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To Prepare:
Take note of the problem, the methods, the findings, and the researchers’ conclusions.
Review the Research Response Exemplar in the Learning Resources for an example of how to complete this Assignment.  
Write a 2-page response to the scholarly, peer-reviewed article you selected. In your response, identify and briefly summarize the article. Then address the following: To what extent do the research findings align with your professional experiences? How might you use this evidence-based research to inform your work as an advanced human services professional practitioner?
The Research Exemplar and Peer Reviewed Article is provided below

International Journal of Caring Sciences September -December 2020 Volume 13 | Issue 3| Page 1555

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Original Article

Social- and Health Care Educators’ Cultural Competence

Ruwang Han, RN, MHSc student
Faculty of Education and Welfare Studies, Department of Caring Science, Åbo Akademi University,
Vaasa, Finland

Monika Koskinen, MHSc
University Teacher, Faculty of Education and Welfare Studies, Department of Caring Science, Åbo
Akademi University, Vaasa, Finland

Kristina Mikkonen, PhD
Post-doctoral researcher, Research Unit of Nursing Science and Health Management, University of Oulu,
Oulu, Finland

Tuulikki Sjogren, PhD
University Lecturer, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

Hilkka Korpi, PhD
University Lecturer, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

Meeri Koivula, PhD
Associate Professor, Faculty of Social Sciences, Tampere University, Tampere, Finland

Minna Koskimaki, MNs, Doctoral candidate
Faculty of Social Sciences, Tampere University, Tampere, Finland

Marja-Leena Lahteenmaki, PhD
Senior Lecturer, Degree Programme in Physiotherapy, Tampere University of Applied Sciences,
Tampere, Finland

Marjorita Sormunen, PhD
Senior Lecturer, Faculty of Health Sciences, Institute of Public Health and Clinical Nutrition, and
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland

Terhi Saaranen, PhD
Professor, Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland,
Kuopio, Finland

Leena Salminen, PhD
Professor, Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland

Outi Wallin, PhD
Lecturer, Degree Programme in Social Services, Tampere University of Applied Sciences, Tampere,
Finland

Maria Kaariainen, PhD
Professor, Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The
Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence

Camilla Koskinen, PhD
Professor, Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger,
Stavanger, Norway
Faculty of Education and Welfare Studies, Department of Caring Science, Åbo Akademi University,
Vaasa, Finland

Correspondence: Ruwang Han, RN, MHSc student, Faculty of Education and Welfare Studies,
Department of Caring Science, Åbo Akademi University, Vaasa, Finland Rantakatu 2, 65100 Vaasa, Finland
E-mail: [email protected]

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Abstract

Introduction and aim: Cultural differences have significant impacts on classroom behaviours and communication in
teaching. The aim of this study is to explore social and healthcare educators’ cultural competence in transcultural
education.
Methodology: Data was collected from semi-structured focus group interviews at universities of applied sciences and
vocational colleges. Inductive content analysis was used in the analysis process.
Results: Educators’ cultural competence in transcultural education emerges as generic categories: transcultural
education, educatorship and ethical attitudes, and underpins by the sub-categories: language and linguistics, different
learning styles, integrating multicultural students, cultural knowledge and sensitivity, collaborating and cooperating,
self-awareness and openness, and respecting and caring.
Conclusion: Cultural competence represents a core competence for social-and health care educators. Educators need
to know students’ background, master different learning styles, be flexible in their pedagogical approaches and have
an open and ethical attitude.

Keywords: Culture, Competence, Social- and healthcare educators, Focus group interview, Content analysis

Introduction

Health professional mobility has increased
continuously over the past 20 years in the
European area, with an increasing amount of
international students (Wismar et al. 2011). It
thereby draws attention to cultural issues of
meeting the educational needs of culturally
diverse students, and educators’ competence to
meet and enable minority students’ qualification
in various professions (Ume-Nwagbo 2012).
Quality education is raised as fundamental for
developing social- and health care educators’
cultural competence and improving the outcome
of education (World Health Organization 2016).
This research is an essential part of the research
project, ‘Competent Educators Together’, and a
previous study that describes cultural and
linguistic competence as a core competence of
social- and health care educators (Mikkonen et al.
2019). As a result of international trends in
social- and health care education, educators are
expected to possess cultural competence in terms
of cultural knowledge and awareness, cultural
interaction, cultural sensitivity and linguistic
diversity (cf. Campinha-Bacote 2008).
Aim and objective: The aim is to explore social-
and health care educators’ cultural competence in
transcultural education. The objective is to
contribute to further development and
implementation of cultural competence into
educators’ curriculum and further training.

Theoretical and conceptual framework: The
theoretical and conceptual framework includes
two main concepts, ‘culture’ and ‘competence’.
Culture is depicted as knowledge, intellectual
awareness, education, cultivation, growing,
enlightenment, learning, a lifestyle, traditions,
beliefs, norms, values, as capabilities and habits

acquired by members of a society (Triandis
1972). According to Kroeber and Kluckholn
(1952), culture describes patterned ways of
thinking, feeling and reacting and the essential
core of culture is traditional ideas and attached
values. ‘Transcultural’ is chosen for this study to
understand educators’ competence to teach
students from other cultural backgrounds than
their own because it describes comparable
features in different cultures (Stevenson 2010).
The generic understanding of the concept of
competence comprises knowledge, skills and
attitudes. Knowledge describes a person’s ability
to understand facts and procedures, skills
describe the ability to perform activities in a
given context, and attitude is a person’s bearing,
feelings, and character. (Osagie et al. 2016,
Delamare Le Deist & Winterton 2005).
According to Sharifi et al. (2019) cultural
competence comprises six components:
awareness, knowledge, sensitivity, skills,
proficiency and dynamicity. Furthermore, main
factors related to cultural competence include
cultural diversity, encounter and interaction,
desire and humility. Campinha-Bacote (2007)
describes cultural competence as an on-going
process, where cultural desire provokes the
whole process. Desire leads to entering the
process of becoming culturally competent by
seeking cultural encounters, gaining cultural
knowledge, performing culturally sensitive
judgments and skills, and being humble in the
process of cultural awareness.

Previous research about educator’s cultural
competence: When educators and students come
from various countries, cultural differences
emerge, for example, the social positions of
educators and students, the understanding of

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curriculum and interaction in education.
Language barriers are described as a challenge in
transcultural education and it is hence relevant to
be aware of language differences and the burden
of adapting to a new learning environment and
effective communication, for example by more
student-centered approaches (Lu & Kitt-Lewis’
2018, Pitkäjärvi et al. 2011, Cox & Yamaguchi
2010). Educators’ cultural competence describes
skills that help to understand and appreciate the
cultural differences in education. Bednarz et al.
(2010) emphasize that educators’ cultural
competence is influenced by educators’ personal
cultural histories and backgrounds, their ways of
thinking and knowledge about cultural patterns
and differences. Morton-Miller (2013) highlights
the necessity of showing interest in students’
cultural background and allowing students to tell
their cultural stories in relation to education,
clinical practice and their own lives. Based on
Lassenius’ study (2011), educators’ cultural
competence consists of affective competence,
cognitive competence and behavioural
competence. Affective competence consists of
educators’ emotions and communicative abilities.
Cognitive competence describes how educators
improve their knowledge about culture,
ethnicities and religions, while behavioural
competence describes educators’ cultural
experience, cultural background and cultural
attitudes. Educators’ cultural competence
develops in a process from cultural awareness to
a need of knowledge and further to cultural
sensitivity. Thus, they possess cultural
competence in interaction and cultural sensitivity.
According to Morton-Miller (2013), educators’
cultural competence involves many experiences
and self-reflection. By reflecting on their own
cultural histories, educators’ understanding and
self-awareness about cultural differences can
influence the curriculum and policies in
education. Gibbs and Culleiton’s (2016) study
shows the importance of nurse educators to value
diversity, respect cultural differences, and adapt
teaching strategies to complement the needs of
culturally diverse students.

Research methods: Data was collected in
social- and health care educational units at seven
universities of applied sciences and two
vocational colleges in Finland during the spring
2018. Sixteen semi-structured focus group
interviews with 2-5 educators per group were
conducted. In total 48 educators participated in
focus group interviews, 33 female and 15 males

aged from 46 to 54 years. Of the respondents 26
were health care educators, 7 social work
educators, 6 physiotherapy educators, 3 public
health educators and 6 from other health care
educations. 41 worked at universities of applied
sciences and 7 worked at vocational colleges. In
relation to working experience, 14 respondents
had less than 5 years’ working experience while
34 respondents had more than 10 years’ working
experience. An interview guide based on the
results of a systematic literature review study
regarding social and health care educators’
competence area was used during the interviews
(Mikkonen et al. 2019). The open-ended theme,
what competences do the social and health care
educators need today and in the future, was
important for this study. The interviews were
recorded with voice recorders and transcribed
into 525 pages text. Elo and Kyngäs’ (2008)
inductive content analysis is used as the analysis
method. The analysis process consists of open
coding, creating categories and abstraction. At
first, the transcribed interviews have been read
through several times and open codes, i.e. notes
and headings, are written in the margins while
reading. Codes and selected unit of analysis
related to them are written into a coding sheet.
After that, the codes are classified into particular
groups with higher order headings by collapsing
those that are similar or dissimilar. Through
further reading and interpretation that gave us an
increased understanding about the content, we
put together unit of analysis and codes and
visualized them as subcategories. In the
abstraction phase, we found seven sub-categories
with similar events and incidents. The sub-
categories resulted in three generic categories
and a main category or general description in
relation to the research topic. Authors XX, XX
and XX performed the data analysis.

Results

Educators’ cultural competence in transcultural
education emerges as the main category of this
study. The generic category, transcultural
education, is underpinned by the sub-categories:
language and linguistics, different learning
styles, integrating multicultural students. The
generic category, educatorship, is underpinned
by the sub-categories: cultural knowledge and
sensitivity, and collaborating and cooperating.
The generic category, ethical attitudes, is
underpinned by the sub-categories: self-
awareness and openness, and respecting and
caring.

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Figure 1. The abstraction process and results

Transcultural education

Language and linguistics: A language skill,
especially knowledge of the English language, is
an essential factor and starting point regarding
whether educators can manage to teach
multicultural students. Educators are aware of the
importance of language skills in education, but
teaching in a foreign language can also be
challenging. They are also aware of multicultural
students’ language difficulties in education. For
some students, grammar and vocabulary can be
their weakness, and they understand terminology
differently and use lingual expressions in the

learning process. Words, or terms, may also have
different meanings in various cultures. Since the
educational language is not the same as students’
native language, they may express opinions
according to their own cultural thinking. As a
result, such different understanding can cause
misunderstandings and turn into a cultural
obstacle in communication. By enhancing
educators’ language ability, educators increase
their self-confidence in teaching, and the
communication between them and students
becomes more understandable.

Different learning styles: The differences of
multicultural students’ learning styles have

Sub-category Generic category Main category

Cultural knowledge
and sensitivity

Collaborating and
cooperating

Self-awareness and
openness

Respecting and caring

Educatorship

Ethical attitudes

Educators’
cultural
competence in
transcultural
education

Transcultural
Education

Language and
linguistics

Different learning
styles

Integrating
multicultural students

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influenced profoundly on students’ absorption of
new knowledge. For example, in some cultures
students are trained to write correct answers
without understanding of text. The study pace
varies among multicultural students; therefore, it
requires educators to utilize what kind of
teaching style in class and to know how to guide
students in education. If cultural differences are
integrated into teaching, students may learn
easier and more effectively. It will also help them
to finish the course, to reach goals in their studies
and increase the quality of education, especially,
when multicultural students have difficulties in
learning. It is valuable if educators are aware of
students’ challenges and can perceive this from
the feedback that they receive from students
about their studies. Thus, educators can obtain
information on how well students have learned
and managed courses and contents. With this
reference, educators can have flexibility in
education and evaluation to complement those
students’ challenges and design a better
curriculum for future students. Additionally,
being creative in teaching can make knowledge
more attractive and memorable.

Integrating multicultural students: When
students come to another cultural society,
cultural differences emerge both in living and
clinical training. Multicultural students may feel
insecure in class, and they can have difficulties
of being integrated. It may take a long time for
an exchange student to adapt to a completely
new environment. It is thereby necessary for
educators to be observant about students’
integration into a new cultural learning process
and help them to integrate with others in class.
Adapting to another cultural environment is not
only about learning new knowledge in school,
but also about norms, traditions and values of
another culture.

Educatorship

Cultural knowledge and sensitivity: The result
emphasises the importance of having cultural
knowledge and sensitivity in education. Thus, it
can minimize misunderstandings and
communication gaps between educators and
students. Certainly, it is not possible for
educators to learn and know each student’s
culture, traditions, values and customs. Educators
require the capacity to know different cultures
and also to see health, care and caring in a global
perspective. Learning a new culture can be a
gradual development as well as a lifelong

exploring procedure that takes time and
presupposes sensitivity, and it is enriching for all
teaching and learning. In order to increase
cultural knowledge, educators talk about
different methods, that is, reading, travelling or
communicating with multicultural students. With
increased cultural knowledge, educators improve
their understanding about different cultures and it
may decrease students’ anxiety and increase
educators’ satisfaction in transcultural teaching.
Cultural sensitivity is thereby beneficial for the
process and outcome of transcultural education.

Collaborating and cooperating: When educators
work cooperatively, educators can help each
other when teaching a multicultural group, for
example, by having more than one educator in
the class or a language educator who serves as a
supportive resource to clarify language
issues. Cooperation among educators reduces
learning stress for students in education. Being
aware of cultural differences can also be part of
organizational culture. It is beneficial to share
knowledge and experience in transcultural
teaching, which can increase educators’
awareness about students’ cultural background
and needs. It can also improve educators’
cultural understanding and help to adjust the
curricula and course plans through a transcultural
perspective. Collaborating with universities
abroad offers educators more opportunities to
meet other cultures. Through being involved in
international cooperation, collaboration or as
exchange educators, educators can benefit
themselves and come together in new networks.
In addition to cooperative academic research and
exchange programs, educators can obtain
additional economic support from transcultural
activities. The budget or financial policy in the
organization can also be a cornerstone for
educators to take initiatives to participate in
transcultural events.

Ethical attitudes

Self-awareness and openness: Self-awareness
and willingness are the basic motive in
transcultural education and educators are
conscious of gaining more cultural knowledge
when teaching a multicultural group. When
possessing the self-awareness and inner
willingness, educators can increase their interest
in, initiatives for and participation to meet new
cultures. It is important for educators to have
self-awareness and motivation to improve and
implement their own skills and ability in

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transcultural education. It is relevant to have
openness when meeting different cultures
without prejudice or discriminations. Being
open-minded is a productive way to show respect,
gain new knowledge and a way of mutual
learning. It is a catalyst to increase and improve
the communication between educators and
students; hence, educators can broaden their
horizons, avoid cultural taboos or bias in
transcultural teaching. When meeting a new
culture without prejudice, cultural experience
will gradually increase.

Respecting and caring: Some students may fall
out-of-step with others in the class due to
challenges in following the study plan. Educators
concern about multicultural students’ challenges
and study capacity, and it is important for them
to discuss and consider challenges in relation to
course planning. A good educator can also be
a ’helpful friend’ to students and a positive and
respectful attitude towards multicultural students
contributes to increasing educators’ interest in
students’ cultural background and building a
harmonious educator-student relationship.
Respecting each individual culture is regarded as
the foundation of transcultural communication.
Caring for students is thereby one irreplaceable
rule of educators’ ethics because it gives students
spiritual support.

Discussion

The results highlight that educators should have
the capacity of cultural knowledge, cultural
sensitivity in transcultural education and the
competence of assisting students in cultural
adaptation. In terms of ‘skills’ of educators, it is
useful to set up the goals of courses and design
the curriculum considering multicultural
students’ different learning styles. Through
knowing and learning students’ cultural
background, educators increase their cultural
knowledge about patterns of students’ thinking
and learning as well as ways of communication
in class. Continuous education or extra training
can improve educators’ skills in transcultural
education. To optimize the learning outcomes, it
is necessary to build collaborations between
educators to help each other in transcultural
education. Cultural differences influence
students’ learning styles, behaviours and
interaction. (Cox & Yamaguchi 2010)
Encouraging educators to participate in
international cooperation will not only benefit
themselves with a wider network of counterparts

from other countries, but also improve their
cultural knowledge. Educators’ attitudes towards
transcultural education and multicultural students
are considered an essential part of cultural
competence. To develop the cultural competence,
educators are supposed to have cultural desire
and willingness to encounter another culture and
communicate with culturally diverse students.
With a deeper understanding of different
cultures, educators develop cultural sensitivities
and avoid cultural taboos in education (cf.
Campinha-Bacote 2008, Campinha-Bacote
2007). Moreover, educators’ self-awareness and
desire are the foundation for gaining cultural
competence in a transcultural context. Educators’
positive attitudes e.g. respect and openness will
improve the educator-student relationship and
students’ satisfaction as well as educators’ self-
achievement and enjoyment in transcultural
education.

Multicultural students’ language barriers have
been reviewed as a challenge for educators in
transcultural education. Sanner and Wilson
(2008) have pointed out that the teaching
language has a direct influence on the result of
transcultural education; however, the main
problem is educators’ attitude such as
discrimination or prejudice. It is meaningful for
educators to be open-minded and respectful
towards other cultures. Additionally, due to
differences in the students’ learning capacity,
educators need to have innovation, creation and
flexibility in their pedagogical approaches in
course and curriculum planning.

Conclusion: With the demographic
globalization, the number of multicultural
students is growing dramatically within social-
and health care education. To provide them with
a competent cultural education, it is crucial to
improve educators’ cultural competence in
transcultural education. Continuous education
will benefit educators in terms of raising their
cultural awareness and offer them a blueprint to
visualize about teaching in multicultural groups.
A specialized education in transcultural learning
should be an additional part of the curriculum for
social and health care educator candidates. In this
way, candidates can easily adjust to a
transcultural environment. Continuous education
and further training is an important supportive
part in increasing educators’ competence to fulfil
transcultural education. Educators need
continuous education so they can use different

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didactical methods or even change their speech
when teaching cultural diversity students.

Ethical considerations: This research was
conducted based on the ethical principles for
research involving human subjects in the
Helsinki Declaration (2013). On 12th December
2017, the ethical committee at the University of
Jyväskylä apprised the ethical permission. All
participating organizations and participants in the
focus group interviews granted research
permission in this study. The respondents were
informed about the process and aim of research
and their participations in the study were
voluntary, confidential and anonymous. The
collected data will be saved for 10 years in
archive files according to General Data
Protection Regulation (GDPR) and the
legislation of personal data.

Acknowledgement: The research is part of the
TerOpe project funded by the Ministry of
Education and Culture in Finland. We would like
to acknowledge the Ministry for providing us the
opportunity to research and extend knowledge of
educators’ competence. We would also like to
acknowledge all the lecturers who participated in
the study.

Name and the postal address of the place
where the work was carried out: Department
of Caring Science, Åbo Akademi University,
Rantakatu 2, 65100, Vaasa, Finland

References

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or ‘taught’?. Contemporary Nurse 28(1-2): 141–
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1

Research Response Exemplar

Student Name

Walden University

2

Research Response Exemplar

The article I read was titled “Service User or Service Provider? How Social Work and

Human Services Students Integrate Dual Identities” by Newcomb et al. (2017). Newcomb et al.

identified a gap in research relating to social work and human services students as service users.

The purpose of their qualitative study, then, was to explore the experiences of students who

accessed helping services—either in childhood or adulthood—and how those experiences

related to their evolving professional identity. The researchers conducted interviews with 20

students, 15 of whom stated they were either a service user now or had been in the past. From the

interviews, the researchers learned that experiencing adverse circumstances and service use led

some students to study the discipline. Participants stated that the practitioners they engaged with

during past service use exhibited either positive or negative role modeling, which helped them

understand what to do and not do as a provider. Participants suggested that their service use led

to a better understanding of themselves and allowed them to make sense of their experiences.

Finally, participants reported that they feared disclosing their past or current service use to peers

and instructors, even while acknowledging the positive effect the service use had on their

identity. They feared their service use would be judged or stigmatized by others. The researchers

then proposed ways to integrate students’ service user (personal) and service provider

(professional) identities within the social work-human services classroom through instructor

modeling, opportunities for safe disclosure, and campus-based student support services.

I connected with this article as both a human services student and a professional working

in the field. First, in my professional experience at an outpatient psychiatric facility, I work with

Note that as you progress in your program, you will become more familiar with research terminology,

approaches, and methodology. Expectations for your papers will grow accordingly. This exemplar

represents what to strive for at this point in your studies.

3

human services practitioners who do not typically reveal their histories regarding mental health

or mental health services such as counseling. This lack of disclosure to peers and residents may

be out of fear for their employment or their sense of authority. However, I see a service use

history as invaluable for the work we do because it establishes empathy with the residents and

demonstrates how service use can help facilitate a productive life. By staying silent, we may be

simply reinforcing the mental health stigma and creating a barrier with the residents when we are

actually quite similar in the adversity that has shaped us. I agree with the researchers when they

say that finding a way to integrate these identities and normalize service user experiences could

lead to success for both practitioners and service users.

As an example, I have used my past experiences with mental health and addiction

recovery at least once in the field—to describe two possible approaches to a service user with

whom I was working. I had been exposed to these human service approaches as an

undergraduate when I was having difficulty with anxiety and benzodiazepine use. Because I had

experienced the approaches on the receiving end, I was able to describe to the service user the

benefits and challenges of each from the user perspective. The service user seemed appreciative

of the firsthand account I provided, and we built a rapport during our conversation.

This research has prompted me to think about how I will continue talking about my own

past service use while working in the field. I would like to do so in a more intentional way that

reduces stigma—and in fact celebrates the process of getting help. It is important to consider the

way in which the provider’s disclosure is made, however. A personal example that helps the

service user contextualize their experience would have a different effect than a provider’s long,

autobiographical monologue dominating a meeting. I may want to look for further studies on the

impact of service use disclosure according to the circumstances surrounding the disclosure.

4

Because this article was about students, it is directly applicable to me now. I can apply

the research as a human services student by being open to my fellow students who want to

discuss our whole identities as not just service providers but users. Overall, the research findings

align with my personal and professional experiences and have encouraged me to investigate the

topic further.

5

Reference

Newcomb, M., Burton, J., & Edwards, N. (2017). Service user or service provider? How social

work and human services students integrate dual identities. Social Work Education,

36(6), 678–689. https://doi.org/10.1080/02615479.2017.1327574

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