HOW CAN CULTURAL COMPETENCE BE ASSESSED? BY MEL STEWART

1
HOW CAN CULTURAL COMPETENCE BE ASSESSED?BY MEL
STEWART
The University Of Birmingham
2
Objectives

• To
• Investigate the notion of cultural competence
• Examine ways which attempt to measure cultural
  competence
• Share the experiences of undergraduates engaged
  in the self-assessment of cultural competence
• Discuss institutional approaches in managing
  cultural competence

3
What is Cultural Competence?

• Cultural Sensitivity
• Cultural diversity
• Political correctness

4
Common Definitions

• 'a set of congruent behaviours, attitudes and
  policies that come together in a system agency or
  among professionals that enables effective work
  in cross-cultural situations.' (HHSOMH 2000).
• Chandra (1996) in 'Facing up to Difference - A
  toolkit for creating culturally
• competent health services for black and minority
  communities'
• denote services perceived by black and minority
  ethnic users as being in harmony with their
  cultural and religious beliefs and not just
  provided by people who are, or assumed to be
  culturally sensitive.

5
Elements of Cultural Competence
6
National Center for Cultural Competence -
Georgetown University

• have a defined set of values and principles, and
  demonstrate behaviors, attitudes, policies and
  structures that enable them to work effectively
  cross-culturally.
• have the capacity to (1) value diversity, (2)
  conduct self-assessment, (3) manage the dynamics
  of difference, (4) acquire and institutionalize
  cultural knowledge and (5) adapt to diversity and
  the cultural contexts of the communities they
  serve.
• incorporate the above in all aspects of policy
  making, administration, practice, service
  delivery and involve systematically consumers,
  key stakeholders and communities.

7
Method

• The study employed a repertory grid approach
• The repertory grid is a formal way of
  demonstrating the mathematical relationship
  between specific constructs (these are normally
  given as adjectives), and elements the people
  construing them.

8
Repertory Grid of Cultural Competence
9
Repertory Grid Clinical Competence
10
Characteristics of a Clinically Competent
Practitioner

• Experienced (11)
• Good Communication skills (11)
• Knowledgeable (10)
• Caring (10)
• Professional (9)
• Enthusiastic (8)
• Confident (7)
• Approachable (6)
• Other characteristics (11)

11
Other Characteristics

• Good patient-relation skills
• E.g. polite
• Making person feel valued
• Committed
• Efficient
• Works well in a team
• etc

12
Characteristics of a Culturally Competent
Practitioner

• Relating to others (n9)
• Open (n8)
• Acceptance (n5)
• Understanding (n5)
• Knowledge (n5)
• Not judgemental (n4)
• Equality (n5)
• Individuality (n3)
• Communication (n3)
• Respect (n3)
• Other

13
Other

• Not self-righteous
• Encouraging
• Tolerant
• Culturally aware
• Not ageist
• Not sexist
• Not aggressive
• Unbiased
• etc

14
Suggestions for increasing cultural competence

• increasing the numbers of underrepresented
  minorities in the health professions and health
  care leadership
• understanding and managing socio-culturally based
  variations in health beliefs, values, and
  behaviours
• Enhance professional education in cultural
  diversity interaction
• Efforts should be made to know about, an avoid
  behaviours that might be offensive, impractical
  or irrelevant
• Updating education in cultural diversity

15
Factors contributing to the Development of
Cultural Competence in Undergraduate Health Care
Curricula

• Awareness and acceptance of the wide range of
  cultural diversity (in developing systems of
  care)
• The acquisition of knowledge of cultural
  differences and similarities and knowledge of
  clients culture
• Knowledge of ones own cultural values and
  identity
• Ability to communicate effectively across
  cultural groups
• Utilisation of knowledge to adapt services and
  skills
• The development of a lifelong learning and
  reflection that includes the examination of
  attitudes and values of cultural groups (Stewart
  2002)

16
Discussion

• Institutional approaches in developing and
  managing cultural competence

17
References

• Chandra, J (1996). Facing up to Difference. A
  Toolkit for creating culturally competent health
  services for black and minority ethnic
  communities. Kings Fund, London.
• U.S. Department of Health and Human Services,
  Office of Minority Health, Resources for Cross
  Cultural Health Care. (2000). Assuring Cultural
  Competence in Health Care Recommendations for
  National Standards and an Outcomes-Focused
  Research Agenda.
• Joseph R. Betancourt, Alexander R. Green, J.
  Emilio Carrillo and Owusu Ananeh-Firempong
  (2003) Defining cultural competence a practical
  framework for addressing racial/ethnic
  disparities in health and health care Public
  Health Reports, Volume 118, Issue 4, Pages
  293-302
• Niemeir JP, Burnett DM, Whitaker DA (2003)
  Cultural Competence in a the Multidisciplinary
  rehabilitation Setting Are we falling short in
  meeting needs? Archivives of Physical and Medical
  Rehabilitation Vol84,Pages 1241-1245
• Stewart M (2002) The Development of Cultural
  Competence in Health Care Undergraduates
  Physiotherapy Vol. 88, No. 10. p 620-29
• http//www3.georgetown.edu/research/gucchd/nccc/fr
  amework.htmllc