Featured in the Summer 2024 print edition of spectRUm magazine.
In today’s diverse world, healthcare providers are faced with numerous challenges that require them to be not only clinically proficient but also culturally competent. Cultural competency in healthcare refers to the ability of providers to effectively deliver services that meet the social, cultural, and linguistic needs of patients. It involves understanding and respecting the cultural beliefs, values, practices, and needs of patients, which can significantly impact health outcomes.
Understanding Cultural Competency
The National Center for Cultural Competence (NCCC) defines cultural competence as “the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes.” Cultural competency goes beyond simple awareness of cultural differences. It requires healthcare providers to possess knowledge about different cultures, adapt their practices to meet the needs of diverse populations and maintain a respectful attitude towards patients from different backgrounds. This approach is essential because cultural factors can influence health behaviors, treatment preferences, and communication styles.
Cultural competency is crucial for achieving successful healthcare outcomes. To truly embed this vital skill, it is necessary to integrate it into the curriculum and learning environment of healthcare education nationwide. This approach ensures that our healthcare professionals graduate with a comprehensive understanding of how to effectively incorporate cultural competency into their practice, having been both taught the principles and experienced cultural competency firsthand.
“As colleges and universities are being targeted for their DEI efforts it is more important now than ever to educate and ensure we are producing health professionals that can address the healthcare needs of diverse communities,” explains Cheryl Brewster, EdD, MA, Roseman University College of Medicine Executive Dean for Equity, Inclusion, and Belonging.
Cultural Competency at Roseman University
Roseman University believes that many of the greatest ideas and discoveries come from a diverse mix of minds, backgrounds, and experiences, and the University is committed to cultivating an inclusive and equitable work and learning environment. Roseman University’s focus is intentional and designed to build a sense of true belonging, creating a place where there is mutual appreciation for our unique backgrounds. The University supports cultural competency through various approaches.
Roseman Student Organizations
Roseman University’s vibrant campus culture allows students, faculty and staff to learn and work in an atmosphere where they can grow both professionally and personally. Students have the opportunity to become active members and leaders of dozens of student organizations, allowing them to meet and foster lifelong colleagues through collaborative learning, community service and advocacy. Roseman’s clubs allow students to discover new passions, meet other students with similar backgrounds and interests, and to expand their perspectives and cultural literacy.
Faculty Diversity
As student populations more accurately reflect the populations that we serve and become more diverse, diversity among faculty and staff is also of vital importance. Faculty, Administration, and Staff of Roseman University are broadly diverse with almost 40 percent of total employees belonging to historically underrepresented groups.
Building Diverse Pipelines
Roseman’s pipeline efforts, including its ASPIRE program, are building critical pathways to enable, inspire, and educate the next generation of healthcare providers by connecting with diverse and underrepresented middle and high school students, to increase the diversity of the healthcare workforce by exposing these students to learning opportunities and support. Roseman’s College of Pharmacy and CVS Health have a one-of-a-kind partnership to increase the number of Hispanic/Latino and/or Spanish-speaking pharmacists to meet the needs of the communities Roseman students serve. The CVS Health Spanish Pathway Program (SPP) provides a unique opportunity for Hispanic/Latino and/or Spanish-speaking high school and undergraduate students to learn about pharmacy career pathways and establish a pipeline of Spanish-speaking students to enter the field of pharmacy with a desire to serve the Hispanic/ Latino community.
Medical Missions
Critical to learning and developing cultural competency is working within diverse communities of need locally, regionally, and globally. Roseman students embark on numerous medical missions around the world, serving at-risk populations in need of primary care. These missions offer students an unparalleled global view of public health issues, alternative healthcare systems, and insight and experience with diverse populations that build empathy, compassion, and cultural competencies.
Serving at Home
Roseman students also are provided numerous opportunities to serve their local communities through events, service, and donation of care to underserved populations. These experiences provide valuable insight to faculty and students alike on the importance of understanding diversity, cultural sensitivity, and varying socioeconomic differences when providing sensitive, culturally competent healthcare.
Diversity, Equity & Inclusion Advisory Council
Roseman University’s Diversity, Equity & Inclusion Advisory Council was created to develop university-wide initiatives that focus on matters related to diversity, equity, and inclusion. This committee, in addition to many other responsibilities, helps promote and maintain a welcoming and respectful community atmosphere at Roseman that visibly encourages understanding and integrity. It also assists in designing university-wide programs, events, and initiatives to increase awareness, inspire action, and support a culture of diversity within the Roseman Community.
According to Gretchen Keys, EdD, MS, Roseman University College of Medicine Assistant Dean for Faculty and Staff Equity, at Roseman University, “At Roseman University we prioritize equity and patient-centered care. Our curriculum, experiential learning, and community engagement ensure students appreciate diverse backgrounds. This approach leads to improved health outcomes and greater equity in healthcare delivery.”
The Impact of Cultural Competency on Patient Care
Cultural competency has a deep impact on patient care. One of the key benefits is improved patient-provider communication. Effective communication is essential for building trust, understanding patient needs and preferences, and ensuring that patients are informed and empowered to make decisions about their health. According to the Agency for Healthcare Research and Quality (AHRQ), “Cultural competence is essential for effective shared decision-making [between the patient and provider].” When healthcare providers understand the cultural context of their patients, they can communicate more effectively, leading to a better understanding of diagnoses, treatment options, and adherence to medical recommendations.
In addition to better patient-provider relationships, cultural competency can lead to better health outcomes. Patients are more likely to trust and follow the advice of providers who understand their cultural backgrounds and respect their values. This can result in improved treatment adherence, better management of chronic conditions, and ultimately, better health outcomes and reduced healthcare costs.
When applying cultural competency into patient care the AHRQ states that it is important to “keep in mind that culture is not homogenous. There is great diversity among individuals—even in the smallest cultural group. Remember, culture changes over time, especially when one cultural group is exposed to and influenced by another culture.”
Challenges to Cultural Competency
Despite its importance, achieving cultural competency in healthcare can be challenging. Language barriers, for example, can hinder effective communication between providers and patients from different linguistic backgrounds. Additionally, cultural differences in health beliefs and practices can lead to misunderstandings and conflicts in the healthcare setting. For these reasons, it is not only important to understand others’ lived experiences, but to also recognize our own limitations when working with people from different backgrounds and cultures. According to The Joint Commission, “Implicit (subconscious) bias refers to the attitudes or stereotypes that affect our understanding, actions and decisions in an unconscious manner. These biases, which encompass both favorable and unfavorable assessments, are activated involuntarily and without an individual’s awareness or intentional control.” Based on a study done in 1995 by Anthony Greenwald and M.R. Benaji, the concept of unconscious bias suggests that “much of our social behavior is driven by learned stereotypes that operate automatically – and therefore unconsciously – when we interact with other people.” The Joint Commission also states that “what makes implicit bias frightening in . . . healthcare is that the results [are] unthinking discrimination of which caregivers are not aware.” It is important to be aware of these challenges associated with cultural competency because as Martin Luther King Jr. stated at the National Convention of the Medical Committee for Human Rights in 1966, “Of all forms of inequity, injustice in healthcare is the most shocking and inhuman.”
Cultural competency is a critical component of effective healthcare delivery. Healthcare providers need to understand and respect the cultural beliefs, values, and practices of their patients to ensure that they receive the highest quality of care possible. By enhancing their cultural competency, starting with their healthcare education experience, healthcare providers can improve patient outcomes, reduce disparities, and ultimately, create a more inclusive and equitable healthcare system for all.
STRATEGIES FOR ENHANCING CULTURAL COMPETENCY
To address these challenges, healthcare providers can adopt several strategies to enhance their cultural competency. The AHRQ suggests several strategies:
- Learn how to interact with diverse patients by keeping an open mind.
- Ask patients about their beliefs regarding their health condition.
- Participate in cultural competence training.
- Be aware of your own culture and how that may affect how you communicate with patients.
- Reach out to cultural brokers to help you learn more about the differences and similarities between cultures.
- Know what you don’t know, meaning don’t be afraid to let your patient know that you are unfamiliar with their culture.
- Provide culturally appropriate decision aids.
- Provide qualified medical interpreters.
- Work to build trust.