Cultural Competence and Humility in Healthcare

Cultural competence and humility in healthcare

Currently, more than 40 million people living in the U.S. were born in another country. This figure represents one-fifth of the world’s immigrants. Nearly every country in the world is represented among U.S. immigrants. 

To provide high-quality care to patients from these diverse backgrounds, all healthcare professionals need to understand the principles of cultural competence and sensitivity in healthcare.  

Cultural humility references the ability to recognize the cultural differences of the patients, which can include their beliefs, values, and behaviors. Conversely, cultural competency refers to the quantifiable set of attitudes that allow healthcare professionals to work effectively within the cultural context of each patient.   

Recommended course: Cultural Competency in Healthcare: A Contemporary Perspective 

Cultural humility and cultural competence 

Cultural humility involves entering into a professional relationship with a patient by honoring the patient’s beliefs, customs, and values. It focuses on lifelong nurturing of self-reflection and self-critique, promotion of interpersonal sensitivity, addressing power imbalances, and promoting the appreciation of intercultural variation and individuality. This humility exemplifies respect for human dignity. 

An important part of cultural humility is identifying one’s own biases, self-understanding, and interpersonal sensitivity. Healthcare professionals seeking to develop humility should nurture an appreciation for the many facets of each patient, including their culture, gender, race, ethnicity, religion, sexual identity, and lifestyle. 

Cultural competency, on the other hand, is a skill that can be taught, trained, and achieved. It is a prerequisite to cultural humility, and it ends with the termination of the provider-patient relationship. On the other hand, cultural humility is an ongoing process, requiring continual self-reflection and self-critique. 

Self-reflection and self-critique 

Self-reflection and self-critique are lifelong processes that allow healthcare professionals to continually refine their understanding of themselves and their actions and reactions. It broadens and deepens their cultural understanding through introspection. 

Self-reflection means paying attention to one’s own thoughts, emotions, decisions, and behaviors. It is important for healthcare professionals to be able to self-reflect in real time as they deal with the variety of situations encountered in an ever-changing healthcare environment 

In some cases, healthcare professionals may attempt to take the emphasis off race, class, gender, and other areas of difference by denying the effect these aspects of diversity have on patients (e.g., “The only race I know is the human race”). While it may stem from good intentions, this attitude negates the experience the patients may have in the larger society, where they experience various degrees of marginalization based on their intersecting identities. 

Language and traditions 

Healthcare professionals must also be careful not to make sweeping generalizations regarding the characteristics or needs of any population. Patients are influenced by a variety of factors including level of acculturation, immigration experience, experiences with discrimination, and ability to speak English. Therefore, it is imperative for healthcare professionals to ask patients about their personal experiences and important events in their lives. 

For example, different cultures have different beliefs about the causes of illness, the role the healthcare providers, and the types of treatment methods. In some cultures, a traditional healer plays a significant role in patient care. In other cultures, patients rely on herbal remedies over Western medicine, while some patients prefer Western medicine over other options. Healthcare providers should understand their patient’s preferences to provide the optimal level of care.  

Along with cultural beliefs, language can also present a challenge to care. In cases where there is no shared language, interpreters may help minimize confusion and misunderstandings. While in-person interpreters have the additional benefit of translating nonverbal and body language, virtual interpreters are available 24/7. 

Assessment tools and treatment 

Healthcare professionals who practice cultural humility also recognize that assessment tools and treatment protocols may not be appropriate for all patients. Historically, many therapeutic strategies employed in patient care were developed without empirically supported research with ethnic minorities.  

However, healthcare professionals should not rely solely on manualized treatment protocols to guide their interventions. Such an approach might fail to appreciate patients’ unique experiences and the effect of differing social environments. Rather, healthcare professionals should adapt their treatment approach in accordance with the patients’ values, experiences, and preferences. They should also strive to understand the influence of the broader societal context.  

Facilitating a respectful partnership allows patients to take the lead in narrating their experiences. They can help identify personal treatment goals while healthcare professionals create an environment that appreciates patients’ perspectives. 

Culturally competent organizations 

Cultural competence and humility extend beyond just individual healthcare practitioners. It also impacts organizational practices and policies. Organizations must be committed to providing culturally sensitive care and promoting diversity within their staff.  

This might include offering cultural competency training to the staff. It may mean hiring staff from a diverse range of backgrounds and cultures. The policies and practices must also be in place to provide the best level of care to the patients.