Week 11: Cultural competence Flashcards
Definition A of culture
The customary beliefs, social forms and material traits of a racial, religious or social group
The characteristic features of everyday existence shared by people in a place or time
Definition B of culture
The set of shared attitudes, values, goals and practices that characterize an institution or organization
Definition C of culture
The set of values, conventions or social practices associated with a particular field, activity or societal characteristic
Definition D of culture
The integrated pattern of human knowledge, belief and behaviour that depends upon the capacity for learning and transmitting knowledge to succeeding generations
Dimensions of cultural groups/identities
- Indigeneity, ethnicity, religion, language, place of origin
- Gender identity, sexual orientation
- Disability or other experience-driven culture
- Age and assumptions about age-related attitudes or abilities
What does the dominant culture in Canadian society value in healthcare?
- Autonomy
- Veracity
What essential competency of kinesiologies applies in this lecture?
3.2: Applies patient/client-centered principles in practice
Competency 3.2 performance indicators
3.2.3 Recognizes the limits of one’s own knowledge, skills and abilities related to managing diversity and equity issues and consults when necessary
3.2.4 Takes into consideration the diversity of the patient/client
3.2.6 Respects the individuality of patients/clients and applies strategies that engage the patient/client in a collaborative approach
Cultural sensitivity
Being aware that cultural differences and similarities exist and both have an effect on values, learning and behaviour
Cultural competence
A set of congruent behaviours, attitudes and policies that come together to enable a system, organization or professionals to work effectively in cross/cultural situations
Cultural humility
A process of openness, self-awareness, being egoless and incorporating self-reflection and critique after willingly interacting with diverse individuals
What are the results of achieving cultural humility?
Mutual empowerment
Respect
Partnerships
Optimal care
Lifelong learning
Cultural safety
An environment perceived as safe by the people who may seek services; free of microaggressions, racism, discrimination or denial of a person’s identity and needs
Why is a cultural competence continuum useful?
For considering how healthcare practitioner may think about intercultural interactions
What is the order of the cultural competence continuum? (neg to pos)
- Cultural destructiveness
- Cultural incapacity
- Cultural blindness
- Cultural pre-competence
- Cultural competence
- Cultural proficiency
Cultural destructiveness
Extreme negative end
Attitudes, policies and practices which are destructive to cultures and consequently to the individuals within the culture
Example of cultural destructiveness
Canadian aboriginals who were forced to go to residential schools by non-aboriginals
Cultural incapacity
Inability of healthcare providers and institutions to help clients from diff cultures
Other aspects of cultural incapacity
Dominant client group serves as the norm for all care
The system conveys that people who are diff are not welcomed or valued
The expectation is that people of minority cultures will adapt to, accept and even be grateful for care provided
Example of cultural incapacity
Lack of language interpreter services
Cultural blindness
Occurs when the existence of cultural differences is denied in a desire to be unbiased and treat all clients identically
Emphasizing equality over equity
Example of cultural blindness
Canadian hospitals give clients cold water with meds but many cultures avoid cold foods and liquids during times of illness
Cultural pre-competence
The recognition of some needs based on culture and some movement towards meeting those needs
Examples of cultural pre-competence
- the desire to deliver high-quality, cost-effective services
- a commitment to civil rights and social justice
- engagement w individuals and communities to ask what can we do
- development of inclusive policies
What is a danger of pre-competence?
False sense of accomplishment or tokenism
Cultural competence
Recognition and respect for differences and ongoing efforts towards self-assessment and working with diversity
Cultural proficiency
Beyond competence; seeking opportunities to create new knowledge and innovative practices
What does cultural competence encompass?
- being aware of one’s own world view
- developing positive attitudes towards cultural differences
- gaining knowledge of diff cultural practices and worldviews
- developing skills for communication and interaction across cultures
Limitations of the cultural competence continuum
- assumes that healthcare professions can learn a quantifiable set of attitudes and skills that allow them to work effectively within the cultural context of the patient/client
- focuses on knowledge acquisition and does not focus on social justice issues
- presented as a technical and communications technique
- potential to stereotype cultural groups
Cultural humility definition
Dynamic and lifelong process focusing on self-reflection and personal critique
What does cultural humility go beyond the concept of cultural competence to include?
- A personal and lifelong commitment to self-evaluation and self-critique
- Recognition of power dynamics and imbalances, desire to fix those power imbalances and to develop partnerships with people and groups who advocate for others
- Institutional accountability
What are the 5 key principles in cultural competemility model?
- Cultural awareness
- Cultural knowledge
- Cultural skill
- Cultural encounter
- Cultural desire
Cultural awareness
Conducting a self-examination of one’s own biases towards other cultures and exploring own cultural and professional background; being aware of the existence of documented racism and other isms in healthcare delivery
Cultural knowledge
The process of seeking and obtaining a sound educational foundation about the worldviews of diff cultures
Example of cultural knowledge
Patients in rehab search for meaning of their illness or disability and it is their worldview that influences what meaning they attach to their health, illness and disability and what they should do when they become ill or disabled
Cultural skill
The ability to conduct a cultural assessment to collect relevant cultural data regarding the client’s presenting problem and accurately conduct a culturally-based physical assessment
Cultural encounter
The process which encourages the healthcare professional to directly engage in face-to-face cultural interactions to challenge beliefs and prevent stereotyping
Cultural desire
The motivation of the healthcare professional to want to engage in the process of becoming culturally aware, culturally knowledgable, culturally skillful and seeking cultural encounters, not the “have to”
What is cultural humility an alternative approach to?
Cultural competence, but they should be viewed as being in apposition, rather than opposition of each other
What is cultural competemility?
Synergistic process between cultural humility and cultural
competence in which cultural humility permeates each of the five components of cultural competence
Unconscious impermeability
Being totally unaware that cultural humility is required during the process of becoming culturally aware, knowledgeable, skillful and obtaining cultural desire and cultural encounters
Conscious impermeability
The awareness that cultural humility must be exhibited during the clinical encounter, however the HPC is unable to display the cultural lens
Conscious permeability
Mindful act of learning how to become culturally humble and to let this cultural lens pervade the entire cultural encounter with the patient
Unconscious permeability
Ability of the HCP to spontaneously operate from a place of cultural
humility when pursuing cultural awareness, knowledge, skill,
desire and encounters
What is cultural competemility from a continuum perspective?
Ongoing process of moving from a position of unconscious impermeability to unconscious permeability when cultural
awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire are being pursued.
What is the most serious barrier to cultural competemility?
Potential to stereotype individuals
