Transcript Cultural Competency Training

Cultural Competency
Training
Family Medicine Research Department
Department of Family Medicine
University at Buffalo
Frances Saad, B.A., Psychology, MSW student, School of Social Work
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
What is Culture?
• Culture includes the shared values, traditions, norms,
customs, religion, arts, history, folklore, language
and/or institutions of a specific group of people.
• In other words, culture is what we live everyday and
what we display in our daily interactions with others.
“That is true culture which helps us to work for the
social betterment of all”
-Henry Ward Beecher
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Cultural Awareness & Sensitivity
• Cultural Awareness
• General term used to indicate that a person is conscious
of the similarities and differences within, between, and
among cultures
• Cultural Sensitivity
• Indicates that a person not only has been an awareness of
the nuances of one’s own culture as well as those of other
cultures, but also that he or she does not assign a negative
or positive value to the differences within, between, and
among cultures-accepts cultural differences nonjudgementally.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
What is Cultural Competency
• Includes skills that enable individuals to increase
their understanding and appreciation of cultural
differences and similarities.
• Allows providers to understand, appreciate, and
work with individuals of cultures other than
their own.
• Involves the willingness and ability of a system
to value the importance of culture in the
delivery of services to all segments of the
population.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Organizational vs. Individual
• Cultural Competence
• Individual
• Organization
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Buffalo State College/SUNY at Buffalo
Research Foundation
A Definition Specific to
Systems of Care
• The integration of knowledge, information, and data
about individuals and groups of people into:
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Clinical standards
Skills
Service approaches and supports
Policies
Measures
Benchmarks
• This occurs on the individual, program and system level
• This promotes effective work in cross-cultural
situations
(Cross et al., 1989; Davis 1997)
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Rationale for cultural competency
• Numerous reasons justify the need for cultural
competence within the health care system:
■ diverse belief systems exist related to health, mental health,
healing and well-being
■ culture influences help-seeking behaviors and attitudes
toward health care providers
■ individual preferences affect traditional and other
approaches to health care
■ patients must overcome personal experiences of biases
within health care systems
■ health care providers from culturally and linguistically
diverse groups are under-represented in current service
delivery systems.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Cohen, E., & Goode, T. D. (1999)
Model for Cultural Competency
• The National Center for Cultural Competence embraces a
conceptual framework and model for achieving cultural
competence based on the Cross et al. definition (1989).
• Cultural competence requires that organizations:
• have a defined set of values and principles, and demonstrate behaviors,
attitudes, policies and
• structures that enable them to work effectively cross-culturally.
• have the capacity to
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value diversity
conduct self-assessment
manage the dynamics of difference
acquire and institutionalize cultural knowledge
adapt to diversity and the cultural contexts of the communities they serve.
• incorporate the above in all aspects of policy making, administration,
practice/service delivery and involve systematically consumers/families.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Barriers to Achieving
Cultural Competency
• Language
• Non-verbal communication
• Gestures, facial expressions, eye contact may have different meanings
in certain cultures
• Stereotyping
• Assignment of characteristics or beliefs about another culture based
on prejudice or limited exposure
• Racism
• Ethnocentrism
• Belief that one’s ethnicity provides the true or correct view of the
world
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Successful Practices in Delivering
Culturally Competent Care
• Define Culture Broadly
• Value Clients’ Cultural Beliefs
• Recognize Complexity in Language
Interpretation
• Translation
• Interpretation
• Facilitate Learning Between Providers and
Communities
Health Resources and Services Administration U.S. Department of Health & Human Services
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Delivery of Culturally
Competent Care
• Tips for Delivering Culturally Competent Care:
• Know where your client was born and what the
implications of birthplace have on health care.
• Know what language your client speaks at home.
• Know whether your client has specific dietary patterns
based on his/her culture.
• Know your client's religion and what treatments may be
prohibited because of its teachings.
• Know the level of independence the client had before the
visit. Know whether independence is a problem for the
client or a welcome asset to the quality of the client's life.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Con’t Delivery of Culturally
Competent Care
• Know the support systems in the clients life.
• Have the client describe how health issues are handled at home
to be aware of the role of family in the patient's culture.
• Understand the importance of individualizing each situation
based on the multitude of cultural issues that can arise.
• Assess the emotional state of the client and try to determine the
cultural dimensions that support it.
• Allow the client to assist you in learning words that describe
his/her illness or situation.
Malone, Beverly L., Ph.D., R.N., FMN, Minority Health Today Magazine, Vol. 1, Number 2, Jan/Feb 2000.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Enhancement of Cultural
Competence
• Cultural Competence activities should include:
• Development of skills through training, use of selfassessment for providers and systems,
• Implementation of objectives to ensure that governance,
administrative policies and practices,
• Clinical skills and practices are responsive to the culture
and diversity within the populations served.
• It is a process of continuous quality improvement.
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Cultural Competency Resources
• U.S. Dept. of Health and Human Services, Health Resources and
Services Administration, Office of Minority Health,
“Conceptualizing Cultural Competence and Identifying Critical
Domains” http://www.hrsa.gov/OMH/cultural/sectionii.htm
• U.S. Dept. of Health and Human Services, Office of Minority
Health, National Standards for Culturally and Linguistically
Appropriate Services in Health Care. Washington, D.C. 2001
• U.S. Dept. of Health and Human Services, Office of the
Surgeon General, Mental Health: Culture, Race and
Ethnicity. Rockville, 2001
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation
Cultural Competence is a
journey, not a destination…
© 2005 CDHS College Relations Group
Buffalo State College/SUNY at Buffalo
Research Foundation