Cultural competence: a conceptual framework for teaching and learning

Abstract

OBJECTIVES The need to address cultural and ethnic diversity issues in medical education as a means to improve the quality of care for all has been widely emphasised. Cultural competence has been suggested as an instrument with which to deal with diversity issues. However, the implementation of culturally competent curricula appears to be difficult. We believe the development of curricula would profit from a framework that provides a practical translation of abstract educational objectives and that is related to competencies underlying the medical curriculum in general. This paper proposes such a framework. METHODSThe framework illustrates the following cultural competencies: knowledge of epidemiology and the differential effects of treatment in various ethnic groups; awareness of how culture shapes individual behaviour and thinking; awareness of the social context in which specific ethnic groups live; awareness of one's own prejudices and tendency to stereotype; ability to transfer information in a way the patient can understand and to use external help (e.g. interpreters) when needed, and ability to adapt to new situations flexibly and creatively.DISCUSSION The framework indicates important aspects in taking care of an ethnically diverse patient population. It shows that there are more dimensions to delivering high-quality care than merely the cultural. Most cultural competencies emphasise a specific aspect of a generic competency that is of extra importance when dealing with patients from different ethnic groups. We hope our framework contributes to the further development of cultural competency in medical curricula.cultural and interprofessional diversity

Cultural Competency Training Requirements in Graduate Medical Education

“…[1][2][3][4][5] The consideration of cultural factors by health care professionals is referred to as ''cultural competence.'' [6][7][8][9][10] Although there currently is no standardized definition of cultural competence, the definition by Cross et al 10 is commonly cited: ''Cultural Competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in crosscultural situations.'' While the manner in which cultural training should best be provided varies in the literature, the need to acknowledge the potential impact of cultural factors is widely supported.…”

Using clinical vignettes to assess doctors’ and medical students’ ability to identify sociocultural factors affecting health and health care

“…A further limitation of our study is the fact that we only assessed respondents' knowledge of social and cultural factors affecting care. Knowledge of sociopolitical conditions in patients' countries of origin, the legal context of asylum in the host country, epidemiology and the manifestation of diseases in different countries and populations, effects of refugee status on health, and differential effects of treatment in various ethnic groups are also considered important for insuring clinical cultural competence (Seeleman et al 2009;Suurmond et al 2010). It remains to be seen whether clinical vignettes can be developed to assess these other areas of knowledge.…”

Cultural Competence in Action: “Lifting the Hood” on Four Case Studies in Medical Education

“…As we realized through our involvement in these projects, discourse and practice around cultural competence may be most developed in the US, but this is increasingly a global conversation involving clinicians, educators, and researchers in other world regions as well (Dogra et al 2010;Knipper et al 2010a, b;Seeleman et al 2009;van Wieringen et al 2001;Wachtler and Troein 2003). In this special issue, we therefore eschew the prevailing US focus of most literature on cultural competence by juxtaposing US examples with perspectives from Canada and Germany that elucidate (a) the particularity of the US context, (b) how cultural competence efforts are adapted to suit local needs in local contexts, and (c) the value of broadening the dialogue to consider how issues of culture, difference, and inequality are, and could be, taken up by health care providers and clinical educators in different countries and different settings.…”