Cultural Competence Assessment Instrument
Also known as: CCA
The Cultural Competence Assessment Instrument (CCA) is a 25-item self-report measure designed to assess healthcare providers' cultural competence across four key domains: diversity experience, awareness, sensitivity, and competence behaviors. Developed by Schim, Doorenbos, and Borse in 2003, the CCA evaluates nurses' and other clinicians' readiness to provide culturally responsive care to diverse patient populations.
Key highlights
- Multidimensional assessment capturing awareness, sensitivity, knowledge, and behavior—the four pillars of cultural competence
- Grounded in nursing theory and extensively used in nursing education research
- Relatively brief and easily administered, allowing feasible integration into program evaluation and staff development workflows
- Published in a peer-reviewed journal with transparent methodology, supporting adoption across diverse healthcare organizations
Intuition
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How it works
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When to use it
The CCA is most appropriate for assessing cultural competence in registered nurses, nursing students, and other healthcare professionals in acute care, primary care, and community health settings. It is particularly useful for evaluating the impact of cultural competence educational interventions and for identifying institutional training needs. The instrument is suitable for both individual and organizational assessment.
Strengths & limitations
- Multidimensional assessment capturing awareness, sensitivity, knowledge, and behavior—the four pillars of cultural competence
- Grounded in nursing theory and extensively used in nursing education research
- Relatively brief and easily administered, allowing feasible integration into program evaluation and staff development workflows
- Published in a peer-reviewed journal with transparent methodology, supporting adoption across diverse healthcare organizations
- Self-report design is vulnerable to social desirability bias; respondents may overestimate their cultural competence
- Limited information on psychometric properties (e.g., test–retest reliability, construct validity evidence) in the original publication
- Scoring rubrics and exact subscale composition are not always clearly delineated in secondary sources; clinicians should consult the original publication
- Cultural competence is influenced by ongoing exposure and learning; cross-sectional administration does not capture developmental trajectory
Common pitfalls
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Applications
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Frequently asked
How long does it take to complete the CCA?
Respondents typically complete the 25-item questionnaire in 10–15 minutes, making it feasible for integration into staff orientation or annual competency assessments.
Can the CCA be used to predict actual cultural competence in clinical practice?
The CCA measures self-assessed cultural competence; while it correlates with some behavioral measures, self-report alone does not fully predict clinical performance. Combine CCA scores with clinical observation and patient feedback for a comprehensive evaluation.
Is there a short form of the CCA?
The literature does not describe a widely validated short form of the CCA. The 25-item version remains the standard. Organizations requiring a briefer assessment may consider alternative instruments such as the TSET or MCI.
Can the CCA be used in non-nursing professions?
Although developed for nurses, the CCA has been adapted for use by other healthcare professionals, including physicians and therapists. Verify that the language and content remain appropriate for your professional context before administering.
Sources
- 1.Schim, S. M., Doorenbos, A. Z., & Borse, N. N. (2003). Cultural competence development in nursing education: An evolutionary process. Journal of Transcultural Nursing, 14(3), 236–244.
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Cite this page
ScholarGate. (2026, June 3). Cultural Competence Assessment Instrument. ScholarGate. https://scholargate.app/transcultural-nursing/cultural-competence-assessment