Cultural Humility in Healthcare ________________________________________________________________
SELF-REFLECTION AND SELF-CRITIQUE Self-reflection and self-critique are ongoing, lifelong processes that allow healthcare professionals to continually refine their understanding of themselves and their actions and reactions within counseling contexts and to continually broaden and deepen their cultural understanding through introspection (Salahshurian and Moore, 2024). Through ongoing self- reflection and critique, the healthcare professional develops a better understanding of the dynamics within and outside the healthcare arena and of the ways these dynamics affect the patient’s life, the healthcare professional’s life, and the interac- tions between healthcare professional and patient. Self-reflection is defined as deliberately paying attention to one’s own thoughts, emotions, decisions, and behaviors. It is important for healthcare professionals to be able to self- reflect in “real time” as they deal with the variety of situations encountered in an ever-changing healthcare environment (Gupta, 2023). Self-critique is the process of critically examining oneself to continually refine their understanding of themselves and their actions and reactions and to continually broaden and deepen their cultural understanding through introspection. Self-reflection and self-critique are best incorporated into practice on a reflexive basis. That is, the ongoing process of self- reflection should result in an automatic process or reflection as an integral part of practice. (Salahshurian and Moore, 2024). RESPECTFUL PARTNERSHIPS Developing respectful partnerships is key to providing health- care services with cultural humility and, more generally, to developing a relationship within the counseling setting that allows work to begin and to continue in a productive fashion. Respectful partnerships include discussing and addressing such difficult topics and issues as race, socioeconomic class, gender, sexual identity, and disability. These discussions are uncomfortable for many; they bring up feelings, often passion- ate, associated with “isms,” group identification, prejudice, quotas, and affirmative action. Yet these differences between healthcare professional and patient are a presence in the room and, when ignored, have the potential to interfere with an honest and open exchange (Minarik, 2017). Healthcare professionals often attempt to take the emphasis off race, class, gender, and other areas of difference by deny- ing the effect these aspects of diversity have on patients (e.g., “The only race I know is the human race”), or by trying to show that they understand the patient’s experience because they, too, are a member of an oppressed group. For example, the African American patient may not feel that the healthcare professional, as a bisexual Jewish woman, understands subtle racial insults from personal experiences. Some healthcare professionals imply that because they personally do not dis- criminate against oppressed groups, no personal or societal problems exist associated with race, class, LGBTQ status, or
disability; this attitude negates the experience the patients may have in the larger society, where they experience various degrees of marginalization based on their intersecting identi- ties (Minarik, 2017). Respectful partnerships are developed when the healthcare professional facilitates a dialogue that illustrates an under- standing of and attends to the complex dynamics related to privilege, oppression, and marginalization present within the patient/healthcare professional relationship and embedded within the larger society. The healthcare professional levels the playing field by conveying a respect for the patient and the patient’s lived reality while inviting the patient to enter an equal partnership with the healthcare professional. Healthcare Professional Consideration The development of respectful partnerships is ongoing and acknowledges that the healthcare professional does not know what the patient’s identity, life, or struggles look like but is eager to learn from the patient. Further, healthcare professionals who are developing respectful partnerships recognize that they may make mistakes and are open to patient feedback regarding those mistakes. Self-Assessment Question 7. All the following statements concerning self- reflection, self-critique, and respectful partnerships are true EXCEPT: A) Discussing and addressing topics and issues such as race and sexual identify may be uncomfortable for many people. B) Healthcare professionals seldom attempt to take emphasis off race, gender, and other areas of differences. C) Self-reflection and self-critique are ongoing, lifelong processes. D) Self-reflection should result in an automatic process as an integral part of practice. LIFELONG LEARNING The commitment to lifelong learning within the ethical standards requires healthcare professionals to participate in activities that keep them current on issues and interventions within healthcare and that allow them to provide patients with the most appropriate care and service. Lifelong learning in the context of cultural humility emphasizes the importance of current issues inclusive of a multicultural perspective that encompass aspects of critical self-reflection and advocacy involving continued growth and learning. According to Brown and colleagues (2021), “Cultural humility considers the fluid- ity and subjectivity of culture and challenges both individuals and institutions to address inequalities.
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