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“Building the Roots”: A Delphi Study Examining the Aims of a Multicultural Competency Graduate Course in Sport and Exercise Psychology “Building the Roots”: A Delphi Study Examining the Aims of a Multicultural Competency Graduate Course in Sport and Exercise Psychology Multicultural Competency Graduate Course in Sport and Exercise Psychology Matthew Paul Gonzalez West Virginia University, mg0041@mix.wvu.edu Follow this and additional works at: https://researchrepository.wvu.edu/etd Part of the Sports Studies Commons Recommended Citation Gonzalez, Matthew Paul, "“Building the Roots”: A Delphi Study Examining the Aims of a Multicultural Competency Graduate Course in Sport and Exercise Psychology" (2023). Graduate Theses, Dissertations, and Problem Reports. 11907. https://researchrepository.wvu.edu/etd/11907 This Dissertation is protected by copyright and/or related rights. It has been brought to you by the The Research Repository @ WVU with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you must obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Dissertation has been accepted for inclusion in WVU Graduate Theses, Dissertations, and Problem Reports collection by an authorized administrator of The Research Repository @ WVU. For more information, please contact researchrepository@mail.wvu.edu. “Building the Roots”: A Delphi Study Examining the Aims of a Multicultural Competency Graduate Course in Sport and Exercise Psychology Matthew P. Gonzalez Dissertation submitted to the College of Applied Human Sciences at West Virginia University in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Sport, Exercise, and Performance Psychology Sam Zizzi, Ph.D., Chair Terilyn C. Shigeno, Ph.D. Jack C. Watson, II, Ph.D. James Wyant, Ph.D. Department of Sport, Exercise, and Performance Psychology Morgantown, West Virginia 2023 Keywords: multicultural, competencies, education, training Copyright 2023 Matthew P. Gonzalez Abstract “Building the Roots”: A Delphi Study Examining the Aims of a Multicultural Competency Graduate Course in Sport and Exercise Psychology Matthew P. Gonzalez Historically, opportunities to develop cultural competency in sport and exercise psychology graduate programs have been limited (Lee, 2015). Recently, major sport psychology organizations across the world have started to require cultural competency in their credentialling requirements. While this represents progress, these requirements can be met with a single course, which falls below the ideal of integrated cultural competency education (Martens et al., 2000). The present study investigated how to maximize the quality of a single course by coming to agreement on a proposed set of impactful and feasible learning outcomes and assessments in that proposed single course related to cultural competency. Eleven sport and exercise psychology professionals with significant expertise in teaching and/or researching cultural competency development completed a three-round Delphi study which resulted in 71 learning outcomes and 33 learning assessments. Of those, the panel fully agreed on the impact and feasibility of 11 learning outcomes and 3 assessments. Further, these professionals provided critical feedback on how to continue to enhance cultural competency in sport and exercise psychology graduate education. iii Table of Contents Acknowledgements ............................................................................................................... vi Introduction ..................................................................................................................................... 1 Research Questions ......................................................................................................................... 5 Methods ................................................................................................................................. 5 Research Design ............................................................................................................................... 5 Sampling and Recruitment ............................................................................................................... 6 Data Collection Procedures .............................................................................................................. 8 Data Analysis ................................................................................................................................. 11 Results and Discussion .......................................................................................................... 12 Consensus Achievement ................................................................................................................ 12 Tripartite Model and Full Consensus Items .................................................................................... 13 Issues of Debate Among Panelists .................................................................................................. 14 Thematic Analysis of Round Three Open Comments ...................................................................... 16 Limitations ..................................................................................................................................... 23 Practical Implications ..................................................................................................................... 24 Conclusion ............................................................................................................................ 24 References ............................................................................................................................ 26 Figures and Tables ................................................................................................................ 32 iv Appendix A – Extended Results ............................................................................................. 38 Research Question #3 .................................................................................................................... 38 Appendix B - Extended Tables and Figures ............................................................................ 42 Appendix C – Extended Review of Literature ......................................................................... 46 Sport Psychology and Culture: A Story of Two Developmental Stages ............................................ 47 Developmental Stage #1: Cultural Awareness ................................................................................ 47 Professional Accreditation, Certification, and Multicultural Competencies .................................... 56 Developmental Stage #2: From Definitions and Research to Cultural Praxis ................................... 59 Cultural Competence ..................................................................................................................... 60 Consequences of Cultural Incompetence ........................................................................................ 64 Culturally Competent Sport Psychology Applied Practice ............................................................... 67 Cultural Competency Development ............................................................................................... 73 Cultural Competency Education and Training ................................................................................. 75 Multicultural Competency Education Outcomes ............................................................................ 80 Measurement of Cultural Competency ........................................................................................... 82 Issues of Measurement and Evaluation .......................................................................................... 88 Critiques of Cultural Competency ................................................................................................... 90 Summary and Future Research ...................................................................................................... 90 Extended Review of Literature References ............................................................................ 92 v Appendix D - American Psychological Association Multicultural Guidelines (APA, 2017) ..... 105 Appendix E – Round One Survey ......................................................................................... 107 Appendix F – Round Two Survey ......................................................................................... 109 Appendix G – Round Three Personalized Survey Example .................................................... 113 Appendix H – Debriefing Round Survey ............................................................................... 125 Acknowledgements vi First and foremost, I would like to thank the chair of this dissertation and my advisor through the program, Dr. Zizzi. Numerous times throughout this process I did things on my own time and probably in a much less conventional way than you would have hoped. I appreciated your patience and guidance the entire time and there is no way this gets done without you. To the members of my dissertation committee… Dr. Shigeno, Dr. Watson, and Dr. Wyant, I likewise appreciate your patience and commitment to helping me finish the job I started years ago. Your insight and guidance have been so invaluable in making this happen. To the members of the Delphi panel… I was humbled by your depth of engagement throughout the lengthy Delphi method. You have truly set the example for me about what it means to be a selfless professional in our field. Thank you so much for being the most integral piece of this whole project. To Dr. Etzel… you invited me into this program six years ago to the month of the date of the defense of this document. Without you taking me on, I would have literally never have gotten the chance to make any of this happen. Thank you so much for getting it all started! To my dear friends in the SEP program… each of you helped keep me afloat in one way or another throughout this process. I treasured your friendship and support the whole way through and am so glad that our paths crossed when they did. To Ari… thank you so much for your help along the way during the multiple rounds of data analysis. Your feedback and perspective contributed so much richness to the data and I am forever appreciative of your willingness to help! To Sofia… there isn’t enough space to properly thank you for all you have done over the last six years. You’ve somehow always known how to push my buttons just the right way and, while it irritated me to the end of my wits at times, I’ve appreciated that so much. While you vii may have beaten me to the finish line on this by a couple years, we tied the race to the counseling masters, and I will hear nothing of it! To Erika… you have been my opposite since I met you. Through the significant differences in our personalities and thoughts about life, I can honestly say that your perspective has deeply widened mine. Thank you for that and for your ever continuing support! To Bobby… you were absolutely the perfect mentor to help get me through this program. You were there every time I needed you, even up until the submission of this document nearly a full six years after first taking me on. I appreciate you man. To Dr. Butryn and Dr. Semerjian, you both saw in me this possibility way before I even could even remotely see it for myself. Your belief and support started this process and at many times you both helped me see it through to the end. Thank you so much. To Zach, Kaylyn, Mike, and Lori… I can’t even begin to say how enormously lucky I am to have you in my life, to have experienced the love of your family, and to watch you spread that love to my son. I love you all so much. To Ken and Cindy… you’ve been part of my family for more than half my life and at some points there I think I may have accounted for more than half of your grocery bills! Thank you for your unending support as I whisked your daughter across the country, back, and then back again across the country to chase down this dream. I love you both so much. To my Mom and Dad… there isn’t enough space here to even remotely come close to expressing how much I love you both and how important your support has been throughout the entirety of my schooling. It would be an outright lie to say I was good student with any sense of direction student until way later in my life. Even so, you both pushed me and stood by me as I made one frustrating decision after another. Mom, it wasn’t until you pointed out to me that I viii could study and make a career out of sports that life started to finally make a little bit of sense. From there the rest, as they say, was history. To my loving wife Jordan… writing this is hard because I’m not even sure where to start. You’ve been my biggest cheerleader in the moments that I have been my biggest critic; my grounding point when my confidence has on occasion floated towards arrogance; and the anchor to our young family while I have been off on various adventures. You’ve done this so willingly and with so little resistance when you probably had every reason to along the way. Nevertheless, you have stood by my side from the beginning and have been my rock through it all. I would have never dreamed that this would have been our life path when I caught you staring at me in sophomore high school English all those years ago and I can’t wait to see what life brings us next. I love you. Lastly, to my son Max… I hope one day I can support you the same way these dear people above have supported me and hope you too find your team of people who will help you reach a goal you never thought possible. If there is anything I have learned from this process of school that I would like for you know, it is this… Life may not always make sense and sometimes internal sense of direction may be hard to come by; but if you focus on bringing your fullest self to the things that matter to you and march to a beat that maybe only you hear, things just seem to shake out in the end. And oftentimes in ways that you didn’t even know were possible. I never even remotely thought sport psychology would have any part of my life; and yet at this point in my life it is somehow it is exactly where I am supposed to be. I dedicate this dissertation to you. Introduction 1 Western foundations of psychological theory have a history of being rooted in European, ethnocentric assumptions (Parham, 2005). The various mental health disciplines, including sport and exercise psychology (SEP), have been critiqued and modified over the past few decades to better meet the needs of an increasingly diverse population. To address this, professionals from a variety of mental health disciplines are investing time and resources towards researching how culturally salient factors may influence clinical relationships and outcomes. One of the critical issues related to service delivery that has been demonstrated is the difference in client retention rates when the cultural background of the client and clinician differ from each other. Overall, about one out of five clients will terminate too early, regardless of identity and culturally salient factors (Swift & Greenburg, 2012). There is evidence, however, that clients identifying as Black, Indigenous, or People of Color (BIPOC) tend to terminate after the first session significantly more than white clients (Cooper & Conklin, 2015; Kilmer et al., 2019). A potential explanation for this discrepancy is that culturally incompetent mental health practitioners unknowingly micro-aggress during their sessions (Capodilupo, 2019). Further, an incomplete understanding of multicultural issues could lead clinicians to oversimplify cultural differences and make mistakes such as “sensitive stereotyping” (Kantos & Breland-Noble, 2002, p. 299) or “ethnic gloss” (Trimble & Bhadra, 2013, p. 500). Both terms refer to when a clinician or researcher falsely make a homogenous assumption about a racial and/or ethnic group. The professional discipline of psychology made significant strides in ratifying the importance of multicultural competency (MCC) by publishing multicultural guidelines three decades ago (APA, 1993). The design of these guidelines was significantly influenced by the work of Sue and his colleagues and their theoretical conceptualization of MCC (Sue et al., 1992). The American Psychological Association (APA) has revised their multicultural guidelines twice 2 more since 1993 to keep current with the latest multicultural research (APA, 2003, 2017). In general, contemporary MCC frameworks across the spectrum of mental health disciplines are informed by the tripartite model (Sue et al., 1992), which states that MCC is influenced by three factors: awareness, knowledge, and skills. In brief, culturally competent awareness is helping someone understand their own cultural identity and how it influences their interactions with the world, while culturally competent knowledge involves gaining an understanding of the rich variety of cultures and the ways in which those cultural worldviews influence peoples’ lives. Culturally competent skills refer to an individual’s capability to identify the appropriateness of interventions and adapt them to better meet the needs of those with relevant culturally salient factors (Sue et al., 2019). While the majority of professionals continue to use the tripartite model to define what is needed to become multiculturally competent, recently, researchers have suggested that the tripartite model can be supplemented with the development of a multicultural orientation, which includes the concepts of cultural humility (a lifelong commitment to the openness and willingness to reflect upon the cultural nature of ourselves and others), cultural comfort (a sense of non-defensive ease in discussing cultural conversations), and cultural opportunities (a willingness to discuss cultural conversations as they arise in session; Hook et al., 2013; Watkins et al., 2019). Recently, some scholars have begun questioning if cultural humility should supplant cultural competency as the aim of multicultural education in SEP (Curvey et al., 2022; Quartiroli et al., 2021). There is a historical pattern documenting a lack of consideration of culturally salient factors in SEP research (Duda & Allison, 1990; Ram et al., 2004) and in presentations at the annual conference of North America’s flagship sport psychology organization (Bejar et al., 2021; Kamphoff et al., 2010), the Association for Applied Sport Psychology (AASP). In response to 3 this recognition, a specialized sub-discipline of Cultural Sport Psychology (CSP) was formalized, and two critical texts were published (Ryba et al., 2010; Schinke & Hanrahan, 2009). These CSP scholars, in addition to the many others who contributed to the development of CSP, through their research and advocacy efforts—created the momentum needed to help the field move towards formally adopting cultural considerations into credentialling requirements. Unfortunately, there appears to be a subset of sport psychology professionals who report a general attitude of hesitancy regarding the integration of CSP’s findings into applied practice (Hacker & Mann, 2017; Quartiroli et al., 2021). Lack of pressure from the leading organizations had been speculated as a potential cause for the sub-standard priority of MCC in SEP (Lee, 2015). Partially in response to the criticism, AASP required a diversity/cultural competency course to have been completed at the graduate level in their updated certification standards in 2017. Furthermore, individuals looking to renew their certification are required to complete at least six continuing education credit hours every five years in diversity. Internationally, similar measures have been taken with organizations such as the International Society for Sport Psychology (ISSP) and European Federation of Sport Psychology (FEPSAC) by including cultural competency in their respective requirements for practice credentials. Since AASP and the international sport psychology community is beginning to formally ratify the importance of cultural competency proficiency in its certification programs, the attention now needs to be turned to examining the quality of the MCC education being provided. There has been research in the sister disciplines of SEP (e.g., psychology, counseling), showing ways in which those disciplines have approached the matter of training and education of MCC. In general, MCC educated through one or more of the following ways: taking and/or teaching 4 courses, attending and/or presenting at conferences, attending workshops, reading texts, and publishing manuscripts (Gillem et al., 2016). In the development of the Multicultural Counseling and Psychotherapy Test (MCPT), researchers suggested that all of these methods except for multicultural courses are correlated with the development of MCC (Gillem et al., 2016). The authors suggested that this exception may be due to the fact that all other options for training represent personal choices as opposed to requirements not necessarily borne of personal interest. Another possible explanation may reflect quality. The lack of congruence between multicultural courses and the development of MCC may be because the practice of multicultural pedagogy seems to emphasize only two-thirds of the tripartite model in practice. More specifically, researchers suggest a majority of faculty who teach about MCC tend to focus on multicultural awareness and knowledge but seem to under-emphasize multicultural skill development (Reynolds, 2011). This finding is of particular concern in SEP since the primary requirement for initial certification as a CMPC is a single course in the diversity domain. Findings from reviews of the effectiveness of MCC training and education have been mixed. One systematic review of the available psychology MCC training literature reinforces Reynolds’ (2011) findings, stating that MCC education and training only reliably increases multicultural knowledge (Benuto et al., 2018). Another more recent review found significant improvement across all facets of the tripartite model in the 37 studies it analyzed (Chu et al., 2022). Research conducted in these disciplines has relied on the application of several different self-report surveys such as the Multicultural Counseling Inventory (MCI; Sodowsky et al., 1994). For a full list of these types of instruments, see the extended review of literature in 5 Appendix C. It is not uncommon to see these self-reports also being used to assess MCC training effectiveness (Chu et al., 2022) in the clinical and counseling psychological fields. At the moment, however, it seems that graduate SEP programs are reticent to evaluate the development of MCC at all (Lee, 2015). For the few programs that do assess for development, evaluation took place through one-on-one meetings with the mentor and mentee, and/or through comprehensive exams. While there is a wealth of information about cultural competency in other fields and MCC momentum building in SEP, there is still a reported lag in SEP in MCC education when compared to psychology and counseling (Curvey et al., 2022). Given all the aforementioned factors and considerations, the purpose of the present study was to determine how a single course in MCC can be optimized, while the field as a whole continues its slow march towards the more favored integrated model whereby cultural considerations are more purposefully emphasized in each course of a program (Martens et al., 2000). Research Questions 1. What are the discrete learning outcomes that SEP educators should design this course around? 2. How can SEP educators assess the development of cultural competencies in this course? 3. How can multicultural skill development be more emphasized in this course? (See extended results) Research Design Methods The current study used the Delphi method to secure consensus among a group of experts by “structuring a group communication process” (Lindstone & Turoff, 2002, p. 3). When this 6 method was originally developed, Delphi “exercises” were conducted by hand in vivo. However, given the advent and widespread use of modern technology, the Delphi method is often conducted digitally through the internet. The Delphi method can be especially helpful when trying to secure consensus about a topic that is highly complex and/or assured to involve some level of disagreement that might hinder the communication process (Lindstone & Turoff, 2002) such as can be predicted in discussing multicultural competencies and education. Delphi studies have already been used in the past to address questions of multicultural competencies in other fields including, but not limited to, nursing (e.g., Jirwe et al., 2009), mental health (e.g., Baima & Sude, 2019), education (e.g., Sprott, 2014), and physical education (e.g. Wyant et al., 2020). Sampling and Recruitment Participants were purposely targeted through two main approaches. First, published articles were searched based on the terms “cultural competency”, “culture”, “cultur[sic]”, and “cultural sport psychology” in the title. These searches targeted publications that dealt exclusively with exploring general cultural competency in sport psychology applied practice. All published authors’ names were added to a database. Second, conference abstracts from major sport psychology conferences over the past five years were searched for presentations, sessions, symposia, workshops, etc. that focused on cultural competency in sport psychology applied practice. In addition, those who conducted more specific cultural competency work (e.g., papers related to a specific dimension of identity) were also noted. These presenters were then added to the database. Within the database, the professionals were scored based on their repeated appearances in the published literature and conference abstracts. Authors publishing or presenting directly on cultural competency education were scored with a two, whereas authors publishing or presenting on a culturally salient variable were scored with a one. The scoring produced a list of 316 authors and/or presenters with at least one entry. The 26 top scoring 7 authors/presenters were sent invitations to participate in the study as well as an additional seven authors/presenters scoring in the top 50 who the author recognized as having significant expertise which was not adequately reflected through the scoring system. From these 33 invitations, 14 responded with interest in participating. All but one of the 14 completed the informed consent and demographics collection survey, thus leaving the formal expert panel with a starting membership of 13. Participant Personal and Professional Demographics The personal demographics of the panel are presented here in a collective format to ensure panel member confidentiality. Panel member age ranged from someone in their mid 30’s to a panel member who identified their age as “65+”. The panel was comprised of five cisgender women, four cisgender men, one panel member who identified as genderqueer, and one panel member who identified as nonbinary. Racially, the panel was comprised of eight members who identified as white, one who identified as Black, one who identified as Asian, and one who identified as biracial. Ethnic identification of the panel members has been withheld for purposes of confidentiality. Panel member sexual orientations were composed of five who identified as gay/lesbian, four who identified as straight/heterosexual, one who identified as queer, and one who declined to respond to that question. The majority of the panel identified as either primarily sport and exercise psychology educators (n = 5) or as researchers (n = 3). The remaining three panel members identified as either an even combination of educator and researcher (n = 2) or applied sport psychology professional (n = 1). As a collective, the average professional experience spent researching cultural competency/diverse experiences in sport psychology was 15.09 years (SD = 9.08; range = 5 years – 31 years) and the average time teaching about cultural competency/diverse 8 experiences in sport psychology was 12.64 years (SD = 11.49; range = 0 years – 35 years). Lastly, three of the panel members reported ever having had the opportunity to teach a graduate course specifically with the purpose of enhancing cultural competency in sport psychology students, several reported having taught a continuing education course in this area (n = 6), and most had led at least one presentation at a conference in this area (n = 9). Data Collection Procedures The Delphi method often occurs in three rounds of data collection and data analysis. In this version of a Delphi study, a modified framework was adopted by using both Qualtrics and Word documents to gather responses from the expert panel asynchronously. Each data collection interval (i.e., round) was three weeks long followed by two weeks of data analysis in preparation for the next round. To prompt the completion of the surveys, members of the expert panel were emailed at regular intervals during each round. The present study finished with an attrition rate of 15.3% by having 11 out of 13 panelists finish. This rate compares favorably with previously published Delphi studies in this area which have ranged from 15-25% attrition through three rounds (Baima & Sude, 2019; Wyant et al., 2020). Round One In the first round of the Delphi process, the finalized panel of experts were provided with two open-ended questions and asked to provide up to 15 responses to each question. 1. In a graduate sport psychology course designed specifically to develop the cultural competency of its students, what learning outcomes would you choose to primarily design the course around? 2. In a graduate sport psychology course designed specifically to develop the cultural 9 competency of its students, what assessment types or strategies would you choose to measure the students for their learning progress in the course? Once responses from all 13 panel members were submitted, they were processed through a limited editing process with the assistance of a second researcher as demonstrated in Wyant et al. (2020). The following editing occurred: compound responses were broken into their component pieces, duplicate or near duplicate responses were removed, select words or phrases were edited to enhance clarity, erroneous defining information was removed, and a select few responses were recategorized as a learning outcome or assessment. At the end of the editing process, 70 learning outcomes and 32 learning assessments were generated. Round Two In round two of the Delphi process, the statements (referred hereto as items) were returned to the 13-member panel. The panel was asked to rate each item on two separate 7-point Likert-type scales from strongly disagree to strongly agree. The results from the Likert-type answers were the primary factor in determining consensus. Baima and Sude (2019) and Wyant et al. (2020) determined group consensus to have been obtained if the item reached an average greater than or equal to 6 on a 7-point Likert-type scale. In the present study, any item averaging a rating of 6 or above was considered to have reached consensus; any items that did not meet this benchmark were not considered to have met consensus. At the conclusion of this round, panelists were given an opportunity to add or revise items that may have been missed. In the present study, only two items were added at the end of round two; bringing the final total of learning outcomes to 71 and learning assessments to 33. Consensus in Delphi studies can take on different meanings in different studies. Often, 10 consensus will simply mean a rating of agreement between the participants (e.g. Jirwe et al., 2009). In the present study, participants rated each item relative to both impact (i.e., the capacity for this recommendation to make a positive change relative to the question) and feasibility (i.e., the likelihood that this recommendation could be effectively delivered and taught to sport psychology students within the constraints of a single course). Consensus was considered to be reached only if both ratings for impact and feasibility averaged above a 6 out of a possible 7. Items meeting consensus in only one dimension were considered to have met partial consensus and were tabulated as such in the results. Round Three In the third round, all learning outcomes and assessments were returned to the panelists alongside their personal ratings and the group rating for each item. The panelists were encouraged to reflect on the difference between their scores and the group cumulative score and from that reflective process, they were allowed to re-evaluate and re-rate these statements. Panelists were also encouraged to provide rationale into why their scores may have differed from that of the group’s. Panelists were provided the opportunity to add rationale to any item, but were specifically encouraged to add this rationale for any items where their score deviated from the group’s by more than 1.5 points. Of the 204 opportunities to re-rate an item, panel members averaged 7.18 re-rated items (range = 0-18). Lastly, panel members were asked to provide Likert-type scores for the two new items constructed in round two. Debriefing Round This Delphi study also included a structured debriefing round for the participants. After the conclusion of round three, final scores for all recommendations were calculated and the final 11 lists were organized. These final results were sent back to all participants along with a message of gratitude for their participation in the study. From there, participants were asked to complete an open-ended survey containing a few questions designed to illicit their thoughts about the results (see Appendix H). Because this fourth round was an organized debrief and not part of the active Delphi process, this round was not counted in the attrition rate for the Delphi study. However, some of the qualitative data generated from the debriefing round was used to illustrate the findings in the results. Nine of the final 11 members completed the debriefing survey. Data Analysis Quantitative data analysis was ongoing throughout the iterative process of completing the Delphi method by calculating average scores for both impact and feasibility. The final list of learning outcomes and assessments are organized in tables by the amount of consensus they reached (i.e., full, impact-only, feasibility-only, or none). Qualitative data collected on the third round of the survey from the panel about their justification for not ratifying one of the statements was descriptively coded and then inductively arranged into themes (Saldaña, 2016). The coding strategy of the qualitative data was designed to describe the panel’s more nuanced thoughts about MCC education in SEP and was not necessarily organized by the individual item that the participant was commenting on. The qualitative data corpus included 110 open-ended comments. These comments were parsed into 171 meaning units, refined into 111 distinguishable codes, then organized into 19 sub-themes, five themes, and lastly into two final super-ordinate themes. The entire process of the qualitative data analysis was conducted with a co-researcher over the course of five meetings. Results and Discussion 12 Consensus Achievement Learning outcomes and assessments were sorted based on whether they achieved full consensus, consensus in impact only, consensus in feasibility only, or no consensus at all. Eleven learning outcomes met full consensus (Table 1), 25 met consensus for impact only (Table 2), eight met consensus for feasibility only (Table 3), and 27 did not meet any consensus (see Table 1 in Appendix B). Of the 33 learning assessments: three met full consensus, one met consensus for impact only, 16 (Table 4) met consensus for feasibility only, and 13 (see Table 2 in Appendix B) did not meet any consensus. The three assessments that met full consensus were: Role play exercises that allow students to confront and challenge others using oppressive languages or actions (M-I: 6.38; SD-I: 0.77; M-F: 6.54; SD-F: 0.78), Develop interview guides/intake forms that are inclusive and gather cultural information about clients (M-I: 6.15; SD-I: 1.21; M-F: 6.15; SD-F: 1.07), and Complete a reflexive diary of own values, beliefs, and practices (M-I: 6.08; SD-I: 0.86; M-F: 6.23; SD-F: 0.73). The single assessment that met impact consensus only read: Shadow a professional working in a setting with students/clients that is different from student’s background and experience (M-I: 6.08; SD-I: 0.64; M-F: 4.92; SD-F: 1.04). The data show a notable pattern whereby the primary barriers in learning outcomes and assessments are opposite to each other. For learning outcomes, the primary barrier for an item to meet consensus was being considered a feasible option, whereas impactful learning assessments were much harder to come by. The primary barrier to feasibility for the learning outcomes is the time constraint imposed by a single course (discussed below). Findings related to the impact barriers associated with the assessments was much less clear. Input from the debriefing round of the survey was split between panel fatigue (given the length of the survey and multiple rounds) and the generally challenging nature of quality assessment relative to designing learning 13 outcomes. Tripartite Model and Full Consensus Items The text of the 11 consensus achieving learning outcome statements lean heavily towards the attitudes and knowledge subscales of the tripartite model (Sue et al., 1992). Notably missing are any learning outcomes directly representative of the skills subscale. Possible reasoning for the lack of skills is described later. However, an argument can be made that the fourth (“Apply learned concepts to various real-life scenarios”) and eleventh (“Articulate ways they can become more culturally competent practitioners”) consensus achieving learning outcomes can include portions of skill development depending on the ways learning outcomes are designed to be met in the course. Interestingly, the three consensus achieving learning assessments were equitably distributed across the tripartite model. The development of an interview guide can be considered an exercise in developing knowledge, the completion of a reflexive diary can be considered an exercise in developing attitudes, and role play of confronting others can be considered an exercise in developing skills. Commentary provided in the debriefing round helped illuminate the reasons for why multicultural competency skills seems to be largely absent from the consensus achieving learning outcomes. Reports from the panel indicated that multicultural competency skills are not aimed at or considered to be feasible due to a lack of time given to multicultural development with respect to the entire program. If the prevailing assumption is that a student comes into the course without stable footing in multicultural competency knowledge and multicultural competency awareness, then those must be addressed first since multicultural competency skills requires a foundation in the former two. This hierarchical approach to MCC development has been described in the 14 literature before. Wells (2000) described a six-stage developmental process ranging from cultural incompetence to cultural proficiency. The author’s stages reflect that knowledge and awareness necessarily come before culturally competent skills and the present study’s results seem to corroborate that. The present study indicated that multicultural competency skills outcomes are perceived to be extremely impactful, however, not feasible in a single course. For example, a review of the 25 learning outcomes that met impact consensus only (Table 2) shows several potential learning outcomes that are skill-based or somewhat skill-based in their aim. This criticism of time constraints of the current education model for MCC development in SEP will be revisited in the qualitative analysis below. Additionally, this uneven attention of the constructs of the tripartite model in education and training has been documented in sister disciplines (e.g., Reynolds, 2011) and is not necessarily a specific criticism of SEP curricula. Issues of Debate Among Panelists Standard deviations were calculated for all items (impact and feasibility individually) as a measure of how contested an item was among the expert panel. A selection of the highest standard deviation of each (learning outcome – impact; learning outcome – feasibility; learning assessment – impact; and learning assessment – feasibility) as well as the lowest rated item for each are presented here to illustrate some of the disagreement among the panel. The item with the highest standard deviation for learning outcomes for impact scores was: Describe the philosophical underpinnings of knowledge (M-I: 4.62; SD-I: 2.10). This same item was also the lowest rated item for impact overall and the highest standard deviation for feasibility (SD-F = 1.75). The lowest item rated for feasibility was “Demonstrate effective skills to appropriately handle situations involving cultural differences” (M-F: 4.08). 15 Some members of the panel questioned the placement of the learning outcome (“Describe the philosophical underpinnings of knowledge”) within the scope of this course, and hoped that these concepts would be, “initiated, addressed, or reinforced in other courses as well, such as qualitative methodologies or philosophy courses.” However, several other of the panel urged educators to consider how having a fundamental grasp of the philosophy of knowledge necessarily impacts the way in which we interact with our clients. One member wrote: I think it is paramount to be able to have a clear understanding of the ontological and epistemological framework leading our work. Such knowledge helps us to be aware of how we engage with our client. For example, do we see multiple realities as coexisting? Do we believe in one reality that can be experienced in different ways? Do we believe in one reality and in one way to understand it? All these approaches impact the work we do. This disagreement will be further highlighted in the thematic analysis that follows. Other items that generated significant open-ended input and debate were “Engage in exploration and commitment to one’s cultural background” and “Be able to work with people of different cultures”, both of which solicited the voluntary input of five of the 11 members. The learning assessment item with the highest standard deviation for impact was “Participate in a cultural activity that is different from the learner’s cultural identities” (M-I = 5.00; SD-I = 1.91). The lowest rated item for impact overall was “Show an understanding of cultural competency issues via exam questions” (M-I = 3.69). The learning assessment item with the highest standard deviation for feasibility was “Complete quizzes on language and concepts associated with cultural competency” (M-F = 6.15; SD-I = 1.77). The lowest rated item for feasibility was “Do sport psychology work with a population that is largely different from student’s background; write a scholarly and culturally informed reflection paper about the 16 experience” (M-F: 4.31). Thematic Analysis of Round Three Open Comments The open-ended comments from the panel in round three were qualitatively analyzed and organized into two superordinate themes, five themes, and 19 subthemes. The full thematic map is presented in Table 5. A large proportion of the commentary was dedicated to critiquing the single course approach to MCC education in SEP; this commentary is reflected in the first two themes presented below. Additionally, a significant portion of the comments were directed at reflecting upon MCC education overall which are reflected in the final three themes. Single Course Critiques One of the most frequently communicated comments directed throughout the whole process of the study was that the panel wanted to ensure that they were heard that the single course model of MCC education was simply not enough to make any significant and lasting progress in developing MCC in SEP students. This opinion is not overwhelmingly surprising given that the single course model was identified as a sub-optimal strategy over two decades ago (Martens et al., 2000). Specifically, the panel felt as if three areas could not be adequately addressed in a single course. First, the panel voiced their opinion that several broad topics (e.g., developing the capability to create inclusive spaces; identifying the differences in norms, beliefs, values, and perceptions between cultures; and understanding the nature of structural discrimination in sport and education) could simply not be done justice in such a short amount of time. The natural consequence of this is that SEP students could be exposed to MCC education that is not adequately deep enough or substantially biases some topics in MCC education over others. Indeed, there is evidence in the MCC training literature that suggests there is already a bias towards training about race/ethnicity, sexual orientation, and more general multicultural 17 identity information and a dearth of trainings that adequately discuss gender, religion, ability, and socioeconomic status (Chu et al., 2022). Further, the bias towards discussing and/or assessing the knowledge and attitudes components over the skills component has likewise been documented (Benuto et al., 2019; Reynolds, 2011). Second, the panel also noted that MCC skill development could not occur in a single semester course either, with several of the panel members explaining later in the debriefing round that skill development requires a strong foundation of MCC knowledge and awareness. One panel member expressed: Skill development requires more than a semester. If programs are only allotting one course to develop multicultural competency, which most programs seem to be, then the focus will remain on knowledge and awareness. This is why it is important to have the development of cultural competency imbedded in the full program so that these skills can be developed throughout a degree program. As mentioned before, this hierarchical theorization of cultural competency development has been previously described (Wells, 2000). To that end, it is possible the uneven application of the tripartite model in MCC education and training may be less a reflection of instructor or curriculum deficiencies, and more a factor of limited time to work through the hierarchy as needed. Lastly, the panel emphasized the importance of “personal” or “reflective” work to develop MCC. This type of work was also something that the panel felt was limited in the span of only one semester. Single Course Opportunities 18 The main purpose of this study was to identify the ways in which the effectiveness of a single course of MCC development in SEP could be maximized. While the prevailing opinion of the panel was that a single course is insufficient in MCC development, the reality is that few programs exceed this model (Lee, 2015) and fewer still reach the preferred integrated model proposed by Martens and colleagues (2000). With that in mind, the panel highlighted several critical opportunities available in a single-course model. First, the panel noted that a single course could be a dedicated platform for which a student could begin their personal journey into MCC. The panel felt that even though a single course was generally insufficient, the dedicated course represented an opportunity to build the foundation to begin the process of MCC development. In support of this point, the idea of a single course serving as a starting point was consistent throughout many of the comments made in both round three and the debriefing round. Second, the panel shared that a single MCC course could help students make reasonable progress towards developing the knowledge and awareness components of the tripartite model. Lastly, a couple of the panel members reported that a possible objective that could be met is the development of learning skills to continue self directed MCC learning and development throughout their careers. The single course as a standalone approach is clearly insufficient. However, the desire for such a course by SEP students, especially early in the graduate program, has been documented in the literature (Curvey et al., 2022). From this insight of the panel, it is clear that a goal of this course must be to help the student understand that this is a process that lasts well beyond a semester and to teach the tools necessary to do the on-going learning required. Previous SEP scholars have advocated that, “sport psychology instructors should aim to instill values related to lifelong learning, multiculturalism, and social justice” (Curvey et al., 2022, p. 14) which is 19 echoed in these findings. Points of Emphasis for MCC Education in SEP In addition to providing input pertaining to a single multicultural competency course, the panel also provided a significant amount of insight into the nature of MCC education in sport and exercise psychology. These insights were broken into three categories: (1) points of emphasis, (2) challenges, and (3) points of uncertainty. In the first category, the panel centered their commentary on five different things to emphasize while teaching MCC in SEP. First, the panel directed a good portion of their focus on the importance of transformational learning while teaching MCC over memorization-based learning. To that end, members of the panel suggested that active, more applied learning could be effective in creating more lasting MCC changes in students. A limited investigation of different styles of teaching activities in MCC education has been explored in a review, but the effectiveness of one activity over another is unclear with the limited evidence available to be reviewed (Benuto et al., 2018). Second, members of the panel stressed that learning outcomes and assessments need to be clearly defined and explained. At times, some panel members seemed unsure of what another panel member had suggested as a learning outcome or assessment. To that end, making sure that learning goals and the language used to discuss MCC topics are made clear is imperative. Third, the panel stressed that MCC education needs to focus on not only being a space to begin personal work and reflection, but to create a space where personal work and reflection are lasting outcomes. The importance of reflectivity and reflexivity have been discussed in the literature previously for its importance (Curvey, 2022; Schinke et al., 2012) and has been theorized into a SEP specific model (Terry, 2009) which makes this recommendation well suited to emphasize 20 throughout the course of MCC education in SEP. Fourth, members of the panel emphasized that critical pedagogy—as it pertains to the practice of sport and exercise psychology—must be central to the learning of MCC. Examples of this included nuanced discussions of power, oppression, and privilege, as well as interrogations of psychology’s western foundation of practice. Lastly, members of the panel stressed that an aim of MCC education should be inspiring life-long learning, development, and assessment of oneself. The panel was abundantly clear that a single course would never be fully sufficient to develop MCC, however, if the course could inspire students to continue their own learning after completing the course, then the course could be seen as more successful in meeting its primary goal. Challenges in MCC Education in SEP Given the panel’s many collective years of expertise, they also detailed a series of challenges they have recognized and/or encountered in the education of MCC in SEP students. First, the panel pointed to a series of constraints of the present educational model that limits the ability to fully educate an SEP student about MCC. One of these limits is the perceived emphasis on momentarily retaining rote knowledge for the purposes of passing an exam and, thereby, the course. This issue can set the stage for performative MCC practices from the student for purposes of passing the course, but not necessarily retaining the skillset to be used later. One panel member pointed out that MCC is “not a check box” and cannot be treated as such. Panel members suggested that lasting MCC development can be more readily achieved if abundant time was dedicated to it in additional courses and practicum or internship programs; or, better yet, lasting MCC development could be integrated across the entire scope of the program as described in Martens et al. (2000). Second, panel members spoke to the inherent complexity of 21 MCC education and spoke truthfully about the difficulty of not only teaching this area, but for students to meaningfully engage with the personal work required to start becoming more MCC. One panel member spoke about this, and the further inherent difficulties of shifting from theory to practice when discussing one of the learning outcomes: To implement these strategies, the practitioners must have first engaged in personal and professional work leading them to understand that the lack of inclusion and adversity toward diversity actually exist and that they play a role in it. This is not a simple journey. While I wish this was something easily implementable, the reality [is] that once we practitioners are asked to make the switch between theory and practice, we do struggle… This difficulty in actively engaging with MCC education has been described previously. Sue et al. (2019) wrote extensively about the wide range of expected cognitive, emotional, and behavioral resistance that a new student might experience when first coming across MCC education. The authors likewise noted that exploration of this resistance is part of the education process as well. Third, panel members reported that a primary challenge they have faced is that there is simply not enough time in the current model of MCC education to provide the requisite amount of practice necessary to become MCC. Some of the panel members spoke about MCC with taxonomical language, suggesting that there are a series of steps required to becoming more MCC. If students are coming into graduate programs with limited MCC knowledge and awareness, then the emphasis of the education has to be placed there. However, as mentioned earlier, MCC skills can only be developed once there is a stable foundation of knowledge and awareness, leaving no time to learn or practice MCC skills. Lastly, a few of the panel members 22 reported a challenge of there simply not being enough SEP professionals or mentors with MCC expertise to deliver quality learning experiences at the graduate level. The mentorship component is particularly concerning given that quality of the similar process of supervision in clinical psychology has been closely connected to overall student satisfaction of their cultural competency training (Benuto et al., 2019). Work investigating MCC development through SEP mentorship is substantially limited and the findings are not promising as results seem to indicate that SEP trainees are largely dissatisfied with the MCC component of the mentorship they receive (Foltz et al., 2015) and that it is largely absent from the process (Fogaca et al., 2018). Points of Uncertainty Lastly, the panel itself presented a variety of MCC opinions that either stood alone or were debated amongst the members of the panel throughout the Delphi process. These deliberations were organized into three subthemes. First, there were general, individual perspectives of MCC education. A few of these comments were emblematic of recent shifts in culturally competent practices. For example, one member pointed out that “safe spaces” were being phased out in favor of the more realistic “brave spaces” (see Arao & Clemens, 2013) for more on that reconceptualization) within the context of one of the proposed learning outcomes. However, several of these standalone comments raised critical questions that could use further introspection in future studies. An example of two of these comments included questions about the critical role of foundational counseling skills in MCC, and cultural variability in what is and is not considered effective assessment. Second was the argument surrounding the role of philosophy of knowledge in the course. As mentioned earlier, this single outcome generated substantial debate among the panel members. In no certain order, panel members in favor of integrating the philosophy of knowledge into the course stated that if someone comes to better understand knowledge, they 23 will also: better understand privilege and oppression, feel an influence in their applied work and client engagement, recognize what is considered “truth”, and better understand how something becomes the status quo. Indeed, this complexity of MCC founded more deeply in these philosophical tenets of CSP has been forwarded as a possible explanation of the resistance to incorporating CSP more widely (Hacker & Mann, 2017). Nevertheless, understanding the basics of the philosophy of knowledge opens up opportunity to discuss more nuanced concerns such as how to rectify the tensions between evidence-based practice in mental health care and cultural competency (Kirmayer, 2012). Lastly, there was a subset of responses throughout the open-responses that cautioned educators about the potential risks of traditional cultural exposure projects, cautioning others that these types of projects can be, “…harmful and dehumanizing to the exposed “cultural other.” This theme included a powerful comment that stated, “Traditionally marginalized communities do not exist to serve as educational material.” Limitations Every study has its limitations. A limitation of this study, and all studies using the Delphi method, is that the final results are only reflective of the panel sitting on the study. It is not only possible, but likely that a different group of people would have ranked these items differently. However, it is unlikely that another sample would have exceeded the total quantity and quality of experience of this group of professionals. Further, a different panel may have created similar items using different language or different items entirely. Another limitation of this study was in its attempt to focus on two separate—but connected—topics in learning outcomes and assessments combined. This factor, paired with the lengthy nature of a Delphi study, and the depth of responses provided panel members may have led to fatigue, specifically towards 24 questions about assessment which were always the second portion of the survey. Similar studies in the future should either split the topics into separate studies or counter-balance the design of the Delphi surveys. Practical Implications The primary implications of this study are threefold. First, it remains clear that opportunities for full-scale graduate education in this area remains few as even a paucity of the panel members reported ever having done that. For sport psychology educators on the fence about deploying such a course, the learning outcomes in Table 1 and assessments in Table 4 can provide a vetted roadmap to start the design process of the course. Second, for those who are not yet able to deploy a full course, they are invited to pick one or two of the learning outcomes or assessments to integrate into their existing courses. And third, it is hoped that the findings of this study can help continue a conversation about cultural competency education in SEP among our graduate students. Specifically, a discussion about the ways in which we can continue to advance towards the integrated model proposed by Martens and colleagues (2000) must continue. A critical theme of these panel findings and discussions was the need for time to develop MCC and the lack of time that is presently provided for it. Addressing this logistical shortcoming remains a key consideration for all SEP graduate program administrators and faculty to take under advisement. Conclusion The purpose of this study was to secure consensus about how to optimize an MCC course in SEP. Through the reflections of 11 expert professionals, a series of agreed upon learning outcomes, learning assessments, and a subset of reflections about how to enhance MCC education have been forwarded. Patterns in the results indicate that time allotted for a single 25 course may not be enough to develop robust MCC. However, careful design of this course can promote a lifelong pattern of learning that can help a SEP student continue quality self-directed learning. It is hoped that these results will both develop the quality of multicultural competency education provided at the graduate level as well as continue a conversation about how to better strengthen multicultural competency education overall in graduate programming. References 26 American Psychological Association (1993). Guidelines for providers of psychological services to ethnic, linguistic, and culturally diverse populations. American Psychologist, 48, 45 48. American Psychological Association (2003). 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