A case study examination of the influence of cultural diversity in the multicultural nursing workforce on the quality of care and patient safety in a Saudi Arabian hospital

The purpose of the study: The purpose of this study is to investigate the influence of cultural diversity, in a multicultural nursing workforce, on the quality and safety of patient care and the work environment at King Abdul-Aziz Medical City, Riyadh region. Study background: Due to global migration and workforce mobility, to varying degrees, cultural diversity exists in most health services around the world, particularly occurring where the health care workforce is multicultural or where the domestic population comprises minority groups from different cultures speaking different languages. Further complexities occur when countries have a multicultural workforce which is different from the population for whom they care, in addition to the workers being from culturally diverse countries and with different languages. In Saudi Arabia the health system is mainly staffed by expatriate nurses who comprise 67.7% of the total number of nurses. Study design: This research utilised a case study design which incorporated multiple methods including survey, qualitative interviews and document review. Methods: The participant nurses were selected for the survey via a population sampling strategy; 319 nurses returned their completed Safety Climate Survey questionnaires. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. For the qualitative component of the study, a purposive sampling strategy was used; 24 nurses were interviewed using a semi-structured interview technique. The documentary review included KAMC-R policy documents that met the inclusion criteria using a predetermined data abstraction instrument. Content analysis was used to analyse the policy documents data. Results: The data revealed the nurses‘ perceptions of the clinical climate in this multicultural environment is that it was unsafe, with a mean score of 3.9 out of 5. No significant difference was detected between the age groups or years of experience of the nurses and the perception of safety climate in this context; the study did reveal a statistically significant difference between the cultural background categories and the perception of safety climate. The qualitative phase indicated that the nurses within this environment were struggling to achieve cultural competence; consequently, they were having difficulties in meeting the patients‘ cultural and spiritual needs as well as maintaining a high standard of care. The results also indicated that nurses were disempowered in this context. Importantly, there was inadequate support by the organisation to manage the cultural diversity issue and to protect patients from any associated risks, as demonstrated by the policy documents and supported by the nurses‘ experiences. The study also illustrated the limitations of the conceptual framework of cultural competence when tested in this multicultural workforce context. Therefore, this study generated amendments to the model that is suitable to be used in the context of a multicultural nursing workforce. Conclusion: The multicultural nature of this nursing work environment is inherently risky due to the conflicts that arise from the different cultural norms, beliefs, behaviours and languages. Further, there was uncertainty within the multicultural nursing workforce about the clinical and cultural safety of the patient care environment and about the cultural safety of the nursing workforce. The findings of the study contribute important new knowledge to the area of patient and nurse safety in a multicultural environment and contribute theoretical development to the field of cultural competence. Specifically, the findings will inform policy and practice related to patient care in the context of cultural diversity.

School Leadership, Literacy and Social Justice : The Place of Local School Curriculum Planning and Reform

School reform is a matter of both redistributive social justice and recognitive social justice. Following Fraser (Justice interruptus: critical reflections on the “postsocialist” condition. Routledge, New York, 1997), we begin from a philosophical and political commitment to the more equitable redistribution of knowledge, credentials, competence, and capacity to children of low socioeconomic, cultural, and linguistic minority and Indigenous communities whose access, achievement, and participation historically have “lagged” behind system norms and benchmarks set by middle class and dominant culture communities. At the same time, we argue that the recognition of these students and their communities’ lifeworlds, knowledges, and experiences in the curriculum, in classroom teaching, and learning is both a means and an end: a means toward improved achievement measured conventionally and a goal for reform and alteration of mainstream curriculum knowledge and what is made to count in the school as valued cultural knowledge and practice. The work that we report here was based on an ongoing 4-year project where a team of university teacher educators/researchers have partnered with school leadership and staff to build relationships within community. The purpose has been to study whether and how engagement with new digital arts and multimodal literacies could have effects on students “conventional” print literacy achievement and, secondly, to study whether and how the overall performance of a school could be generated through a focus on professional conversations and partnerships in curriculum and instruction – rather than the top-down implementation of a predetermined pedagogical scheme, package, or approach.

Parenting satisfaction and self-efficacy : a longitudinal study of mothers of children with Down Syndrome

Continuities and changes in parenting sense of competence were examined for mothers of children with Down syndrome from early childhood to adolescence. The sample comprised 25 mothers whose child with Down syndrome was aged 4-6 years in the first phase of the study, and 11-15 years at the second time point. Maternal satisfaction with parenting increased over time, but there were no changes in parenting self-efficacy. Scores on these measures were no different from those reported in a normative sample of mothers of typically developing children, suggesting that the challenges of parenting a child with Down syndrome do not impact significantly on parenting sense of competence during the early childhood and adolescent periods. There were some significant relationships of maternal sense of competence with child characteristics and self-reported parenting style, mostly in the expected direction.

International pre-service teachers' self-confidence in critical reflective thinking and writing through an intercultural Patches program

This paper describes part of an action research study that was designed to explore the outcomes of an ongoing program in which the participants, a group of domestic and international pre-service teachers and lecturers, worked together in reflective writing workshops. While the primary long-term goal of the program was to develop the intercultural competence and understanding of all of the participants through social activities, the development of social relationships was initiated and supported by involving the participants in weekly writing workshops that focused on shared salient skills of critical reflective thinking and writing. The focus of this paper is upon the outcomes for the international students, a cohort of second year pre-service teachers from Malaysia. Findings indicated that the program was successful in developing the Malaysian pre-service teachers’ self-confidence in perceiving themselves as writers and future teachers of writing, in shifting their focus from writing product to writing process and content, and in increasing the depth of their critical reflective thinking and writing

Pragmatics, perceptions and strategies in Chinese college English learning

This study investigated Chinese College English students. perceptions of pragmatics, their pragmatic competence in selected speech acts, strategies they employed in acquiring pragmatic knowledge, as well as their general approach to learning English as a foreign language. The research was triggered by a national curriculum initiative that prioritizes the need for College English students to enhance their ability to use English effectively in different social interactions (Chinese College English Education and Supervisory Committee, 2007). The traditional "grammar-translation" and "examination-oriented" method is believed to have reduced Chinese College English students to what is dubbed "mute" and "deaf" language learners (Zhang, 2008; Zhao, 2009). Many students lack pragmatic knowledge on how to interpret discourse by relating utterances to their meanings, understanding the intention of language users, and how language is used in specific settings (Bachman & Palmer, 1996, 2010). There is an increasing body of literature on awareness-raising of the importance of pragmatic knowledge and strategies for classroom instruction. However, to date, researchers have tended to focus largely on the teaching of pragmatics, rather than on how students acquire pragmatic competence (Bardovi-Harlig & Dornyei, 1998; Du, 2004; Hou, 2007; Ruan, 2007; Schauer, 2009). It is this gap in the research that this study fills, with a focus on different types of pragmatic knowledge, learner perceptions of such knowledge, and learning strategies that College English students employ in the process of learning English in general, and pragmatics in particular. Three strands of theories of second language acquisition (Ellis, 1985, 1994): pragmatics (Levinson, 1983; Mey, 2001; Yule, 1996), intercultural communications (Kramsch, 1998; Samovar & Porter, 1997; Samovar, Porter & McDaniel, 2009) and English as a lingua franca (ELF) (Canagarajah, 2006; Firth, 1996; Pennycook, 2010) were employed to establish a conceptual framework for data collection and analyses. Key constructs derived from the three related theories helped to form a typology for a detailed examination and theorization of the empirical evidence gathered from different sources. Four research instruments: a questionnaire (N=237), Discourse Completion Tasks (DCTs) (N=55), focus group interviews (N=18), and a textbook tasks analysis were employed to collect data for this systematic inquiry. Data collected by different instruments were analyzed and compared by way of a triangulation to enhance its validity and reliability. Major findings derived from different sources highlighted that, although College English students were grammatically advanced language learners, they displayed limited pragmatic knowledge and a highly restricted repertoire of language learning strategies. The majority of the respondents, however, believed that pragmatic knowledge was as important as linguistic knowledge in the process of developing communicative competence for interaction in different contexts. It was argued that a combination of a less than sufficient English proficiency, limited knowledge of pragmatics, inadequate language materials and tasks, and a small stock of language learning strategies, were a major hindrance to effective learning and communication, resulting in pragmatic failures in many intercultural communication situations. As the first systematic study of how Chinese College English students learned pragmatics, the research provided a solid empirical base for developing a tentative model for the learning of pragmatics in a College English classroom in China and similar educational contexts. The model was strengthened by a unique combination of theories of pragmatics, intercultural communication and ELF. Findings from this research provided insights into how Chinese College English students perceived pragmatics in the English as foreign language (EFL) curriculum, the processes of learning, as well as strategies they utilized in developing linguistic and pragmatic knowledge and competence.

The Australian curriculum : implications for teaching and assessment

Teachers will be aware of the raft of educational changes introduced recently and also of the associated challenges and opportunities that such educational reforms present. This PETAA Paper commences with an overview of the major educational changes and how they impinge on teachers’ classroom practice in the teaching of English and makes explicit the implications for policy support. This article aims to provide teachers with some insight into how they might respond in their teaching to develop their own assessment and pedagogic practices and in so doing support students to improve in their learning and to achieve higher standards. A group of teachers’ classroom practice, which has applicability to both Upper Primary and Middle School English teaching, is analysed to demonstrate how these teachers have pedagogically incorporated some of the ‘general capabilities’ and a cross-curriculum priority of ‘Aboriginal and Torres Strait Islander histories and cultures’ into their classroom practice.

Victims’ perceptions of traditional and cyberbullying, and the psychosocial correlates of their victimisation

It is well recognised that there are serious correlates for victims of traditional bullying. These have been shown to include increased levels of depression, anxiety and psychosomatic symptoms, in addition to often severe physical harm and even suicide. Bullied students also feel more socially ineffective; have greater interpersonal difficulties, together with higher absenteeism from school and lower academic competence. In the emerging field of cyberbullying many researchers have hypothesised a greater impact and more severe consequences for victims because of the 24/7 nature and the possibility of the wider audience with this form of bullying. However, to date there is scarce empirical evidence to support this. This study sought to compare victims’ perceptions of the harshness and impact of bullying by traditional and cyber means. The major findings showed that although students who had been victimised by traditional bullying reported that they felt their bullying was harsher, crueller and had more impact on their lives than those students who had been cyberbullied, the correlates of their mental health revealed that cyber victims reported significantly more social difficulties, higher anxiety levels and depression than traditional victims. The implications for school counsellors and mental health workers are discussed.

From the editor

Intelligence and context, knowledge, competence, and performance and results summarize the content of the papers presented to readers in this issue of the Journal. This is a very relevant series of papers as, for the past 50 years, project management has become a well-accepted way to manage organizations. The field of project management has evolved from operational research techniques and tools to a discipline of management encompassing various schools of thought (Söderlund, 2002; Turner, Huemann, Anbari, & Bredillet, 2010)...

From the editor

In this issue of the Project Management Journal, the reader will explore understanding better the contribution of project management to organizational performance, discovering the necessity to move beyond the old reigning paradigm of single-loop project control, raising the question whether PMP® certification leads to better performance, learning how to develop project management competence through a course based on service learning and an experiential learning approach, supporting new product development with the use of “dormant knowledge,” and increasing performance of virtual new product development projects...

Talk and web searching in an early years classroom

Recent Australian early childhood policy and curriculum guidelines promoting the use of technologies invite investigations of young children’s practices in classrooms. This study examined the practices of one preparatory year classroom, to show teacher and child interactions as they engaged in Web searching. The study investigated the in situ practices of the teacher and children to show how they accomplished the Web search. The data corpus consists of eight hours of videorecorded interactions over three days where children and teachers engaged in Web searching. One episode was selected that showed a teacher and two children undertaking a Web search. The episode is shown to consist of four phases: deciding on a new search subject, inputting the search query, considering the result options, and exploring the selected result. The sociological perspectives of ethnomethodology and conversation analysis were employed as the conceptual and methodological frameworks of the study, to analyse the video-recorded teacher and child interactions as they co-constructed a Web search. Ethnomethodology is concerned with how people make ‘sense’ in everyday interactions, and conversation analysis focuses on the sequential features of interaction to show how the interaction unfolds moment by moment. This extended single case analysis showed how the Web search was accomplished over multiple turns, and how the children and teacher collaboratively engaged in talk. There are four main findings. The first was that Web searching featured sustained teacher-child interaction, requiring a particular sort of classroom organisation to enable the teacher to work in this sustained way. The second finding was that the teacher’s actions recognised the children’s interactional competence in situ, orchestrating an interactional climate where everyone was heard. The third finding was that the teacher drew upon a range of interactional resources designed to progress the activity at hand, that of accomplishing the Web search. The teacher drew upon the interactional resources of interrogatives, discourse markers, and multi-unit turns during the Web search, and these assisted the teacher and children to co-construct their discussion, decide upon and co-ordinate their future actions, and accomplish the Web search in a timely way. The fourth finding explicates how particular social and pedagogic orders are accomplished through talk, where children collaborated with each other and with the teacher to complete the Web search. The study makes three key recommendations for the field of early childhood education. The study’s first recommendation is that fine-grained transcription and analysis of interaction aids in understanding interactional practices of Web searching. This study offers material for use in professional development, such as using transcribed and videorecorded interactions to highlight how teachers strategically engage with children, that is, how talk works in classroom settings. Another strategy is to focus on the social interactions of members engaging in Web searches, which is likely to be of interest to teachers as they work to engage with children in an increasingly online environment. The second recommendation involves classroom organisation; how teachers consider and plan for extended periods of time for Web searching, and how teachers accommodate children’s prior knowledge of Web searching in their classrooms. The third recommendation is in relation to future empirical research, with suggested possible topics focusing on the social interactions of children as they engage with peers as they Web search, as well as investigations of techno-literacy skills as children use the Internet in the early years.

Factors affecting the motivation of TEFL academics in higher education in China

This study investigates the motivation of English language lecturers in a Chinese university. Recent studies have shown that low morale and job dissatisfaction are significant problems identified in lecturers who teach English in universities in China. Given the importance of teaching English as a second language in China, this problem has potentially significant ramifications for the nation’s future. Low staff morale is likely to be associated with less effective teaching and poor student learning outcomes. Although the problem is acknowledged, there has been limited research to understand the underlying contributing factors. To address this, a sequential explanatory mixed methods approach was adopted and implemented in two phases at a large regional university in Northern China. The participants in the main study were 100 lecturers from two colleges at this university. All of the lecturers were responsible for teaching English as a foreign language (TEFL); 50 were teaching English majors and 50 were teaching university students whose majors were not English. The research was informed by a synthesis of self determination theory and theories of organisational culture. The study found: 1) in contrast to previously reported studies, lecturers in this institution were in general autonomously motivated in teaching. 2) However, their level of motivation was influenced by their personal experiences and varied sense of competence, relatedness and autonomy. 3) In particular, personal experiences and contextual factors such as the influence of Chinese culture, societal context, and organisational climate were significant in regulating lecturers’ motivation to teach. The findings are significant for leaders in higher education who need to implement policies that foster effective work environments. The study has also provided insights into the capacity of self determination theory to explain motivation in a Chinese culture.

Factor analysis of the Self Report Version of the Strengths and Difficulties Questionnaire in a sample of children with intellectual disability

The rate of emotional and behavioral disturbance in children with intellectual disability (ID) is up to four times higher than that of their typically developing peers. It is important to identify these difficulties in children with ID as early as possible to prevent the chronic co-morbidity of ID and psychopathology. Children with ID have traditionally been assessed via proxy reporting, but appropriate and psychometrically rigorous instruments are needed so that children can report on their own emotions and behaviors. In this study, the factor structure of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) was examined in a population of 128 children with ID (mean age = 12 years). Exploratory and Confirmatory Factor Analysis showed a three factor model (comprising Positive Relationships, Negative Behavior and Emotional Competence) to be a better measure than the original five factor SDQ model in this population.

Identities and transformational experiences for quantitative problem solving : gender comparisons of first-year university science students

Women are underrepresented in science, technology, engineering and mathematics (STEM) areas in university settings; however this may be the result of attitude rather than aptitude. There is widespread agreement that quantitative problem-solving is essential for graduate competence and preparedness in science and other STEM subjects. The research question addresses the identities and transformative experiences (experiential, perception, & motivation) of both male and female university science students in quantitative problem solving. This study used surveys to investigate first-year university students’ (231 females and 198 males) perceptions of their quantitative problem solving. Stata (statistical analysis package version 11) analysed gender differences in quantitative problem solving using descriptive and inferential statistics. Males perceived themselves with a higher mathematics identity than females. Results showed that there was statistical significance (p<0.05) between the genders on 21 of the 30 survey items associated with transformative experiences. Males appeared to have a willingness to be involved in quantitative problem solving outside their science coursework requirements. Positive attitudes towards STEM-type subjects may need to be nurtured in females before arriving in the university setting (e.g., high school or earlier). Females also need equitable STEM education opportunities such as conversations or activities outside school with family and friends to develop more positive attitudes in these fields.