To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with 21 transplant surgeons specializing in kidney and liver transplants in Ankara, this study reveals how health illiteracy, culture, and folklore create significant barriers. Surgeons navigate these challenges while enduring harsh working conditions. This research highlights the critical role of cultural competency in transplant surgery, emphasizing the necessity for surgeons to understand and address the diverse cultural needs of their patients. Key findings indicate that surgeons must balance medical expertise with cultural sensitivity to deliver effective care. This study identifies four main cultural barriers: spiritual trust, family politics, health illiteracy, and subcultural incompetency. Effective transplant surgery requires a combination of theoretical proficiency and cultural awareness to meet a patient\'s needs and improve surgical outcomes.

BACKGROUND: Caring for an increasingly older and multicultural patient population requires nurses and APNs who are able to integrate cultural competency in meeting the needs of their patients while decreasing health care disparities. A study-abroad immersion experience is one way to instill deep learning and cultural competency.
OBJECTIVE: The purpose of this study was to understand the lived experience of baccalaureate nursing students and APN students working together in a study-abroad, service-learning experience.
METHODS: Using Interpretive Phenomenological Analysis (IPA) (Smith & Osborn, 2003), we explored the lived experience of Baccalaureate and Advanced Practice Nursing Students in a service-learning, study-abroad experience in Belize.
RESULTS: Emergent themes derived from students\' journal transcripts were: (1) Allowing learning to take place; (2) Practicing nursing with limited resources (3) A different take on culture; and (4) Kinship with peers. From this theme two sub themes emerged: 1) students\' connection with the people and the country, and 2) students\' connection with each other.
CONCLUSIONS: Cultural immersion prepared students to work in Belize with different patient groups, having varied perspectives related to their health. Students learned that the core values of dignity and caring require that we, as nurses, go where the patient is-not where we want the patient to be. This is tested when students are confronted with a culture not their own.

The delivery of culturally competent health care is recognized as critical to providing quality, equitable care for marginalized groups. This includes immigrant patients and families who experience significant barriers to health care and poor health outcomes. However, operationalization of cultural competence challenges health care delivery. Complementary concepts have also emerged such as cultural humility, cultural safety, and structural competence, recognizing the need for multi-level approaches involving patients, families, clinicians, health care organizations, the larger community, and policymakers. In this review, we define cultural competency and related frameworks and their applicability to immigrant patients and families. The evolution in terminology reflects an increasingly more comprehensive approach to understanding culture as multidimensional and shaped by social and structural factors. We then highlight strategies at each level, focusing on clinicians and organizations to leverage loci of control most directly within clinicians\' reach. Community-level strategies include community engagement (ie, vis-à-vis community health workers or community advisory boards) for clinical and research practice. Organization-level strategies include \"immigrant-friendly,\" or \"immigration-informed\" policies aimed at reducing immigration-related stressors, like limiting cooperation with immigration enforcement agencies or developing medical-legal partnerships to assist with patients\' legal needs. Lastly, policy-level strategies seek to change local and federal policies to address needs beyond health care (eg, education, housing, other social services), taking a \"Health in All\" policies approach that articulates health considerations into policymaking across sectors. Finally, we conclude with suggestions for future directions that center the experiences of immigrants, with the ultimate goal of sustainably meeting the complex needs of immigrant patients and families.

OBJECTIVE: Despite increases in the US foreign-born population, medical education opportunities in immigrant and refugee health (IRH) remain limited. We summarize findings for published IRH curricula and offer recommendations for integrating IRH into pediatric residency programs.
METHODS: We performed a literature review of articles describing the design, implementation, or assessment of IRH curricula for US-based undergraduate and graduate medical trainees.
RESULTS: The literature review identified 36 articles from 21 institutions describing 37 unique curricula. Three curricula included pediatric residency programs. Commonly taught topics included cultural humility, interpreter use, and immigration status as a social determinant of health. Immigrant-focused training experiences existed at continuity clinics, clinics for refugees or asylum seekers, and dedicated electives/rotations. Curricula were most frequently described as stand-alone electives/rotations.
CONCLUSIONS: IRH curricula provide opportunities to develop skills in clinical care, advocacy, and community partnerships with immigrant populations. Pediatric residency programs should align the IRH curriculum with existing learning priorities, support and hire faculty with expertise in IRH, and partner with community organizations with expertise. Programs can also consider how to best support learners interested in careers focusing on immigrant populations. Further work is needed to establish competencies and validated tools measuring trainee satisfaction and clinical competency for IRH curricula.

OBJECTIVE: This study was conducted to develop a cultural competence scale for nurses regarding the lesbian, gay, bisexual, and transgender (LGBT) community and to test its validity and reliability.
METHODS: The study adhered to the 8-step process outlined by DeVellis, with an initial set of 25 items derived through a literature review and individual interviews. Following an expert validity assessment, 24 items were validated. Subsequently, a preliminary survey was conducted among 23 nurses with experience caring for LGBT patients. Data were then collected from a final sample of 322 nurses using the 24 items. Item analysis, item-total score correlation, examination of construct and convergent validity, and reliability testing were performed.
RESULTS: The item-level content validity index exceeded .80, and the explanatory power of the construct validity was 63.63%. The factor loadings varied between 0.57 and 0.80. The scale comprised five factors: cultural skills, with seven items; cultural awareness, with five items; cultural encounters, with three items; cultural pursuit, with three items; and cultural knowledge, with three items; totaling 21 items. Convergent validity demonstrated a high correlation, affirming the scale\'s validity. Internal consistency analysis yielded an overall reliability coefficient of 0.97, signifying very high reliability. Each item is scored from 1 to 6 (total score range, 21-126), with higher scores reflecting greater cultural competence in LGBT care.
CONCLUSIONS: This scale facilitates the measurement of LGBT cultural competence among nurses. Therefore, its use should provide foundational data to support LGBT-focused nursing education programs.

OBJECTIVE: to evaluate the level of cultural competence of an undergraduate nursing students\' population from four European higher education institutions.
METHODS: a total of 168 nursing students from four different countries were included in our study. The study methodology involved a cross-sectional assessment of cultural competence among undergraduate nursing students from four European universities. Data collection included sociodemographic variables, as well as the following validated tools: the Intercultural Sensitivity Scale, the Cultural Competence Assessment Tool (student version) and the Cultural Awareness Scale.
RESULTS: our results indicated that students demonstrated a high level of intercultural sensitivity but a moderate level of cultural competence and cultural awareness. Variations existed among students from different countries, suggesting potential differences in educational approaches. Despite expectations that higher-level students would exhibit greater cultural competence, no significant differences were found by year of study, indicating a lack of effective integration of cultural competence into nursing curricula.
CONCLUSIONS: nurse educators should consider the students\' cultural competence before designing related study programmes. Training programmes related to cultural competence should include elements which have been associated with enhanced cultural competence, including language skills, cultural encounter, and opportunities for internationalisation.

UNASSIGNED: Increasing racial and ethnic diversity in U.S. nursing facilities has necessitated the provision of more culturally competent care. This study explored the cultural challenges in providing palliative care from the perspective of certified nursing assistants (CNAs) and nurses in nursing facilities.
UNASSIGNED: A thematic analysis approach was used to examine data from semi-structured interviews with 12 CNAs and 11 nurses from six nursing facilities in a U.S. Midwestern state.
UNASSIGNED: Four themes emerged from the data: Cultural Needs Expressed by Residents, Cultural Needs Expressed by Family Members, Accommodating Residents\' Cultural Needs, and Organizational Responses to Cultural Competency Challenges.
UNASSIGNED: Results highlighted the training variations on diversity and cultural competency issues and the varying cultural competency levels possessed by staff. To support residents\' culture-related needs, staff need education and support. Organizations can provide foundational resources for this diversity of cultural expression, including providing more culturally diverse programming facilities. [Journal of Gerontological Nursing, 50(7), 35-41.].

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