Cultural theorist Campinha-Bacote describes cultural competency as a continuum, which
Cultural theorist Campinha-Bacote describes cultural competency as a continuum, which implies continual growth and development (Kersey-Matusiak, 2019).
Discuss the following:
• What is cultural competence?
• Are there steps nurses can take to achieve it?
• How does it differ from cultural humility?
• Briefly describe how a lack of cultural sensitivity may impact patients’ health and well-being and their future encounters with the healthcare system.
• Why is it more important to focus on cultural humility rather than achieving cultural competence?
Expert Answer and Explanation
In the healthcare sector, cultural competence focuses on the ability of a nurse or any other medical professional to be aware of their cultural beliefs and values. Additionally, cultural competence also includes the awareness of how personal culture and perspectives are different from that of others (Kersey-Matusiak, 2018).
In the case of a nurse, cultural competence focuses on the ability to differentiate one’s cultural beliefs from that of the patient. Nurses can take different initiatives and steps to achieve cultural competence. The most efficient strategy is to interact with patients, improve self-awareness and learn about different cultures within the community. The strategies are key as they will create the needed awareness, and help improve the outcome of care.
Cultural competence differs from cultural humility in different ways. Cultural competence encompasses the ability to work with patients from different cultures while at the same time identifying the impact that cultural bias might have on care delivery. On the other hand, cultural humility entails the capacity for care providers to recognize their limitations, assumptions, or challenges when working with other cultures to avoid bias or predetermined patient care (Kersey-Matusiak, 2018).
When nurses are not sensitive to cultural differences, they tend to provide biased medical care that does not meet patient autonomy. As a result, patient satisfaction is negatively affected. With modernization, care providers are more likely to encounter patients from different cultures which requires the need for cultural competence. Focusing on cultural humility is more sustainable than trying to be more culturally competent as a nurse cannot be able to be aware of different cultures. However, a nurse can identify their biases and adjust their care depending on the needs of the patient through cultural humility (Kersey-Matusiak, 2018).
Reference
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer. ISBN: 9780826137272.
Alternative Answer
Cultural competence is the ability to appreciate, interact, and understand others cultures or beliefs that are different from their own (DeAngelis, 2015). “Cultural competence is defined as the attitudes, knowledge, and skills necessary for providing quality care to diverse populations” (Kersey-Matusiak, 2019, p.8). Culturally competent nurses are able to deliver care that values the beliefs of their patients (Kersey-Matusiak, 2019). Culturally competent care does not just happen; there are steps nurses must take to become culturally competent.
To become culturally competent, one must learn who they are first (Clay, 2010). Learn about your ancestors, personal background, be curious, and perform a self-assessment (Clay, 2010). Learn about different cultures by immersing yourself in their literature, language, and customs (Clay, 2010). Become comfortable in unfamiliar surroundings, converse with different religious groups, volunteer at community centers, and make friends with people of different cultures (Clay, 2010).
Attend diversity training seminars to collaborate with other professionals (Clay, 2010). If culturally competent training is not offered at your institution, submit a process to formalize educational material for your organization and peers (Clay, 2010).
Cultural humility recognizes that bias may occur and nurses need to understand and eliminate their own prejudices (Kersey-Matusiak, 2019). Healthcare providers need to recognize that their perspectives are influenced by policies that are dominated on the basis of whiteness and maleness (Kersey-Matusiak, 2019). Cultural humility addresses unconscious biases a nurse may possess and empowers the nurse to work towards eliminating these biases while providing culturally competent care.
Cultural sensitivity is having an attitude towards a specific culture or ethnic background and not saying offensive things directed at that background (Kersey-Matusiak, 2019). Cultural sensitivity can also include the avoidance of particular words, phrases, or categorizations of individuals (Kersey-Matusiak, 2019). An example of cultural sensitivity was the removal of the Washington Redskins name from the NFL due to the thoughts and feelings of the Native Americans.
Nursing is a trusted profession by the public. Nurses as well as other healthcare providers must provide culturally sensitive care to know how to communicate with their patients and develop professional relationships (The Role of Cultural Sensitivity in Building Patient Relationships, 2019). Nurses must understand nonverbal communication, inclusive language, cultural customs, relatable medical terms, and the use of personal touch (The Role of Cultural Sensitivity in Building Patient Relationships, 2019). Failure to utilize culturally sensitive care can create unwanted distress for patients and they may fail to seek medical attention when required as a result. Nurses must be able to make their patients feel comfortable in a healthcare setting.
Cultural competence is learning to accept and understand other cultures. Cultural humility is recognizing personal biases that may distort your perception of other cultures. Cultural sensitivity is recognizing those biases and behaving in an acceptable way towards different backgrounds. Providing care with “cultural sensitivity and cultural humility are both means to the end being cultural competence” (Kersey-Matusiak, 2019, p. 6).
References
Clay, R. (2010). https://www.apa.org/gradpsych/2010/09/culturally-competent. www.apa.org. https://www.apa.org/gradpsych/2010/09/culturally-competent.
DeAngelis, T. (2015, March). In search of cultural competence. American Psychological Association. https://www.apa.org/monitor/2015/03/cultural-competence.
Kersey-Matusiak, G. (2019). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.).
The Role of Cultural Sensitivity in Building Patient Relationships. (2019, July 11). Minority Nurse. https://minoritynurse.com/the-role-of-cultural-sensitivity-in-building-patient-relationships/.
Module 1 Assignment
Assignment Description:
Part 1: For this assignment, conduct a cultural self-assessment using the Staircase Self-Assessment Model and write a 1250–1500-word reflection essay.
To understand culture and cultural diversity, you must understand your own culture and beliefs. Utilizing the Staircase Self-Assessment Model as a means of determining your level of cultural competency, write a 1250 to 1500-word essay outlining the six stages: cultural destructiveness, cultural incapacity, cultural blindness, pre-competency, basic cultural competency, and advance cultural competency. Determine your level on the staircase by answering the following questions. Please be mindful that your responses will not be judged; only your knowledge of the Staircase Self-Assessment Model will be evaluated:
Step 1:
• How much do I value becoming culturally competent?
• What actions have I taken recently or in the past when caring for culturally diverse patients that demonstrate my motivation?
Step 2:
• How much do I know about my cultural heritage or racial identity and its relationship to my own healthcare beliefs and practices?
• Have I discussed these issues with my parents, grandparents, or other relatives?
Step 3:
• How much do I know about cultural groups that differ from my own?
Step 4:
• How culturally diverse is my social network?
• How many encounters with cultural group members outside my social network do I have? Are these relationships superficial, or do I have social contact beyond the workplace?
Step 5:
• Am I able to independently identify the potential or actual problems that originate from cultural conflicts, or am I surprised by them?
• Do I serve as a culturally competent role model/mentor for others?
Step 6:
• Have I developed problem-solving strategies to manage cultural conflicts?
• Am I able to manage or resolve cultural problems or issues that arise, and what resources do I use?
Once you have completed the self-assessment, address the following questions:
1. Why are self-knowledge and understanding a critical step in achieving cultural competence?
2. How has the “cultural self-assessment” exercise influenced your awareness of personal and professional values, attitudes, and practices, including prejudices and biases?
3. How will your interactions with patients and families change as a result of this self-reflection?
Remember, you answer these questions from your perspective, so there is no right or wrong response. You must address each question. Although the information on your self-assessment paper is strictly confidential, if you do not wish to self-disclose a specific area from the Staircase, indicate that by explaining in detail why you do not want to disclose. You are not required to provide citations/references in this paper. Attention should be paid to grammar, spelling, and punctuation.
Part 2: Go to Think Cultural Health located on the U.S. Department of Health & Human Services Office of Minority Health website (you may access it from the following URL (https://thinkculturalhealth.hhs.gov/). Click on the Education tab. Select nurses and create your account (there are approximately seven questions to answer). Register for the Think Cultural Health program for nurses: Nurses – Culturally Competent Nursing Care: A Cornerstone of Caring.
For Module 1, you will only register and review the objectives of Course I. Throughout the next 7 Modules; you will complete the program. There are three (3) courses. The estimated time to complete the entire program is nine (9) hours.
When you register, please Do Not select the CNE Nursing option. You must select the option, Statement of Participation. You will submit the Statement of Participation in Module 7
Expert Answer and Explanation
Staircase Self-Assessment Model
Cultural diversity is a key factor for any medical professional and can be used to ensure efficient working relations. It is important that different interventions and models are applied to help improve the efficiency and outcome of care. The Staircase Self-Assessment Model can be used to help understand the aspect of cultural competency and how it can be applied within the healthcare sector. This paper will focus on the analysis of the Staircase Self-Assessment Model to explore the issue of cultural competency.
Stages of the Staircase Self-Assessment Model
Cultural Destructiveness
Cultural destructiveness occurs when a person denies patient healthcare services as of the difference in the culturally and linguistically diverse background. The aspect denotes that there can be challenges with the delivery of care when the nurse and patient come from different or diverse cultures, in this regard, the cultural difference would have facilitated the destruction of services that would have been rendered under other conditions.
Cultural Incapacity
The concept of cultural incapacity originates from the lack of capacity to meet the needs of patients from all ethnic, linguistic, and ethnic backgrounds. Incapacity is different from destructiveness since it focuses on the inability of the facility to meet different needs. The incapacity can be derived from the lack of resources or amenities to ensure that the facility meets all its services to different cultural different patients.
Cultural Blindness
The component of cultural blindness is the deliberate oversight of the aspect of culture and how it can be used to meet the different outcomes of care. When a care provider provides the same standard form of care to all patients regardless of their cultural background can be referred to as cultural blindness. The aspect denotes that the treatment is only based on the medical need of the patient and not the alignment with cultural norms. Blindness treats each person equally and care is not based on cultural and ethnic needs, but rather based on standard protocols that apply to all.
Cultural Pre-Competency
The pre-competence aspect focuses on the strategies within which agencies or individual care providers attempt to improve their cultural awareness. The process is essential as it creates a means by which a person can further improve their understanding of culture and its impact on others. Cultural awareness within the pre-competence level can be viewed as the early stages toward proficiency.
Basic Cultural Competency
The stage of cultural competency is the continued attempts for a person to make cultural adjustments when interacting with a patient from diverse cultures other than their own. It is important for individuals in this stage to learn how to identify the differences and work on improving the general outcome. The strategies would help in increasing self-awareness and cultural understanding.
Advance Cultural Competency
Also called cultural proficiency, this stage is based on the overall ability of a person to respect and accept the different cultural and linguistic backgrounds of the patient. The person can easily and efficiently adapt to the values of the patient and meet their specific and individual needs.
Evaluation of Staircase Self-Assessment
Step 1:
- How much do I value becoming culturally competent?
I believe cultural competence is the basis for the future of nursing and needs to be adopted by all nurses. Cultural competency can improve the efficiency of the healthcare sector and bring about the desired changes and positive outcomes.
- What actions have I taken recently or in the past when caring for culturally diverse patients that demonstrate my motivation?
The main strategy I have taken when caring for culturally diverse patients is to first create a relationship during the assessment where I intentionally ask about their culture and preferences in terms of medical care and treatment.
Step 2:
- How much do I know about my cultural heritage or racial identity and its relationship to my own healthcare beliefs and practices?
I have a strong and in-depth understanding of my cultural heritage and racial identity. I am also conversant with how my culture affects my personal healthcare beliefs and practices.
- Have I discussed these issues with my parents, grandparents, or other relatives?
I am yet to have a detailed and candid discussion of the issues with my immediate or extended family but I occasionally ask various questions regarding complex issues that I need clarification on about the culture.
Step 3:
- How much do I know about cultural groups that differ from my own?
Despite having been in the healthcare industry for a while, there are way too many cultures and I cannot have an excellent understanding of all. However, I can rate myself as having above-average awareness of cultural groups that are different from my own.
Step 4:
- How culturally diverse is my social network?
My social network is diverse as I have friends and colleagues from different cultural, ethnic, social, and economic classes. I tend to freely interact with people regardless of their backgrounds and affiliation.
- How many encounters with cultural group members outside my social network do I have? Are these relationships superficial, or do I have social contact beyond the workplace?
I encounter different cultural group members outside my social network very often within my workplace and personal life. While the majority of the interaction is superficial, some of them proceed beyond the workplace to become friends and become part of my social network.
Step 5:
- Am I able to independently identify the potential or actual problems that originate from cultural conflicts, or am I surprised by them?
Through my competency in cultural differences, I can identify problems that can originate from cultural conflicts. While some of the problems are repetitive, some cultures can come as a surprise and require an additional assessment to learn and adjust.
- Do I serve as a culturally competent role model/mentor for others?
I am yet to be proficient in terms of cultural competence and while I can help others learn and improve their level of competence, I am yet to be a mentor. However, I hope to one day attain the level where I can be able to mentor and guide others.
Step 6:
- Have I developed problem-solving strategies to manage cultural conflicts?
At the beginning of my practice, I had challenges accepting and understanding the essence of cultural integration. However, I have become more aware of the need for understanding and accepting diversity.
- Am I able to manage or resolve cultural problems or issues that arise, and what resources do I use?
I am in a position to efficiently and easily resolve cultural problems that might arise. I believe that communication is a key resource and understanding the diverse needs of the patient through active listening and communication can help resolve the issue.
Critical Step in Achieving Cultural Competence
Self-knowledge and understanding are the basis of a person’s ability to know their strengths and weaknesses. Understanding what can trigger a person and how they respond to external stimuli can help in shaping the correct attitude and response to cultural differences and help improve on the weaknesses. Embracing the strengths and working on the weaknesses is a key strategy that can be used by an individual to achieve greater cultural competence and by extension, better patient outcomes
Impact of Cultural Self-Assessment
Engaging in cultural self-assessment has had a positive impact on my awareness of personal and professional values in different ways. I have been able to identify the areas of strength, and overall perception concerning the issues around cultural diversity. The role of the care provider can be impactful if they identify and understand how a patient’s culture can impact the overall outcome of care.
The self-assessment has also impacted my attitude towards patients from different cultures and practices as they relate to the delivery of care practices. I have also learned the importance of culture and the need to eliminate or mitigate issues of prejudice and cultures through cultural differentiations.
Interactions with Patients and Family
Following the self-reflection, I believe that I will have a different and more profound relationship with patients. I have had a chance to understand my cultural awareness and how it affects my delivery of care. The process helps provide a profound understanding of cultures and how different cultures can lead to different outcomes in care.
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FAQs
What is the continuum of cultural competence?
The Continuum of Cultural Competence is a conceptual framework that illustrates the stages or levels of cultural competence that individuals and organizations can progress through in their journey toward providing culturally sensitive and equitable care. This model, often associated with Dr. Terry Cross, outlines several stages, each representing a different level of cultural competence. These stages are as follows:
- Cultural Destructiveness:
- This is the lowest stage on the continuum, characterized by overt discrimination, racism, and ethnocentrism. Individuals or organizations in this stage actively harm or oppress individuals from different cultural backgrounds.
- Cultural Incapacity:
- In this stage, individuals or organizations may not engage in overt discrimination but still exhibit a lack of capacity to effectively respond to the needs of diverse cultural groups. There is limited awareness or acknowledgment of cultural differences.
- Cultural Blindness:
- Cultural blindness is marked by the belief that cultural differences do not matter or should be ignored. People at this stage often claim to treat everyone the same, but in doing so, they fail to recognize and address unique cultural needs.
- Cultural Pre-Competence:
- At this stage, individuals or organizations recognize the importance of cultural competence and may take some initial steps to improve their knowledge and skills. However, these efforts are often inconsistent and may not be well-integrated into practice.
- Cultural Competence:
- Cultural competence represents a higher level of awareness, knowledge, and skills in working with individuals from diverse cultural backgrounds. Those in this stage actively seek to understand and address cultural differences, and they provide more effective and respectful care.
- Cultural Proficiency:
- Cultural proficiency is the highest stage on the continuum. At this level, individuals or organizations not only demonstrate cultural competence but also actively advocate for cultural diversity and social justice. They work to eliminate health disparities and promote equity.
It’s important to note that the Continuum of Cultural Competence is not a linear progression, and individuals or organizations may exhibit characteristics from multiple stages simultaneously. Progression along the continuum is not automatic and requires intentional efforts to improve cultural competence.
The goal is for individuals and organizations to strive for cultural proficiency, where they not only provide culturally sensitive care but also actively work to create inclusive and equitable healthcare environments. This model emphasizes that cultural competence is an ongoing journey of self-awareness, education, and advocacy, rather than a fixed destination.
What is cultural competence/cultural competence definition/culturally competent
Cultural competence refers to the ability to understand, appreciate, and effectively interact with people from diverse cultures. It involves having a deep understanding of the values, beliefs, customs, and norms of different cultural groups, as well as the ability to communicate and collaborate with people from these groups in a respectful and effective manner.
Cultural competence is important in a wide range of settings, including healthcare, education, social services, and business, where it can help to promote better outcomes and build stronger relationships with clients, colleagues, and customers from different cultural backgrounds.
In practice, cultural competence involves a combination of skills, knowledge, and attitudes, such as active listening, empathy, self-awareness, and an openness to learning about and from other cultures. It also requires an ongoing commitment to personal and professional development in this area.
What are the 5 constructs of Campinha-Bacote’s model of the process of cultural competence?
Campinha-Bacote’s model of the process of cultural competence, often referred to as the “Cultural Competence Model,” outlines five key constructs that healthcare professionals can use to develop cultural competence and provide culturally sensitive care. These constructs are essential for delivering healthcare that respects the diverse backgrounds and needs of patients. The five constructs are:
- Cultural Awareness:
- Cultural awareness is the foundation of cultural competence. It involves recognizing and understanding one’s own cultural beliefs, values, biases, and assumptions.
- Healthcare providers need to be self-aware and reflect on their own cultural background to avoid imposing their values on patients.
- Cultural awareness also includes an appreciation of the cultural diversity of patient populations.
- Cultural Knowledge:
- Cultural knowledge refers to the acquisition of knowledge about diverse cultural groups, their customs, beliefs, practices, and healthcare needs.
- Healthcare professionals must educate themselves about the cultural backgrounds of their patients to provide culturally competent care.
- Understanding the impact of culture on health and healthcare-seeking behaviors is a key component of cultural knowledge.
- Cultural Skill:
- Cultural skill involves the ability to apply cultural awareness and knowledge effectively in healthcare interactions.
- This construct emphasizes communication skills, such as active listening, asking culturally sensitive questions, and adapting communication styles to meet the needs of patients from different cultural backgrounds.
- Cultural skill also involves the ability to conduct culturally competent assessments and provide appropriate care interventions.
- Cultural Encounters:
- Cultural encounters involve direct interactions with patients from diverse cultural backgrounds.
- These encounters provide healthcare professionals with practical experience in applying cultural competence in real-life situations.
- By engaging in cultural encounters, healthcare providers gain insights into the unique needs and perspectives of individual patients.
- Cultural Desire:
- Cultural desire refers to the motivation and commitment of healthcare professionals to become culturally competent.
- It involves a genuine interest in understanding and respecting the cultural backgrounds of patients and a willingness to continually learn and improve.
- Cultural desire is considered the most critical construct, as it drives the ongoing development of cultural competence.
Campinha-Bacote’s model emphasizes that cultural competence is not a static state but a dynamic process. Healthcare professionals should continuously strive to enhance their cultural competence by engaging in self-assessment, acquiring cultural knowledge, honing cultural skills, seeking cultural encounters, and maintaining a strong cultural desire. By doing so, they can provide care that is respectful, responsive, and tailored to the individual needs and preferences of their diverse patient populations.
What is Dr Campinha-Bacote referring to when she asks have I asked myself the right questions?
When Dr. Campinha-Bacote asks, “Have I asked myself the right questions?” in the context of cultural competence, she is prompting healthcare professionals to engage in self-reflection and critical self-assessment regarding their own cultural awareness, biases, and readiness to provide culturally competent care. This question encourages healthcare providers to evaluate their own attitudes and behaviors in relation to cultural competence.
Specifically, this inquiry encourages healthcare professionals to consider the following:
- Self-Reflection: Healthcare providers should reflect on their own cultural background, beliefs, values, and biases. They should ask themselves whether they are aware of their own cultural influences and how these may impact their interactions with patients from diverse cultural backgrounds.
- Biases and Assumptions: Healthcare professionals should assess whether they hold any biases or make assumptions about patients based on their cultural background. It’s important to recognize and challenge any stereotypes or preconceived notions that may affect the quality of care provided.
- Cultural Competence Development: Healthcare providers should consider whether they have actively pursued cultural competence training, education, and self-improvement. They should assess their commitment to ongoing learning and development in the field of cultural competence.
- Communication Skills: Healthcare professionals should evaluate their communication skills and whether they are effectively adapting their communication styles to meet the needs of patients from diverse cultural backgrounds. This includes asking themselves whether they actively listen, ask culturally sensitive questions, and ensure that patients understand their healthcare instructions.
- Cultural Desire: Healthcare providers should examine their motivation and willingness to provide culturally competent care. They should ask themselves whether they genuinely desire to understand and respect the cultural backgrounds of their patients and whether they are dedicated to continually improving their cultural competence.
In essence, Dr. Campinha-Bacote’s question encourages healthcare professionals to engage in introspection and self-assessment to ensure that they are actively working toward cultural competence. It emphasizes that becoming culturally competent requires ongoing self-awareness, self-improvement, and a commitment to providing equitable and culturally sensitive care to all patients, regardless of their cultural backgrounds.
