Cultural Empathy and Cultural Competence Among Nursing Students Toward North Korean Defectors: Mediating Effects of Multicultural Efficacy and the Moderating Role of Intellectual Humility

INTRODUCTION: This study examined the mediating effect of multicultural efficacy and the moderating effect of intellectual humility on the relationship between cultural empathy and cultural competence toward North Korean defectors among nursing students. METHODS: A cross-sectional survey was conducted with 156 nursing students from three universities in South Korea in 2025. Data were analyzed using Pearson's correlations and Hayes' PROCESS Model 7 with 50,000 bootstrap resamples. RESULTS: Cultural competence was positively associated with cultural empathy, multicultural efficacy, and intellectual humility. Multicultural efficacy mediated the relationship between cultural empathy and cultural competence. Intellectual humility moderated the association between cultural empathy and multicultural efficacy but not the indirect effect on cultural competence through multicultural efficacy. DISCUSSION: Multicultural efficacy is a critical mechanism linking cultural empathy to cultural competence among nursing students. Intellectual humility appears to facilitate the early pathway between cultural empathy and multicultural efficacy rather than an overall indirect pathway.