The Workings of a Multicultural Research Team

Abstract

Purpose

Transcultural nurse researchers are exposed to the challenges of developing and maintaining a multiethnic team. With the example of a multicultural research study of family caregivers conducted in the Miami-Dade area, the authors guide the readers through steps of developing a culturally competent and effective team.

Design

Pointing out challenges and successes, the authors illustrate team processes and successful strategies relative to recruitment of qualified members, training and team maintenance, and evaluation of team effectiveness.

Method

With relevant concepts from the literature applied to practical examples, the authors demonstrate how cultural team competence grows in a supportive work environment.

Internationally and domestically, the American work-force has become more culturally diverse, and traditional homogeneous work groups are progressively replaced by multicultural teams in order to succeed in a competitive market (Milliken & Martins, 1996). The immigration flow during the 20th century is the major cause of the contemporary diversification of the population and has turned the United States into the nation with the most complex culture mix on the planet (Tienda, 2002). Thus, the need to learn how to manage heterogeneous work groups is evident (Alba, 1999; Milliken & Martins, 1996).

Whereas this phenomenon of diversification has constituted the focus for transcultural nurse researchers, conducting research in a multicultural environment is gradually becoming a common experience for all nurse researchers in the United States, and multicultural research models, once reserved for border states, are now a necessity throughout the nation. Controlling bias in data collection and interpretation has become a formidable challenge that can best be handled with research teams composed of ethnically diverse members who understand the cultural views of the study participants and the community context from which the data originate (Sauquet & Jacobs, 1998).

The purpose of this article is to expose transcultural nurse researchers to the challenges of developing and maintaining a culturally sensitive and effective multicultural team. The article addresses the principles outlined in the literature that are related to recruitment, team building, team maintenance, and performance evaluation and translates these theoretical concepts into research methods through the example of a multicultural study conducted in the Miami-Dade area with family members who give care to older relatives in their homes. The ultimate aim is to stimulate transcultural researchers to evaluate the described elements of team building and team maintenance and adapt those that are appropriate to their own studies, thereby developing cultural competence within their own teams.

A well-functioning multicultural work team may be one of the best venues to reach culturally congruent findings and interpretations. Bliss (2004) described it as a group of people dedicated to a common purpose. Through regular and frequent interaction with one another, team members collaborate to accomplish the activities necessary to reach their goal. Under most circumstances, the literature evaluates team performance as superior to individual performance (Johnson & Johnson, 1996); however, negative factors are not excluded. Watson, Johnson, and Merrit (1998) pointed out that a threat to team integrity exists if beliefs and actions of individuals are incongruent with the goals of the team. They described the need to balance team orientation with self-orientation. The potential for such imbalance in a team is greatest when individuals with different cultural and/or academic backgrounds are expected to work together (Watson, Johnson, & Merrit, 1998).

Therefore, we will explain how we have avoided such imbalance and how working with a multicultural research team in our study of family caregiving has benefited us in many ways. The discussion in this article is guided by the model of Campinha-Bacote (2002) in that the readers are introduced to the four components necessary to acquire cultural competence in our research team. Because cultural desire was the most essential recruitment criterion, we describe the selection of team members who had the motivation and the potential to become culturally competent; the process of stimulating and sharpening cultural awareness is illustrated in the sections about team training and team meetings with discussions of cases representing different cultures; cultural encounters have became part of the interviewers’ daily life and each interview presents a new and unique challenge with variations in ethnicity, immigration history, family structure, economic status, and caregiving situation; cultural knowledge constitutes the objective of formal and informal training; and cultural skills have developed gradually through interviewing practice, supervised home visits and peer guidance during home visits, postinterview discussions, and team meetings.

Background

The Miami-Dade County, with almost 2.3 million residents, is the largest county in the state of Florida. In terms of ethnicity, more than 60% of the residents identify themselves as Hispanic and 20% as Black. Both of these groups are multicultural, from countries in South, Central, and North America and the Caribbean. More than 50% of the people in Miami-Dade are foreign-born, which is the largest percentage of any city in the United States, and more than 70% speak a language other than English at home. Although the area represents the center of Cuban immigration, it is also an attractive destination for internal migration of both Black and White people, and immigrants from all continents have made Miami their home. In fact, residents coming from Latin American countries other than Cuba have surpassed Cubans in numbers. In terms of the socioeconomic landscape, Miami-Dade County as a whole is one of the poorest in the nation, with 18.4% of individuals living below the poverty line. Approximately 32% of Miami-Dade residents have not completed a high school education and only 28% have earned a university degree (U.S. Census Bureau, 2005).

The multicultural and multiracial makeup of Miami-Dade County presents logistical challenges to any research team in terms of obtaining accurate data. Based on survey results from the U.S. Census Bureau (2005), people in the county identify themselves as part of six different racial groups: Whites, Blacks/African Americans, American Indians/Alaska Natives, Asians, Native Hawaiians/Other Pacific Islanders, and Other Races. As part of these racial designations, more than 25 ethnic groups are said to reside within the area. In addition to speaking one or two of the major languages (English, Spanish, and Creole), recent immigrants from Eastern Europe, Asia, and Africa communicate in many other languages and dialects as well.

Our study, “Culture, Family Patterns and Caregiver Resource Use” investigates caregiving arrangements and cultural attitudes of families from across the ethnic spectrum in Miami-Dade County. It is a 4-year endeavor (2004 to 2008) funded by the National Institutes of Health (NIH). The investigative team is based in a research-focused university in South Florida and conducts in-home interviews with the caregivers of relatives 65 years old or older. The study seeks to explore the use of formal and informal resources as they relate to the family process and cultural attitudes.

Nonbiased data unaffected by cultural and language differences and perceptions are intrinsic to the study’s validity and success and a challenge to obtain. To increase access to caregivers, the survey instrument is available in English and Spanish. Based on feedback from the Haitian community and their leaders, translation into Creole seems problematic because the more affluent older patients speak proper French rather than Creole and many of those who speak Creole cannot read it. Luckily, most of the younger adult caregivers of their elderly family members are able to respond in English, sometimes with clarifications offered by our Haitian data collector.

Challenges of Multicultural Teams

Foldy (2004) claimed that multicultural teams (teams that comprise a mix of cultures and ethnicities) that can engage in quality work with research subjects of multiple backgrounds are needed because of the strong preference of people to associate with others who appraise their world in a similar fashion and the general view that peers are more likely to share culturally determined ways to handle sensitive situations. Thus, a multicultural team seems best able to collect data that accurately reflect the needs and perceptions of diverse ethnic communities and answer complex research questions (Pasik, Stewart, Bird, & D’Onofrio, 2001); yet when pulling together a group of individuals of different cultural and/or academic backgrounds, unique challenges come into view for the team leader and the team members alike (Owens & Neale, 1999). Procuring quality data in a multicultural team depends on the extent to which the team surmounts culturally established barriers and works together harmoniously.

Even though the literature has praised culturally diverse teams for maximizing the expertise of individual members, providing more accurate information, being more creative and innovative, and building more insight than homogeneous groups, other studies found that such teams have exhibited less group cohesion and more interpersonal conflict (Shaw & Barrett-Power, 1998; Williams & O’Reilley, 1998). This suggests that members of multicultural teams have to overcome stark differences in the members’ cultural background and must work harder at creating and maintaining the work relationships (Baugh & Graen, 1997). Because culture determines not only the way team members approach and experience problematic circumstances but also the way they solve them (Foldy, 2004; Shaw & Barrett-Power, 1998), the team has to learn creative ways of resolving conflict. Conflict appears to have complex consequences on group effectiveness (Nibler & Harris, 2003); however, recent research suggests that intragroup conflict, if worked through successfully, may benefit ultimate team functioning (Amason, 1996; Jehn, 1994). Consequently, in successful teams, the members solve behavioral conflicts and attune their individual goals and behavior patterns to those sanctioned by the team (Solomon, 1995).

As we planned our study, we realized that cultural rights had to be granted not only to research subjects but to all the team members. Developing such cultural awareness presented the first step toward developing high sensitivity and tolerance of cultural differences within the team needed to achieve team cohesion. Discussions in the literature directed us to focus on trustworthiness and effective communication as essential prerequisites for cohesion and optimal functioning in multicultural teams.

Trustworthiness in a multicultural team, perceived as cultural value, is a crucial factor affecting cross-cultural interactions but cannot be taken for granted. Trust is a cultural acquisition. Since the moment of birth, people develop patterns of trust, or distrust, through cultural norms and collective experiences (Mishler & Rose, 2001). As Putnam (1993) explained it, culturally developed interpersonal trust or distrust expands to local population groups, and ultimately creates a mindset that will be transmitted to future generations. People who trust each other are more likely to cooperate with each other in formal and informal activities, yet even culturally homogeneous societies or teams include variations in trust levels among individuals. Trust in any team is an asset to be built gradually and systematically (Putnam, 1993).

Communication is also culturally acquired. Language helps to organize knowledge of the world and characterize culture; therefore, language is an integral aspect of behavior and fuses cognitive and affective processes (Hamers & Blanc, 2000). Mastering communication not only implies verbal fluency but also ability to judge the contents of a conversation within its cultural context by using nonverbal clues. Nonverbal language results in actions and behaviors that carry diverse meaning for different groups and an inherent risk of being misinterpreted as improper by people of other cultural groups (Ji, Zhang, & Nisbett, 2004).

Appelbaum, Shapiro, and Elbaz (1998) used Nancy Adler’s work to expose the three barriers to effective communication that need to be prevented in cross-cultural communication: cross-cultural misperception, misinterpretation, and misevaluation. Cross-cultural misperception is evident when a person’s perceptual patterns are selective and inaccurate due to cultural bias. Cross-cultural misinterpretation refers to the predisposition to categorize situations from our own cultural perspective and apply it to other ethnic groups. Finally, cross-cultural misevaluation means that we use our own cultural values as the norm to judge and consequently misjudge others.

Effective work in cultural sensitivity entails detecting and correcting these communication barriers as they occur. A context-specific approach has been advocated to enhance processes leading to cultural awareness and sensitivity (Miller, 1999). Such an approach entails cognitive interpretation of verbal language and nonverbal behaviors based on the knowledge of the speaker’s cultural background. Key to a team’s success, generally as well as in our team, is the ability to acknowledge and respect the individual members’ cultural orientation and develop an environment that encourages growth (Watson, Johnson, Kamalesh, & Critelli, 1998).

In summary, trustworthiness and culturally sensitive communication were the desired outcomes of the team-building processes described below. Trustworthiness was cultivated through formal and informal education. Effective open communication that respected the members’ cultural uniqueness served as the instrument to understand and reconcile differences. In our study, such a process has built a context in which team effectiveness is possible.

The Research Team

Jehn, Northcraft, and Neale (1999) discovered several types of team diversity that have the potential of evoking conflict and, consequently, influence the effectiveness of the team. They suggested that for a team to be effective, members should have high information diversity (differences in knowledge bases and perspectives such as educational background, experience, and expertise) and low value diversity (agreement on the goal, mission, and tasks of the group). Low value diversity is also instrumental in increasing efficiency and morale in the team.

To apply the above concepts to the study of caregivers, there is a need to initiate the discussion with a description of the team composition. Supervised by the principal investigator (PI), the team is composed of a project manager who also collects data, a quality assurance person, a research assistant, and four data collectors. The team includes two members from Colombia, one from Honduras, one Puerto Rican, a person with roots in the Midwest, one from Jamaica, and one from Haiti, representing six distinct ethnicities. Whereas all team members have at least a bachelor’s-level education and extensive experience in working with people of many cultures, their occupations range from nursing, medicine, physical therapy, and public health to professional writing, bank customer service, and secretarial work in an import business. They vary considerably in age from 22 to more than 60 years, suggesting high information diversity. The oldest member, born in the United States, has managerial experience and excellent organizational and people skills but no knowledge of Spanish. Of the immigrants, one woman from Colombia is a highly educated writer for Latin American newspapers with considerable experience in working with groups and counseling youth. She has sincere compassion for people in difficult situations, but her knowledge of English is limited. The two other Hispanic women are educated at the bachelor level, are younger, and have recently immigrated. Having ambitious advanced educational plans, they have made great efforts in learning the English language and are sufficiently fluent in conversation. The woman from Haiti has achieved an academic degree since coming to Miami and speaks excellent English, Creole, and French, whereas the youngest interviewer from Jamaica is less experienced in research but willing to learn. The young man from Puerto Rico is a graduate in public health with excellent command of English and Spanish, leadership qualities, and abilities to establish rapport with people of all kinds.

This diversity in culture, age, gender, and education has led to differential assignments of responsibility and thus power differentials within the team. The person with managerial skills received the role of project director in addition to being an interviewer and has earned respect from all due to her organizational skills and talent to relate to people. The PI has rewarded the other members’ talents with special responsibilities such as assisting in staff training at data collection sites, contributing to a column for the newsletter, writing a report, or participating in a research presentation. Key to maintaining motivation and striving for high goals is for the PI and other leaders to recognize all members’ contributions in group meetings or the newsletter, involve them in all steps of the research process, acknowledge their ideas and contributions, and solve any type of interpersonal conflicts in open discussion either in a person-to-person meeting or with the group.

Value diversity has been reduced over time. The initial selection and hiring process as described below has resulted in a group of individuals who ascribe to a set of common qualities such as being caring, honest, reliable, and detail oriented. Training and team-building processes were geared to overcoming barriers due to value diversity. Learning about each other’s culture and sharing perceptions and thought processes openly were key to success. The most obvious diversity existed in the perception of time and the importance of being on time. Through discussions, personal reminders and peer pressure, punctuality has become a team goal recognized as important by all. Over time, our team has become cohesive and effective.

Recruitment

Based on the above discussion, recruitment of a multi-cultural team involves the process of finding and selecting the kind of team members that enhance the accuracy of the data collected and ensure valid study results. We wondered how much diversity was required to enjoy maximum creativity and innovation in the team while minimizing the risk of group instability and conflict through discrepancies in value diversity (Jehn et al., 1999).

Austin (1997) suggested that optimal diversity depends on factors such as individual tolerance levels for novelty and differing environmental cultural context. Unfortunately, however, Austin offered no clear definition of an optimal level of diversity or directions how to achieve it. Instead, he suggested to manage human resources efficiently and make sure that team members are matched with the infrastructure of the project, the roles they are to assume, and the tasks they are expected to accomplish.

Data that accurately reflect the needs of culturally and linguistically diverse members in the team and groups in the community are critical for programs striving to impact policies and addressing health disparities (Pasick et al., 2001). For that reason, our search for data collectors focused on people who were trustworthy and able to communicate clearly with research participants and were ready to prevent conflict through cultural sensitivity. At the same time, we were striving for an optimal level of diversity in the team, namely, information diversity, that goes beyond demographic and social composition.

By means of a selection process, we evaluated special personal and professional talents in addition to professional background and experience. To match the demand of the project and data collection procedures, we screened applicants for organization skills, promptness, and attention to detail through the use of targeted interview questions, examination of past task performance, and relevant statements in reference letters. Of special importance to assume their expected role, however, was the ability to establish rapport with the team and the research participants. Here, we found that best suited were people with intensive experience in dealing with people, preferably with the elderly, through professional work or voluntary activities.

Even though successful team assimilation cannot be predicted, an applicant’s composure during the interview, politeness, ability to engage in a meaningful discussion with us, seriousness about doing quality work, and the desire to use the job opportunity as a venue for growth were indicators that proved reliable over time.

We found language skills and eloquence in their main language fundamental to the success of data collectors but rated the above-cited personal characteristics higher than their ability to speak English without flaws. To assist our Hispanic members with communication in team meetings, we assigned our quality assurance person the additional role of Spanish language specialist, educator, and interpreter to make sure that everyone understood the process of interviewing and was able to follow the discussion of issues in the team. His role was vital for the development of group cohesion because he was able to interpret not only spoken language but also nonverbal cues for the team. Because he was very sensitive to differing cultural perspectives, he acted as liaison between the Hispanic, Caribbean, and White American factions of our team and brought conflicts to the attention of the PI and the team before they escalated.

Based on different ethnic roots, family constellations, ages and maturity levels, professional experience, and life expectations, information diversity was considerable in our team. At all times, however, the members shared at least two of the following characteristics with at least one other person: native language, race, nationality, U.S. citizenship or immigration status, gender, educational experiences, or spiritual orientation. We found that having something in common with others fostered cohesion and stimulated mutual interest in each other’s differences.

The success of our recruitment effort is evident. Our team meetings are relaxed and educational for all. Serious work is being conducted, interspersed with sound humor that helps in the remediation of conflict without denying its significance. It is gratifying to see the clear connection between team spirit leading to the feeling of support by the others and accomplishment of quality work as evidenced by positive feedback from the interviewed caregivers.

Team Building

Cross-cultural research must be culturally sensitive by nature. It is advisable for team members to be flexible and diversity-conscious. Team members, especially those in the field, need to handle culturally determined issues with effective communication and strategies to gain trust (Watson, Johnson, Kamalesh, et al., 1998).

For that purpose, experienced faculty conducted a 1-day training workshop. Initially, the training concentrated predominantly on the operational components of the research project. Because the faculty wanted the team to feel invested and integrated in the project operation, they explained each step of the research process and the roles of all research participants from recruitment to data analysis and report writing. Next, they introduced the interviewers to the standardized data-collecting tool, stressing the purpose of each item. This was followed by a lecture and discussion about interviewing techniques where the faculty promoted maintenance of conversational flexibility for rapport building with the participants in order to obtain quality data. Nevertheless, aspects such as a caring attitude, politeness, communication skills, clear speech, and tolerance could not be taught entirely through formal instruction. The team members learned to apply the techniques of conducting an interview as faculty supervised them during practiced, role-played interview sessions. During the exercise, the faculty attempted to reinforce inherent communication strengths based on previous experiences with older adults by discussing past experiences, practicing interviewing with each other, and later discussing performance skills in the field. They gave each member opportunities to offer constructive feedback.

Research with human subjects merits the highest ethical standards. Thus, we were striving for agreement in ethical core values. Through extensive training, we raised the team’s ethics awareness to the level required for proper research conduct. The second part of our workshop involved cultural ethics training relative to interactions with research participants that reached beyond the actual interviewing process. A mental health specialist led the team in a discussion on building trusting relationships in which she emphasized showing respect for the uniqueness of each participant. As part of a discussion of situations that involved ethical issues, the team members could share their own feelings and reactions with each other in a process that brought them closer to each other as human beings. In addition, team members completed an intensive course on the protection of human participants followed by additional training sessions on the topic of research misconduct and ethical issues in managing private data offered by the university.

Due to the intensive training of our culturally diverse team members, our investigation benefited from helpful insight but also from a more effective way of managing resources, and thereby improving the chances of obtaining valid results.

Team Maintenance

Even though the literature cites that cultural differences have an impact on group interaction and performance, such ultimate effects have not been predicted with certainty (Day, Dosa, & Jorgensen, 1995). Instead, final results depend entirely on the management of the team. Leaders of multicultural research teams who are flexible and sensitive to cultural differences seem to effectively motivate team members and stimulate cooperation within a learning environment. Day, Dosa, and Jorgensen (1995) brought up three significant factors that facilitate the work of research teams: (a) quality of team leadership, (b) effective use of face-to-face meetings, and (c) personality characteristics of the team members. The authors also suggested that interpersonal communication and tolerance are the most important constituents of an optimal research process and information flow, and therefore, team members need periodic reminding.

Team maintenance is very important to our research project. Biweekly meetings allow for the various members of the team to interact, exchange best practices, and discuss especially important situations or events encountered in the field. The meetings are a forum, in which team members express how their data collection is progressing, what situations they have observed during their home visits, and which special needs of interviewed caregivers merit attention. Data collectors select one or two cases and share their experiences with the rest of the team members. During this time, ideas are exchanged about interviewing techniques or trust building, and questions are raised about family problems, cultural differences, or emotional reactions they have observed. The team members perceive these sessions as a validation of their effort, support, and stimulation for growth. A process of growth is observable as the interviewers increasingly report the use of their own resources during difficult situations and evaluate these situations with growing cultural sensitivity.

Another instrument of affirmation is a newsletter to the community of collaborative partners that contains updated information on the research progress. The newsletter contains a section on team news, in which a short biography of a team member is portrayed; and in a special issue section, the PI reports stories from the field with direct input from the team members. The newsletter contributes to the team members’ pride in the project and enhances appreciation for each other.

Evaluation of Performance

Evaluating the team on a regular basis is both a quality control measure and a motivating factor for ongoing team performance. The question then arises whether the evaluation should focus on individual team members or on overall team performance. The fact that teams outperform the average individual if the conditions are conducive to cooperation (Johnson & Johnson, 1996) speaks to the need of looking at the team as an independent system with qualities beyond its members. Nevertheless, Watson, Johnson, and Merrit (1998) claimed that neglecting the individuals in the team can be problematic in that group fragmentation may occur if their needs are not met. This is to say that group and self-oriented behaviors are not inevitably opposite extremes, but that at times they may compete and at other times complement each other. Therefore, we evaluate (a) the team as a whole in terms of structure and process; (b) the team members for job performance, communication, and cultural understanding; and (c) the collaboration within the team. The team’s effectiveness is the interplay of all three components.

Our evaluation focuses first on the coherence of the project structure and operation in evaluative discussions during team meetings. The idea is that if the members are continuously engaged and interested, the framework that keeps the team together is satisfactory. The other aspect of overall team effectiveness concerns team output measured by the number of interviews, timely scheduling, success with recruitment and avoidance of rejection, quality of data and data entry, ongoing literature searches, and report writing. We regularly compare our performance with the grant timeline and reassign tasks to assist each other if one or more functions lag behind.

Individual evaluations are the task of the PI, but progress reports include data from self-evaluations and team discussions. The PI shares the progress report with each team member and opens problem areas for team discussion.

As individual performance is of major importance for the overall operation of the team, multiple quality control protocols are in place. We make phone calls to every 10th study participant, using a set of standardized questions related to interviewing quality, and, to check for habitual errors, we accompany the data collectors on each tenth visit, double-checking with them the marking of the participant responses on the questionnaires. So far, quality reports have been consistently positive, and the team receives regular feedback about its professionalism and compassion with the caregivers during team meetings. The fact that the participants experience the data collectors as persons who speak their language and are sensitive about their culture seems to provide the basis for quality data and motivates the members to perform optimally in the entire scope of the operation.

Collaboration is facilitated by an operational format in which team members can maximize their autonomy and exhibit a sense of project ownership. To assess this phenomenon, we examine the team members’ satisfaction with the process, their roles, and the roles of their leaders. We have discussions about these issues; collect feedback about role assignments, responsibilities, and compensation; and invite ideas for improvement in the project operation, including the supervisory performance.

Interview appointment setting and successful survey completion depend on the collaboration of the team members as well as the role functions of individuals. For members who are engaged in setting up appointments, placing reminder telephone calls, or arranging ride shares to visit in pairs, communication is of paramount importance, and the number of completed interviews speaks to the quality of their work. A steady number of qualified participants decide to complete the survey and welcome our team members into their homes.

The personal gains and cultural enrichment gained through the nature of the project and the diversity of the team is indeed invaluable. This again is made visible on the overall project level as an extremely low turnover rate. Within 3 years, we have lost only one person on the team, not because of dissatisfaction, but for reason of moving away from the area.

Conclusion

Overall, the function of our multicultural team has been a success that rendered us compelled to report our strategies to other researchers confronted with similar challenges. (a) Our team has helped to refine research procedures and instruments used in the study by offering important ideas and suggestions derived from various cultural perspectives and educational backgrounds. (b) Cultural awareness training has occurred as a by-product of team function as team members share their experiences and reaction regarding the communities and homes in which the study participants live and offer advice to those unfamiliar with certain situations. (c) Access to hard-to-reach populations has been maximized as the various data collectors participate directly in recruiting research subjects of their own culture and make appointments with them. (d) The team’s multilingual abilities have enhanced communication with participants which in turn facilitates recruitment and the conduct of the survey. Consequently, productivity has increased with the team members mutually supporting each other.

Conflict is unavoidable in any team, but we have been successful in managing it, and it has not compromised the operations of the project. Together, we have established a team that allows cross-cultural learning and joint problem solving. Through sensitive team leadership, team commitment, and cooperation, we master challenges together; in fact, conflicts have helped to stimulate member participation in problem solving, strengthened team cohesion, and positively affected the performance of team colleagues and the group as a whole.

The maintenance of communication among the team members driven by a feeling of belonging together has been shown to be one of our formulas for success. Communication has been enhanced through periodic group meetings. These meetings have opened the team members’ minds and sharpened the understanding of each other’s culturally based behaviors and ways of thinking. Another challenge that data collectors face frequently is unpredictable problem situations in the field. Initial phone calls for help and advice from the team leaders are now being replaced by creative strategies employed independently. Learning from case discussions in the team meetings is being directly applied to everyday functioning.

Most important for all transcultural nurse researchers are awareness regarding their coworkers’ cultures, as well as those of the study participants, and the appreciation of each person’s uniqueness. With cultural sensitivity in place, a multicultural team can provide an unparalleled opportunity for personal growth and social enrichment.