Lecture 3: Cross-Cultural Clinical Skills

Question 1

What is the continuum of cultural competency?

Answer 1

1. Cultural destructiveness (actively berating a person)
2. Cultural incapacity (willing to support but unable to actually provide support)
3. Cultural blindness (attempting to treat everyone the same regardless)
4. Cultural precompetency (recognize culture and make some adaptations)
5. Cultural proficiency (values diversity and continuously adapts)
6. Cultural competency (100% can never be fully achieved)

Question 2

Define Disease vs Illness

Answer 2

• Disease: Malfunctioning of physiologic and/or psychological processes in a patient.
• Illness: psychosocial experience and meaning of perceived disease for patient, family, and friends.

Question 3

What are the models of communication?

Answer 3

• Western biomedical: S/S are due to pathophys or etiology
• Explanatory model (8 questions asking about patient beliefs)
• BATHE (psychosocial context of life/situation)
• BELIEF (similar to explanatory but also adds in opportunity for patient to educate provider and provide empathy)
• ETHNIC (Improving cultural competence and discussion of alternative treatment)
• LEARN (Cultural competence and general)
• 4 C’s (mini explanatory model)
• HOPE (Spirituality)
• FICA (Spirituality)
• SPIRIT (Spirituality)

Spiritualty: HOPE, FICA, SPIRIT
Culture: LEARN, ETHNIC

Question 4

What kind of programs are interpreters required to provide oral language assistance?

Answer 4

• Medicaid
• Medicare
• Federally-funded

Question 5

Describe the order of interpreter preference.

Answer 5

1. Bilingual clinician
2. In-person interpreter
3. Remote interpreter
4. Family/friend

Family/friend is the WORST!!!!!

Question 6

What is the main caveat with using a traditional or alternative medicine provider?

Answer 6

Cases have to be handled individually and with great sensitivity, or else we might alienate our patient.