The aim of this study was to describe and analyse the outcome of a 3-year study program from a student perspective for the purpose of promoting culturally congruent nursing care. Students were asked to complete questionnaires that included cases with open-ended questions at the beginning and end of the 3-year program. Two nursing situations were described and the students had to imagine how they would act in such cases. Ninety-two students completed the two questionnaires and the result of a manifest content analysis of their answers is presented. Four categories were formulated from the content analysis; an inviting attitude, a non-inviting attitude, a knowledge-driven attitude and a non-knowledge-driven attitude. An inviting attitude meant that the students found different strategies for approaching the patient and his/her spouse or parent. A non-inviting attitude implied that the students became frustrated with the situation and had more difficulty finding solutions that would enhance the relationship. A knowledge-driven attitude meant that the students described how they found it important to base nursing actions on knowledge of the patient. A non-knowledge-driven attitude meant that the students’ responses indicated that they did not consider knowledge to be the foundation of their nursing actions. The study demonstrates marked changes in the students’ approaches to culturally sensitive issues at the end of the education program.