Patient Care: Cultural Humility and Cultural Competence
In the medical context, cultural humility may be defined as a process of being aware of how people's culture can impact their health behaviours and in turn using this awareness to cultivate sensitive approaches in treating patients. Culturally competent care assumes that healthcare providers can ‘learn a quantifiable set of attitudes and communication skills’ that will allow them to work effectively within the cultural context of the patients they come across. Cultural competence is the ability to engage knowledgeably with people across cultures. Developing cultural humility in itself is a prerequisite to cultural competency. It does so by forming a foundation for healthcare providers to consider possible power imbalances that may arise between a doctor and patient when cultural differences may have an impact on the potential clinical outcome for the patient.
In clinical practice, lack of awareness of cultural perceptions introduces the risk of subconscious imposition of personal beliefs during patient interactions. the concept of cultural humility in which the elements of self-questioning, immersion into an individual patient's point of view, active listening, and flexibility all serve to confront and address cultural biases or assumptions a healthcare provider may hold.
Cultural humility involves understanding the complexity of identities — that even in sameness there is difference — and that a clinician will never be fully competent about the evolving and dynamic nature of a patient's experiences. An awareness of the self is central to the notion of cultural humility — who a person is informs how they see another. Awareness may stem from self-reflective questions such as:
Which parts of my identity am I aware of? Which are most salient?
Which parts of my identity are privileged and/or marginalized?
How does my sense of identity shift based on context and settings?
What are the parts onto which people project? And which parts are received well, by whom?
What might be my own blind spots and biases?
With this awareness, a provider can ask questions about how they receive the patient: Who is this person, and how do I make sense of them? What knowledge and awareness do I have about their culture? What thoughts and feelings emerge from me about them?
A provider operating with cultural humility must listen with interest and curiosity, have an awareness of their own possible biases and attempt a non-judgmental stance about what they hear, and recognize their inherent status of privilege as a provider and be willing to be taught by their patients.
One challenge is that healthcare executives, providers, and others working in the system aren’t having honest, authentic conversations about systemic or individual biases because it makes them uncomfortable. Everyone has biases. Avoiding or concealing them only escalates the problem. Instead, healthcare institutions and providers need to raise them to the surface and become more comfortable with having uncomfortable conversations to effect change.
For this, cultural competence and humility and sensitivity trainings are essential. Contact Pam at https://wa.me/message/RKVWCEWGN5NMN1
