A Practice Beyond Cultural Humility

Grauf-Grounds, Claudia; Sellers, Tina Schermer; Edwards, Scott A.; Cheon, Hee-Sun; MacDonald, Don; Whitney, Shawn; Rivera, Peter M.

doi:10.4324/9780429340901

Cited by 4 publications

(4 citation statements)

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“…2,3 Such interactions raise the risk of reproducing the power discrepancy between providers that embody medical expertise and authority and patients that embody lay expertise based on their actual lived experiences. 10 The risks and limitations of the cultural competence approach to providing services are also supported by the peer-reviewed literature on the effectiveness of cultural competence trainings and programs. We examined published reports within the past 2 decades, since government entities began mandating trainings in cultural competence in the early 2000s.…”

Section: Health Services Insightsmentioning

confidence: 98%

“…3 Given the shortcomings of cultural competence trainings, like others, we recommend trainings that foster providers' cultural humility. 2,4,10 Cultural humility refers to an orientation towards caring for one's patients that is based on: self-reflexivity and assessment, appreciation of patents' expertise on the social and cultural context of their lives, openness to establishing power-balanced relationships with patients, and a lifelong dedication to learning. [2][3][4]10,15 Cultural humility means admitting that one does not know and is willing to learn from patients about their experiences, while being aware of one's own embeddedness in culture(s).…”

Section: Health Services Insightsmentioning

confidence: 99%

“…[15][16][17] Therefore, cultural humility trainings are process-oriented and aim to enhance providers' capabilities to deliver patientcentered care, while cultural competence trainings are contentoriented and aim to increase providers' knowledge, confidence and self-efficacy in communicating with and treating diverse patients. 10 The suggestion to focus on fostering provider awareness, openness and humility through the recognition of their own bias, privilege and the limits of their knowledge and expertise was suggested in a seminal article by Tervalon and Murray-García in 1998. 4 Yet, only recently, have researchers and practitioners began to advocate for humility trainings, and most of this work is theoretical.…”

Section: Health Services Insightsmentioning

confidence: 99%

mentioning

confidence: 99%

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Rethinking Cultural Competence: Shifting to Cultural Humility

Lekas

Pahl

Lewis

2020

Health�Serv�Insights

150

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Healthcare and social services providers are deemed culturally competent when they offer culturally appropriate care to the populations they serve. While a review of the literature highlights the limited effectiveness of cultural competence training, its value remains largely unchallenged and it is institutionally mandated as a means of decreasing health disparities and improving quality of care. A plethora of trainings are designed to expose providers to different cultures and expand their understanding of the beliefs, values and behavior thus, achieving competence. Although this intention is commendable, training providers in becoming competent in various cultures presents the risk of stereotyping, stigmatizing, and othering patients and can foster implicit racist attitudes and behaviors. Further, by disregarding intersectionality, cultural competence trainings tend to undermine provider recognition that patients inhabit multiple social statuses that potentially shape their beliefs, values and behavior. To address these risks, we propose training providers in cultural humility, that is, an orientation to care that is based on self-reflexivity, appreciation of patients’ lay expertise, openness to sharing power with patients, and to continue learning from one’s patients. We also briefly discuss our own cultural humility training. Training providers in cultural humility and abandoning the term cultural competence is a long-awaited paradigm shift that must be advanced.

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Section: Health Services Insightsmentioning

confidence: 98%