A Practice Beyond Cultural Humility

Rethinking Cultural Competence: Shifting to Cultural Humility

“…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.…”

“…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).…”

“…[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.…”

“…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…”