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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Sep 12, 2025
Date Accepted: Mar 26, 2026

The final, peer-reviewed published version of this preprint can be found here:

Development and Validation of a Culturally Competent Care Module and Its Effect on Nurses’ Cultural Competence and Patient Satisfaction: Protocol for a Randomized Controlled Trial in a Tertiary Care Hospital in India

Ittup L

Development and Validation of a Culturally Competent Care Module and Its Effect on Nurses’ Cultural Competence and Patient Satisfaction: Protocol for a Randomized Controlled Trial in a Tertiary Care Hospital in India

JMIR Res Protoc 2026;15:e84015

DOI: 10.2196/84015

PMID: 42525446

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Development and Validation of a Culturally Competent Care Module (CCCM) and Its Efficacy on Nurses’ Cultural Competence and Patient Satisfaction: A Randomized Controlled Trial in a Tertiary Care Hospital in India. Study Protocol

  • Ligy Ittup

ABSTRACT

Background:

Background Cultural competence in nursing is defined, as the capacity to deliver care that is respectful of and responsive to, the cultural and linguistic needs of patients. It involves integrating cultural awareness, knowledge, and behaviors into clinical practice to promote effective cross-cultural interactions. This approach is increasingly recognized as critical to reducing health disparities, improving communication, fostering trust, and enhancing both patient satisfaction and clinical outcomes [1]. India’s healthcare system operates within a highly diverse cultural landscape, further complicated by a growing internal migration from rural to urban areas driven by economic opportunities. Simultaneously, India continues to be a global hub for medical tourism, with over 2.1 million medical tourists recorded in 2024 alone. On a global scale, migration has reached unprecedented levels, with 304 million international migrants worldwide in mid-2024 [2]. These demographic shifts create urgent demands for culturally congruent care across all levels of healthcare delivery. The importance of cultural integration extends beyond the clinical domain. In the information technology sector, for instance, cultural misalignment rather than technological or financial limitations has been identified as a major contributor to project failure. Organizations that proactively embed cultural integration into strategic planning report enhanced innovation, improved knowledge transfer, and more effective implementation [3]. These insights underscore the transferable value of cultural competence across sectors, including healthcare. Evidence-based literature highlights that cultural competence training significantly improves nurse–patient communication and enhances culturally safe care [4]. In multicultural healthcare environments, such as those studied in Portugal, culturally competent nursing is positively associated with improved work environments and equitable patient outcomes [5]. Furthermore, cultural competence plays a vital role in addressing health inequities by ensuring inclusive and accessible healthcare services [6]. Despite its growing significance, cultural competence remains under-addressed within Indian nursing education and practice. There is a lack of standardized, context-specific training modules tailored to the Indian healthcare context. This study aims to bridge that gap by developing and evaluating a structured Culturally Competent Care Module (CCCM) for nurses. It will assess the impact of CCCM on the cultural competence of nurses and patient satisfaction compared to standard nursing care. The findings will inform clinical training strategies and contribute to policy frameworks supporting equitable, culturally responsive healthcare in India.

Objective:

• To develop and validate a culturally tailored Culturally Competent Care Module (CCCM) and assess its effectiveness in enhancing the cultural competence of nurses and improving patient satisfaction in a tertiary care hospital setting. • To evaluate the impact of a structured Culturally Competent Care Module (CCCM) on nurses’ cultural competence and patient satisfaction compared to standard nursing care, using a randomized controlled trial design.

Methods:

This study is a randomized, parallel group, pre-test post-test controlled trial, to be conducted in the medical-surgical wards of Acharya Vinoba Bhave Rural Hospital, Wardha District, Maharashtra. The intervention involves training registered nurses using a structured Culturally Competent Care Module (CCCM), while the comparator group will continue with standard nursing care. The primary hypothesis is that nurses who receive CCCM training will demonstrate a significantly higher level of cultural competence, and the patients under their care will report greater satisfaction, compared to those in the control group. Randomization will be employed to ensure group equivalence and minimize the risk of sample contamination.

Results:

Its a protocol.

Conclusions:

This study protocol outlines a rigorously designed randomized controlled trial aimed at addressing a critical gap in the integration of culturally competent nursing care within the Indian healthcare system. By developing, validating, and evaluating the Culturally Competent Care Module (CCCM), this research offers a scalable and evidence-informed intervention for improving nurse cultural competence and patient satisfaction. The findings are expected to inform curriculum development, institutional training programs, and national nursing policy, contributing to more inclusive and responsive healthcare delivery in India’s increasingly multicultural clinical environments. Clinical Trial: CTRI/2025/06/088982.


 Citation

Please cite as:

Ittup L

Development and Validation of a Culturally Competent Care Module and Its Effect on Nurses’ Cultural Competence and Patient Satisfaction: Protocol for a Randomized Controlled Trial in a Tertiary Care Hospital in India

JMIR Res Protoc 2026;15:e84015

DOI: 10.2196/84015

PMID: 42525446

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