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Cultural Competence and Cultural Humility
The goal of ’cultural competency’ is to prepare physicians to provide quality care to diverse populations. The need for ’cultural competency’ has come from the intention of providing quality care to immigrants and marginalized populations as well as the hope of reducing disparities in the quality of health care. One approach is to learn about individual cultures and their characteristics, and similarly examine marginal groups and communities. However, narrowly defining the beliefs of specific groups could lead to stereotyping and avoidance of more careful examination of other factors that influence an individual patient’s actions.[20][19][18]
A good starting point might be to understand what assumptions and biases you bring to each patient encounter. It is easy for all of us to make assumptions about the non-biological contributors to health - the social determinants of health. We make assumptions about education and literacy, about having adequate housing and access to clean water without being aware of it. We have biases that create attitudes that may put patients at a disadvantage - and impair their health in the process.
The relevance of culture to health can be explored in a general sense as it applies to specific patients. A better approach would be to focus on issues that arise (in a specific patient’s case) because of cultural differences and how they may influence patient care.
The goal of ’cultural humility’ may be more appropriate for physicians who wish to provide quality care to patients of all cultures, and really is another face of patient-centred cared. ’Cultural humility’ involves a lifelong commitment to self-awareness and self-evaluation.
The "Quality and Culture Quiz" might stimulate you to think about cultural competence and to reflect on your experiences.
This quiz is but one resource from Management Sciences for Health (MSH), a nonprofit international health organization composed of more than 2,000 people from 73 nations. Their mission is to save lives and improve the health of the world’s poorest and most vulnerable people by closing the gap between knowledge and action in public health.
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18. Schilder AJ, Kennedy C, Goldstone IL, Ogden RD, Hogg RS, O’Shaughnessy MV. "Being dealt with as a whole person." Care seeking and adherence: the benefits of culturally competent care. Social Science & Medicine. 2001;52:1643-1659.
19. Kaiser Permanente National Diversity Council. A Provider’s Handbook on Culturally Competent Care: Lesbian, Gay, Bisexual and Transgendered Population. Oakland, CA. Kaiser Permanente; 2000.
20. Davis V, Christilaw JE, Edwards C, Francoeur D, Grant LJ, Parish B, Saraf-Dhar R, Steben M. SOGC Clinical Practice Guidelines. Policy Statement No. 87. Lesbian Health Guidelines. Journal of the Society of Obstetricians and Gynecologists of Canada. 2000;22(3):202-205. sogc.medical.org/SOGCnet/sogc_docs/common/guide/pdfs/ps87.pdf. Accessed on July 18, 2003.