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For the purposes
of Health Professions Diversity grants, cultural
competence is defined simply as the level of knowledge-based
skills required to provide effective clinical care to patients from
a particular ethnic or racial group.
Others definitions
focus on the health care delivery system or the individual health
care provider. A few focus on health professions schools,
and even fewer address undergraduate institutions and students in
the education pipeline.
No single definition
of cultural competence is yet universally accepted, either in practice
or in health professions education. Most have a common element,
which requires the adjustment or recognition of one’s own culture
in order to understand the culture of a patient. Neither is
there consensus about how best to provide the necessary knowledge,
skills, experience, and attitudes to effectively serve diverse populations.
Some individuals even doubt the legitimacy of teaching cultural
competence at all.
To advance
the discussion of cultural competence and its meaning, the BHPr
Division of Health Professions Diversity has compiled a representation
of definitions of cultural competence.
From the
President’s
Initiative on Race and Health Town Hall Meeting
July 10, 1998: Cultural competence is the ability to deliver
effective medical care to people from different cultures.
By understanding, valuing and incorporating the cultural differences
of America’s diverse population and examining one’s own health-related
values and beliefs, health providers deliver more effective and
cost-efficient care.
U.S. Department
of Health and Human Services workgroups say:
Cultural competence comprises behaviors, attitudes, and policies
that can come together on a continuum: that will ensure that a system,
agency, program, or individual can function effectively and appropriately
in diverse cultural interaction and settings. It ensures
an understanding, appreciation, and respect of cultural differences
and similarities within, among and between groups. Cultural
competency is a goal that a system, agency, program or individual
continually aspires to achieve.
Health Resources
and Services Administration Bureau of Health Professions Division
of Nursing:
Cultural competence is a set of academic and interpersonal skills
that allow an individual to increase their understanding and appreciation
of cultural differences and similarities within, among and between
groups. This requires a willingness and ability to draw on
community-based values, traditions, and customs and to work with
knowledgeable persons of both and from the community in developing
targeted interventions, communications, and other supports.
Health Resources
and Services Administration Bureau of Primary Health Care:
Cultural competence is a set of attitudes, skills, behaviors, and
policies that enable organizations and staff to work effectively
in cross-cultural situations. It reflects the ability to acquire
and use knowledge of the health-related beliefs, attitudes, practices
and communication patterns of clients and their families to improve
services, strengthen programs, increase community participation,
and close the gaps in health status among diverse population groups.
Cultural competence also focuses its attention on population-specific
issues including health-related beliefs and cultural values (the
socioeconomic perspective), disease prevalence (the epidemiologic
perspective), and treatment efficacy (the outcome perspective).
Health Resources
and Services Administration Bureau of Primary Health Care Office
of Women and Minority Health:
Cultural and linguistic competence is a set of congruent behaviors,
attitudes and policies that come together in a system, agency or
among professionals that enables effective work in cross-cultural
situations. "Culture" refers to integrated patterns
of human behavior that include the language, thoughts, communications,
actions, customs, beliefs, values, and institutions of racial, ethnic,
religious or social groups. "Competence" implies
having the capacity to function effectively as an individual and
an organization within the context of the cultural beliefs, behaviors
and needs presented by consumers and their communities.
Substance
Abuse and Mental Health Services Administration Center for Mental
Health Services:
Cultural Competence includes: Attaining the knowledge, skills, and
attitudes to enable administrators and practitioners within system
of care to provide effective care for diverse populations, i.e.,
to work within the person’s values and reality conditions.
Recovery and rehabilitation are more likely to occur where managed
care systems, services, and providers have and utilize knowledge
and skills that are culturally competent and compatible with the
backgrounds of consumers from the four underserved/underrepresented
racial/ethnic groups, their families, and communities.
Cultural competence acknowledges and incorporates variance in normative
acceptable behaviors, beliefs and values in determining an individual’s
mental wellness/illness, and incorporating those variables into
assessment and treatment.
National
Center of Cultural Competence:
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 cross-cultural situations. (Cross, T., Bazron, B.,
Dennis, K., & Isaacs (1989). Towards A Culturally Competent
System of Care Volume 1. Washington, DC: Georgetown University
Child Development Center, CASSP Technical Assistance Center).
American
Medical Association:
Any group of people who share experiences, language, and values
that permit them to communicate knowledge not shared by those outside
the culture. Culturally competent physicians are able to provide
patient-centered care by adjusting their attitudes and behaviors
to account for the impact of emotional, cultural, social and psychological
issues on the main biomedical ailment. Cultural Competence Compendium,
1999.
American
Medical Association:
The knowledge and interpersonal skills that allow providers to understand,
appreciate, and work with individuals from cultures other than their
own. It involves an awareness and acceptance of cultural differences;
self-awareness; knowledge of patient’s culture; and adaptation of
skills.
Culturally Competent Health Care for Adolescents, 1994.
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