Cultural Competence

Many of the elements of person-centered care complement the development of cultural competence and can mitigate the risk of cultural awareness feeding stereotypes. But cultural competence is also essential to be truly person-centered. After all, to provide care focused on the individual requires the ability to effectively work cross-culturally. In fact, we could consider cultural competence an honorary element of person-centered care; the 7th element, if you will.

And while person-centered care and cultural competency each support the other, they serve different purposes. Person-centered care aims to improve care by being individualized and working with the client rather than on the client. And the goal of cultural competency is to provide equitable care regardless of culture or language.

It should be noted that one does not take a course and suddenly arrive at cultural competency; it is a continuous process of learning, reflecting, and improving.

Definition

Cultural competence in healthcare describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs.

- Betancourt et al., 2002

How do we develop cultural competence?

There are many models and methods for becoming more culturally competent as well as experts who advocate for cultural humility alongside or in place of competence. The important thing is to recognize the need for greater cultural awareness and find a model that can help you and your team to work more effectively cross-culturally. 

One model, Josepha Campinha-Bacote’s Model of Cultural Competence, identifies five interdependent constructs needed to develop cultural competence. 

Cultural encounters - The continuous process of interacting with patients from culturally diverse backgrounds in order to validate, refine or modify existing values, beliefs, and practices about a cultural group and to develop cultural desire, cultural awareness, cultural skill, and cultural knowledge.

Cultural desire - The motivation of the healthcare professional to "want to" engage in the process of becoming culturally competent; not the "have to."

Cultural awareness - The deliberate self-examination and in-depth exploration of one's biases, stereotypes, prejudices, assumptions and “isms” that one holds about individuals and groups who are different from them.

Cultural knowledge - The process of seeking and obtaining a sound educational base about culturally and ethnically diverse groups.

Cultural skill - The ability to collect culturally relevant data regarding the patient's presenting problem, as well as accurately performing a culturally-based physical assessment in a culturally sensitive manner.

Resources to guide and assess cultural competency