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action research, advocacy, American Indians, collaborative relationships, community building, cultural competence, Lakota, multiculturalism, Native Americans, teaching learning



  1. Kavanagh, Kathryn MS, PhD, RN
  2. Absalom, Kathleen BSN, RN
  3. Beil, William Jr. BS, BSN, RN
  4. Schliessmann, Lucia BA, MSN, RN


Addressing how nurses become culturally competent is essential for knowledge development beyond why sociocultural understandings are important.This article reports participatory research conducted during intercultural immersion learning experiences of non-native nurses on an Indian reservation. Emphasizing collaborative relationships within unfamiliar social, political, and economic circumstances, and using Diekelmann's "concernful practices" as an organizing scheme, prompted participants to explicate practices that promote intercultural connecting. Suggesting integral shifts in value orientations with changes in cultural competence, the findings argue for attending to associations between those dynamics and potential for developing co-responsibility (with consumer groups) for advocating improved health and health care.