Cultural Competency Instructional Module

Cultural Competency Module

“It is much more important to know what sort of person has a disease, than what sort of disease a person has.”

Sir William Osler

A printable overview of this topic is available HERE

“A melting pot.” How often has this phrase been used to describe this Country and its population? But does the blending suggested by this phrase really exist? More specifically, do members of a given culture (those sharing an integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group) ‘melt’ into the healthcare system? Does medicine bridge cultural bounds and provide a standard of care to all patients? Unfortunately the answer to these questions is ‘no’, so how can we as healthcare providers address these issues and begin to effect a change? The initial step is awareness.

The objectives of this module are fourfold: (i) To generate a sense of awareness about cultural differences and cultural competency, (ii) To provide an approach to patients of differing cultures, (iii) To offer suggestions for making your practice more ‘culturally competent’, and (iv) To present questions that can generate a dialogue between you and your learner about cultural differences and cultural competency.

1. The LEARN Model - First described by Berlin and Fowkes, this approach can be used to identify, acknowledge, and negotiate some of the cultural differences that may exist between healthcare providers and their patients. The acronym stands for: Listen, Explain, Acknowledge, Recommend, and Negotiate.

a) Listen - Ask open-ended questions to develop an understanding of the patient’s thoughts and beliefs about their illness. Examples might be: “What do you think is causing this problem?” “What kinds of treatments do you think you should receive?”

b) Explain - Provide your interpretation of the medical condition.

c) Acknowledge - Acknowledge the patient’s beliefs about their condition and attempt to find areas of agreement between explanatory models.

d) Recommend - Recommend a care plan that involves both explanatory models.

e) Negotiate - Decide upon a care plan that is agreeable to both parties. Usually this represents an amalgamation of the two belief systems.

2. Techniques - The following are some cultural competency techniques you can apply to your practice:

a) Interpreters - Having individuals available to provide foreign language or American Sign Language services to your patients is an important and essential step. Providing patient handouts/information in a variety of foreign languages can augment this service.

b) Employment - Minority staff can be an invaluable asset to any practice. They can offer some insight into the culture to which they belong, assist in communication by providing interpreter services, and potentially create a more welcoming environment to members of their culture.

c) Training - Cultural competency/awareness programs are important tools for ‘bridging the gaps’ that exist between members of different cultures. Click HERE for information about cultural competency conferences offered by the University of Kentucky.

d) Traditional healers - The significant role that traditional healers take in the healthcare of many minority Americans should not be overlooked. Try to coordinate your care with these healers just as you would with any other provider. This practice can ensure continuity, avoid incompatible therapies, and potentially improve patient compliance with traditional health practices.

3. Questions - Asking questions is an effective way to generate a dialogue between you and your student about cultural differences and cultural competency. Here are some suggestions:

a) How would you define culture and ‘cultural competency’?

b) Has your definition of culture and cultural competency changed during your medical training? If so, how? Why?

c) Are there things we can do as healthcare providers to make our practices more ‘culturally competent’?

d) Can you think of some reasons why access to healthcare might be difficult for members of a different culture?

e) If members of a culture are defined as ‘sharing an integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group’, how many different cultures can you identify within this community? How might we better serve members of these different cultures?

f) Have you personally encountered any obstacles in providing care to members of a different culture? If so, what were they? Did you find a way to overcome these obstacles? If so, what did you do?

g) What do you think is the biggest obstacle for providing healthcare to members of a different culture? Can you think of possible solutions?

h) Have you taken a cultural competency workshop/training session? If so, what did you learn?

i) How did your upbringing affect the view you have of other cultures?

Cultural Competency Module

“It is much more important to know what sort of person has a disease, than what sort of disease a person has.”

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