This refers to attempts (often well-intentioned) to be unbiased by ignoring the fact of a person’s race. Personal reflection is a valuable tool for physicians to critically examine their own ethnocentric views and behaviours.Ĭultural blindness. You may be tempted to say “So, why are you consulting me, then?” Ethnocentrism is often unconscious and implicit in a person’s behaviour – perhaps you had little interest in reading up on the herbal remedy.
For example, you may be trained in Western medicine, but your patient insists on taking a herbal remedy. The sense that one’s own beliefs, values, and ways of life are superior to, and more desirable than, those of others. Here are some biases that can arise:Įthnocentrism. Our culture influences the way we perceive virtually everything around us, often unconsciously. A culturally competent clinician is aware of the dynamics when cultures interact: “Culturally competent communication leaves our patients feeling that their concerns were understood, a trusting relationship was formed and, above all, that they were treated with respect.” 2 When a clinician is unfamiliar with a patient’s culture, a direct approach is often the best: ask the patient what you need to understand about her culture and background in order to be able to help her. Clinicians who are not aware of their own cultural biases may unconsciously impose their cultural values on other people (more detail in the Nerd’s Corner box “The cultural lens”). Awareness of one’s own culture is an important first step towards cultural competency. “As physicians, we must make multiple communication adjustments each day when interacting with our patients to provide care that is responsive to the diverse cultural backgrounds of patients in our highly multicultural nation.” 2 Culturally competent clinicians are self-aware and value diversity they acknowledge differences without feeling threatened by them.
Culturally safe practice implies the ability to keep these differing perspectives in mind whilst treating the patient as a person worthy of respect in his own right.Ĭultural competency in medical practice requires that the clinician respects and appreciates diversity in society. It implies that the care provider has reflected on her own identity and on the perceptions of her that others from different cultures may hold. “A culturally competent physician considers a patient’s cultural background when discussing and providing medical advice and treatment, and communicates effectively to enable patients to understand their treatment options.” 1Ĭultural safety goes a step beyond cultural competence (adapting to differences) to understanding that there exist inherent power imbalances and possible institutional discrimination that derive from historical relationships between people of different origins. Within the intermixing of modern society, many of us seek to retain a sense of cultural identity and may often refer to our cultural roots, for example using double-barrelled descriptions such as African-American or Ukrainian-Canadian.Ĭultural awareness refers to observing and being conscious of similarities and contrasts between cultural groups, and understanding the way in which culture may affect different people’s approach to health, illness, and healing.Ĭultural sensitivity is being aware of (and understanding) the characteristic values and perceptions of your own culture and the way in which this may shape your approach to patients from other cultures.Ĭultural competence refers to the attitudes, knowledge, and skills of practitioners necessary to become effective health care providers for patients from diverse backgrounds. In hunter-gathering and nomadic times, a person’s survival likely benefited from establishing strong bonds with an in-group of trusted clan-mates with whom one co-operated and shared, versus out-groups against which there was competition for scarce resources. Humans have a strong drive to maintain the sense of identity that comes from membership in an identifiable group. In Chapter 2 we defined culture in terms of the shared knowledge, beliefs, and values that characterize a social group. Cultural Awareness, Sensitivity, and Safety
Other patients in the unit and their families were finding this behaviour disrespectful of their need for tranquility. Five or six family members are in the room with Darryl and they often pray out loud together with him. During her rounds of the palliative care unit, the chief nurse said he was having problems with the family of one of the dying patients, Darryl Crow, who is a member of a local First Nations community. Middleton joined the practice six months ago, after her residency training. Rao is having lunch with the most recent recruit to the clinic.
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