Nurses With Higher Cultural Competence Don’t Always Perform Better – New Study

Emmy
van Esch, University
of Auckland, Waipapa Taumata Rau; Hanoku
Bathula, University
of Auckland, Waipapa Taumata Rau, and Laszlo
Sajtos, University
of Auckland, Waipapa Taumata Rau

The
ability to function effectively in intercultural settings
has been termed “cultural intelligence” – and it is
often celebrated as a kind of modern superpower.

But our latest
research reveals a more complicated reality.

Previous
research has largely highlighted the bright side of
cultural intelligence, linking it to positive workplace
outcomes such as improved performance.

But we
found another side, and evidence of this in one of the most
critical settings: healthcare.

We collected data
from nurses working in New Zealand, a highly diverse country
where nurses have to interact daily with patients, families
and colleagues from a wide range of cultural backgrounds.

This diversity has grown even further after the
COVID pandemic, with many internationally qualified nurses
joining the workforce from around the
world.

Cultural intelligence therefore seems
essential. We expected it would help them perform better and
feel more satisfied at work. But that is not what we found
– which may have implications for the way cultural
intelligence is taught.

What cultural
intelligence means

Cultural intelligence consists
of four
dimensions.

Metacognitive cultural
intelligence refers to the mental processes we use to
acquire and understand cultural knowledge. This is about
being aware of our own thinking processes related to
culture, questioning cultural assumptions and adapting our
thinking patterns.

Cognitive cultural intelligence
refers to knowledge of the norms, practices and conventions
of different cultures. It involves knowing the similarities
and differences between cultures.

Motivational
cultural intelligence refers to the capability and
willingness to learn about and function in culturally
diverse situations.

Behavioural cultural
intelligence refers to the capability to demonstrate
appropriate verbal and nonverbal actions when interacting
with people from different cultural
backgrounds.

When cultural knowledge
backfires

Previous research has generally focused
on cultural intelligence as a single
construct and has shown positive associations with
performance outcomes.

However, we found results
are not consistent across the individual components of
cultural intelligence.

Surprisingly, we found
nurses with higher levels of cultural knowledge (cognitive
cultural intelligence) actually performed worse and reported
lower job satisfaction.

In other words, knowing
more about cultural differences does not automatically
translate to better care and may even get in the way.

We believe this suggests too much knowledge can
backfire. Cultural knowledge may create cognitive overload,
where nurses are overwhelmed by too much information.

It may also lead to cognitive entrenchment, where
deep expertise fosters rigid thinking, making it harder to
adapt to the unique needs of each patient.

This
matters because healthcare workers often attend cultural
knowledge training. In these training sessions, they are
taught about cultural norms, values and differences in the
belief that more knowledge will lead to better care. Our
findings suggest this may not always be the
case.

Why thinking about thinking
matters

We also found evidence for the bright side
of cultural intelligence.

Nurses who are more aware
of and adapt their own thinking processes related to culture
(metacognitive cultural intelligence) performed better
and reported higher job satisfaction.

We believe
these nurses are better at understanding and interpreting
cultural nuances, leading to fewer misunderstandings as they
adjust their assumptions during patient interactions.

This likely contributes to improved job
performance, as nurses can navigate cultural differences
more effectively and provide culturally sensitive and
appropriate care.

We also found motivational and
behavioural cultural intelligence did not have a significant
effect on job performance or job satisfaction.

This may be due to the specific nature of nursing
work. Nurses often operate in environments with clearly
defined roles and responsibilities, where core tasks are
highly structured. This may reduce the need for high levels
of intrinsic motivation or flexible behaviour to perform
effectively.

Taken together, our findings challenge
the idea that more cultural knowledge is always better.
Deeper understanding of cultural norms, values and
differences does not always lead to better care.

Instead, in highstakes intercultural work
environments such as healthcare, cultural
competence training needs to move beyond facts about
other cultures.

Cultural competence is not merely
about acquiring knowledge but about developing the
reflective and adaptive capabilities necessary to navigate
complex, culturally diverse environments.

In
healthcare, that distinction matters more than we think.

Emmy
van Esch, Lecturer (Assistant Professor) in Management
and International Business, University
of Auckland, Waipapa Taumata Rau; Hanoku
Bathula, Professional Teaching Fellow in Management and
International Business, University
of Auckland, Waipapa Taumata Rau, and Laszlo
Sajtos, Associate Professor in Marketing, University
of Auckland, Waipapa Taumata Rau

This article is republished from The Conversation
under a Creative Commons license. Read the original
article.