Comprehensive practice of cultural competence

    Comprehensive practice of cultural competence requires an open attitude, self-awareness, awareness of others, cultural knowledge, and cultural skills. Let’s review the following model, which lays out these five building blocks along a cyclical path: We start at the top with open attitude. To possess a fully open attitude, you must not only know what you intend to learn, but also try to move forward with a spirit of curiosity about yourself and others. Consider that there is much you do not know and be ready to receive new information with an open mind. Be prepared to expose yourself to diverse ideas and alternative viewpoints, through clinical encounters, use of CultureVision, and anywhere else you have the opportunity to engage with people you might consider different from yourself. Some key elements of an open attitude include: • Being open to a wide variety of ideas and approaches • Seeking out divergent views and contrary arguments • Considering the full range of pros and cons on an issue Another element of cultural competence is self-awareness regarding your own worldview. In order to walk a mile in someone else’s shoes, you first have to take your own shoes off. In other words, you must turn a flashlight onto your own culture, beliefs, values, and background. This allows you to more objectively explore what you may subconsciously be bringing to every interpersonal interaction. Components of self-awareness include: • Understanding your personal background and culture • Awareness of your assumptions, biases, and judgments • Awareness of how others might perceive you and your role • Knowledge of strengths and limitations • Ability to recognize your personal biases, cultural incompetence, or exclusive behavior • Capacity for self-reflection and intervention This reflective process of self-evaluation helps facilitate the development of awareness of others: the recognition that all individuals are uniquely programmed with their own background, worldview, beliefs and values, and that while these may not match up with your own, they are equally valid and valuable. The capacity for awareness of self and others is deeply connected to cultural humility, in which we are able to recognize that our perspective is just that: our own perspective. From awareness of others, we move on to cultural knowledge, the acquisition of information about others’ values, norms, and beliefs. CultureVision is a useful tool for providing extensive archetypical cultural knowledge. This resource, in addition to other online and offline research, provides an information base from which you can engage in your own conversations and inquiries. With practice, the cultural knowledge that you obtain can develop into cultural skills, which includes asking more informed questions about your patients’ beliefs and practices around healthcare. Other valuable cultural skills include: • Ability to adapt your communication style to different individuals, groups, and cultures • The use of active listening skills • Establishing relationships based on mutual trust • Clearly identifying areas of conflict or concern and recognizing their impact • Making clear requests of others • Implementing processes that promote organizational cultural competence and inclusion You’ll note that this process is cyclical and always ongoing. It may, however, not always be sequential. As we continue to learn more about our self and others, we adjust our approach and assumptions. Our cultural lenses shift as we engage in new experiences and interactions. Successfully engaging all components of this model opens the door to the development of cultural competence, and respectfully meeting the needs of patients of all backgrounds.   Use the space that follows to evaluate your relationship to these five components of cultural competence. In particular, ask yourself: • What are my strengths? o Example (cultural knowledge): My frequent interactions with Chinese patients have helped me understand the culture’s archetypical concept of health • In which of these areas have I been challenged? o Example (self-awareness): I recognize that in the past I’ve judged patients who didn’t consistently follow my care instructions. • Are there opportunities for growth? o Example (cultural skills): I’d like to work on my active listening skills. Strengths Challenges Growth opportunities Open Attitude Self-Awareness Awareness of Others   Cultural Knowledge Cultural Skills Now that you have examined your strengths, challenges, and growth opportunities, what steps do you commit to taking in order to develop your culturally competent care?