Cultural diversity in healthcare – the role of leadership and education

Published: 13.06.2024 / Publication / Blog

The shortage of nurses is a global issue that already threatens the ability to deliver safe and effective care. According to the World Health Organization (WHO), this gap in the healthcare workforce, especially in Europe, could be characterised as a ‘ticking time bomb’ that could worsen health outcomes and, in extreme cases, lead to system collapse (WHO, 2022).

The reasons for this nurse shortage and an overall insufficient workforce are complicated and multifaced, including an ageing population, poor working conditions, low pay, high workloads and the fact that a lesser amount of young people choose nursing careers. One, in the recent years, widely practiced solution for this workforce crisis is international recruitment, which has been estimated to lead to a more diverse and multicultural nursing workforce (Cheng et al., 2022; Tevameri, 2021). This action again, poses new challenges, especially from the perspective of support and inclusion. In this blog post, that is based on a master’s thesis, we will present one possible solution to the problem.

The cornerstone of successful inclusion of a multicultural workforce is open and authentic communication as well as respect (Le, 2021; Debesay, 2022). Nursing managers have a key role in creating an atmosphere of trust. Our thesis focuses on the inevitably multicultural future of nursing in Finnish healthcare organisations, benefits and challenges of a culturally diverse workforce and suggests practical solutions for nursing managers who are in position to implement diversity strategies in practice. In the current climate, with the nursing workforce becoming more and more multicultural and diverse, many nursing leaders and managers are faced with new situations and do not have enough tools to lead a diverse and multicultural team (Kamau, 2023). As a part of our master’s thesis, we created a Massive Online Open Course (MOOC) on how to lead a multicultural team, to provide leaders and managers in healthcare organisations with knowledge and tools to better manage these new challenges. The MOOC consists of 4 parts, an Introduction, Module 1: Cultural diversity in Finnish healthcare, Module 2: Practical solutions for leading a culturally diverse team in healthcare and a Workshop. To overcome challenges and reach for practical solutions, the MOOC focuses on cultural diversity in healthcare and provides evidence-based knowledge to support leaders in their daily work. To effectively overcome the above-mentioned challenges, new leadership competencies and lifelong learning processes are needed, and for this, MOOCs are a viable and accessible option.

Online learning has many forms and one of these, more open, educational possibilities are MOOCs (Bates, 2022). A massive open online course is aimed at an unlimited number of students and is suitable for a topic that can potentially interest a wide audience. Enrolling in MOOCs is accessible to every potential learner and courses may have students with different backgrounds and cultures (AlDahdouh & Osório, 2016). For the development of nursing leadership, online courses such as MOOCs, offer a practical tool. The online format allows nurses to access education remotely, providing flexibility in scheduling and location. This kind of flexible and job-related opportunities to develop individuals’ expertise enables career advancement for more demanding tasks and can increase the quality of services (The Ministry of Social Affairs and Health, 2023). As nurses advance into leadership positions, educational programs and courses offered online provide a path for the needed professional growth.

The results of the literature review in our study were solid and united in conclusions, that in healthcare, diverse teams perform better and increase innovations (Wills, 2023; Miller, 2023; Narayan et al., 2021). Promoting diversity has shown to have a positive impact on overall performance, decision making and innovations. Diverse teams have doubled their chance of finding the right solution, but they are also more likely to have conflicts and longer discussions (Wills, 2023). In healthcare settings, diversity among the nursing staff as well as among other healthcare professionals increases the quality of care and improves overall patient satisfaction (Le, 2021). Healthcare providers who understand this connection, have the advantage of offering familiar services to diverse patients. The principal findings in our thesis were related to the inevitable diverse and multicultural future of nursing in healthcare organisations where cultural competencies, communication, educational interventions, and attitudes toward diversity play a crucial part. This suggests that improving skills and knowledge, as well as changing attitudes and behaviours towards diversity, are important factors in meeting the current and future needs in healthcare (Corbie et al., 2022). The reviewed articles highlighted the role and importance of all healthcare professional, and especially the healthcare leaders, in supporting the various features of promoting diversity, equity, and inclusion (Debesay et al., 2022).  Although the specific focus of each included article differed, all the articles had quite similar findings, and mentioned the positive effects and impacts that cultural diversity brings, and that challenges are possible to overcome. As healthcare is becoming more diverse, leaders are in a key role to implement strategies on diversity, equity, and inclusion. According to the findings, also humility and sensitiveness are important issues. Success in collaboration and co-operation in work environments were seen when the experiences of working in a culturally diverse team grew and team members got familiar with the different backgrounds of the members. The reviewed articles also showed that when leaders showed example and genuinely fostered an inclusive culture, this made an important difference that effected not only migrant nurses, but native nurses as well (Chua et al., 2023; Koesnell, et a.,2019).

The reviewed articles also mentioned the most common stumbling blocks in leading a multicultural team in healthcare organisations. These were insufficient knowledge, communication including lack of common understanding, change leadership education, intolerance and difficulties adapting to new ways of thinking (Uman et al., 2023; Koesnell et al., 2019; Debesay et al., 2022). Healthcare leaders are in a key role showing appreciations and cultural sensitiveness with humility in achieving successful inclusion and functioning multicultural diversity. Culturally diverse societies need care givers with various backgrounds. In improving the integration of a multicultural team in healthcare the management can learn from the past and from different work fields. Communication is an issue that arises on several occasions. Communication refers to language as well as interaction among teams. Language barriers and misunderstandings should be discussed and models and methods that support everyone’s way to speak and to be understood should be developed (Safdar et al., 2023).

As can be seen, successful implementation of diversity, equity, and inclusion has its demands. Online learning, in this case through a MOOC, on the topic of multicultural leadership in healthcare has the possibility to make this implementation more efficient. It can also support long-lasting and future-oriented ways to gain personal and professional goals in the form of providing leaders with solutions that respond to the rapidly changing multicultural needs in the healthcare sector. As the nursing shortage and workforce crisis is unlikely to be solved in the near future, all measures to bring alleviation to the problem are necessary to take. The increase in diversity and multiculture that international recruitment brings poses new challenges and demands on nursing leaders. In fostering diversity and inclusion, education plays a pivotal role, as it not only equips healthcare leaders with the necessary knowledge and skills but also influences their attitudes and perspectives. So, why not accept the challenge and upgrade your knowledge? The Cultural Diversity in Healthcare MOOC (3 ECTS) will be available at Arcada next autumn (2024).

Marjukka Honkanen, Master student in Healthcare Leadership, Arcada UAS

Liisa von Schoultz, Master student in Healthcare Leadership, Arcada UAS

Jonas Tana, Ph.D., Principal lecturer in Healthcare, Degree Program Director, Arcada UAS


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Cultural diversity in healthcare – the role of leadership and education

The shortage of nurses is a global issue that already threatens the ability to deliver safe and effective care. According to the World Health Organization (WHO), this gap in the healthcare workforce, especially in Europe, could be characterised as a ‘ticking time bomb’ that could worsen health outcomes and, in extreme cases, lead to system collapse (WHO, 2022).

Category: Publication

Can Machine Learning aid in finding key factors to improve the Finnish healthcare system?

Finland is in the process of change in our health care system. The Nordic well-fare system is challenged in Finland, for instance, due to difficulties in attracting nurses, changing demographics in Finland, and a general pressure to reduce costs in the whole public sector. This poses severe challenges for the entire healthcare sector. Can Machine Learning (i.e., the subfield of Artificial Intelligence, which focuses on having a machine imitate intelligent human behavior) be used to understand relationships between different critical properties of our healthcare system? Yes, it can! An excellent example of how this can be done is found in a scientific paper by Hu et al. (2020), where the authors investigated nurses' willingness to report errors in a specific geographical area of the US.

Category: Publication