1. Williams, Linda A. BSN, RN
  2. Kruse, Lynda MS, RN,C, CNS


Nursing has long realized that the impact of a person's culture is an important component of planning the care of individuals. Recently the Joint Commission on the Accreditation of Health Care Organizations has begun to require evidence that healthcare workers have knowledge of the impact of cultural background on patient and family response to health and illness. An education fair is a creative and fun method of educating large numbers of employees with consideration for cost, time, and resource management. This article will address how to assess and utilize available resources for organizing and setting up a culture fair.


According to conservative estimates, minorities currently comprise more than 26% of the total U.S. population and are expected to swell beyond 52% by the year 2050 (U.S. Bureau of the Census, 1994 estimates). In an effort to promote true holistic care to all people, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) states "a patient's cultural and family contexts and individual background are important factors in his or her response to illness and treatment.." (Assessment of Patients, JCAHO p. PE-6). The staff development educators at Presbyterian Hospital of Oklahoma City, Oklahoma, not only concurred, but predated the statement, creating a culture fair to provide cultural awareness education. A culture fair is a creative, fun, and informative method of explaining cultural, religious, and ethnic differences to healthcare workers while addressing issues of cost, time management, and appropriate use of resources.


In a diverse society, healthcare workers must be prepared to work with all patients regardless of cultural background and to provide culturally appropriate care. Learning about one's own culture is a natural process as we acquire knowledge about family structure and hierarchy, religious rituals, foods to eat for particular holidays, and even which holidays to celebrate.


Healthcare workers must overcome the natural tendency for ethnocentricity-the belief that their customs and values are superior to others. Although it is important to be culturally sensitive, learning about every culture and all particular beliefs and practices is an impossible task. Healthcare workers, particularly nurses, must have the ability to assess the influences of culture on their patients, be sensitive to how these differences influence relationships with patients, and find value and worth in all individuals (Grossman, 1994).


Communication as well as orientation to time and space should be assessed on every patient. Does the patient speak English? Can the nurse speak directly to the patient or must the nurse talk to the eldest female of the family? Do appointment times have meaning in the patient's culture? What is the distance of personal space for the patient? Not all members of a specific cultural group observe the commonly known practices and beliefs of that cultural group. It is vital to quality patient care that the nurse ascertain the needs and preferences of specific patients by assessing each patient as an individual (Baxter, 1988).


Nursing has long realized the impact of culture upon a person's perception of illness and wellness. The Joint Commission on Accreditation of Healthcare Organizations also holds patient care facilities accountable for the assessment of the cultural needs of the patient. Hospitals face the challenge of educating large numbers of people on cultural issues while being conscious of cost containment, time management, and the appropriate use of resources. To this end, our institution organized a multidiciplinary team consisting of nurses, dietitians, social workers, and clergy to create an educational plan for culture awareness. A Culture Fair was developed as a creative and fun method of exposing healthcare workers to cultural, religious, and ethnic information.