Date Posted: July 24, 2026

Author/s: Bianca Gabriel C. Budlong, Niña Tristen Andrea F. Moreno, Danielle Louise V. Alonzo, Pauline Veronica L. David, Alec Gabriel S. Ferrer, Emmanuel Carlos A. Logronio, Mariah Julia S. Pampliega,Venice Mirielle C. Ronquillo, Angelo Kyle Torres, Melanie Grace S. Francisco RN MAN, Aries M. Lagmay RN MAN

Background: Cultural competence is an important skill among nursing students in providing safe, respectful, and effective patient-centered care in diverse healthcare settings. However, most nursing students have limited exposure to patients from different cultural backgrounds, which may affect their readiness to apply cultural knowledge in actual clinical practice. Most studies focus on traditional teaching methods such as lectures and discussions, while experiential approaches remain less explored. Simulation-based learning provides an interactive and controlled environment where students can practice communication, decision-making, and culturally-sensitive care.

Objective: This study aimed to determine how a simulation-based approach contributes to the enhancement of cultural competence among nursing students.

Methods: The study used a quasi-experimental pre- and post-test design to examine the effect of a simulation-based approach on the cultural competence of twenty-five nursing students who were selected through purposive sampling. A three-station simulation involving culturally diverse patient scenarios using standardized patients (SPs) was conducted. Pre- and post-test assessments were administered using the adopted Better and Effective Nursing Education for Improving Transcultural Nursing Skills, Cultural Competence, and Cultural Sensitivity Tool (BENEFITS – CCCSAT) to measure the changes in knowledge, skills, and attitudes. Data were analyzed using descriptive statistics, such as weighted mean and standard deviation, and inferential statistics to determine significant differences between pre-test and post-test results.

Results: The simulation-based approach positively enhanced the cultural competence of nursing students across all five domains. Three domains showed statistically significant improvement after the intervention: Challenges and Barriers to Providing Culturally Competent Care (t = -4,21, p = 0.0003), Culturally Sensitive Communication (t = -2.54, p = 0.0178), and Perceived Meaning of Cultural Care (t = -3.30, p = 0.0030). The remaining two domains, Respect for Cultural Diversity and Achieving Cultural Competence, showed positive but non-significant increases (p > 0.05), attributed to the participants’ already high baseline competence prior to the intervention.

Conclusion: This study demonstrated that the simulation based approach using standardized patients significantly enhanced the cultural competence of nursing students, particularly in recognizing challenges and barriers, improving culturally sensitive communication, and deepening the perceived meaning of cultural care, highlighting its potential for integration into nursing curricula.

Keywords: Cultural competence, simulation-based learning, nursing students, culturally sensitive communication, cultural diversity, quantitative research, nursing education