Guided by the cultural competence and confidence (CCC) model, the Transcultural Self-Efficacy Tool (TSET) was used to evaluate the influence of cultural competence education on the transcultural self-efficacy (TSE) perceptions of undergraduate nursing students following an integrated approach to cultural competence education. Results continue to support that TSE is influenced by formalized education and other learning experiences. As hypothesized, compared with novice students, advanced students' scores were higher for all subscales in both cross-sectional (n = 147) and longitudinal (n = 36) study designs. Results from analysis of variance and covariance demonstrated that none of the demographic variables predicted change; semester was the sole predictor, lending additional support that (a) the educational interventions throughout the four semesters influenced TSE changes and (b) all students regardless of background benefit (and require) formalized cultural competence education. Implications for nurse educators conclude the article.

he factor structure of the Transcultural Self-Efficacy Tool (TSET) was analyzed using data from 272 culturally diverse undergraduate nursing students. The TSET is a questionnaire designed to measure students' confidence for performing general transcultural nursing skills among diverse client populations. Using the most recent imputation techniques for missing data, researchers demonstrate how common exploratory factor analysis (CEFA)--(as opposed to principal components analysis)--can (and should be) used in examining the factorial composition of the tool. Standard errors for factor loadings were computed and utilized in deciding whether a given item loaded significantly on a factor and whether the difference between the factor loadings of two or more items on the same factor were statistically significant. The CEFA, comprised of 69 of the 83 items, yielded four factors--"Knowledge and Understanding'," "Interview," "Awareness, Acceptance, and Appreciation," and "Recognition"--with internal consistency ranging from .94 to .98. Reliability of the total instrument was .99. It was concluded that the present CEFA study continues to support that the TSET assesses the multidimensional nature of transcultural self-efficacy while also differentiating between three types of learning: cognitive, practical, and affective. The benefits of this support allow the researcher/ educator to move beyond mere assessment to the design, implementation, and evaluation of diagnostic-prescriptive teaching strategies for cultural competence education.

This study illustrates how a diagnostic testing model can be used to make detailed comparisons between student populations participating in international assessments. The performance of Turkish students on the TIMSS-R mathematics test was reanalyzed with a diagnostic testing model called the Rule Space Model. First, mathematical and cognitive skills ('attributes') measured by the test were determined. One hundred sixty-two items were coded in terms of their attribute involvement, creating an incidence matrix-the Q-matrix. Using the Q-matrix and the student response data, each student's attribute mastery profile was determined. Mean attribute mastery levels of Turkish students were computed and compared to those of their American peers. It was shown that Turkish students were weak in algebra and probability/statistics. They also demonstrated poor profiles in skills such as applying rules in algebra, approximation/estimation, solving open-ended problems, recognizing patterns and relationships, and quantitative reading.

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Student and teacher ratings were relatively close, suggesting that respondents took the task of CCCET completion seriously and honestly, that cultural competence was a visible theme throughout the course, and that students and instructors worked closely together in the clinical practicum setting to achieve learning objectives (including cultural competence).