The role of the health care organization in supporting nurses in the delivery of culturally competent care

This study was designed to explore ways in which health care organizations (HCOs) can support nurses in their delivery of culturally competent care. While cultural competence has become a priority for the federal government as well as the major health professional organizations, its integration into care delivery has not yet been realized. Health professionals cite a lack of educational preparation, time, and organizational resources as barriers. Most experts in the field agree that the cultural and linguistic needs of ethnic minorities pose challenges that individual care providers are unable to manage without the support of the health care organizations within which they practice. While several studies have identified implications for HCOs, there is a paucity of research on their role in this aspect of care delivery. Using a qualitative design with a case study approach, data collection included face-to-face interviews with 23 registered nurses, document analysis, and reports of critical incidents. The site chosen was a large health care system in South Florida that serves a culturally diverse population. Major findings from the study included language barriers, lack of training, difficulty with cultural differences, lack of organizational support, and reliance on culturally diverse staff members. Most nurses thought the ethnic mix was adequate, but rated other supports such as language services, training, and patient education materials as inadequate. Some of the recommendations for organizational performance were to provide the expectations and support for culturally competent care. Implications and recommendations for practice include nurses using trained interpreters instead of relying on coworkers or trying to "wing it", pursuing training, and advocating for organizational supports for culturally competent care. Implications and recommendations for theory included a blended model that combines both models in the conceptual framework. Recommendations for future research were for studies on the impact of language bathers on care delivery, develop and test a quantitative instrument, and to incorporate Gilbert's model into nursing research.

Content -area teachers' perceptions of the effect of the meta -training on their instructional practices

The purpose of this study was to explore the content-area teachers' perceptions of the effect that compliance with the teacher training for content-area teachers of Limited English Proficient (LEP) students mandated by the Consent Decree had on their instructional practices within the content-area classroom. In order to provide an overview of the factors which had an effect on the content-area teachers' mandated training, various areas were reviewed: history of legislative actions that led up to the Consent Decree; stipulations set forth in the Consent Decree; Miami-Dade County Public Schools District LEP Plan including stipulations for teacher training; research on teacher training for teachers of language minority students; and the process of change. This descriptive study specifically addresses teachers' perceptions of the effectiveness of the mandated teacher training as it relates to language minority students. ^ Content-area teachers who had completed the mandated teacher training were surveyed using self-administered anonymous questionnaires mailed to their school sites. Questions focused on the teachers' perceptions of: students' need of second language instructional strategies within the content-area classroom; teacher training requirements mandated by the Consent Decree; and changes in their instructional practices as a result of the training. ^ Based on the responses of the subjects, the results of this study indicate the overall success of the training implemented to comply with the stipulations set forth in the Consent Decree. In general, the results indicate that the teachers perceive that they are ultimately in agreement with the mandated training. The results also indicate that the teachers perceive a need for second language strategies when working with language minority students. These results can serve as starting point for further research not only into teachers' perceptions of the effectiveness of training for teachers of language minority students but also into the outcomes of this teacher training as it is reflected within the classroom. ^

What secondary English to speakers of other languages (ESOL) teachers know about social and academic language and instructional strategies for limited English proficient students

The purpose of this study was to examine what secondary English to Speakers of Other Languages (ESOL) teachers understand about social and academic language, what instructional strategies they use for Limited English Proficient (LEP) students, and how these concepts are operationalized in their daily practice. ^ This was a mixed method study incorporating both quantitative and qualitative data collection and interpretation. Written questionnaires and individual interviews addressed the questions on teachers' definitions of social and academic language and their strategy use. Classroom observations provided verification of their definitions and their descriptions of instruction for academic language. ^ Findings indicated that teachers' definitions of social and academic language were still developing and that there were ambiguities in identifying examples of social and academic language. The use of graphic organizers or visual supports, groups or peer partners, role play or drama, and modeling were the strategies teachers consistently listed for beginner, intermediate, advanced and multiple level classes. Additionally, teachers' descriptions of their instruction were congruent with what was observed in their classroom practice. ^ It appeared that this population of secondary ESOL teachers was in the process of evolving their definitions of social and academic language and were at different stages in this evolution. Teachers' definitions of language influenced their instruction. Furthermore, those who had clear constructs of language were able to operationalize them in their classroom instruction. ^

Cultural influence and learning to teach: Beginning teachers' perceptions of teacher preparation programs and school support systems

Beginning teachers in the field of English Language Arts and Reading are responsible for providing literacy instruction to students. Teachers need a broad background in teaching reading, writing, listening, speaking, and viewing, as well as critical thinking. In secondary schools in particular, beginning English Language Arts and Reading teachers are also faced with the challenge of preparing students to be proficient enough readers and writers to meet required State standards. Beginning teachers must navigate compelling challenges that exist during the first years of teaching. The school support systems available to new teachers are an integral part of their educational development. ^ This qualitative study was conceptualized as an in-depth examination of the experiences and perceptions of eight beginning teachers. They represented different racial/ethnic groups, attended different teacher preparation programs, and taught in different school cultures. The data were collected through formal and informal interviews and classroom observations. A qualitative system of data analysis was used to examine the patterns relating to the interrelationship between teacher preparation programs and school support systems. ^ The experiences of the beginning teachers in this study indicated that teacher education programs should provide preservice teachers with a critical knowledge base for teaching literature, language, and composition. A liberal arts background in English, followed by an extensive program focusing on pedagogy, seems to provide a thorough level of curriculum and instructional practices needed for teaching in 21st century classrooms. The data further suggested that a school support system should pair beginning teachers with mentor teachers and provide a caring, professional environment that seeks to nurture the teacher as she/he develops during the first years of teaching. ^

Teacher efficacy of special education teachers of English language learners with disabilities

This research examined the perceived teacher efficacy of special education teachers of English Language Learners (ELLs) with educational disabilities by surveying 202 elementary special education teachers using the EXCEL Teacher Inventory. EXCEL consists of 20 teacher efficacy items, three open-ended questions, and participant demographic items. ^ Overall participant teacher efficacy scores were high. Of the variables assessed, a statistically significant difference in perceived efficacy was found with self-reported proficiency in the language of the target students. No statistically significant differences in teacher efficacy scores were found for (a) levels of teacher preparation; (b) number of years of teaching experience; or (c) socioeconomic status of the students. A multiple regression analysis indicated that, of the variables listed above, proficiency in the language of the target students accounted for significant variance in predicting the level of teachers' perceived efficacy. ^ Responses to the open-ended questions about what was most helpful when working with ELLs with disabilities yielded two major themes: organizational issues and teacher issues. Participants wrote numerous comments about the value of support from educational professionals and parents. Many participants recommended individuals in preservice programs take ESOL content specific courses. ^ The results demonstrate the positive correlation between proficiency in the language of the target students and teacher efficacy. This suggests that teachers of ELLs with disabilities have proficiency in the ELLs' native language (or have support from others who are language proficient) that allows them to distinguish between language difference and language disability and provide instruction in the native language when needed. Further, results from open-ended questions suggest that special education teacher preparation programs should include courses related specifically to strategies for teaching ELLs with disabilities, not just ELLs. ^

The effects of a General Instructional Strategies course on the utilization of effective instructional strategies by teachers

The focus of this study was to explain the extent to which theoretically effective teaching strategies taught in a course on generic instructional strategies are being implemented by teachers in their actual teaching practice. ^ A multivariate causal-comparative (ex-post-facto) design was used to answer the research question. A teacher observation protocol, the General Instructional Strategies Analysis (GISA) was constructed and used to assess the utilization of instructional strategies in the classroom. The data of this study also included open-ended field notes taken during observations. ^ Multivariate Analyses of Variance (MANOVA) was used to compare the teaching strategies (set, effective explanation, hands-on activity, cooperative learning activity, higher order questioning, closure) of the group who had taken a general instructional strategies course (N=36) and the group who had not (N=36). Results showed a statistically significant difference between the two groups. The group who had taken the course implemented these strategies more effectively in almost all categories of effective teaching. Follow-up univariate tests of the dependent variables showed significant differences between the two groups in five of the six areas (hands-on activity being an exception). A second MANOVA compared the two groups on the effective use of attending behaviors (teacher movement/eye contact/body language/physical space, brief verbal acknowledgements/voice inflection/modulation/pitch, use of visuals, prompting/probing, praise/feedback/rewards, wait-time I and II). Results also showed a multivariate difference between the two groups. Follow-up univariate tests on the related dependent variables showed that five of the six were significantly different between the two groups. The group who had taken the course implemented the strategies more effectively. An analysis of the field notes provided further evidence regarding the pervasiveness of these differences between the teaching practices of the two groups. ^ It was concluded that taking a course in general instructional strategies increases the utilization of effective strategies in the classroom by teachers. ^

Illustrating Cognitive Connections between Math and Language in Pre-Service Teachers’ Perceptions of Common or Everyday Terms

This paper introduces a new construct that we term Math Mediated Language (MML) focusing on the notion that common or everyday terms with mathematical meanings are important building blocks for students’ mathematical reasoning. A survey given to 96 pre-service early childhood educators indicated clear patterns of perceptions of these terms.

A Study of Teacher Efficacy of Special Education Teachers of English Language Learners with Disabilities

This research examined the perceived teacher efficacy of special education teachers of English Language Learners with disabilities. The results demonstrate the positive correlation between proficiency in the language of the target students and teacher efficacy. An analysis of responses yielded two major themes, organizational and teacher issues, affecting teacher performance.

The effects of trained teachers' integration of dialogic reading discourse on Hispanic English Language Learners' literacy skills in kindergarten

This quasi-experimental Analysis of Covariance (ANCOVA) study explored whether the vocabulary and reading comprehension mean scores of Hispanic Kindergarten ELs whose teachers were trained to utilize Dialogic Reading (DR) discourse were higher than the mean scores of Hispanic ELs in kindergarten whose teachers were not trained to utilize DR discourse strategies. Sixty-three self-identified Hispanic, English Language Kindergarten students and four teachers participated in the study. The teachers were randomly assigned to either the experimental group (DR trained) or control group by drawing names from a hat. Student assignment to experimental versus comparison group was based on the teacher's assignment to either the experimental or comparison group. Thirty-one were assigned to the control group and 32 to the experimental group. The teachers were instructed to read the story to a group of six students (maximum) at a time, utilizing the DR discourse strategies they had been trained to implement. Subjects were read a story each week during the 8-week duration of the study. Teachers in the experimental group collaboratively selected 10 words each week from the Read Together Talk Together (RTTT) instructional stories that were utilized for vocabulary instruction. A test of homogeneity was conducted to evaluate whether the variance among the dependent variables was the same across the groups. An Analyses of Covariance (ANCOVA) was applied to analyze students' vocabulary and comprehension mean scores in the experimental group and the comparison group. The results of the study demonstrated a significant increase in the vocabulary and reading comprehension mean scores for the students whose teachers had been trained in DR discourse strategies. When comparing the two groups, the results revealed a statistically significant difference (p < 0.05). In conclusion, this study was conducted to explore how DR discourse may be an effective technique to teach literacy skills. The findings of this study showed that vocabulary knowledge and reading comprehension of Hispanic ELs were positively affected by the teachers' inclusion of dialogue during storybook reading. Its outcomes accentuated the need for teachers to provide assistance to ELs as they develop vocabulary knowledge and reading comprehension skills.

Evoking non-repertory verbal behavior across operant classes : the effects of motor echoic sign language training within the context of a motivating operation

The individual effects that echoic, mand, and sign language training procedures have on the acquisition of verbal behavior have been widely demonstrated, but more efficient strategies are still needed. This study combined all three treatment strategies into one treatment intervention in order to investigate the joint effects they may have on verbal behavior. Six participants took part in the study. Intervention totaled 1 hour/day for 5 days/week until mastery criterion for motor echoic behavior was achieved. Although motor echoic behavior were solely targeted for acquisition, significant increases in spontaneous motor mands were noted in all treatment participants. Additionally, 4 treatment participants also demonstrated significant gains in vocal echoics and spontaneous vocal mands. No significant increases were noted for the control participant. Results suggest that the aforementioned procedure may provide more efficient results as a first-step to teaching a functional repertoire of verbal behavior to developmentally delayed children.

Curriculum development in a heritage language community-based school: A Qualitative inquiry regarding a Brazilian-Portuguese program in South Florida

This research aimed to describe, understand, and discuss the curriculum development process of a Brazilian-Portuguese heritage language community-based school in South Florida. This study was guided by the following research questions: (a) What roles does this HL community-based school aim to play for its students? This investigation was also related to the subsidiary question: (b) How does this HL community-based school organize its curriculum development process? In order to explore these research questions, I observed and interviewed teachers and coordinators based on a qualitative research approach. I analyzed the interviews’ transcripts, and the program’s website with a central focus of describing and understanding their curriculum development process. Hopefully, the findings will help Brazilian and other HL community schools toward discussing and elaborating their own curriculum development, as well as to look for specific teacher training courses.