The Purnell model for cultural competence (PMCC), developed in 1991

Select a Transcultural Nursing Model/Theory.
Briefly explain the model/theory in your own words so your classmates will understand the general premises of the model/theory.
Then, explain how you would be able to apply the model in your practice setting.
Model: The Purnell model for cultural competence (PMCC)

The Purnell model for cultural competence (PMCC), developed in 1991, was initially a framework for clinical assessment tool (Purnell, 2002). Dr. Larry Purnell’s book, Culturally Competent Health Care, won the 2006 American Journal of Nursing Award while his other book Transcultural Health Care: A Culturally Competent Approach is the recipient of the Brandon Hill Book Award (Purnell, 2007).

Purnell coauthored Developing Cultural Competence in Physical Therapy with Lattanzi; this book was adopted by the Center for International Rehabilitation and Research Information Exchange (Purnell, 2007). The Commission on Internationalization and Cultural Competence for the European Union project for the Bologna-Sorbonne-Salamanca World Health Organization declarations has retained Dr. Purnell as consultant and has adopted the PMCC as framework (Purnell, 2007).The PMCC shows a circle with four rims: (1) global society (ouside rim); (2) community (second rim); (3) family (third rim); and (4) indi-vidual (fourth rim) (Purnell, 2002, 2004, 2005, 2008) (Figure 2.1).

The dark center of the circle denotes the unknown.Purnell (2002, 2008) used a jagged line on the bottom of the cir-cle to illustrate the “nonlinear concept of cultural competence” (p. 20). Furthermore, Purnell (2008) listed four levels of cultural competence, namely, unconsciously incompetent, consciously incompetent, consciously competent, and unconsciously competent (p. 21).Unconsciously incompe-tent is defi ned as the absence of awareness that one lacks knowledge about other cultures; consciously incompetent denotes presence of awareness about the lack of that knowledge; consciously competent describes learning about the client’s culture and rendering culturally fi t interventions; and unconsciously competent refers to the innate provision of culturally congruent care to multicultural clients (Purnell, 2008).

The four rims, along with conscious competence, make up the macrolevel of the PMCC.The PMCC aims to provide a framework for all health care pro-viders to study cultural concepts and characteristics and to interrelate characteristics of culture to promote culturally competent and sensitive health care (Purnell, 2008). According to Purnell (2008), there are 20 assumptions that serve as basis for the PMCC; three of the 20 assump-tions are as follows:

Culture has a powerful infl uence on one’s interpretation of and

• responses to health care;Caregivers need both culture-general and culture-specifi c

• information in order to provide culturally . . . competent care;Caregivers who can assess, plan, intervene, and evaluate in a

• culturally competent manner will improve the care of clients whom they serve.



Sagar, P. L. (2012). Transcultural Nursing Theory and Models : Application in Nursing Education, Practice, and Administration. Springer Publishing Company.

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