Cultural Humility Versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education

Abstract

Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respectfully deliver health care to the increasingly diverse populations of the United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.

Developing the Cultural Awareness Skills of Behavior Analysts

“…One strategy to enhance cultural self-awareness is talking about our diverse client interactions with a professional community in group discussions, written forums, journals, mentorship meetings, verbal feedback sessions, or self-reflective exercises (Tervalon and Murray-Garcia 1998). Skinner (1974) emphasized the relationship between self-awareness and control over our own behavior,and proposed that talking about our behavior is how we achieve self-awareness.…”

Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians

“…(LO1) Identify the influences of structures on patient health (LO2) Identify the influences of structures on the clinical encounter (LO3) Generate strategies to respond to the influences of structures in the clinic (LO4) Generate strategies to respond to the influences of structures beyond the clinic (LO5) Describe structural humility as an approach to apply in and beyond the clinic Structural humility, 17 inspired by cultural humility, 18 encourages a self-reflective approach, working in collaboration with patients and communities to develop understanding of and responses to structural vulnerability. 11,[19][20][21] …”

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

“…Organizations should seek to hire and retain a diverse workforce and should ensure that all staff, regardless of demographics, are trained and given the resources to provide culturally sensitive services. 42 Both racial and ethnic minority patients [42][43][44]92,93 and…”