Headings Clinical Question (PICOT) Author (Year) Purpose of Study

(Why study was

Explanation of Clinical Question in PICOT
(APA Citation) done as stated by
Headings Format
authors)

In hospitalized patients (P), how does a McGaughey J, et al.

rapid response team (I) affect the number Cochrane Database
Example of cardiac arrests (O) during a three-month Syst Rev 2007;3:
None
period (T)? CD005529

Hyun, Wang Keum, and Park

Eun Young. “The Quality of
Patient-Centered Nursing
In hospitalization patients (P), does the 4 Care Perceived by Cancer
Cs of individualized patient-centered care Patients Who Have Had an
(I) affect the satisfaction of diverse Operation.” Asian Oncology None
pregnant women (O) during parental Nursing, vol. 21, no. 2, June
hospital visits (T)? 2021, pp. 65–73. CINAHL
Complete, EBSCOhost,
doi:10.5388/aon.2021.21.2.6
determinants
5. Accessed 18matter from
Sept. 2021.
decision maker's
In hospitalization patients (P), does the 4 perspective? Results from a
Cs of individualized patient-centered care qualitative interview study Author states in study there
(I) affect the satisfaction of diverse across various health and are barrier in patient-
pregnant women (O) during parental social care organisations. centered care
hospital visits (T)? BMJ Open. 2019 Apr
1;9(4):e027591. doi:
10.1136/bmjopen-2018-
027591. Erratum in: BMJ

Abualhaija, N. (2021).
In hospitalization patients (P), does the 4 Clarifying Cultural
Cs of individualized patient-centered care Competence in Nursing: A To claify the concept of
(I) affect the satisfaction of diverse Concept Analysis Approach. cultural competence
pregnant women (O) during parental
Journal of Cultural Diversity,
hospital visits (T)? 28(1), 3–14.

Kotrotsiou, S., Stathopoulou,

A., Fountouki, A.,
In hospitalization patients (P), does the 4 Theofanidis, D., Katsiana, A.,
Cs of individualized patient-centered care & Paralikas, T. (2020). Study investigates the level
(I) affect the satisfaction of diverse Investigation of Cultural of cultural awareness of
pregnant women (O) during parental Competence in Greek nursing student
Nursing Students.
hospital visits (T)?
International Journal of
Caring Sciences, 13(3), 1898–
1905.

In hospitalization patients (P), does the 4 nursing education on nursing
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
https://doi.org/10.1016/j.ne
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
Tosun, B. (2021). Addressing
the effects of transcultural
Study synthesize the
students’ cultural findings of studies
competence: A systematic evaluating educational
review. Nurse Education in programs providing
curricular transcultural
Practice, 55, 103171. nursing education.
pr.2021.103171
Safoura Yadollahi, Abbas
Ebadi, & Marziyeh
Asadizaker. (2020). Study aimed at introducing
Measuring Cultural the scales for measuring
Competence in Nursing: A cultural competence in
Review Study. Journal of nursing
Client-Centered Nursing
Care, 6(3), 203–212.
Standardized Patients
Designed as Interventions to
Develop Nursing Students’ Study examines a
Cultural Competence: A combination of lecture,
Systematic Review. Journal case-based learning, and
of Transcultural Nursing : simulation with SPs can
Official Journal of the
increase nursing students'
Transcultural Nursing cultural competence
Society,
Kurowska, & Krystian
10436596211023968.
Barzykowski. (2021).
Evaluating the Effectiveness Study evaluates the cultural
of Cultural Education competence and cultural
Training: Cultural intelligence of masters'd
Competence and Cultural egree students before
Intelligence Development graduation and two months
among Nursing Students. after cultural educational
International Journal of training
Environmental Research and
Public Health, 18(4002),
Byrne, D. (2020). Evaluating Study evaluates the use of
Cultural Competence in SPs in nursing education in
Undergraduate Nursing the areas of health
Students using Standardized assessment, psychiatric
Patients. Teaching & care, students’ anxiety,
Learning in Nursing, 15(1), disability, communication,
57–60. and psychomotor skills
S., Kalkan, I., Kömürcü, N.,
Coelho, M., Coelho, T., Casa-
Nova, A., Cordeiro, R., Study completed to
Ramón-Arbués, E., Moreno- nvestigate nursing
González, S., & Tambo- lecturers' perception and
Lizalde, E. (2021). Nursing experience of teaching
Lecturers’ Perception and cultural competence in 4
Experience of Teaching undegraduate nursing
Cultural Competence: A programs.
European Qualitative Study.
J.,International
Liao, L.-L., & Chang,
JournalL.-C.
of
(2021). Cultural competence Study compares pre-
graduate students, newly
among pre-graduate nursing
graduated nurses,
students, new graduate
registered nurses, and
nurses, nurse mentors, and nurse mentors respective
registered nurses: A
comparative descriptive levels of cultural
study. Nurse Education competence, and to
determine associated
Today, 97, 104701.
Sullivan, J., Hugill, K., ElQader influencing factors.
https://doi.org/10.1016/j.ne
AElraoush, T. A., Mathias, J.,
Aimed to address cultural
& Al Hetmi, M. O. (2021). diversity in professional
Piloting of a nursing and educational and language
midwifery competence
backgrounds in piloting an
framework in the cultural educationnally led
context of a middle eastern
country. Nurse Education in competence framework
model connecting clinical
Practice, 51, 102969. practice and education
https://doi.org/10.1016/j.ne
J., Convissar, J., & Young, S.
pr.2021.102969
S. (2018). What Do Clinicians
Who Deliver Maternity Author wants to help
Services Think Patient- people understand how
professionals approach
Centered Care Is and How Is patient-centered care in
That Different for Vulnerable
Women? A Qualitative maternity sservices to
Study. Journal of Pregnancy, ensure clinicans and policies
1–7. makers are alert
https://doi.org/10.1155/201

In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
Ličen, S., Karnjuš, I., &
Prosen, M. (2021).
Measuring Cultural
Awareness Among Slovene
Nursing Student: A Cross-
Sectional Study. Journal of
Transcultural Nursing, 32(1),
77–85.
The purpose of this study
was to assess the level of
cultural awareness held by
undergraduate nursing
students

Chicago 17th Edition

In hospitalization patients (P), does the 4
Cs of individualized patient-centered care
(I) affect the satisfaction of diverse
pregnant women (O) during parental
hospital visits (T)?
(Author-Date)
Reference List Study to identify trends in
global health competency
Kang, Jiwon, Jeongeun Song, improvement programs for
and Wonjung Noh. 2020. “A nurses and to verify their
Systematic Review and effects
Meta‐analysis of the Effects
of Global Health
Competency Improvement
 Major Variables
Sample/Setting Studied with
Design/Method Ethics Definitions Measurement Data Analysis

(Number &
(Name & author
characteristics of
of scale(s) used
participants; attrition (List & define
to measure (Statistics used to
(How was study rate & why) independent &
outcome answer clinical
carried out?) (How are subjects’ dependent
variables; include question)
rights protected; risks variables)  reliability &
vs benefits; informed
validity data)
consent, etc.)

HMR: Australia: overall

SR (Cochrane review) N = 2 studies
hospital mortality
Purpose: effect of RRT on 24 adult hospitals IV: RRT (Rapid without DNR UK:
HMR Attrition: Not Reported Response Team) simplified Acute
• Searched 6 databases IRB approval obtained;
DV1: HMR (Hospital- Physiology Score (SAPS) Odds Ratio
from 1990-2006 informed consent described, wide
mortality rates) II death probablity
• Excluded all but 2 RCTs data safety plan described in
one estimate
                             

EBSCOhost, IV: Provide patient Author indicated that

doi:10.5388/aon.2021.21. N= 2 Study Attrition: Not centered care DV; used descriptive
2.65. Accessed 18 Sept. Reported Peer-reviewed quality of patient- research to analyze Multivariate Analysis
2021. centerd care data is sufficent

Decision makers
identified similar
IV: Inititate patient- determinants
Multiple HSCOs in a N=24 participants in n=20 centered care - facilitating or
maximum variation semistructured face-to-face centered care DV: obstructing the Descriptive Analysis
sampling strategy varying interviews conducted August Redesign implementation of PCC.
by HSCOs types. 2017 to May 2018. interventions Several determinants at
the HSCO's inner setting
and the individual level

Rodgers' evolutionan
method used to in relation
to cultural competence
Analysis of literature
IV: Use of Rodger's influenced concept's
N 4 Studies conceptions Concept DV:Change attributes, references,
amongst nurses using patterns amongst and consquences of Metanalysis
Rodger's evolution. study in relation to the
nurses
pyramid for cutural
competence

N= 120 Sample consisted of

120 nursing of second- and
third-year students data were SPSS 23.0 was used for
collected via face to face IV: Older age data
Synchronous interviews using the Clinical awareness of cultural analysis, applying the Descriptive and
correlation study Culture Competence competence DV:Better Inductive Stastics
patient outcome methods of Descriptive
Questionnaire for the and Inductive Statistics
exploration of their cultural
capacity.
 debates, discussions,
case scenarios,
practicums, simulation, Research studies were
11 research papers, (n = IV: Effectiveness of international learning identified using
Methodological 1375) nursing students’ transcultural nusing projects, experiential database searches and
systematic review study outputs were included in this DV: Providing more learning, storytelling, manual searches via
review. training to nuses and traditional teaching review studies’
lectures. In ten studies, reference lists
an increase in the level
of culture-related
Random articles on
Measurement of cultural culural competency. 16
Current narrative rstudy competency, nursing, nursing IV: Cultural articles on cultural
conducted by searching competence discovered,
students, and cultural Competency DV:
the internet and library 12 in Enlgish and are Casual Analysis
resources through credible sensitivity” were used sufficent data on applicable, 9 desiggned
databases individually and in cultural competency of conceptual
combination
framework, 6 had
evalutions
Ten studies met the
inclusion criteria.
Outcomes of simulation
Conducted a systematic IV: Teaching cultural with SPs increased
competence DV: levels of nursing
Using published review of studies on increase cultural students' cultural Systematic Analysis
guidelines simulation using SPs to teach
competency for competence.
cultural competence. nursing students Simulations with SPs
were used in theoretical
and practicum courses
Questionnaires used to of nursing
study: Cross-Cultural Study show effiency of
Competence Inventory N: 130 master’s nursing training workshops and
IV: Cultural
(CCCI) and the Cultural students took part in this cultural education
Intelligence Scale (CQS). evaluative study: 64 Competency before programs in a form that
Two consecutive classes individuals in 2019 (study 1) graduation DV: aims to improve the Systematic Analysis
Effiency of
(2019 and 2020) of and 66 individuals in 2020 development of
training/workshops
master’s nursing students (study 2) culturally sensitive
were tested twice (pre- attitudes.
test, post-test).
N= 28 ophomore-level
Inventory for Assessing the nursing students enrolled in a
Of 38, majority of them
Process of Cultural four-credit introduction to IV: Cultural
were women analyzed
Competence among professional nursing course in competence DV: Qualitive Analysis
data using SPSS, open
Healthcare Professionals – a medium-sized, Classes Quality of care
ended quesiton
student version IAPCC-SV randomly seleted to contorl
and experimental conditions
cultural competence.
Semi-structured personal
interviews were held with
N= 24 Semi-structured IV: Cultural Each study was used
a sample of 24 lecturers personal
interviews were held competence DV: differently from analysis
from four European with a sample of 24 lecturers Readiness of nursing and depends on Descriptive Statsitics
universities. The
from four European lecture teaching qualitive data given in
anonymized transcripts
universities. cultural competence the study.
were analyzed
qualitatively following
Braun and Clark's phases N=756 nurses/students (103
pre-graduate nurses, 321
IV: Cultural
newly graduated nurses, 101
Competence of One-way analysis of
Comparative cross- registered nurses, and 231
knowledge and variance and
sectional study amongst nurse mentors Cultural awareness, and skills hierarchical regression Statistical analysis
three universities and Competence Scale for Pre- DV: Experience of analysis used statistical
three hospitals Graduated Students to
Licensed Professionals was caring for patients analysis
from diverse cultures
used to measure the cultural
competence level. Objective was to
implement a flexible
Q-PACE promoted
Effectiveness of using accountability framework to allow for
and provided a IV: Cultural universal application,
(PDSA) iterative four step solid infrastructure for nurses Competence DV: PDSA based on evidence-
cycle for quality and midwives to maintain AND Q-pace providing based principles ( Leung Descriptive Analysis
improvement in and evidence competence in better patient et al., 2016 ) to
healthcare and industry line with strategic and outcome promote safe, confident
and Q- PACE
national priorities and compassionate
care.
Most clinicians
did not cite any of the
IV: Cultural core concepts of
Qualitative competence amongst patient-centered care
interview guide for N= 4 Studies used - qualative providers DV: Building as defned by the Meta Analysis
approach was used
providers trust focused on Institute of Medicine or
Patient centered care Te Institute of
Patient and Family
Centered Care directly

N2 on experimental, cross-
Purpose of study was to sectional design was applied
assess the level of cultural to a purposive sample of 149 Competence of
awareness held by undergraduate nursing
undergraduate nursing students. Data were collected students DV: Cultural
students based on the Cultural
Awareness Scale (CAS)
N= 19 Nineteen studies were
Ovid MEDLINE, Embase,
and ProQuest and the reviewed. Among them, 12
Cumulative Index studies were used for the
meta‐analysis. The meta‐
Cochrane methods were
analysis indicated that global
used to conduct a health competency
systematic review, meta‐ improvement programs
analysis, and sensitivity
analysis affected multicultural self‐
efficacy
No statistically
significant differences
IV: Cultural were seen between the
students' demographic
Undergrad nursing (gender and age) and Meta Analysis
other data (year of
awareness study and religion)
related to the overall
CAS score (p >.05).
iv: Cultural
Competence DV: Cochrane methods were
used to conduct a
Global Helath
systematic review, Meta analysis
competence meta‐analysis, and
improvement sensitivity analysis.
programs

Findings
(Statistical or
qualitative findings)
Weaknesses: *Didn't include
OR - Austalia: 0.98 (95% CI,
0.83-1.16) OR - UK: 0.52 (95% discussion
CI, 0.32-0.85)
more research
Quality of patient-centered
nursing care perceived by
cancer patients was 5.18 ±
0.81.
Identification possible starting
points for initiating the
tailoring of interventions and
implementation strategies and may have limited resoures for
the redesign of HSCOs towards
more patient-centredness
It is probable Rodger's model
gives conceptional clarity to
four attributed studied by
author
Clinical Culture Competence
Questionnaire (CCC-Q)
research tool was used
for data collection.
Appraisal: Level of
Evidence Worth to
Practice
Conclusion(s)
(Study’s level of
evidence?)
(Strengths,
weaknesses,
limitations; feasibility
of use in practice.
*level of evidence +
quality of evidence =
strength of evidence
& confidence to act)
Systematic Review
full body of evidence;
*Conflicting results of
retained studies; *No
of impact of lower-
level evidence;
*Recommendation - need
Conclusion: Inconclusive
Systematic Review Level 1
Weakness: Didn't include all
variable impacting patients
Research was completed
Systematic Review Level 1
Weakness: Decision-makers
better interventions
Systematic Review:
Weakness: Difficult to
quanrify all studies provided
by author, qualitive data
needed
higher scores than women
(p=0.001).
The educational level
statistically related to
Knowledge (p=0.018) and
Skills (p=0.023). A significant
positive correlation arises
between the range of
knowledge and skills which
suggests that increasing the
level of

PRISMA Recommendation
Guidelines
he keywords “cultural
competence, cultural
competency, cultural
instruments, the measurement
of cultural competency,
nursing, nursing students, and
cultural sensitivity” were used
individually
Simulations with SPs were
used in theoretical and
practicum courses of nursing
students' cultural competence
the post-test showed that the
surveyed students in both
study 1 and study 2 obtained
significantly higher overall
results in terms of cultural
intelligence (p = 0.001; p =
0.004, respectively) as well as nurses
in the behavioral (p = 0.001; p
= 0.002) and cognitive (p =
0.001; p = 0.008, respectively)
There was no significant
difference between those who
received the lecture and those
who received the lecture plus
simulation F (1,36) = .117, p
= .734.
interviewees were female
(70.8%), married (83.3%) and
had a white ethnic background
(95.8%). All of our participants
described themselves as
middle or high social class, and
all of them were born in the
country where they were
working at the time of being
interviewed. 80% of our
participants spoke at least
Particpants like newly
graduated nurses, registered
nurses, and nurse mentors
have different level s of
cultural competence
Use of evidence based practice
with the q-pace model proved
to be effective in most respect
but had certain limitations
Study suggests vulnerable
pregnant women
create a further diference that relevant information about
may be generalizable to
vulnerable men and vulnerable patient's health, especillay
nonpregnant women and use
of Maslow's hierachy of needs any providers Ned to study
proved to be a good start for
PC
Study LEVEL 1 Papers
examined underline the
notion that it is key for nurses
to be familiar with the
different cultural habits and
ways to care for patients in
such circumstances.
System Review 1 Weaknesses
scale didn't study enough
cocneptional
framewors.Recommendation:
Needs more studies to fully
exam text Conclusion:
Comparison scales will be
based on different
coneptional frameworks
Systematic Review 1
Weaknessess:
Implementation may be
limited Reommendation :
Increase access to theoritical
practical courses to online
learning Conclusion:
Beneficial for educators
Case Control Study Level 3
Primary Research Study
Weaknesses Limited
educational resources
Conclusion: Benefical for
Conclusion: Beneficial
for patients
Case Control Study Level 3
Primary Research Study
Weaknesses results did show
significant changes
Conclusion: More Research
Needed
Case Study Level 2
Weaknesses only three
lecturers from Belgium were
recruited to participate in this
study possible that a larger
sample of Belgian participants
may have provided an
additional or an alternative
perspective.
Systematic Review Level 1:
Weakness Didn't include all
evidence Minimual discussion
on how to make particpants
more ready upon graduation
Conclusion: More Research
Needed
ystematic Review Level 1:
Weakness Q-PACE MODEL is
limited to international
perspectives. May not fully
capture the enture pilot
evalutions Conclusion: More
Research Needed
Systematic Review Level 1
Weakness: Study may not all
those with limited access to
more research before
conclusions can be made.
Results show that the nursing
students had a moderately Systematic Review 1
high level of cultural
Weaknessess:
awareness for all CAS Implementation may be
subscales (M = 194.0). No limited Reommendation :
significant differences were
seen between the students' Increase access to theoritical
practical courses learning
demographic (gender and age) Conclusion: Beneficial for
and other data (year of study
educators
and religion) related to the
overall CAS score (p >.05)
System Review 1 Weaknesses
The findings can be used as the framewors.Recommendation:
More studies are needed to
basis for global health
clarify their effectiveness.
competency improvement Conclusion: More studies
programs. needed to fully examine the
topic