Objective:  Significant health disparities exist between childbearing women and newborns from different cultures.  Culturally competent nurses are essential to providing adequate care and reducing these disparities.  Unfortunately, many nurses who provide care to this population acknowledge they are not culturally competent.  This study’s purpose was to evaluate the effect of two different online cultural competence continuing education (CE) interventions on the cultural competence level of obstetrical and neonatal nurses.  It was hypothesized that there would be a greater increase in the Cultural Competence Assessment (CCA) scores of the nurses in the socially interactive course group compared to those in the socially isolated course group, and that both groups would have greater increases in CCA scores than the control group.  The relationships between CCA scores and educational level and between CCA scores and previous diversity training were also explored.

Design: Experimental pre- and post-test.

Setting: The study was conducted completely online.

Patients/Participants: A non-probability national sample of obstetrical and neonatal nurses was used.

Methods: AWHONN section leaders were asked to distribute information about the study to their membership.  Members wishing to participate registered online and were randomly assigned to the three groups.  All participants were asked to complete a pre-test during the week experimental groups began the four-week, 10 hour, cultural competence CE courses.  They were also asked to complete a post-test during the final week.  

Results:  Ninety-three nurses completed the study.  Analysis of covariance revealed a significant difference between groups in post-test CCA scores after controlling for pre-test scores [F(2,61) = 5.2, p = .008].  The socially isolated group scored significantly higher than the control (p = .006), but the socially interactive group didn’t score significantly higher than the control group or the socially isolated group.  CCA scores weren’t related to educational level or previous diversity training (yes/no), but were related to number of types of previous diversity training (r₂ = .173, p = .047).

Conclusion/Implications for nursing practice: Nurses who provide care to childbearing women and newborns are not currently culturally competent.  It is recommended that nursing utilize asynchronous socially isolated online CE and educate nurses about its technology.  Nurses should be exposed to more types of cultural diversity training and must consistently utilize cultural assessment tools, ideally tailored to their specialty area.  Finally, nursing areas must have cultural reference materials specific to their patient populations.

Keywords:  cultural competence, continuing education, women’s health, obstetrical nursing, neonatal nursing.