A multidisciplinary teaching model was used to develop a pilot course for students in the human service professions of nursing, education, and social work to gain additional knowledge and skills in providing diverse clients with culturally appropriate services during field and clinical experiences. This article focuses on the process of developing a multidisciplinary course in cultural competence that is consistent with a university mission to prepare students for leadership and service in an increasingly diverse society. Using the theoretical framework of Campinha-Bacote's process of cultural competence and the six developmental stages of intercultural competence in Bennett's developmental model of intercultural sensitivity, the course content covered the five components of cultural awareness, cultural knowledge, cultural skills, cultural encounters, and cultural desire. Students' written reflections indicated growth in acquisition of cultural knowledge, skills, and desire. Faculty collaboration across disciplines included the benefits of an enriched knowledge base and shared scholarship.

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Ethnopharmacologic research has revealed that ethnicity significantly affects drug response. Genetic or cultural factors, or both, may influence a given drug's pharmacokinetics (its absorption, metabolism, distribution, and elimination) and pharmacodynamics (its mechanism of action and effects at the target site), as well as patient adherence and education. In addition, the tremendous variation within each of the broader racial and ethnic categories defined by the U.S. Census Bureau (categories often used by researchers) must be considered. Nurses need to become knowledgeable about drugs that are likely to elicit varied responses in people with different ethnic backgrounds, as well as the potential for adverse effects. The existing ethnopharmacologic research focuses primarily on psychotropic and anti-hypertensive agents, as does this article. Cultural assessment of every patient is vital; thus Leininger's Sunrise Model and Giger and Davidhizar's Transcultural Assessment Models are briefly described as well.

I. IntroductIon A. This chapter presents cultural concepts and principles essential to effective cross-cultural communication. B. It focuses on building cross-cultural communication skills, critical in transcultural nursing and health care. c. A case study is presented at the end of the chapter to enhance application of cultural knowledge and communication. II. nAture of cross-culturAl communIcAtIon A. Cross-cultural communication skills are critical in a global society where encounters with diverse groups are part of everyday life. All interactions are cross-cultural, as human beings tend to be bounded by a set of symbols and meanings that have been culturally imprinted in time (Samovar, Porter & McDaniel, 2004). B. Communication is a process that occurs whenever meaning is attributed to behavior or the residue of behavior. 1. Cross-cultural or intercultural communication is between individuals and groups whose perceptions and symbol systems are distinct enough to alter the communication event (Samovar & Porter, 1995). Differences can occur across and within the same groups. 2. Communication is symbolic, as it uses verbal, nonverbal, and visual representations to create shared meanings. 3. Culture and communication are intricately bound; one cannot understand communication without understanding its social and cultural context. 4. Communication is a complex process; language is at best an approximation of reality. 5. In communication, one can only infer about the other; hence, seeking and giving feedback, facilitating comfort in the exchange, listening and observing, and using other resources, such as interpreters, are critical. c. Elements of Cross-Cultural Communication 1. Perception (Singer, 1987) a. Process by which an individual selects, evaluates, and organizes stimuli from the external world. b. Based on beliefs, values, and attitude systems 2. Verbal processes-how we talk to each other and think 3. Nonverbal processes-use of actions to communicate III. culturAl context of cross-culturAl communIcAtIon A. Cultural values and beliefs 1. Influence perceptions of the other's credibility, trustworthiness, and acceptance 2. For example, belief in a person's capacity to bear pain as a sign of moral strength is likely to be associated with intolerance of patients overtly complaining of pain.

Ethnopharmacologic research has revealed that ethnicity significantly affects drug response. Genetic or cultural factors, or both, may influence a given drug's pharmacokinetics (its absorption, metabolism, distribution, and elimination) and pharmacodynamics (its mechanism of action and effects at the target site), as well as patient adherence and education. In addition, the tremendous variation within each of the broader racial and ethnic categories defined by the U.S. Census Bureau (categories often used by researchers) must be considered. Nurses need to become knowledgeable about drugs that are likely to elicit varied responses in people with different ethnic backgrounds, as well as the potential for adverse effects. The existing ethnopharmacologic research focuses primarily on psychotropic and antihypertensive agents, as does this article. Cultural assessment of every patient is vital; thus Leininger's Sunrise Model and Giger and Davidhizar's Transcultural Assessment Models are briefly described as well.