● How, as healthcare professionals, do we address in- equalities? ● How am I extending my responsibility beyond individual patients? ● How am I advocating for policy and practice changes at institutional, community, state, and national levels? ● What institutional structures are in place that address inequalities? ● What training and professional development activities are offered at our institution or in our community that address inequalities? ● How can we engage our community to make sure its voice is heard in this work? (Adapted and updated from Fisher-Borne et al., 2015, p. 176) These types of questions can provide a starting point for healthcare professionals to address social injustices. Healthcare professionals can use their positions to advocate for changes in society to promote social justice. Working toward social justice, patients are empowered and can help create an environment in which equal rights, treatment, and opportunity are available to all. Self-Assessment Quiz Question #10 The factors that are common to all definitions of social justice include: a. White identity. b. Equal opportunity. c. Equal incomes. d. Diversity in all groups. DIFFERENCES BETWEEN MULTICULTURAL COMPETENCY AND CULTURAL HUMILITY
Cultural humility is a conceptual framework that was first developed and utilized in the field of medicine and nursing in the 1990s. Since that time, it has become more widely applied to all helping professions. The framework is intended to address some of the shortcomings within the cultural competency and multicultural counseling frameworks. The approach of cultural humility differs from the multicultural competency approach in that it recognizes that knowledge of different cultural backgrounds is not sufficient to develop an effective patient/healthcare professional relationship with each individual. The cultural competency and multicultural counseling frameworks are most often criticized for creating a model that serves to “other” ethnic, racial, and various minority groups (Carten, 2016, p. xlii) while not acknowledging “Whiteness” as an identity and as a culture. “Othering” is the term used for the “biased assumptions about populations viewed as ‘the other’ at various times in the country’s history” as well as in the present (Carten, 2016, p. xlii).
Othering assumes that various oppressed and marginalized populations are different from the American “norm,” commonly understood as a White, middle class, able- bodied, straight, male, and individually responsible for any difficulties they may experience. Multicultural patient care delivery and cultural competency frameworks commonly assume that the healthcare professional is White and that patients are the “other” and set out to describe what various racial and ethnic groups believe and how they act as a group. On the other hand, a cultural humility framework emphasizes self-understanding as primary to understanding others. To facilitate self-understanding, cultural humility encourages ongoing critical self-reflection, asking the healthcare professionals to delve into their cultural identity and its effect on the delivery of patient care. Cultural humility makes no assumption regarding the healthcare professional’s identity and especially challenges White practitioners to explore and understand their “White identity” (Carten, 2016). Table 7 illustrates the differences between (multi)cultural competence and cultural humility frameworks.
Table 7: (Multi) Cultural Competence and Cultural Humility (Multi) Cultural Competence
Cultural Humility
● Acknowledges layers of cultural identity. ● Recognizes danger of stereotyping.
● Acknowledges layers of cultural identity. ● Understands that working with cultural differences is an ongoing, lifelong process. ● Emphasizes understanding self as well as understanding patients. ● Assumes an understanding of self, communities, and colleagues is needed to understand patients. ● Requires humility and a recognition and understanding of power imbalances within the patient-healthcare professionals’ relationship and in society. ● Ongoing critical self-reflection. ● Lifelong learning. ● Institutional accountability and change. ● Addressing and challenging power imbalances.
Perspectives on Culture
● Assumes the problem is a lack of knowledge, awareness, and skills to work across lines of difference. ● Individuals and organizations develop the values, knowledge, and skills to work across lines of difference.
Assumptions
● Knowledge. ● Skills. ● Values. ● Behaviors.
Components
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Book Code: SWNY1224
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