Advancing health equity through transcultural nursing

When international nursing scholars arrived at UH Hilo for the first time, they found something they couldn't get anywhere else: a nursing program built from the ground up around culture. On March 25, four BSN seniors helped host the 22nd Annual Transcultural Nursing Symposium — bringing global healthcare leaders face-to-face with indigenous healing practices like lāʻau lapaʻau and the foundational idea that a "one size fits all" model of care has no place in Hawaiʻi.

Organized in part as a dedicated senior project by four exceptional nursing students in the Bachelor of Science in Nursing (BSN) program, the symposium’s overarching theme was “Patterns of Educational Approaches and Care Delivery Promoting Health Equity.”

The final semester in the Bachelor’s of Science Nursing program is focused on their senior capstone projects. This year, four seniors tackled running the annual Transcultural Nursing Symposium alongside their instructors. (From left to right: Dr. Luzviminda Miguel, UHH School of Nursing Associate Professor; Elijah Cacal; Jacob Kabes; Victoria “Tori” Yamashita; Mark Velasco; Dr. Katherine Daub, former UHH School of Nursing Director and adjunct faculty member)

Elijah Cacal

Elijah Cacal, a BSN senior from Kona and a Kamehameha Schools Kāpalama alum, was drawn to the profession after working with COVID-19 testing and vaccination teams in West Hawaiʻi. “Hawaiʻi is such a culturally diverse place that we need to stop placing a 'one size fits all' model on how care is performed," he explained. By integrating cultural practices with modern medicine and identifying social determinants of health, he noted, providers can foster drastic improvements in the community. “I know I want to stay on [the] Big Island to improve the health of my community however I can."

Dr. Katharyn “Kay” Daub, tenured professor of nursing, noted the critical timing of this focus. “This year’s theme highlights the importance of promoting health equity, as evidence shows that social determinants of health affect health outcomes,” she explained. The event successfully brought together faculty, students, and community members to engage, interact, and learn from experts on how culturally grounded care can advance health equity.

Dr. Daub with Hawaiʻi County Mayor Kimo Alameda, who stopped by the symposium to thanked students for choosing healthcare professions and encouraged them to give back to their communities after graduation

Dr. Daub also reminded attendees of the program’s deep roots, honoring the founder of the UH Hilo School of Nursing, Dr. Genevieve Lehuanani O’Kilauea Kinney. Having studied directly under transcultural nursing pioneer Dr. Madeleine Leininger, Dr. Kinney wove culture care into the very fabric of the school. Today, UH Hilo boasts the first Doctor of Nursing Practice (DNP) program in the state with a rural health promotion focus. Remarkably, every single course contains a transcultural objective — a pioneering curriculum framework developed by Professor Emerita Dr. Dula F. Pacquiao.

Mark Velasco

“Culturally grounded care builds trust and improves communication between patients and providers. When care respects cultural values and beliefs, patients are more likely to engage in their care, which helps reduce health disparities and improve health outcomes,” explained Mark Velasco, a BSN senior who has experience in multiple clinical settings, including community and acute care.

By focusing on a “Grow Our Own” strategy, the UH Hilo School of Nursing continues to empower residents from underserved areas to pursue advanced education and return home to serve.

Associate Professor Luzviminda Miguel, DNP, emphasized that the symposium serves as a roadmap for resilience, helping students transform into confident professionals ready to serve with both technical expertise and heart. Exposure to global leaders proves to students that their potential extends “from the bedside to the boardroom.”

Miguel said the prevailing spirit of the day echoed a core philosophy of transcultural nursing. “It is our passion and our hope that nurses worldwide will be trained in transcultural caring in order to provide culturally competent care to our communities, our global community.”

Prof. Miguel with junior students from the UH Hilo School of Nursing

Reflecting on the milestone event, Miguel beautifully summarized its ultimate takeaway. “Knowing that the work we do today helps improve healthcare access for Hawaiʻi’s rural and underserved communities is deeply meaningful. Every nurse has the potential to move mountains.”