CDE Appendix 1 Literature Review - Central East Local Health ...

The Culture, Diversity and Equity Project: Literature Review
(CE, 2003). The (2003) Report opens up with the following twelve ‘Guiding Principles’ for cultural competence
education and training of health care professionals (in no particular order):
1. The goals of cultural competence training should be: 1) increased self- awareness and receptivity to diverse
patient populations on the part of health care professionals; 2) clinical excellence and strong therapeutic
alliances with patients; and 3) reduction of health care disparities through improved quality and costeffective
care for all populations.
2. In all trainings, there should be a broad and inclusive definition of cultural and population diversity
including consideration of race, ethnicity, class, age, gender, sexual orientation, disability, language,
religion and other indices of difference.
3. Training efforts should be developmental, in terms of the institution and the individual. Institutions may start
out simply in their inclusion of cultural competency training as a specific area of study but are
expected to build in more complex, integrated and in-depth attention to cultural issues in later stages of
professional education. Trainees should be expected to become progressively more sophisticated in
understanding the complexities of diversity and culture as they relate to patient populations and health
care. Both instructional programs and student learning should be regularly evaluated in order to provide
feedback to the on-going development of educational programs.
4. Cultural competence training is best organized around enhancing providers’ attitudes, knowledge and skills, and
attention to the interaction of these three factors is important at every level of the training. It is important to
recognize the extensive pre-existing knowledge and skill base of health care professionals, and to seek to
promote cultural competence within this context.
5. While factual information is important, educators should focus on process-oriented tools and concepts
that will serve the practitioner well in communicating and developing therapeutic alliances with all types of
patients.
6. Cultural competence training is best integrated into numerous courses, symposia and experiential,
clinical, evaluation and practicum activities as they occur throughout an educational curriculum. Attention
may need to be directed to faculty, staff and administrative development in cultural competence in order to
effect this integration.
7. Following on the above, cultural competence education should be institutionalized within a school
or health care organization so that when curriculum or training is planned or changed, appropriate
cultural competence issues can be included.
8. Cultural competence education is best achieved within an interdisciplinary framework and context, drawing
upon the numerous fields that contribute to skill and knowledge in the field.
9. Education and training should be respectful of the needs, the practice contexts and the levels of
receptivity of the learners.
10. Education in cultural competence should be congruent with, and, where possible, framed in the context of
existing policy and educational guidelines of professional accreditation and practice organizations, such
as the Accreditation Council on Graduate Medical Education, the Liaison Committee on
Medical Education, the American Academy of Nursing, the National Association of Social Workers,
the Society for Public Health Education and the Academies and Colleges of Family Practice,
Paediatrics, Emergency Medicine and Obstetrics and Gynaecology.
11. Wherever possible, diverse patients, community representatives, consumers and advocates should participate
as resources in the design, implementation and evaluation of cultural competence curricula.
12. Finally, cultural competence education should take place in a safe, non- judgmental, supportive
environment. While the Principles and Recommended Standards are focused on the education and training
of health care professionals, the schools and organizations in which they study and work must be
settings that are conducive to functioning in a culturally competent way and visibly support the goals of
culturally competent care.
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