Cultural competence

When new technologies are not available to all members of a society, they can exacerbate existing inequalities in the system of medical care. Currently the structure of the U.S. health care system is fundamentally flawed. Racial and ethnic disparities in health status and health care, more than 40 million uninsured, spiraling health care costs, and inadequate levels of culturally competent medical care are all evidence of this problem. 

Campinha-Bacote, J., The Process of Cultural Competence in the Delivery of Health Care Services, Transcultural C.A.R.E. Associates, Ohio (1998 and 1999). 

Cross, T.L., et al., "Toward a Culturally Competent System of Care," Vol. 1 Monograph on Effective Services for Minority Children Who Are Severely Emotionally Disturbed. Washington, DC CASSP Technical Assistance Center, Georgetown University Child Development Center (1989). 

From Canned Foods to Canny Consumers Cultural Competence... 

Therapists train and practice in a world that is very different from that of physicians. Because therapists contact with physicians is often limited, they rarely have opportunities to immerse themselves in the culture of medicine in order to learn about the roles, customs, and beliefs of its members. Just as it is important to be culturally competent with patients from ethnically diverse backgrounds, knowledge of and appreciation for medical culture is also helpful and can strengthen collaborative relationships. 

To deal with the health care dimensions of LEP, hospitals, clinics, and physician s offices must plan for and undertake a culturally competent response. The Rural Action Center, an initiative of the Department of Health and Human Services, defines cultural competence as... 

Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. (2003). Developing cultural competence in disaster mental health programs Guiding principles and recommendations. 

Kleinman and Benson (2006) imply that sometimes those who teach cultural competence hold the view that culture can be reduced to a technical skill (p. 1673). Rather, it should suggest that we educate ourselves and others to explore the complexity of cultural influences openly. 

Kleinman, A., Benson, P. (2006). Anthropology in the clinic The problem of cultural competency and how to fix it. Public Library of Science Medicine, 3(10), e294. doi 10.1371/joumal. pmed.0030294... 

Tervalon, M., 8c Murray-Garcia, J. (1998). Gultural humility versus cultural competence A critical distinction in defining physiciantraining outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117. 

I created the inclusion equation to help depict the interrelated variables necessary to create and sustain inclusive cultures (see Figure 7.1). There are two broad components of the inclusion model it depicts macro and micro inclusion practices. The two macro aspects focus on organizational culture and organizational systems. At the micro level, the model identifies individual cultural competence and emotional intelligence as the two core requirements to create and sustain inclusion. The components of the model are interdependent and work synergistically. When any one aspect is weak or absent, it severely inhibits the ability of an organization to effectively practice inclusion. 

Values + Effective Systems + Cultural Competence + Emotional Intelligence Inclusion... 

Inclusion requires individuals to become culturally competent. As the first step, individuals must work on becoming aware of microinequities and their conscious as well as unconscious biases. The journey to becoming more culturally competent... 

I believe that cultural competence is the linchpin to ensure inclusion. A focus solely on awareness and sensitivity training will not change behaviors and ways of thinking. To become culturally competent takes study, time, and practice. The first step is assessing one s current level of cultural competence. 

The Winters Group uses the Intercultural Development Inventory (IDI Hammer, 2010 Hammer Bennett, 2003) to measure cultural competence (we typically use this term rather than inter-cultural competence, though we mean the same thing). The IDI, owned by Dr. Mitchell Hammer and IDI, LLC, and based on Milton Bennett s Developmental Model of Intercultural Sensitivity (DMIS M. J. Bennett, 1986 J. M. Bennett M. J. Bennett, 2004 see also Bennett, Chapter 5, this volume), is useful in providing a framework for understanding the developmental stages of cultural competence. 

As is inherent in these concepts and the required self-examination, the quest for inclusion is not possible without the willingness to be vulnerable and honest about oneself. Self-awareness and ongoing self-reflection are the foundation for enhancing cultural competence and one s ability to think and behave inclusively. 

My manager has the cultural competence (knowledge and skills) to effectively manage a diverse team or workgroup. 

Demonstrate an ability to conceptualize and deliver culturally competent professional services in their respective areas to diverse populations. ... 

The substantial literature on course transformation focuses on the course as the unit of intervention. Notably, there is less attention to how faculty ought to work together to construct student learning outcomes that will support the development of culturally competent students. Courses are not islands they function collectively to foster the student s education. Program faculty should work as a team to revise student learning outcomes and to determine the role of specific courses in fostering student achievement of these outcomes. 

However, international issues are increasingly seen as integrally related to domestic diversity issues they are being viewed as another important area of diversity in which differences based on power and privilege affect opportunities and outcomes. Over the past decade, the American Council on Education (ACE) has sponsored several initiatives to address the historical divide between multicultural education and internationalization and to foster an exploration of common goals and opportunities, with the ultimate aim of graduating students who are culturally competent citizens of the world (see Olson et al., 2007). 

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