamwork contexts in design education are not without particular challenges. In particular, two broad issues have been identified: first, many students leave academia without having been taught the knowledge and skills of how to design in teams; second, teaching, assessment and assignment design need to be better informed by a clear understanding of what leads to effective teamwork and the learning of teamwork skills. In recognition of the lack of a structured approach to integrating teamwork learning into the curricula of design programs, this project set out to answer three primary research questions: • How do we teach teamwork skills in the context of design? • How do we assess teamwork skills?• How do design students best learn teamwork skills?In addition, four more specific questions were investigated:1. Is there a common range of learning objectives for group-and-team-work in architecture and related design disciplines that will enable the teaching of consistent and measurable outcomes?2. Do group and team formation methods, learning styles and team-role preferences impact students’ academic and course satisfaction outcomes?3. What combinations of group-and-team formation methods, teaching and assessment models significantly improve learning outcomes?4. For design students across different disciplines with different learning styles and cultural origins, are there significant differences in performance, student satisfaction (as measured through questionnaires and unit evaluations), group-and-team working abilities and student participation?To elucidate these questions, a design-based research methodology was followed comprising an iterative series of enquiries: (a) A literature review was completed to investigate: what constitutes effective teamwork, what contributes to effectiveness in teams, what leads to positive design outcomes for teams, and what leads to effective learning in teams. The review encompassed a range of contexts: from work-teams in corporate settings, to professional design teams, to education outside of and within the design disciplines. The review informed a theoretical framework for understanding what factors impact the effectiveness of student design teams. (b) The validity of this multi-factorial Framework of Effectiveness in Student Design Teams was tested via surveys of educators’ teaching practices and attitudes, and of students’ learning experiences. 638 students and 68 teachers completed surveys: two pilot surveys for participants at the four partner institutions, which then informed two national surveys completed by participants from the majority of design schools across Australia. (c) The data collected provided evidence for 22 teamwork factors impacting team effectiveness in student design teams. Pedagogic responses and strategies to these 22 teamwork factors were devised, tested and refined via case studies, focus groups and workshops. (d) In addition, 35 educators from a wide range of design schools and disciplines across Australia attended two National Teaching Symposiums. The first symposium investigated the wider conceptualisation of teamwork within the design disciplines, and the second focused on curriculum level approaches to structuring the teaching of teamwork skills identified in the Framework.The Framework of Effectiveness in Student Design Teams identifies 22 factors impacting effective teamwork, along with teaching responses and strategies that design educators might use to better support student learning. The teamwork factors and teaching strategies are categorised according to three groups of input (Task Characteristics, Individual Level Factors and Team Level Factors), two groups of processes (Teaching Practice & Support Structures and Team Processes), and three categories of output (Task Performance, Teamwork Skills, and Attitudinal Outcomes). Eight of the 22 teamwork factors directly relate to the skills that need to be developed in students, one factor relates to design outputs, and the other thirteen factors inform pedagogies that can be designed for better learning outcomes. In Table 10 of Section 4, we outline which of the 22 teamwork factors pertain to each of five stakeholder groups (curriculum leaders, teachers, students, employers and the professional bodies); thus establishing who will make best use the information and recommendations we make. In the body of this report we summarise the 22 teamwork factors and teaching strategies informed by the Framework of Effectiveness in Student Design Teams, and give succinct recommendations arising from them. This material is covered in depth by the project outputs. For instance, the teaching and assessment strategies will be expanded upon in a projected book on Teaching Teamwork in Design. The strategies are also elucidated by examples of good practice presented in our case studies, and by Manuals on Teamwork for Teachers and Students. Moreover, the project website (design.com index.html=""> visited by representatives of stakeholder groups in Australia and Canada), is seeding a burgeoning community of practice that promises dissemination, critical evaluation and the subsequent refinement of our materials, tools, strategies and recommendations. The following three primary outputs have been produced by the project in answer to the primary research questions:1. A theoretical Framework of Effectiveness in Student Design Teams;2. Manuals on Teamwork for Teachers and Students (available from the website);3. Case studies of good/innovative practices in teaching and assessing teamwork in design;In addition, five secondary outputs/outcomes have been produced that provide more nuanced responses:4. Detailed recommendations for the professional accrediting bodies and curriculum leaders;5. Online survey data (from over 700 participants), plus Team Effectiveness Scale to determine the factors influencing effective learning and successful outputs for student design teams;6. A community of practice in policy, programs, practice and dialogue;7. A detailed book proposal (with sample chapter), submitted to prospective publishers, on Teaching Teamwork in Design; 8. An annotated bibliography (accessed via the project website) on learning, teaching and assessing teamwork.The project has already had an international impact. As well as papers presented in Canada and New Zealand, the surveys were participated in by six Canadian schools of architecture, whose teaching leaders also provided early feedback on the project aims and objectives during visits made to them by the project leader. In addition, design schools in Vancouver, Canada, and San Diego in the USA have already utilised the Teacher’s Manual, and in February 2014 the project findings were discussed at Tel Aviv University in a forum focusing on the challenges for sustainability in architectural education.design.com>

Promoting appreciation of cultural diversity and inclusion with the Stephanie Alexander Kitchen garden program

Purpose – The purpose of this paper is to present emergent findings from an evaluation of the Stephanie Alexander Kitchen Garden (SAKG) Program showing that the program promoted appreciation of cultural diversity and inclusion of culturally diverse groups. Design/methodology/approach – The findings reported here are from the qualitative component of a mixed-method, nonrandomized, pre- and post-comparison evaluation study. Focus groups and interviews were held with school principals, teachers, program specialist staff, parents, volunteers and children at the program schools. Findings – In a culturally diverse school, the program enhanced the school’s capacity to engage and include children and families from migrant backgrounds. In less diverse settings, the program provided opportunities for schools to teach children about cultural diversity. Research limitations/implications – Assessing the program’s impact on multicultural education was not a specific objective of this study, rather these findings emerged as an unanticipated outcome during interviews and focus groups that explored participants’ views on important changes to schools associated with the program. Thus, the quantitative component of the evaluation did not assess the extent of this program impact and further research is recommended. Practical implications – The program may have particular value in culturally diverse schools, providing benefits in terms of engagement of children and families and potentially, in the longer term, associated improvements in learning outcomes. Social implications – These findings suggest that the program can help to promote social equity and inclusion for culturally diverse groups. Originality/value – This paper highlights critical equity implications associated with school-based programs’ capacity to include culturally and linguistically diverse groups.

Aggregating cultural heritage data for research use: The humanities networked infrastructure (HuNI)

This paper looks at the Humanities Networked Infrastructure (HuNI), a service which aggregates data from thirty Australian data sources and makes them available for use by researchers across the humanities and creative arts. We discuss the methods used by HuNI to aggregate data, as well as the conceptual framework which has shaped the design of HuNI’s Data Model around six core entity types. Two of the key functions available to users of HuNI – building collections and creating links – are discussed, together with their design rationale.

Perceptions of change in office space design: redesigning Barwon Water’s office environment

In early 2015 Barwon Water received State government funding to rationalise and renovate its various Geelong-based administrative offices into one complex. Integral to the renovations is a new green-star retrofit of the existing Ryrie Street complex by GHD Woodhead. The project will consolidate all of Barwon Water’s offices onto one site, increase floor space, provide a new ‘green’ atrium, and adopt an open plan layout. Having set a new strategic direction, Barwon Water is now undergoing a wholesale cultural and operational change in order to realise these strategic objectives. Aspirations for workplace design have been identified as: environmentally sustainable; foster innovation and creativity; establish connections; improve communication and collaboration; provide efficient space for effective work; flexibility over time; welcoming and connected to the community; healthy; and, up to date technology. This paper investigates Barwon Water staff perceptions and apprehensions of this prospective consolidation, particularly the proposed open plan office environment. While most research in this topic is informed by an immediate pre-design workshop of staff needs, this research provides a longitudinal perspective of human perceptions about work place environment change and a review of how changes in office environment synergistically align to architectural responses and changes in corporate strategies.

Meet the phallic teacher: curriculum design and identity in a neoliberal imaginary

This paper introduces the concept of the phallic teacher, a spectral figure that needs to be negotiated in teachers’ everyday work and in school-based disciplinary communities of practice. Reporting the findings of a three year doctoral study completed in 2014, the paper looks closely at how English teachers design both curriculum and identity in an environment where feminist and poststructuralist work of the late 20th century seems to have lost traction.These observations are based on empirical research in a Victorian school, combined with autoethnographic writing and other materials connecting teachers’ and researchers’ lives to the broader cultural postfeminist debate. The paper makes room for an absent subject, the teacher, marginalised in neoliberal discourses of curriculum and critiques the masculinist hegemony of outcomes and standards-based education. This provides us with new ways to challenge increasingly dominant current paradigms and to conceptualise a different future in which the standpoints of teachers are privileged in curriculum theory and curricular innovation.

Cultural respect encompassing simulation training: being heard about health through broadband

BACKGROUND: Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity - defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire - of the streamed simulations. DESIGN AND METHODS: In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. RESULTS: Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. CONCLUSIONS: Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals' learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training. Significance for public healthThere are significant health inequalities for migrant populations. They commonly have poorer access to health services and poorer health outcomes than the Australian-born population. The factors are multiple, complex and include language and cultural barriers. To address these disparities, culturally competent patient-centred care is increasingly recognised to be critical to improving care quality, patient satisfaction, patient compliance and patient outcomes. Yet there is a lack of quality in the teaching and learning of cultural competence in healthcare education curricula, particularly in rural settings where qualified trainers and resources can be limited. The Cultural Respect Encompassing Simulation Training (CREST) program offers opportunities to health professional students and practitioners to learn and develop communication skills with professionally trained culturally and linguistically diverse simulated patients who contribute their experiences and health perspectives. It has already been shown to contribute to health professionals' learning and is effective in improving cultural competency in urban settings. This study demonstrates that CREST when delivered via live video-streaming and simulation can achieve similar results in rural settings.

The design philosophy of Edenic gardens: tracing ‘Paradise Myth’ in landscape architecture

This paper explores the Eden mythology in both western and eastern cultures, and its reflection on people’s perception and use of nature. It aims to examine how cultural ideologies and systems of beliefs in relation to Eden have affected landscape making and how landscape icons influenced other cultures subsequently. This study describes how narratives of Eden evolved and influenced landscape design by explaining the narratives of Paradise and Arcadia in eastern and western cultures as two distinct landscape narratives, with a brief history of their emergence and evolution. It discusses the ways in which landscape architecture reflects the prevailing attitudes towards nature in a society by studying the ancient world’s philosophies and ideologies as a starting-point for this investigation. The paper then focuses on the Persian paradise garden and explains the notion of iconography, as a visual explanation of an idea in landscape design. It projects the transformation of Persian paradise gardens’ icons and patterns in landscape architecture through historical and spatial explorations.

Curriculum as colour and curves: a synthesis of Black theory, design and creativity realised as critical curriculum writing

This article looks to three inspirational Black women, bell hooks, Stacey McBride-Irby and Patricia Williams, in the pursuit of radical curriculum. While today curriculum is critiqued as racialised, gendered, sexualised and classed, the formats of curriculum documents such as text books, units of work and lesson plans have changed little. These documents are often conceived as linear sequences of steps leading to outcomes, and their voices are distanced and ‘neutral’. Drawing on a doctoral study of curriculum design in Australia, this article embraces a different approach by opening up a unit of work on girls’ popular culture to hooks’ invocations to teach to transgress, so that curriculum might be experienced as colour and curves, rather than a monochrome route to a pre-determined end point. Through this, along with hooks, I invite teachers to live pedagogy, rather than to deliver it.

Introduction to perspectives on architectural design research

If something called ‘design research’ was to begin tomorrow, what might we want it to encompass: how designers design, how they learn to design, what the limits and shapers of design might be? What other aspects of architectural activity should it deal with? Minimally, there is a range of possible social, cultural and environmental matters which could be considered and which certainly impinge on questions of why designing is undertaken and who, or what, it is for. But, such issues were central prior to there being something called ‘design research’. In grumpier moments over two decades it has been tempting to suspect some architects of using the term to fashionably relabel what they do. Enriched accounts, such as the range offered in this book, are required to clarify whether or not it is a useful construct. Since I am a fabricator and make things (up) as a way of designing, let me engage in a little fabricating around design research: tales of its history, present context, and of ideas for its future.

Recognizing appropriate representation of Indigenous knowledge in professional design practice

This paper focuses on the need for designers to follow clear, concise, workable practises to engage appropriately and ethically with indigenous knowledge on projects involving the graphical depiction of indigenous culture. Incorporating indigenous symbols into visual communication design strategies impacts a wide range of stakeholders and therefore requires a sensitive approach with broad consultation in regard to permissions and intellectual property rights; issues can be worked through if respectful practice methods are applied. This paper acknowledges cultural appropriation is not new and that creative, cross cultural interpretation and expressions of hybridity should be encouraged. However respectful communication, consultation, and collaboration are required whenever commercial application of indigenous culture is attempted. To demonstrate the need for clarity, three case study examples will be presented, each with design solutions involving the use of graphical depictions of indigenous culture and each selected due to the varying degrees of stakeholder engagement undertaken in the design process. The introduction of the ladder of stakeholder engagement theory is a new concept introduced in this paper that can be employed to better consider the appropriate and ethical engagement of designers with indigenous knowledge.