Transcript Chapter 2 - American Pharmacists Association

Cultural Self-Assessment
Essentials of Cultural Competence in Pharmacy
Practice: Chapter 2 Notes
Chapter Authors: Dr. Kimberly Vess Halbur and
Dr. Duane A. Halbur
Learning Objectives
1. List and explain the attitudes, knowledge and skills necessary for
2.
3.
4.
5.
cultural competence.
Identify at least 5 steps that can enhance one’s cultural
competence
Examine personal cultural background, beliefs and biases that
impact one’s work as a pharmacist
Identify existing instruments that assess cultural competence
Summarize personal results on the Multicultural Awareness
Inventory
Definition of Cultural Competence
 …encompasses one’s knowledge, attitudes and skills.
 An ongoing process that grows and develops throughout the
duration of one’s career and lifetime.
CC in Pharmacy Practice
 Accreditation Council for Pharmacy Education: pharmacists must be
able to design, implement, monitor, evaluate, and adjust pharmacy
care plans that are patient-specific; addressing health literacy, cultural
diversity, and behavioral psychosocial issues.
 Biologic factors such as genetic variations in gene structure, drug
metabolism enzymes, receptor proteins also play a role in the efficacy
and toxicity of a drug in patients with different racial and ethnic
backgrounds.
 Phamacogenetic and pharmacogenomic research (research in the
variation of drug response resulting from inherited differences in
drug metabolism or drug targets based upon individual genes or all
genes)
 Pharmacogentics & pharmacogenomics have revealed genetic
differences among populations that may affect a drug’s
pharmacokinetic and pharmacodynamic properties.
Attitudes
 Positive attitudes are needed toward your own culture as
well as the cultural heritage of your patients.
 This begins by being able to appreciate, value and respect
differences between your own heritage and that of your
patients in areas such as race, ethnicity, socioeconomic
status, religion, sexual orientation and cultural and
health beliefs.
Knowledge
 Culturally competent pharmacists deliberately seek out
various worldviews and explanatory models of disease,
knowing that knowledge can help promote understanding
between cultures.
 Pharmacists need to seek knowledge about other cultures
and use that knowledge to inform their skills and practice.
Skills
 Culturally competent pharmacists possess insight, patient
assessment, and communication skills necessary to work with
diverse populations.
 Work toward continuous improvement in communication
skills every day by seeking consultation with translators,
cultural brokers, spiritual leaders and traditional healers.
Initial Steps Toward Cultural
Competence
1. Examine your cultural background.
2. Assess your level of cultural competence.
3. Immerse yourself in a community that you would like to learn more about.
4. Work with culturally/ethnically organized student groups, patient groups, or community
groups.
5. Read about culture-specific disease states and evidence-based interventions and practice.
6. Host a brown-bag lunch focused on cultural competency.
7. Reach out to religious leaders and organizations.
8. Seek out traditional cultural healers.
9. Talk with patients from diverse backgrounds in your community.
10. Continue to learn.
Role of Cultural Competence in
Pharmacy Practice

Oppression
Racism
 1. The belief that race accounts for differences in human character or ability and that
a particular race is superior to others.2. Discrimination or prejudice based on race.







Race
1. A local geographic or global human population distinguished as a more or less
distinct group by genetically transmitted physical characteristics.
2. A group of people united or classified together on the basis of common history,
nationality, or geographic distribution: the German race.
3. A genealogical line; a lineage.
4. Humans considered as a group.
Ethnicity
More terms…
 Cultural Blindness—differences are ignored. Treat all people the
same thereby only meeting the needs of the dominant group.
 Privilege—1 a. special advantage, immunity, permission, right, or
benefit granted to or enjoyed by an individual, class, or caste. b.
Such an advantage, immunity, or right held as a prerogative of status
or rank, and exercised to the exclusion or detriment of others.
 2. The principle of granting and maintaining a special right or
immunity: a society based on privilege.
 Cultural Privilege
 A Caucasian professor’s view:
http://www.ndsu.edu/ndsu/news/magazine/vol06_issue02/privi
leged.shtml
Cultural Competence
 Elusive
 No end point
 Requires openness of mind
 Galanti (2004) points out the difference between a
generalization and a stereotype is that a generalization is a
starting point whereas a stereotype is an end point.
Reflection Questions
1.Your cultural background will impact your practice as a pharmacist. What
positive implications could your background contribute to your role as a
pharmacist? What negative implications might exist?
2. In which areas of cultural competence do you feel most confident? In which
areas do you feel least confident?
3. What did you learn when you read the cases of Brian and Sunita? What ideas did
you have about Jewish people or Native Americans before reading the cases?
After?
4. What diverse groups exist in your community that you could learn more about?
What steps have you taken to become more competent in these areas?
5. Name the group(s) of people against whom you were taught biases. What have
you done to rectify those beliefs? What can you still do?
6. What steps will you take to ensure an ongoing commitment to being a culturally
competent pharmacist?