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

The Culture, Diversity and Equity Project: Literature Review
Appendix 6: Recommended Standards for the Content of Cultural Competence
Education
Attitudes:
• Similar to all aspects of health care professionals’ continuing education, cultural competence education
should be a continuous learning process as well. Cultural competence education for health care
professionals should foster a lifelong commitment to learning and self-evaluation through an ability to
recognize and question their own assumptions, biases, stereotypes and responses.
• Health care professionals should be encouraged to adopt attitudes of open-mindedness and respect for all
patients including those who differ from them socially or culturally.
• Health care practitioners should be taught techniques that promote patient- and family-centered care, along
with the understanding that effective therapeutic alliances may be construed differently across patients and
cultures.
• As they learn about health care disparities and inequities and the factors that lead to unequal treatment, health
care professionals should be encouraged to undertake a commitment to equal quality care for all and
fairness in the health care setting.
• To actively serve this commitment, educators can teach students ways to identify systemic or
organizational barriers to access and use of services by their patients and encourage them to be
proactive within their practice environments to eliminate these barriers.
Knowledge:
• Self-awareness and self-knowledge are the first types of knowledge cross- cultural training would seek
to establish. This involves bringing to the learner’s awareness internalized beliefs, values, norms,
stereotypes and biases. They should be made aware of how ethnocentrism, that is, the belief that one’s own
culture is superior to others, operates in all cultures and encouraged to be attentive to the possibility of
ethnocentrism in their own thinking. They should be made aware of how ethnocentrism may influence
their own interaction with patients.
• Essential to their understanding of both themselves and their patients is an understanding of the concept of
culture. The theory of culture makes clear the connections between worldview, beliefs, norms and
behaviors related to health, illness and care-seeking in different populations. In this regard, practitioners
can be taught to explore how their own cultures, including the cultures of biomedicine, inform their
perceptions and behaviors. All people operate within multiple cultures.
• Information about local and national demographics would be part of a health professional’s cultural competence
education. This should include attention to specific populations, immigration and changing demographics,
such as alterations in age or occupational distributions. Students/trainees should be encouraged to
draw implications from this information for their current and future professional practices. Organizations
should have a process in place to reassess relevant demographics on a consistent basis.
• Practitioners need to know the legal, regulatory and accreditation issues which address cultural and
linguistic issues in health care. These would include such things as the position of the federal
Department of Health and Human Services (DHHS) on civil rights and language access, federal and state
cultural competence contract requirements for publicly funded health care and state legislation around
the provision of language services and culturally sensitive health care. The DHHS Recommended Standards for
Culturally and Linguistically Appropriate Health Care Services should be reviewed.
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