The purposes of this study were to evaluate the effect of integrating cultural content (ICC) in an undergraduate nursing curriculum on students' self-perceived cultural competence, and to determine whether a 5-week clinical immersion in international nursing (ICC Plus) had any additional effect on students' self-perceived cultural competence. Cultural competence was measured using a 28-item scale regarding students' self-perceived knowledge, self-awareness, and comfort with skills of cultural competence. Pretest scores from admission into the program were matched with posttest scores obtained just prior to graduation for 32 students, 7 of whom also participated in a 5-week immersion experience in Guatemala. Results, expressed in effect sizes, showed small to moderate gains for the 25 students in the ICC group, and very large gains for the 7 students in the ICC Plus group, related to perceived cultural competence. These results are consistent with the two-phase (cognitive and affective) development of cultural competence proposed by Wells.

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