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NursingDiscussion postCultural competence

DNP 825 Topic 3 DQ 2: culture, literacy and change

This prompt is two posts joined together, and the second half — how well your own institution's change protocol works — is the one people answer in a sentence and could answer best.

Editorial process

Last reviewed · August 15, 2026

01

Two questions bolted together, and both are graded

Take the halves separately, because they are separate questions and both carry marks. On culture and health literacy, the useful examples are the ones where culture affects comprehension rather than compliance. Health literacy is not the same as language proficiency, though translation is part of it: a patient who speaks fluent English may still have no frame for a probabilistic risk statement, may come from a tradition in which the family rather than the individual receives medical information, may understand a diagnosis in terms of balance or imbalance rather than pathology, or may not ask a question because questioning a clinician would be rude. Each of those produces a specific measure — a professional interpreter rather than a family member, teach-back framed as a check on your own explanation, involving the family decision-maker deliberately, and asking what the patient thinks caused the problem. Comprehension rather than compliance is the axis to write on.

The second half asks about your own institution and it is the more interesting question, because you can answer it from evidence rather than from reading. How effective is the current protocol for implementing practice changes: is there a route from a nurse's observation to a change, does anybody use it, how long does it take, and what happened to the last three changes attempted. Barriers and facilitators should be named at organisational level rather than as personal qualities — whether there is a shared governance or practice council with actual authority, whether nursing has a route to change a protocol without a physician sponsor, whether education time exists, whether the electronic record can be modified and how long that takes, and whether anyone measures afterwards. A facilitator worth naming is a sponsor with budget authority, since almost every stalled change traces back to its absence.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Distinguish health literacy from language proficiency.
  • 02
    Identify culturally specific comprehension barriers and matched measures.
  • 03
    Assess an institution's change protocol from evidence rather than impression.
  • 04
    Name organisational barriers and facilitators rather than personal ones.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

Describe an example where a patient’s culture could impact health literacy. What measures would you employ to address the health literacy barrier? How effective is the current protocol for implementing practice changes in your institution? Examine any barriers and the facilitators for implementing an evidence-based change in your specific setting?
Course-wide instructions that accompany this question

Important information for writing discussion questions and participation Hi Class, Please read through the following information on writing a Discussion question response and participation posts. Contact me if you have any questions. Important information on Writing a Discussion Question Your response needs to be a minimum of 150 words (not including your list of references) There needs to be at least TWO references with ONE being a peer reviewed professional journal article. Include in-text citations in your response Do not include quotes—instead summarize and paraphrase the information Follow APA-7th edition Points will be deducted if the above is not followed Participation –replies to your classmates or instructor A minimum of 6 responses per week, on at least 3 days of the week. Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article Each response needs to be at least 75 words in length (does not include your list of references) Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count. Follow APA 7th edition Points will be deducted if the above is not followed Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points. Here are some helpful links Student paper example Citing Sources The Writing Center is a great resource Welcome to class Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to. I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you. Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted. If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations. Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements. Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course! DNP 825 Topic 3 DQ 2 Describe an example where a patient’s culture could impact health literacy. Name: Discussion Rubric Grid View List View Excellent 90–100 Good 80–89 Fair 70–79 Poor 0–69 Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. Main Posting: Writing 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Posting: Timely and full participation 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date. 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date. 7 (7%) – 7 (7%) Posts main Discussion by due date. 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date. First Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. First Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. First Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Second Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. Second Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. Second Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Total Points: 100 Name: Discussion Rubric

02

Turn the brief into deliverables

  1. 01
    A specific example of culture affecting health literacy.
  2. 02
    Measures matched to that barrier.
  3. 03
    An assessment of your institution's change protocol.
  4. 04
    Barriers and facilitators named at organisational level.
03

Culture and literacy, then your institution's protocol

01

Culture and comprehension

Give an example where cultural frame affects understanding rather than adherence.

02

Matched measures

Propose interpreters, teach-back, family involvement and explanatory-model questions.

03

Your institution's protocol

Assess the route from observation to change using a real recent example.

04

Barriers and facilitators

Name governance, authority, education time, record change and measurement.

04

Evidence on both halves

Recommended databases

  • AHRQ health literacy resources
  • Office of Minority Health CLAS standards
  • CINAHL
  • Your organisation's policy library

Search sequence

  1. 1.
    Read the CLAS standards for what an organisation is expected to provide.
  2. 2.
    Find out what your institution's actual practice change route is, in writing.
  3. 3.
    Identify the last three practice changes attempted and what happened to each.
  4. 4.
    Search cultural explanatory models for the question to ask a patient.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    Culturally and Linguistically Appropriate Services

    Office of Minority Health, U.S. Department of Health and Human Services · 2024

    The national standards for culturally and linguistically appropriate services, which is what the measures should be drawn from.

  2. 02

    Health Literacy Universal Precautions Toolkit

    Agency for Healthcare Research and Quality · 2024

    The universal precautions toolkit, source of the specific techniques for the first half.

  3. 03

    Nursing managers' perspectives on facilitators of and barriers to evidence-based practice: A cross-sectional study

    Nursing Open (Wiley), via PubMed Central · 2023

    Reported facilitators and barriers to evidence-based practice, evidence for how to frame the second half.

  4. 04

    PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice

    Implementation Science (BMC), Gill Harvey and Alison Kitson · 2016

    An implementation framework treating context as a determinant, which is where organisational barriers get their vocabulary.

  5. 05

    Cultural Competence in the Care of Muslim Patients and Their Families

    StatPearls, NCBI Bookshelf · 2023

    A worked account of culturally specific care considerations, useful as a model for the example.

06

Review before submission

Common mistakes

  • Treating health literacy as a language problem only.
  • Answering the culture half fully and the protocol half in one line.
  • Describing barriers as staff attitudes rather than as structures.
  • Assessing the protocol without reference to any actual change attempt.
  • Using a family member as interpreter, which the evidence advises against.

Submission checklist

  • Does your example show culture affecting comprehension, not just language?
  • Is each measure matched to the barrier it addresses?
  • Is the protocol assessment grounded in something that actually happened?
  • Are barriers and facilitators organisational?
  • Do both halves get comparable space?

Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.

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Aaron Bishop

MA, Education

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Reviewed by

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PhD, Rhetoric & Composition

Argumentation and thesis development

Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.

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