Effective multicultural communication begins with valuing other cultures.
The author provides information about events that have impacted nursing and nursing education in Indonesia and shares tips for effective multicultural communication.
I am passionate about global nursing education and have taught nurses for more than 25 years. I have had the opportunity to teach in several countries, the most recent being Indonesia, where I have taught in a pre-licensure nursing program for the last six years.
Indonesia is the world’s largest island country and the fourth most populated. Its approximately 264 million people
, composed of more than 300 ethnic groups
, speak more than 700 dialects. It is an exciting privilege to help train Indonesia’s next generation of nurses.
Increasing capacity, advancing excellence
Several events have made a significant impact on the nursing profession in Indonesia. The first was implementation of Indonesian National Coverage for Health, which provides basic healthcare services to all Indonesians. Another was passage in October 2014 of the Nurse Practice Act (Undang-Undang Republik Indonesia Tentang Keperawatan
). This act defines nurses and nursing; details preregistration requirements, which include passing a national competency exam; provides a professional scope of practice; and mandates that nurses continue professional development to maintain nursing registration. The first national competency exam was held in December 2014.
These events have emphasized the necessity of enlarging the nursing workforce in Indonesia and increasing nursing education capacity and excellence. Throughout the country, nurses who are prepared to meet the complex healthcare needs of patients, families, and communities are needed. As a result, there is increased demand for nursing schools to graduate students who are able to pass the national competency exam and meet Indonesia’s complex healthcare needs.
Indonesian pre-licensure education options include a diploma program as well as a bachelor program with a profession component, each with separate national competency exams. The diploma program takes about three years to complete, and graduates are required to sit for a diploma nurse national competency exam before practicing. The bachelor program takes about four years to complete. After receiving a bachelor’s degree, those who take this route are required to complete the profession program and pass the professional nurse national competency exam before practicing as a nurse.
The profession program provides intense, hands-on, clinical experience in various areas of nursing, including basic professional nursing, medical-surgical, maternity, pediatrics, family and community, geriatric, mental health, emergency and critical care, palliative, and management. The profession program takes approximately 10 to 12 months to complete. One challenge has been that some students complete the bachelor program and transition to other countries to complete a master’s degree without completing the profession program. In so doing, they do not take the professional nurse national competency exam.
Tips for multicultural teaching
The students I teach have diverse backgrounds and come from all over Indonesia. To be culturally relevant in this multicultural setting, I have modified my teaching practice, including teaching methods and evaluation. Here are some lessons I have learned.
Be respectful: Being respectful includes acknowledging and valuing the diverse cultures represented in a classroom or clinical setting. It also involves being aware of one’s own cultural values and beliefs and creating a safe learning environment where all feel free to share their cultural values and beliefs. I have found that students enjoy talking about their culture, as it is part of who they are. They also enjoy hearing about my culture. When sharing, remember that one culture is not better or worse than another—they are just different. Being respectful involves embracing that diversity.
Listen: Actively listen to students, other faculty members, hospital staff, and other stakeholders. The goal of listening is to hear. What are they saying? What can I learn from them? Also, listen to determine if key learning objectives have been achieved and if there are misunderstandings. As I have become more aware of potential miscommunication, I have learned to listen to myself when speaking to avoid using idioms and expressions that may not be understood.
Be flexible: Flexibility is important when working in multicultural settings. Nothing works the way I think it is going to work, and that is OK. As I culturally contextualize my teaching practice, being flexible is a must. For example, when I introduce and explain—with the help of a translator—teaching methods with which students may be unfamiliar, such as a flipped classroom and group work, I need to constantly assess if they understand what I am teaching as well as how I am teaching it—the teaching methodology. I have to be flexible and make revisions when needed.
Collaborate: Learning to be respectful and flexible and really listening to those around me have provided great opportunities to collaborate. These collaborations have included team teaching, research projects, and revision of nursing curriculum. I have learned so much, and I am grateful for the opportunity to collaborate with my amazing Indonesian colleagues and be actively involved in teaching nursing students here.
It has been great to work together to make a difference in nursing education and help train the next generation of nurses in Indonesia. Teaching in Indonesia has given me the opportunity to share my passion for global nursing education with others and has furthered my understanding of teaching in multicultural classrooms. RNL
Christine L. Sommers, MN, RN, CNE, is executive dean, Faculty of Nursing, Universitas Pelita Harapan, Jakarta, Indonesia.