Henderson, Saras; Horne, Maria; Hills, Ruth; Kendall, Elizabeth
This study aims to conduct a concept analysis on cultural competence in community healthcare. Clarification of the concept of cultural competence is needed to enable clarity in the definition and operation, research and theory development to assist healthcare providers to better understand this evolving concept. Rodgers' evolutionary concept analysis method was used to clarify the concept's context, surrogate terms, antecedents, attributes and consequences and to determine implications for further research. Articles from 2004 to 2015 were sought from Medline, PubMed, CINAHL and Scopus using the terms "cultural competency" AND "health," "cultural competence" OR "cultural safety" OR "cultural knowledge" OR "cultural awareness" OR cultural sensitivity OR "cultural skill" AND "Health." Articles with antecedents, attributes and consequences of cultural competence in community health were included. The 26 articles selected included nursing (n = 8), health (n = 8), psychology (n = 2), social work (n = 1), mental health (n = 3), medicine (n = 3) and occupational therapy (n = 1). Findings identify cultural openness, awareness, desire, knowledge and sensitivity and encounter as antecedents of cultural competence. Defining attributes are respecting and tailoring care aligned with clients' values, needs, practices and expectations, providing equitable and ethical care, and understanding. Consequences of cultural competence are satisfaction with care, the perception of quality healthcare, better adherence to treatments, effective interaction and improved health outcomes. An interesting finding is that the antecedents and attributes of cultural competence appear to represent a superficial level of understanding, sometimes only manifested through the need for social desirability. What is reported as critical in sustaining competence is the carers' capacity for a higher level of moral reasoning attainable through formal education in cultural and ethics knowledge. Our
Gendron, Tracey; Maddux, Stu; Krinsky, Lisa; White, Jay; Lockeman, Kelly; Metcalfe, Yohvane; Aggarwal, Sadashiv
The population of the aging lesbian, gay, bisexual and transgender (LGBT) community is significant and growing rapidly. As LGBT individuals age and begin to move into healthcare communities, they are fearful of apathy, discrimination, and abuse by healthcare providers and other residents. Person-centered cultural competence and sensitivity among…
Grant, Julian; Parry, Yvonne; Guerin, Pauline
This research explored how the concept of cultural competence was represented and expressed through health policies that were intended to improve the quality and efficacy of healthcare provided to families from culturally marginalised communities, particularly women and children with refugee backgrounds. A critical document analysis was conducted of policies that inform healthcare for families from culturally marginalised communities in two local government areas in South Australia. The analysis identified two major themes: lack of, or inconsistent, definitions of 'culture' and 'cultural competency' and related terms; and the paradoxical use of language to determine care. Cultural competence within health services has been identified as an important factor that can improve the health outcomes for families from marginalised communities. However, inconsistency in definitions, understanding and implementation of cultural competence in health practice makes it difficult to implement care using these frameworks. Clearly defined pathways are necessary from health policy to inform culturally competent service delivery. The capacity for policy directives to effectively circumvent the potential deleterious outcomes of culturally incompetent services is only possible when that policy provides clear definitions and instructions. Consultation and partnership are necessary to develop effective definitions and processes relating to cultural competence. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.
Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S
Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner
Joshua L. Schwarz PhD
Full Text Available This study presents the measurement properties of 5 scales used in the Healthcare Provider Cultural Competence Instrument (HPCCI. The HPCCI measures a health care provider’s cultural competence along 5 primary dimensions: (1 awareness/sensitivity, (2 behaviors, (3 patient-centered communication, (4 practice orientation, and (5 self-assessment. Exploratory factor analysis demonstrated that the 5 scales were distinct, and within each scale items loaded as expected. Reliability statistics indicated a high level of internal consistency within each scale. The results indicate that the HPCCI effectively measures the cultural competence of health care providers and can provide useful professional feedback for practitioners and organizations seeking to increase a practitioner’s cultural competence.
Aragaw, Amanu; Yigzaw, Tegbar; Tetemke, Desalegn; G/Amlak, Wubalem
Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural
Bernhard, Gerda; Knibbe, Ronald A; von Wolff, Alessa; Dingoyan, Demet; Schulz, Holger; Mösko, Mike
Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs' cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcare perspective, 2) to develop a self-report instrument to assess cultural competence of HCPs and 3) to evaluate the psychometric properties of the new instrument. The conceptual model and initial item pool, which were applied to the cross-cultural competence instrument for the healthcare profession (CCCHP), were derived from an expert survey (n = 23), interviews with HCPs (n = 12), and a broad narrative review on assessment instruments and conceptual models of cultural competence. The item pool was reduced systematically, which resulted in a 59-item instrument. A sample of 336 psychologists, in advanced psychotherapeutic training, and 409 medical students participated, in order to evaluate the construct validity and reliability of the CCCHP. Construct validity was supported by principal component analysis, which led to a 32-item six-component solution with 50% of the total variance explained. The different dimensions of HCPs' cultural competence are: Cross-Cultural Motivation/Curiosity, Cross-Cultural Attitudes, Cross-Cultural Skills, Cross-Cultural Knowledge/Awareness and Cross-Cultural Emotions/Empathy. For the total instrument, the internal consistency reliability was .87 and the dimension's Cronbach's α ranged from .54 to .84. The discriminating power of the CCCHP was indicated by statistically significant mean differences in CCCHP subscale scores between predefined groups. The 32-item CCCHP exhibits acceptable psychometric properties, particularly content and construct validity to examine HCPs' cultural competence. The CCCHP with its five dimensions offers a comprehensive assessment of HCPs' cultural competence, and has the
Dell'Aversana, Giuseppina; Bruno, Andreina
Cultural competence (CC) for professionals and organizations has been recognized as a key strategy to reduce health care inequalities for migrants and to promote responsiveness to diversity. For decades its main aim has been matching health services to the cultural needs of migrant users. Otherwise literature highlighted the need to find a pragmatic middle way between the 'static' and the 'dynamic' views of culture that are recognizable in CC approaches. A pragmatic middle way to CC will be proposed as the way to respect diversity, even responding to cultural issues, without stereotyping or discriminating. To understand conditions that favor this pragmatic middle way this study aims to explore: (1) perceptions of healthcare providers in managing diversity; (2) strategies used to meet health needs at a professional and organizational level. A qualitative case study was conducted in a healthcare service renowned for its engagement in migrant sensitive care. Four different professional figures involved in CC strategies at different levels, both managerial and non-managerial, were interviewed. Data were analyzed using thematic analysis. Findings indicated that dealing with diversity poses challenges for healthcare providers, by confronting them with multilevel barriers to quality of care. A pragmatic middle way to CC seems to rely on complex understanding of the interaction between patients social conditions and the capacity of the institutional system to promote equity. Professional and organizational strategies, such as inter-professional and intersectional collaboration, cultural food adaptation and professional training can enhance quality of care, patient compliance responding to social and cultural needs.
Bernhard, Gerda; Knibbe, Ronald A.; von Wolff, Alessa; Dingoyan, Demet; Schulz, Holger; Mösko, Mike
Background Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs’ cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcare perspective, 2) to develop a self-report instrument to assess cultural competence of HCPs and 3) to evaluate the psychometric properties of the new instrument. Methods The conceptual model and initial item pool, which were applied to the cross-cultural competence instrument for the healthcare profession (CCCHP), were derived from an expert survey (n = 23), interviews with HCPs (n = 12), and a broad narrative review on assessment instruments and conceptual models of cultural competence. The item pool was reduced systematically, which resulted in a 59-item instrument. A sample of 336 psychologists, in advanced psychotherapeutic training, and 409 medical students participated, in order to evaluate the construct validity and reliability of the CCCHP. Results Construct validity was supported by principal component analysis, which led to a 32-item six-component solution with 50% of the total variance explained. The different dimensions of HCPs’ cultural competence are: Cross-Cultural Motivation/Curiosity, Cross-Cultural Attitudes, Cross-Cultural Skills, Cross-Cultural Knowledge/Awareness and Cross-Cultural Emotions/Empathy. For the total instrument, the internal consistency reliability was .87 and the dimension’s Cronbach’s α ranged from .54 to .84. The discriminating power of the CCCHP was indicated by statistically significant mean differences in CCCHP subscale scores between predefined groups. Conclusions The 32-item CCCHP exhibits acceptable psychometric properties, particularly content and construct validity to examine HCPs’ cultural competence. The CCCHP with its five dimensions offers a comprehensive
Palmer, Richard C; Samson, Raquel; Triantis, Maria; Mullan, Irene D
To develop and evaluate a continuing medical education (CME) course aimed at improving healthcare provider knowledge about breast cancer health disparities and the importance of cross-cultural communication in provider-patient interactions about breast cancer screening. An interactive web-based CME course was developed and contained information about breast cancer disparities, the role of culture in healthcare decision making, and demonstrated a model of cross-cultural communication. A single group pre-/post-test design was used to assess knowledge changes. Data on user satisfaction was also collected. In all, 132 participants registered for the CME with 103 completing both assessments. Differences between pre-/post-test show a significant increase in knowledge (70% vs. 94%; p training was an appropriate tool to train healthcare providers about cultural competency and health disparities. There was an overall high level of satisfaction among all users. Users felt that learning objectives were met and the web-based format was appropriate and easy to use and suggests that web-based CME formats are an appropriate tool to teach cultural competency skills. However, more information is needed to understand how the CME impacted practice behaviors.
This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which – while not explicitly mentioned in the editorial – most effectively concretizes the tensions at the heart of this analysis of healthcare. PMID:29626406
Hunter, Jennifer L; Krantz, Steven
A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.
Full Text Available Abstract Background To develop and evaluate a continuing medical education (CME course aimed at improving healthcare provider knowledge about breast cancer health disparities and the importance of cross-cultural communication in provider-patient interactions about breast cancer screening. Methods An interactive web-based CME course was developed and contained information about breast cancer disparities, the role of culture in healthcare decision making, and demonstrated a model of cross-cultural communication. A single group pre-/post-test design was used to assess knowledge changes. Data on user satisfaction was also collected. Results In all, 132 participants registered for the CME with 103 completing both assessments. Differences between pre-/post-test show a significant increase in knowledge (70% vs. 94%; p Conclusion There was an overall high level of satisfaction among all users. Users felt that learning objectives were met and the web-based format was appropriate and easy to use and suggests that web-based CME formats are an appropriate tool to teach cultural competency skills. However, more information is needed to understand how the CME impacted practice behaviors.
Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne
Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective
Dreachslin, Janice L; Weech-Maldonado, Robert; Gail, Judith; Epané, Josué Patien; Wainio, Joyce Anne
How can healthcare leaders build a sustainable infrastructure to leverage workforce diversity and deliver culturally and linguistically appropriate care to patients? To answer that question, two health systems participated in the National Center for Healthcare Leadership's diversity leadership demonstration project, November 2008 to December 2013. Each system provided one intervention hospital and one control hospital.The control hospital in each system participated in pre- and postassessments but received no preassessment feedback and no intervention support. Each intervention hospital's C-suite leadership and demonstration project manager worked with a diversity coach provided by the National Center for Healthcare Leadership to design and implement an action plan to improve diversity and cultural competence practices and build a sustainable infrastructure. Plans explored areas of strength and areas for improvement that were identified through preintervention assessments. The assessments focused on five competencies of strategic diversity management and culturally and linguistically appropriate care: diversity leadership, strategic human resource management, organizational climate, diversity climate, and patient cultural competence.This article describes each intervention hospital's success in action plan implementation and reports results of postintervention interviews with leadership to provide a blueprint for sustainable change.
Garran, Ann Marie; Werkmeister Rozas, Lisa
In 2001, the National Association of Social Workers (NASW) adopted 10 discrete standards of culturally competent practice which undergird our commitment to diversity and social justice. The concept of intersectionality is newly emerging in social work, though, causing us to reflect on our current conceptualizations of cultural competence.…
Dauvrin, M; Lorant, V
This study investigated the role of social relationships in the sharing of cultural competence by testing two hypotheses: cultural competence is a socially shared behaviour; and central healthcare professionals are more culturally competent than non-central healthcare professionals. Sustaining cultural competence in healthcare services relies on the assumption that being culturally competent is a socially shared behaviour among health professionals. This assumption has never been tested. Organizational aspects surrounding cultural competence are poorly considered. This therefore leads to a heterogeneous implementation of cultural competence - especially in continental Europe. We carried out a social network analysis in 24 Belgian inpatient and outpatient health services. All healthcare professionals (ego) were requested to fill in a questionnaire (Survey on social relationships of health care professionals) on their level of cultural competence and to identify their professional relationships (alter). We fitted regression models to assess whether (1) at the dyadic level, ego cultural competence was associated with alter cultural competence, and (2) health professionals of greater centrality had greater cultural competence. At the dyadic level, no significant associations were found between ego cultural competence and alter cultural competence, with the exception of subjective exposure to intercultural situations. No significant associations were found between centrality and cultural competence, except for subjective exposure to intercultural situations. Being culturally competent is not a shared behaviour among health professionals. The most central healthcare professionals are not more culturally competent than less central health professionals. Culturally competent health care is not yet a norm in health services. Health care and training authorities should either make cultural competent health care a licensing criteria or reward culturally competent health care
Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick
As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.
Mendias, Elnora P.; Guevara, Edilma B.
Eight criteria for culturally competent scholarship (contextuality, relevance, communication styles, awareness of identity and power differences, disclosure, reciprocation, empowerment, time) were applied to an international education/research nursing program. Appropriate measures for each were developed and ways to improve the program were…
Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen
Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.
Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians. PMID:24479405
Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research
Petersen, Rikke Agnete
There is a need to better prepare nursing and other caring professionals for compassionate and culturally competent care. The IENE4 project aims to adress this need. The authors conducted an review of literature pertaining to three aspects, i.e. universal components of compassion; measuring...... compassion; and learning culturally competent compassion....
Qureshi, A; Collazos, F; Ramos, M; Casas, M
Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.
Lin, Chin-Nu; Mastel-Smith, Beth; Alfred, Danita; Lin, Yu-Hua
Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.
Blanchet Garneau, Amélie; Pepin, Jacinthe
In nursing education, most of the current teaching practices perpetuate an essentialist perspective of culture and make it imperative to refresh the concept of cultural competence in nursing. The purpose of this article is to propose a constructivist definition of cultural competence that stems from the conclusions of an extensive critical review of the literature on the concepts of culture, cultural competence, and cultural safety among nurses and other health professionals. The proposed constructivist definition is situated in the unitary-transformative paradigm in nursing as defined by Newman and colleagues. It makes the connection between the field of competency-based education and the nursing discipline. Cultural competence in a constructivist paradigm that is oriented toward critical, reflective practice can help us develop knowledge about the role of nurses in reducing health inequalities and lead to a comprehensive ethical reflection about the social mandate of health care professionals. © The Author(s) 2014.
Brooks, Audrey J.; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S.; Kreitzer, Mary Jo; Lee, Jeannie K.; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia
In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 “meta-competencies” through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232
Sørensen, Janne; Jervelund, Signe Smith; Nørredam, Marie Louise
the survey, and 199 responded. The response rate is 14%. Data were analysed through descriptive calculations, and answers to open-ended questions were coded using content analysis. Results: Results showed that 82.4% of the informants agreed or strongly agreed that the medical education programme should...... in receiving training on cultural competence. Conclusions: Generally, there is interest in and acknowledgement of the importance of cultural competence in Danish medical education among teachers at the University of Copenhagen. This creates an opportunity to implement cultural competence in the medical...
Riis, Anita Holm
a Scandinavian and mostly a Danish context. A key point of the analysis indicates that a highly efficient health sector may entail an implicit duality: On the one hand, the therapist can relate pragmatically to the patient when engaging in cultural meetings. On the other hand, the therapist may be personally......This article aims to present a theoretical view of how cultural thinking and action in meetings between patient and therapist can be analyzed with special attention to raising awareness of underlying prejudices and preconceptions in such encounters. The examples in the article are all taken from...... challenged when cultural thinking leads to ethical dilemmas....
Brotanek, Jane M; Seeley, Christina E; Flores, Glenn
There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.
Full Text Available This contribution deals with a topic of intercultural management as a source of competitive advantages whose significance together with the development of the international trade becomes more important. Firms that expand into foreign markets must adapt themselves to different cultures to be able to communicate effectively with the local background and to achieve the best possible results. This entry is based on the methodology of action research and includes the analysis of the intercultural context of the company Skanska Property CZ
Cultural competence in business Japanese requires more than superficial knowledge of business etiquette. One must truly understand why Japanese people think and act differently from their American counterparts. For example, instruction in the use of Japanese taxis must be accompanied by instruction in the concept and implications of seating order…
Wicks, Angela M; St Clair, Lynda
Facing a complex environment driven by two decades of dramatic change, healthcare organizations are adopting new strategic frameworks such as the Balanced Scorecard (BSC) to evaluate performance (Kaplan and Norton 1992). The BSC was not originally developed as a performance management tool, however. Rather, it was designed as a tool to communicate strategy and, as such, provides little guidance when actual outcomes fall short of desired outcomes. In addition, although the BSC is an improvement over exclusively financial measures, it has three conceptual limitations that are especially problematic for evaluating healthcare organizations: (1) it underemphasizes the employee perspective, (2) it is founded on a control-based management philosophy, and (3) it emphasizes making trade-offs. To address these limitations, we propose using the Competing Values Framework (CVF), a theoretically grounded, comprehensive approach to understanding and improving organizational and managerial performance by focusing on four action imperatives: competing, controlling, collaborating, and creating. The CVF pays particular attention to the employee perspective, is consistent with a commitment-based management philosophy, and emphasizes transcending apparent paradoxes to identify win-win solutions. Rather than focusing on customer satisfaction or employee satisfaction, the CVF looks for ways to satisfy customers and employees while still addressing financial constraints and growth opportunities. The CVF also can be used to assess both the culture of the organization and the competencies of individual managers, thereby providing a clear link between strategy and implementation.
Nynas, Suzette Marie
Context: Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients. Objective: To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care,…
Beadling, Charles; Maza, John; Nakano, Gregg; Mahmood, Maysaa; Jawad, Shakir; Al-Ameri, Ali; Zuerlein, Scott; Anderson, Warner
This article presents findings from a survey conducted to examine the availability of foreign language and culture training to Civil Affairs health personnel and the relevance of that training to the tasks they perform. Civil Affairs forces recognize the value of cross-cultural communication competence because their missions involve a significant level of interaction with foreign governments? officials, military, and civilians. Members of the 95th Civil Affairs Brigade (Airborne) who had a health-related military occupational specialty code were invited to participate in the survey. More than 45% of those surveyed were foreign language qualified. Many also received predeployment language and culture training specific to the area of deployment. Significantly more respondents reported receiving cultural training and training on how to work effectively with interpreters than having received foreign language training. Respondents perceived interpreters as important assets and were generally satisfied with their performance. Findings from the survey highlight a need to identify standard requirements for predeployment language training that focuses on medical and health terminology and to determine the best delivery platform(s). Civil Affairs health personnel would benefit from additional cultural training that focuses on health and healthcare in the country or region of deployment. Investing in the development of distance learning capabilities as a platform for delivering health-specific language and culture training may help ease the time and resources constraints that limit the ability of Civil Affairs health personnel to access the training they need. 2012.
Jennifer de Beer
Full Text Available Background. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA. Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities.Objective. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA.Methods. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R cultural competence questionnaire.Â Results. The overall cultural competence score for the respondents was 70.2 (standard deviation 7.2 out of a possible 100, with 77 (74% of the respondents scoring in the awareness range, 26 (25% in the competent range, and only 1 in the proficient range. Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses.Conclusion. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.
Horvat, Lidia; Horey, Dell; Romios, Panayiota; Kis-Rigo, John
Cultural competence education for health professionals aims to ensure all people receive equitable, effective health care, particularly those from culturally and linguistically diverse (CALD) backgrounds. It has emerged as a strategy in high-income English-speaking countries in response to evidence of health disparities, structural inequalities, and poorer quality health care and outcomes among people from minority CALD backgrounds. However there is a paucity of evidence to link cultural competence education with patient, professional and organisational outcomes. To assess efficacy, for this review we developed a four-dimensional conceptual framework comprising educational content, pedagogical approach, structure of the intervention, and participant characteristics to provide consistency in describing and assessing interventions. We use the term 'CALD participants' when referring to minority CALD populations as a whole. When referring to participants in included studies we describe them in terms used by study authors. To assess the effects of cultural competence education interventions for health professionals on patient-related outcomes, health professional outcomes, and healthcare organisation outcomes. We searched: MEDLINE (OvidSP) (1946 to June 2012); Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) (June 2012); EMBASE (OvidSP) (1988 to June 2012); CINAHL (EbscoHOST) (1981 to June 2012); PsycINFO (OvidSP) (1806 to June 2012); Proquest Dissertations and Theses database (1861 to October 2011); ERIC (CSA) (1966 to October 2011); LILACS (1982 to March 2012); and Current Contents (OvidSP) (1993 Week 27 to June 2012).Searches in MEDLINE, CENTRAL, PsycINFO, EMBASE, Proquest Dissertations and Theses, ERIC and Current Contents were updated in February 2014. Searches in CINAHL were updated in March 2014.There were no language restrictions. We included randomised controlled trials (RCTs), cluster RCTs, and controlled clinical trials of
Krajewski-Jaime, Elvia R.; And Others
Cultural competence assumes greater importance in the United States as international relations shift and the United States changes its own demographic makeup. Hispanics have significant health care needs and cultural beliefs that influence their acceptance of service. As part of an effort to build cultural competence in undergraduate social work…
Jin, Harry; Earnshaw, Valerie A.; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Desai, Mayur M.; John, Jacob; Altice, Frederick L.
Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed...
Karcanes, James A
.... Understanding the different levels of cultural awareness -- cultural consideration, cultural understanding, and cultural competence -- will help usher in a new focus on culture-centric warfare...
Meyer, Eric G; Writer, Brian W; Brim, William
Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.
Jin, Harry; Earnshaw, Valerie A.; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Desai, Mayur M.; John, Jacob; Altice, Frederick L.
Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia. PMID:24625279
Jin, Harry; Earnshaw, Valerie A; Wickersham, Jeffrey A; Kamarulzaman, Adeeba; Desai, Mayur M; John, Jacob; Altice, Frederick L
Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.
Kim, Sa Kil; Oh, Yeon Ju; Luo, Meiling; Lee, Yong Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The nuclear safety cultural competency model should be supplemented through a bottom-up approach such as behavioral event interview. The developed model, however, is meaningful for determining what should be dealt for enhancing safety cultural competency of nuclear organizations. The more details of the developing process, results, and applications will be introduced later. Organizational culture include safety culture in terms of its organizational characteristics.
Petrovich, Anne; Lowe, Mitzi
One of the areas of increased importance to social work pedagogy is the development of culturally competent practice skills. In focus groups, first and second year students, and recent alumni reflected on their growing awareness and competence concerning cultural diversity. Meaningful patterns emerged emphasizing the importance of psychologically…
Samu, Kathleen Seataoai; Suaalii-Sauni, Tamasailau
Cultural competency is about the ability of individuals and systems to respond respectfully and effectively to the cultural needs of peoples of all cultures. Its general attributes include knowledge, attitudes, skills and professional judgment. In Pacific mental health, 'the cultural' is generally understood to be ethnic culture. Accordingly, Pacific cultural competencies assume ethnic specific markers. In mental health Pacific cultural competencies has seen a blending of cultural and clinical beliefs and practices. This paper provides an overview of five key theme areas arising from Auckland-based ethnic-specific Pacific workshop data: language, family, tapu relationships, skills and organisation policy. Workshop participants comprised of Pacific mental health providers, Pacific consumers, family members of Pacific consumers and members of the Pacific community members. This paper purports that identifying the perceptions of different Pacific groups on ethnic-specific elements of cultural competencies are necessary to build and strengthen the capacity and capability of mental health services to provide culturally relevant services.
Govender, Pragashnie; Mpanza, December M; Carey, Tarryn; Jiyane, Kwenzile; Andrews, Bicolé; Mashele, Sam
Occupational therapy relies primarily on communication between the therapist and client for effective intervention. Adequate communication may be influenced by language and cultural differences between the therapist and client. Cultural competence in relation to language and culture is thus a vital part in practice. Limited research exists on cultural competence in occupational therapy students. This study thus aimed to explore the cultural competence of final year students and their perceptions of their own cultural competence, with respect to language and culture in their practice as students. An explorative qualitative study design was utilised with a nonprobability purposeful sample of 21 final year undergraduate students at a tertiary institute in South Africa. Three focus groups were conducted, comprising between 6 and 8 students in each group. Thematic analysis using inductive reasoning was undertaken in order to analyse the students' experiences and understanding of cultural competence. Findings of the study suggest that cultural competence, in relation to language and culture, influences the occupational therapy intervention process. It was shown to both positively and negatively influence intervention through supporting or hindering rapport building, client centeredness, and effective intervention.
Full Text Available Occupational therapy relies primarily on communication between the therapist and client for effective intervention. Adequate communication may be influenced by language and cultural differences between the therapist and client. Cultural competence in relation to language and culture is thus a vital part in practice. Limited research exists on cultural competence in occupational therapy students. This study thus aimed to explore the cultural competence of final year students and their perceptions of their own cultural competence, with respect to language and culture in their practice as students. An explorative qualitative study design was utilised with a nonprobability purposeful sample of 21 final year undergraduate students at a tertiary institute in South Africa. Three focus groups were conducted, comprising between 6 and 8 students in each group. Thematic analysis using inductive reasoning was undertaken in order to analyse the students’ experiences and understanding of cultural competence. Findings of the study suggest that cultural competence, in relation to language and culture, influences the occupational therapy intervention process. It was shown to both positively and negatively influence intervention through supporting or hindering rapport building, client centeredness, and effective intervention.
Cultural competency in the delivery of health care to diverse population groups has become an urgent need in the United States. Yet, despite the incorporation of cultural competency education into nursing curricula, inequities in health care remain. The purpose of this mixed-method study was to identify if differences in perceptions of cultural competence were present in senior nursing students (N = 11) before and after cultural immersion experiences on an Indian reservation. Preimmersion results revealed that the majority considered themselves culturally competent, whereas after immersion, there was a downward shift in scores. Triangulation of the quantitative results alongside a hermeneutic phenomenological analysis of the students' reflective journals revealed a paradox. Students perceived themselves as culturally competent, yet their journals demonstrated many negative stereotypes. Three common themes emerged: seeing with closed eyes, seeing through a fused horizon, and disruption to reshaping. These combined results revealed the misperceptions regarding the concept of cultural competency. Efforts must be made in nursing education to teach students the importance of adopting an ethic of cultural humility, where we emphasize attentive listening and openness to other cultures, and stress the importance of self-reflection and self-critique in our interactions with others. © 2014.
Interrelations exist between people's behaviour and the reasons for it as explained by culture. The healthcare theory put forward by the American nurse Madeleine Leininger, at the end of the 1970s, integrates anthropology Identifying and understanding the patient's culture enables nursing care to be adapted to the patient's own view of his/her disease.
Mitchell, Lindsay; Boak, George
Purpose: The purpose of this article is to review the use of competence frameworks in the UK healthcare sector and to explore characteristics of the sector that may influence the success of projects to develop new frameworks. Design/methodology/approach: The paper draws on project reports and evaluations of practice in a range of recent projects…
Kohlbry, Pamela Wolfe
This article reports research findings on the effect of an international immersion service-learning project on the level and components of cultural competence of baccalaureate (BSN) nursing students. A triangulated methodology was used to determine changes in components and level of cultural competence pre- and postexperience. The theoretical model The Process of Cultural Competence in the Delivery of Healthcare Services was used. It identifies five central constructs in the process of becoming culturally competent: cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. The sample of 121 BSN nursing students was gathered from three southern California universities. Data were collected from 2009 to 2013. Using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version© and Cultural Self-Efficacy Scale, constructs of cultural competency were measured in pre- and posttest participants who participated in international service-learning immersion experiences. A demographic survey and open-ended qualitative questions were completed at the posttrip meeting. Mean, frequencies, and correlations with demographic data and survey data were calculated. Pre- and posttrip means were analyzed. Qualitative analysis from six open-ended questions completed at the posttest were coded and themes emerged. The research findings demonstrated the impact of the international service-learning project on building cultural competency in nursing students. Quantitative findings revealed statistically significant differences between pre- and posttest surveys for two of the five constructs of cultural competence. Qualitative analysis supported the quantitative findings in cultural competency constructs found in the model. The research findings support nursing education program use of international service-learning immersion experiences to foster cultural competence in nursing students. Findings from
Weech-Maldonado, Robert; Elliott, Marc N; Pradhan, Rohit; Schiller, Cameron; Dreachslin, Janice; Hays, Ron D
Cultural competency has been proposed as an organizational strategy to address racial/ethnic disparities in the healthcare system; disparities are a long-standing policy challenge whose relevance is only increasing with the increasing population diversity of the US and across the world. Using an integrative conceptual framework based on the resource dependency and institutional theories, we examine the relationship between organizational and market factors and hospitals' degree of cultural competency. Our sample consists of 119 hospitals located in the state of California (US) and is constructed using the following datasets for the year 2006: Cultural Competency Assessment Tool of Hospitals (CCATH) Survey, California's Office of Statewide Health Planning & Development's Hospital Inpatient Discharges and Annual Hospital Financial Data, American Hospital Association's Annual Survey, and the Area Resource File. The dependent variable consists of the degree of hospital cultural competency, as assessed by the CCATH overall score. Organizational variables include ownership status, teaching hospital, payer mix, size, system membership, financial performance, and the proportion of inpatient racial/ethnic minorities. Market characteristics included hospital competition, the proportion of racial/ethnic minorities in the area, metropolitan area, and per capita income. Regression analyses were conducted to assess the relationship between the CCATH overall score and organizational and market variables. Our results show that hospitals which are not-for-profit, serve a more diverse inpatient population, and are located in more competitive and affluent markets exhibit a higher degree of cultural competency. Our results underscore the importance of both institutional and competitive market pressures in guiding hospital behavior. For instance, while not-for-profit may adopt innovative/progressive policies like cultural competency simply as a function of their organizational goals
Lo, Edward C M; Tan, Hai P
For successful implementation of oral healthcare services for elders, there is a need to understand and respond to their oral health beliefs, perceived needs and preferred type of care services, all of which are shaped by their cultural beliefs and values. This poses challenges to oral healthcare providers, especially when serving a diverse elderly population with people coming from different cultural backgrounds. The general principles of oral healthcare provision and their adaptation to serve culturally diverse elderly populations are discussed. The oral health beliefs and behaviours of Chinese, an ethnic group that can be found in many countries across the world, are highlighted and used as examples. Chinese elders generally attach a higher value to the physical functions than to the appearance of their dentition and prefer to use traditional self-care methods to deal with their oral health problems rather than to seek professional services. There is need to incorporate into the training of oral healthcare providers the competence to adapt their services to the beliefs and practices of culturally diverse elderly population groups in different settings. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.
Leggat Sandra G
Full Text Available Abstract Background Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. Methods Members of a state branch of the professional association of Australian health service managers participated in a teamwork survey. Results The 37% response rate enabled identification of a management teamwork competency set comprising leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome. Conclusion Although not part of the research question the data suggested that the competencies for effective teamwork are perceived to be different for management and clinical teams, and there are differences in the perceptions of effective teamwork competencies between male and female health service managers. This study adds to the growing evidence that the focus on individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork.
Rubino, Louis; Freshman, Brenda
Recently, entrepreneurial behavior is becoming more accepted in the healthcare field. This article describes an attempt to foster development of positive entrepreneurial competencies in the undergraduate health administration classroom. Through a literature review on entrepreneurs, eight competency clusters are identified; decision making, strategic thinking, risk taking, confidence building, communicating ideas, motivating team members, tolerance of ambiguity, and internal locus of control. These clusters are used to promote entrepreneurial skills for students though identified learning-centered activities and supplement an instructional style that facilitates thoughtful reflection.
The world has closely-knitted economic, social, and cultural relations that offer greater entrepreneurial and professional opportunities than ever before. Students in the 21st century global society will live and work in a rapidly changing social, economic, and political world; they will require global cultural competencies to be successful. Study…
With the healthcare industry changing rapidly, organizations seek finance leaders who have skills that go beyond traditional expertise in revenue and expenses. These additional competencies fall under the heading of soft-leadership skills and include the ability to be strategy-oriented, agile, passionate, inspirational, influential, communicative, dependable, driven, integrative, and engaged. Networking, participation in a mentoring program, and continuing education provide avenues for finance leaders to develop these sorts of skills.
McGinnis, Sandra L; Brush, Barbara L; Moore, Jean
Proponents of health workforce diversity argue that increasing the number of minority health care providers will enhance cultural similarity between patients and providers as well as the health system's capacity to provide culturally competent care. Measuring cultural similarity has been difficult, however, given that current benchmarks of workforce diversity categorize health workers by major racial/ethnic classifications rather than by cultural measures. This study examined the use of national racial/ethnic categories in both patient and registered nurse (RN) populations and found them to be a poor indicator of cultural similarity. Rather, we found that cultural similarity between RN and patient populations needs to be established at the level of local labor markets and broadened to include other cultural parameters such as country of origin, primary language, and self-identified ancestry. Only then can the relationship between cultural similarity and cultural competence be accurately determined and its outcomes measured.
Eddey, Gary E; Robey, Kenneth L
Cultural competence extends beyond understanding those values, beliefs, and needs that are associated with patients' age or gender or with their racial, ethnic, or religious backgrounds. People hold many simultaneous cultural associations, and each have implications for the care process. The "culture of disability" is a pan-ethnic culture for which a set of physician competencies are required to ensure appropriate, culturally sensitive care to persons with congenital or acquired disabilities. Such competencies include communicating with patients who have deficits in verbal communication and avoidance of infantilizing speech; understanding the values and needs of persons with disabilities; the ability to encourage self-advocacy skills of patients and families; acknowledging the core values of disability culture including the emphasis on interdependence rather than independence; and feeling comfortable with patients with complex disabilities. Medical schools have developed programs to increase students' exposure to persons with disabilities and it is suggested that such programs are most effective when they are the result of collaboration with community-based facilities or organizations that serve persons with disabilities in the natural environment. Combining lecture-based instruction and structured experiences with the opportunity for students to interact with patients in their natural environments may facilitate development of competencies with respect to patients with disabilities. The culture of disability should be included as one of the many cultures addressed in cultural competence initiatives in medical school and residency curricula.
Clark, Mary Jo
Increasing globalization, population diversity and health disparities among non-dominant cultures necessitate cross-cultural research. Research with other cultures is fraught with challenges that must be addressed by the competent cross-cultural researcher. Areas for consideration include choice of research foci, ethical concerns, cultural adaptation of research measurements and interventions, participant recruitment and retention, strategies for data collection and analysis, dissemination of findings and perspectives of time. Approaches to dealing with these challenges are addressed, with an emphasis on community-based participatory research. © 2012 Blackwell Publishing Asia Pty Ltd.
Sorensen, Janne; Norredam, Marie; Dogra, Nisha
the project Culturally Competent in Medical Education involving 13 partners from 11 countries.4 The project aimed to support the implementation of CC in medical curricula. First, a Delphi Study involving 34 experts was conducted to develop a framework of core cultural competencies for medical school teachers...... stage of the project was a survey conducted to identify the strengths, gaps, and limitations of CC in the programmes of the 13 medical school project partners. Based on the Delphi study and survey findings, we created guidelines for the development and delivery of CC training at medical schools.4...... The proposed guidelines were presented in September 2015 in Amsterdam at a workshop entitled: “How to integrate cultural competence in medical education”. A range of participants attended the workshop, including the project partners, deans and faculty members of Dutch medical schools, physicians, and students...
Kohli, Hermeet K.; Kohli, Amarpreet S.; Huber, Ruth; Faul, Anna C.
Twofold purpose of this study was to develop a framework to understand cultural competence in graduating social work students, and test that framework for appropriateness and predictability using multivariate statistics. Scale and predictor variables were collected using an online instrument from a nationwide convenience sample of graduating…
Connecting care Competencies and Culture are core fundamentals in responding to disasters. Thick coordination between professionals, communities and agencies in different geographical areas is crucial to the happening of appropriate preparedness and thus efficient response and mitigation of a disaster. In the next few articles, we present diverse examples related to the preparedness and recovery process to adverse disasters across the globe PMID:19561968
Annandale, Neil O.; Heath, Melissa Allen; Dean, Brenda; Kemple, Ana; Takino, Yozo
This study reviewed school-based crisis planning resources and guidelines provided by 40 state departments of education and offices of safe and drug-free schools. Content was examined for indications of cultural competency. The most frequently reported topics included: (a) assisting students with mental and physical disabilities, (b) tapping into…
Cruz, J P; Alquwez, N; Cruz, C P; Felicilda-Reynaldo, R F D; Vitorino, L M; Islam, S M S
This study assessed the cultural competence of nursing students in a Saudi University. With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team. A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version. The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence. The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background. Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved. With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in
Sloand, Elizabeth; Groves, Sara; Brager, Rosemarie
The importance of cultural competency in all areas of American society is well accepted. Indeed, the evolving demographics of the country make it imperative. A wide range of educational and work settings has addressed the concept, from business and government to education and health. Cultural competency is particularly critical in the realm of healthcare, as the potential impact on quality of health and life is at stake. Nursing is a leader in this field, with a long theoretical and practice history of attention to, and respect for, individual differences. This article reviews cultural competency education in nursing and its respective educational settings. Common threads and different models are discussed. The program components of cultural competency education in one School of Nursing are highlighted. Future directions towards refining cultural competency education are presented.
Lopes-Murphy, Solange A.; Murphy, Christopher G.
The increasing cultural and linguistic diversity in academic settings necessitates greater cultural competence on the part of teachers, and enhancing the cultural competence of teachers requires a greater understanding of both the level of cultural competence among teachers and the experiences that enhance cultural competence. Teacher educators…
Adebukola E. Oyewunmi
Full Text Available Purpose: Diversity is synonymous with difference. The diverse workforce presents an array of complexities which necessitates the deployment of specific managerial competencies. Empirical evidences have indicated the role of emotional intelligence in the enhancement of abilities. Thus, this study investigated the relationship between emotional intelligence and diversity management competency amongst healthcare managers in Southwest Nigeria. Design: The descriptive survey method was adopted for the study. A total of 360 respondents completed the structured questionnaire titled Emotional Intelligence and Diversity Management Competency Questionnaire (EIDMCQ. Data was analyzed using descriptive and inferential statistics such as, Multiple Regression Analyses and Pearson Product Moment Correlation Statistical methods. Findings: A positive correlation was found between emotional intelligence and diversity management competency. Gender, ethnicity, and age, did not moderate the relationship between emotional intelligence and diversity management competency. Practical Implications: As difference is the reality of modern organizations, it is important to conceptualize it as normal and positive. Emotional intelligence is recommended as a critical tool to normalize the individual perceptions of difference. The re-assessment of the functions of managers must be followed by total commitment to capacity building in emotional intelligence, as well as the re-engineering of organizational and national cultures to promote equal opportunities, inclusion and diversity leveraging. Originality/value: This study pioneers research on emotional intelligence and diversity management competency in Nigeria’s public healthcare sector. It conceptualizes diversity management on an individual- managerial level. Practical interventions are provided to enhance the application of specific competencies to optimize a diverse workplace.
Rogers, Margaret R.; Lopez, Emilia C.
Study sought to identify critical cross-cultural competencies for school psychologists. To identify the competencies, an extensive literature search about cross-cultural school psychology competencies was conducted, as well as a questionnaire to ask expert panelists. The 102 competencies identified cover 14 major domains of professional activities…
Bentley, Paul; Jovanovic, Ana; Sharma, Pankaj
Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies.
Decker, P J
Data from 103 for-profit, nonprofit, and government-owned hospitals, spread across about half of the United States clearly show that there are common elements and several core competencies in all hospitals, some probably driven by JCAHO accreditation standards, but others coming from universal experience stemming from the changes in healthcare. The common competencies that are not, in my opinion, driven directly by the JCAHO standards include professionalism, accountability, self-esteem, customer service/focus, communication, information management/using data in decision making, and teamwork. There are several possible connections among the core competencies that suggest that the effects of accountability and possibly self-esteem on such outcomes as patient satisfaction and quality of care should be the subject of more research in healthcare settings. There are, however, several possible interventions to increase the core competency base of any hospital, which can be applied without this research. Executives and managers who attempt to measure and change these common competencies through selection, assessment, organizational system change, or reward and compensation systems will change the competence base of their workforce in critical areas needed in the future healthcare economy. Using a competence model incorporating these competencies may change the culture of the organization toward that which will be needed for survival in the twenty-first century.
de Leon Siantz, Mary Lou
This article describes an expanded leadership role needed in schools of nursing as the nurse of the 21st century is prepared to assume expanded roles in a diverse society. With schools of nursing becoming more global, and the diverse population of the United States rapidly growing, a critical need exists for nurses who are ready to partner in the health care that multicultural communities need locally, nationally, and globally. Diversity and cultural competence have now become central issues in nursing education, research, practice, and health policy. Diversity leadership in a school of nursing can no longer concentrate only on issues of affirmative action, recruitment, and retention. The purpose of this article is to discuss how diversity leadership must increasingly focus on building a corporate environment in schools of nursing that integrates diversity and cultural competence with the strategic plan of the School's Chief Nursing Officer, across academic programs, research, practice, and public policy to eliminate health disparities in partnership with faculty, students, staff, the University infrastructure, and the community at large. The theoretical framework that guided the strategic planning is based on the model used by the Robert Wood Johnson Executive Nurse Fellowship Program. Examples of program initiatives designed to implement the strategic plan to strengthen the diversity and cultural competence of one school of nursing environment are described.
This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which - while not explicitly mentioned in the editorial - most effectively concretizes the tensions at the heart of this analysis of healthcare. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Full Text Available Writing is a skill derived from a long way of learning and exercises. Different from other language skills, writing is considered the difficult language skill to acquire since it involves many aspects of linguistics, social, and writing knowledge and conventions. There are at least three important elements of writing useful to produce a good piece of composition, language competence, writing competence and cultural competence. This paper shows the influence of these three elements in order to produce good, readable, communicative, and successful writing
Kessler, Remi A; Coates, Wendy C; Chanmugam, Arjun
The objective of this study was to analyze the content and volume of literature that has been written on cultural competency in emergency medicine (EM) since its educational imperative was first described by the Institute of Medicine in 2002. We conducted a comprehensive literature search through the PubMed portal in January 2015 to identify all articles and reviews that addressed cultural competency in EM. Articles were included in the review if cultural competency was described or if its impact on healthcare disparities or curriculum development was described. Two reviewers independently investigated all relevant articles. These articles were then summarized. Of the 73 abstracts identified in the initial search, only 10 met criteria for inclusion. A common theme found among these 10 articles is that cultural competency in EM is essential to reducing healthcare disparities and improving patient care. These articles were consistent in their support for cross-cultural educational advancements in the EM curriculum. Despite the documented importance of cultural competency education in medicine, there appears to be only 10 articles over the past 12 years regarding its development and implementation in EM. This comprehensive literature review underscores the relative dearth of publications related to cultural competency in EM. The limited number of articles found is striking when compared to the growth of EM research over the same time period and can serve as a stimulus for further research in this significant area of EM education.
To understand the relationships among certain key factors such as organizational climate, self-efficacy and outcome expectation on registered nurses, with regard to the development of registered nurses' cross-cultural competence. The focus is specifically on the use of a social cognitive framework for nurses for providing intercultural nursing care to international patients. This study also aims to examine the relationship between nurses' cross-cultural competence and nursing intellectual capital. Given the influence of globalization on healthcare services, healthcare providers need to have enough cross-cultural competence to effectively care for patients from different cultures. Thus, the development of cross-cultural competence in nursing care has become an important issue. A quantitative method and a cross-sectional design were employed in this study. Data were collected from 309 RN working in 16 healthcare institutions in Taiwan from May to August 2013. Structural equation modelling, in combination with the smart partial least squares method, was used to measure the relationships in the research model. The results show that outcome expectation has a stronger impact on nurses' cross-cultural competence than self-efficacy. In addition, it was found that the cross-cultural competence of nurses has a positive impact on nursing intellectual capital. Nursing supervisors should promote a higher level of outcome expectation on nurses to enhance the improvement of their cross-cultural competence. Raising the cross-cultural competence of nurses will aid in the accumulation of nursing intellectual capital. © 2016 John Wiley & Sons Ltd.
Oikarainen, Ashlee; Mikkonen, Kristina; Tuomikoski, Anna-Maria; Elo, Satu; Pitkänen, Salla; Ruotsalainen, Heidi; Kääriäinen, Maria
To describe mentors' competence in mentoring culturally and linguistically diverse nursing students during clinical placement and identify the factors that affect mentoring. Healthcare education is confronted by several challenges in a time characterized by globalization and increasing international migration. Nursing students from diverse backgrounds continue to experience difficulties during clinical placement. Students can overcome these difficulties and assume responsibility for their learning when mentored by supportive and competent mentors. A cross-sectional, descriptive explorative study design was used. Data were collected during spring 2016 through a survey sent to mentors (n = 3,355) employed at five university hospitals in Finland. Mentors' competence in mentoring culturally and linguistically diverse nursing students was measured with the self-assessment Mentors' Competence Instrument and the Cultural and Linguistic Diversity in Mentoring scale. The analysis included descriptive statistics, non-parametric tests and binary logistic regression analysis. Mentors with experience mentoring nursing students from diverse backgrounds rated their overall competence in mentoring as good. However, the results show continued challenges related to competence in linguistic diversity in mentoring. Seven factors that affect mentors' competence in linguistic diversity were identified. Despite high evaluations by mentors of competence related to cultural diversity in mentoring, there are still opportunities for improvement in this area. Innovative and effective strategies are needed to develop mentors' competence in mentoring culturally and linguistically diverse nursing students. Educational and healthcare organizations should strive to enhance collaboration and increase the competence of both mentors and nursing students to work in increasingly diverse healthcare environments. © 2017 John Wiley & Sons Ltd.
Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret
To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.
Seeleman, Conny; Hermans, Jessie; Lamkaddem, Majda; Suurmond, Jeanine; Stronks, Karien; Essink-Bot, Marie-Louise
Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper
Daily, Elaine; Padjen, Patricia; Birnbaum, Marvin
In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role
Zwijnenberg, N.C.; Hendriks, M.; Hoogervorst-Schilp, J.; Wagner, C.
Background: By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals’ views on the feedback of a patient safety culture assessment. Methods: Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a web...
Zwijnenberg, N.C.; Hendriks, M.; Hoogervorst-Schilp, J.; Wagner, C.
Background: By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals’ views on the
Groves, Patricia S; Meisenbach, Rebecca J; Scott-Cawiezell, Jill
This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system. © 2011 Blackwell Publishing Ltd.
Cultural sensitivity and cultural competence in the selection of culturally sensitive treatments is a requisite for effective counseling practice in working with diverse clients and their families, particularly when clients present with health issues or medical problems. Described here is a strategy for selecting culturally sensitive treatments…
Meyer, Eric G; Hall-Clark, Brittany N; Hamaoka, Derrick; Peterson, Alan L
Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists. An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general. Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care. The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.
Castillo, Richard J; Guo, Kristina L
Increased racial and ethnic diversity in the United States brings challenges and opportunities for health care organizations to provide culturally competent services that effectively meet the needs of diverse populations. The need to provide more culturally competent care is essential to reducing and eliminating health disparities among minorities. By removing barriers to cultural competence and placing a stronger emphasis on culture in health care, health care organizations will be better able to address the unique health care needs of minorities. Organizations should assess cultural differences, gain greater cultural knowledge, and provide cultural competence training to deliver high-quality services. This article develops a framework to guide health care organizations as they focus on establishing culturally competent strategies and implementing best practices aimed to improve quality of care and achieve better outcomes for minority populations.
Bustamante, Rebecca M.; Skidmore, Susan T.; Nelson, Judith A.; Jones, Brandolyn E.
Globally, public schools enroll culturally and linguistically diverse student populations and teacher preparation programs must assess the cultural competence of preservice teachers. Yet, few adequately tested measures of teacher cultural competence are available. In this research study, a sample of 396 preservice teachers were surveyed to…
Kim, Irene J.; Kim, Luke I. C.; Kelly, James G.
The authors provide an in-depth examination of the historical background, cultural values, family roles, and community contexts of Korean Americans as an aid to both researchers and clinicians in developing cultural competence with this particular group. First, the concept of cultural competence is defined. A brief history of Korean immigration…
Suurmond, Jeanine; Seeleman, Conny; Rupp, Ines; Goosen, Simone; Stronks, Karien
Asylum seekers often have complex medical needs. Little is known about the cultural competences health care providers should have in their contact with asylum seekers in order to meet their needs. Cultural competence is generally defined as a combination of knowledge about certain cultural groups,
Shewchuk, Richard M; O'Connor, Stephen J; Fine, David J
Healthcare organizations, health management professional associations, and educational institutions have begun to examine carefully what it means to be a fully competent healthcare executive. As a result, an upsurge in interest in healthcare management competencies has been observed recently. The present study uses two critically important groups of informants as participants: health management practitioners and faculty. Using the nominal group process, health administrators identified critical environmental issues perceived to have an impact on healthcare executives today. These issues were employed in a card-sort assessment and a survey was administered to a nationwide sample of health administrators. These data were used to create a map and five clusters of the environmental landscape of healthcare management. These clusters of environmental issues provided a framework for having groups of administrators and faculty members generate and rank perceived behavioral competencies relative to each cluster. Implications for healthcare management practice, education, and research are discussed.
This case study examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area (GTA). Because of changing demographic trends and ethnic minorities underutilizing hospice palliative care services, this research examined the current state of culturally competent care in a hospice setting, and the challenges to providing culturally competent care in a hospice in the GTA. A case study was conducted with a hospice and included in-depth interviews with 14 hospice volunteers. The findings reveal that volunteers encountered cultural clashes when their level of cultural competency was weak. Second, volunteers revealed there was a lack of adequate cultural competency training with their hospice, and finally, there was a lack of ethnic, cultural, and linguistic diversity among the hospice volunteers.
Janet E. Fox
Full Text Available As society grows increasingly diverse, it is critical that youth development professionals are equipped with cultural core competencies. This descriptive study gauged the perceived level of cultural competence among 4-H Youth Development professionals from a Southern state in the United States. Based on the 4-H Professional Research, Knowledge, and Competency (PRKC Model (Stone & Rennekamp, 2004, youth development professionals rated their cultural competence (equity, access, and opportunity in eight core competency areas. Based on a five-point Likert scale ranging from 0 = No knowledge to 4 = Expert, youth development professionals evaluated their cultural competence ranging from 0.66 to 4.00. According to an interpretive scale, most youth development professionals rated their competence as intermediate. Participants reported the skills of active listening and an open attitude as areas in which they felt most competent. Areas of least competence were community outreach policies and procedures. No significant relationships existed between the demographic variables of gender, degree earned, and field of study when compared to perceived cultural competence. The findings will be used to detect deficiencies and create opportunities for professional training and development experiences in supporting the cultural competence and growth of youth professionals.
Jernigan, Valarie Blue Bird; Hearod, Jordan B; Tran, Kim; Norris, Keith C; Buchwald, Dedra
In the United States, medical students must demonstrate a standard level of "cultural competence," upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system.
Jernigan, Valarie Blue Bird; Hearod, Jordan B.; Tran, Kim; Norris, Keith C.; Buchwald, Dedra
In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify content gaps and opportunities for curriculum improvement. A total of 18 programs are assessed. Findings support previous research that cultural competence training can improve the knowledge, attitudes, and skills of medical trainees. However, wide variation in the conceptualization, implementation, and evaluation of cultural competence training programs exists, leading to differences in training quality and outcomes. More research is needed to establish optimal approaches to implementing and evaluating cultural competence training that incorporate cultural humility, the social determinants of health, and broader structural competency within the medical system. PMID:27818848
Li, Sisi; Bamidis, Panagiotis D; Konstantinidis, Stathis Th; Traver, Vicente; Car, Josip; Zary, Nabil
A major challenge for healthcare quality improvement is the lack of IT skills and knowledge of healthcare workforce, as well as their ambivalent attitudes toward IT. This article identifies and prioritizes actions needed to improve the IT skills of healthcare workforce across the EU. A total of 46 experts, representing different fields of expertise in healthcare and geolocations, systematically listed and scored actions that would improve IT skills among healthcare workforce. The Child Health and Nutrition Research Initiative methodology was used for research priority-setting. The participants evaluated the actions using the following criteria: feasibility, effectiveness, deliverability, and maximum impact on IT skills improvement. The leading priority actions were related to appropriate training, integrating eHealth in curricula, involving healthcare workforce in the eHealth solution development, improving awareness of eHealth, and learning arrangement. As the different professionals' needs are prioritized, healthcare workforce should be actively and continuously included in the development of eHealth solutions.
Lopes-Murphy, Solange A.
Cultural competence and CQ involve awareness of cultural similarities and differences, knowledge of differences in cultural values, and intercultural encounters. To assess college students' cultural competence and cultural intelligence gains, this experimental study evaluated the impact of two globalization projects on these two constructs. The…
Pielach, Martin; Schubert, Hans-Joachim
Leadership in social services and healthcare organizations is marked by high levels of complexity and contradiction, which cannot be fully explained by politically, economically, and socially induced changes. Rather, it is the particularities of service provision in healthcare and social services that confront executives with specific demands. This study aimed to capture and prioritize required leadership competencies in healthcare and social services organizations. A three-step Delphi study was conducted with executives and managerial staff, who are job holders and thus experts on their occupation. For the first step, an explorative qualitative approach was chosen to record general opinion without prior assumptions. The following two steps weighted and selected the competency requirements in step one using rating- and ranking procedures. Results of the Delphi inquiry imply high relevance of social and personal competencies. Approximately 66 % of the competencies assessed in round three were social and personal competencies. 12 out of the 15 highest rated competencies in Delphi step three can be assigned to these two competency categories. In contrast, the importance of professional as well as methodical competencies was rated as less important. Only two methodical competencies and one professional competency were rated as very important by the panel. Nevertheless, the importance of executive professional and methodical competencies in healthcare and social services organizations is emphasized by high ratings of the competencies "Sector-specific expertise" and "Analytical skills". The methodical competency "Analytical skills" was identified by the Delphi respondents as the most important competency requirement. Social and personal requirements are of primary importance for leadership in healthcare and social services organizations. These results mostly correspond to leadership requirements posited in the literature on leadership skills. Emphasis should be on the
Rowland, Michael L; Bean, Canise Y; Casamassimo, Paul S
During the last decade, cultural competency has received a great deal of attention in health care and the literature of many fields, including education, social services, law, and health care. The dental education literature provides little information regarding status, strategies, or guiding principles of cultural competency education in U.S. dental schools. This study was an attempt to describe the status of cultural competency education in U.S. dental schools. A web-based thirty-question survey regarding cultural competency education coursework, teaching, course materials, and content was sent in 2005 to the assistant/associate deans for academic affairs at fifty-six U.S. dental schools, followed up by subsequent email messages. Thirty-four (61 percent) dental school officials responded to the survey. The majority of respondents (twenty-eight; 82 percent) did not have a specific stand-alone cultural competency course, but indicated it was integrated into the curriculum. Recognition of local and national community diversity needs prompted course creation in most schools. Respondents at almost two-thirds of schools indicated that their impression of students' acceptance was positive. Teachers of cultural competency were primarily white female dentists. Few schools required faculty to have similar cultural competency or diversity training. Thirty-three of the thirty-four U.S. dental schools responding to this survey offer some form of coursework in cultural competency with little standardization and a variety of methods and strategies to teach dental students.
Tanabe, Marianne K. G.
With the aging and diversifying of the elder population in the United States, there is a pressing need for an organized and effective curriculum in cultural competence. The Accreditation Council for Graduate Medical Education (ACGME) requires that the curriculum for Geriatric Medicine Fellowship training include cultural competency training.…
Leever, Martin G
Terms such as 'cultural competence' and 'transcultural nursing' have comfortably taken their place in the lexicon of health care. Their high profile is a reflection of the diversity of western societies and health care's commitment to provide care that is responsive to the values and beliefs of all who require treatment. However, the relationship between cultural competence and familiar ethical concepts such as patient autonomy has been an uneasy one. This article explores the moral foundations of cultural competence, ultimately locating them in patient autonomy and patient good. The discussion of patient good raises questions about the moral relevance of a value's rootedness in a particular culture. I argue that the moral justification for honoring cultural values has more to do with the fact that patients are strongly committed to them than it does with their cultural rootedness. Finally, I suggest an organizational approach to cultural competence that emphasizes overall organizational preparedness.
Love, Dianne B.; Ayadi, M. Femi
As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a…
Prenestini, Anna; Lega, Federico
Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.
Munz, James A.
This qualitative research study addressed the problem that the healthcare industry has no clear evidence of the academic competencies that influence the attainment of organizational success. The study was based on one case study at a Commission on Accreditation of Healthcare Management Education (CAHME) accredited Masters of Health Administration…
Mozhgan Javadnoori; Sanaz Zangeneh; Mitra Tadayon; Mohamadreza Akhoond
Background & aim: Sexual health education is one of the responsibilities of healthcare workers at schools, which can reduce the risk of sexually transmitted diseases such as AIDS, unwanted pregnancy, abortion, substance abuse, sexual violence, and suicidal tendencies. This study aimed to investigate healthcare workers’ competence in sexual health education for female adolescents at schools. Methods:This cross-sectional study was conducted on 300 healthcare workers, responsible for sexual heal...
Carnevale, Franco A; Macdonald, Mary Ellen; Razack, Saleem; Steinert, Yvonne
An interdisciplinary faculty development workshop on cultural competency (CC) was implemented and evaluated for the Faculty of Medicine at McGill University. It consisted of a 4-hour workshop and 2 follow-up sessions. A reflective practice framework was used. The project was evaluated using the Multicultural Assessment Questionnaire (MAQ), evaluation forms completed by participants, and detailed field notes taken during the sessions. The workshop was attended by 49 faculty members with diverse professional backgrounds. Statistically significant improvements were measured using the MAQ. On a scale of 1 to 5 (5 = very useful) on the evaluation form, the majority of participants (76.1%) gave the workshop a score of 4 or 5 for overall usefulness. A thematic analysis of field-note data highlighted participant responses to specific activities in the workshop. Participants expressed a need for faculty development initiatives on CC such as this one. Copyright© by Ingram School of Nursing, McGill University.
Costantino, Giuseppe; Malgady, Robert G.; Primavera, Louis H.
This study investigated a new 2-factor construct, termed "cultural congruence", which is related to cultural competence in the delivery of mental health services to ethnic minority clients. Cultural congruence was defined as the distance between the cultural competence characteristics of the health care organization and the clients' perception of…
Marla B. Hall
Full Text Available Racial and ethnic minority health data from a national perspective indicates there is much to learn in the public health workforce about the ongoing health disparities crisis. This suggests a level of urgency to assist our public health professionals in obtaining specific skills sets that will assist them in working better with vulnerable populations. The purpose of this research is to assess cultural competence knowledge and programmatic skill sets, utilizing an explorational case study, of individuals employed within an urban public health department. In order to effectively evaluate these constructs, a quantitative research approach was employed to examine participants’ knowledge and competencies of the subject matter. This data was further analyzed to determine if continuing education participation and training was correlated to the levels of culturally competent practice engagement and self-reported confidence. In addition, researchers obtained data on the availability of employer sponsored training opportunities. The data suggested when health professionals engage in cultural competence education, their level of awareness of unique characteristics between ethnic and racial minorities increased. Those who exhibited the healthiest behaviors, as it relates to effectively working with diverse populations, had a heightened sense of knowledge related to culture and healthcare services. Continuing education in cultural competence is an essential strategy for improving public health employees’ effectiveness in working with diverse clients and reducing racial and ethnic health disparities. As the finding illustrated, training programs must incorporate educational components which foster skill building to enable subsequent culturally appropriate clinical interactions.
Ly, Catherine L; Chun, Maria B J
Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Madden, Erin Fanning
Communities struggling with access to healthcare in the U.S. are often considered to be disadvantaged and lacking in resources. Yet, these communities develop and nurture valuable strategies for healthcare access that are underrecognized by health scholars. Combining medical sociology and critical race theory perspectives on cultural capital, this paper examines the health-relevant cultural resources, or Cultural Health Capital, in South Texas Mexican American border communities. Ethnographic data collected during 2011-2013 in Cameron and Hidalgo counties on the U.S.-Mexico border provide empirical evidence for expanding existing notions of health-relevant cultural capital. These Mexican American communities use a range of cultural resources to manage healthcare exclusion and negotiate care in alternative healthcare spaces like community clinics, flea markets and Mexican pharmacies. Navigational, social, familial, and linguistic skills and knowledge are used to access doctors and prescription drugs in these spaces despite social barriers to mainstream healthcare (e.g. cost, English language skills, etc.). Cultural capital used in marginalized communities to navigate limited healthcare options may not always fully counteract healthcare exclusion. Nevertheless, recognizing the cultural resources used in Mexican American communities to facilitate healthcare challenges deficit views and yields important findings for policymakers, healthcare providers, and advocates seeking to capitalize on community resources to improve healthcare access. Copyright © 2015 Elsevier Ltd. All rights reserved.
Huda A. Al-Shehri
Full Text Available Objectives: To probe dental students’ perceptions on their cultural competency and international student exchange programs as a way of improving cultural competency training. Methods: A cross-sectional survey (n=460 was distributed to predoctoral students at the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia in May 2014 at the male and female university campuses. Descriptive statistics were carried out using Statistical Package for Social Sciences (p=0.05. Results: It was found that 79.6% of students think that teaching them regarding cultural diversity is important. Only 41% of students thought their dental education teaches them on the importance of volunteerism and philanthropy. Most students (89.8% think that international student exchanges can enhance their cultural competence. Conclusion: In this study, it was found that students believe that cultural competence is important and participation in international student exchange programs can enhance their training.
Al-Shehri, Huda A; Al-Taweel, Sara M; Ivanoff, Chris S
To probe dental students' perceptions on their cultural competency and international student exchange programs as a way of improving cultural competency training. A cross-sectional survey (n=460) was distributed to predoctoral students at the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia in May 2014 at the male and female university campuses. Descriptive statistics were carried out using Statistical Package for Social Sciences (p=0.05). It was found that 79.6% of students think that teaching them regarding cultural diversity is important. Only 41% of students thought their dental education teaches them on the importance of volunteerism and philanthropy. Most students (89.8%) think that international student exchanges can enhance their cultural competence. In this study, it was found that students believe that cultural competence is important and participation in international student exchange programs can enhance their training.
Zachariadou, Theodora; Zannetos, Savvas; Pavlakis, Andreas
The concept of organizational culture is important in understanding the behaviour of individuals in organizations as they manage external demands and internal social changes. Cyprus healthcare system is under restructuring and soon a new healthcare scheme will be implemented starting at the Primary Healthcare (PHC) level. The aim of the study was to investigate the underlying culture encountered in the PHC setting of Cyprus and to identify possible differences in desired and prevailing cultures among healthcare professionals. The population of the study included all general practitioners (GPs) and nursing staff working at the 42 PHC centres throughout the island. The shortened version of the Organizational Culture Profile questionnaire comprising 28 statements on organizational values was used in the study. The instrument was already translated and validated in Greek and cross-cultural adaptation was performed. Participants were required to indicate the organization's characteristic cultural values orientation along a five-point Likert scale ranging from "Very Much = 1" to "Not at all= 5". Statistical analysis was performed using SPSS 16.0. Student t-test was used to compare means between two groups of variables whereas for more than two groups analysis of variance (ANOVA) was applied. From the total of 306 healthcare professionals, 223 participated in the study (72.9%). The majority of participants were women (75.3%) and mean age was 42.6 ± 10.7 years. Culture dimension "performance orientation" was the desired culture among healthcare professionals (mean: 1.39 ± 0.45). "Supportiveness" and "social responsibility" were the main cultures encountered in PHC (means: 2.37 ± 0.80, 2.38 ± 0.83). Statistical significant differences were identified between desired and prevailing cultures for all culture dimensions (p= 0.000). This was the first study performed in Cyprus assessing organizational culture in the PHC setting. In the forthcoming health system reform
Wong, Chin Hoong; Chen, Lee Ping; Koh, Kwee Choy; Chua, Siew Houy; Jong, Darren Chee Hiung; Mohd Fauzi, Nurliyana Mardhiah; Lim, Sue Yin
Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this co...
When preparing students for study abroad, understanding the religious dimension of the target country/culture is generally viewed as essential for cultural competency training. What is generally left unexamined is the civil religious culture that might be operative. This essay first provides an introduction to the concept as it was introduced by…
Full Text Available The aim of this study is to explore the influence of education and additional factors influencing students’ awareness of intercultural differences. For the purposes of this research assessment was carried out with regard to their role in promoting cultural awareness and facing cross-cultural challenges posed by unfamiliar cross-cultural contexts. Cultural education is presumed to be a key factor for achieving a significant increase of cultural sensitivity and cultural awareness in order to ensure successful cross-cultural communication and increase mobility of students/working professionals. For this study, it was assumed that the cultural awareness of students increases due to the courses they take and their overall study experience. A special questionnaire was developed for the purposes of this research, and the obtained results were statistically analyzed with the help of descriptive statistics, the non-parametric chi-square test, and the Mann-Whitney test. The research has shown that intercultural competence has a statistically significant positive effect on the readiness of students to participate in study and work programs abroad. Thus, it is mandatory that foreign language competence as well as intercultural competence be a priority of the curriculum if we are to increase the number of highly educated experts who will be capable to compete successfully as students or professionals in all fields and all cultural areas. If we recognize that globalization has made the world a global village, we all need the intercultural competence to successfully live in it.
Holyfield, Lavern J; Miller, Barbara H
Policies exist to promote fairness and equal access to opportunities and services that address basic human needs of all U.S. citizens. Nonetheless, health disparities continue to persist among certain subpopulations, including those of racial, ethnic, geographic, socioeconomic, and other cultural identity groups. The Commission on Dental Accreditation (CODA) has added standards to address this concern. According to the most recent standards, adopted in 2010 for implementation in July 2013, CODA stipulates that "students should learn about factors and practices associated with disparities in health." Thus, it is imperative that dental schools develop strategies to comply with this addition. One key strategy for compliance is the inclusion of cultural competence training in the dental curriculum. A survey, the Dental Tool for Assessing Cultural Competence Training (D-TACCT), based on the Association of American Medical Colleges' Tool for Assessing Cultural Competence Training (TACCT), was sent to the academic deans at seventy-one U.S. and Canadian dental schools to determine best practices for cultural competence training. The survey was completed by thirty-seven individuals, for a 52 percent response rate. This article describes the use of this survey as a guide for developing culturally competent strategies and enhancing cultural competence training in dental schools.
Siegel, Carole; Haugland, Gary; Reid-Rose, Lenora; Hopper, Kim
The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chinese day treatment program in a community-based agency. Nine study-trained field researchers used a semistructured instrument that captures program genealogy, structure, processes, and cultural infusion. Program cultural elements were identified from field notes and from individual and group interviews of consumers and staff (N=104). A research-group consensus process with feedback from program staff was used to group elements by shared characteristics into the program components of cultural competence. Components included communication competencies (with use of colloquialisms and accepted forms of address); staff in culturally acceptable roles; culturally framed trust building (such as pairing youths with mentors), stigma reduction, friendly milieus (such as serving culturally familiar foods and playing music popular with the culture), and services; and peer, family, and community involvement (including use of peer counselors and mentors, hosting parent weekends, and linking clients with senior center and community services). Incorporating these components into any program in which underserved cultural populations are seen is recommended for improving cultural competence.
Lyons, Zaza; Laugharne, Jonathan
Multiculturalism is a familiar concept in many developed countries. While cultural competency training is part of most medical curricula, training in cultural psychiatry at the undergraduate level is typically minimal. It is important that medical graduates are both culturally competent and able to respond to the mental health needs of patients…
Echeverri, Margarita; Brookover, Cecile; Kennedy, Kathleen
Pharmacists play an increasingly important role in medication therapy management, which requires communicating effectively with patients. Pharmacy students completed the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire, and their results were used to identify patterns in self-assessment of cultural competence. In general, students rated their knowledge as less than their skills and attitudes. Important differences were found by race, comparing each group with its counterparts: African American students rated their perceived competencies regarding patient discrimination and barriers to health care at a significantly higher level; Asian American students rated their attitudes to engaging in self-reflection and their knowledge in multicultural issues at significantly lower level; and White students rated their awareness regarding racial dynamics at a significantly lower level. It is recommended to consider the students’ cultural, racial, and ethnic backgrounds before developing curriculum in cultural competence and, perhaps, to develop targeted educational interventions for specific groups. PMID:23395945
... in country studies classes (based on Turkish language teaching practice) ... the acquisition of common cultural competence in foreign language education. ... analysis of methodological frameworks offered by Russian and foreign specialists.
Jagers, Robert J.
Describes evolving efforts to promote African American children's social and emotional competencies, examining moral competence. Proposes a cultural psychology framework to highlight the theme of communalism and morality of care. Identifies various moral events, offering knowledge of moral emotions and moral self-efficacy as key constructs.…
Epner, D E; Baile, W F
Much of the early literature on 'cultural competence' focuses on the 'categorical' or 'multicultural' approach, in which providers learn relevant attitudes, values, beliefs, and behaviors of certain cultural groups. In essence, this involves learning key 'dos and don'ts' for each group. Literature and educational materials of this kind focus on broad ethnic, racial, religious, or national groups, such as 'African American', 'Hispanic', or 'Asian'. The problem with this categorical or 'list of traits' approach to clinical cultural competence is that culture is multidimensional and dynamic. Culture comprises multiple variables, affecting all aspects of experience. Cultural processes frequently differ within the same ethnic or social group because of differences in age cohort, gender, political association, class, religion, ethnicity, and even personality. Culture is therefore a very elusive and nebulous concept, like art. The multicultural approach to cultural competence results in stereotypical thinking rather than clinical competence. A newer, cross cultural approach to culturally competent clinical practice focuses on foundational communication skills, awareness of cross-cutting cultural and social issues, and health beliefs that are present in all cultures. We can think of these as universal human beliefs, needs, and traits. This patient centered approach relies on identifying and negotiating different styles of communication, decision-making preferences, roles of family, sexual and gender issues, and issues of mistrust, prejudice, and racism, among other factors. In the current paper, we describe 'cultural' challenges that arise in the care of four patients from disparate cultures, each of whom has advanced colon cancer that is no longer responding to chemotherapy. We then illustrate how to apply principles of patient centered care to these challenges.
Waldman, J Deane; Smith, Howard L; Hood, Jacqueline N
The U.S. healthcare system requires radical, not incremental, change. Management issues in healthcare delivery are fundamentally different from those in the business world. Systems thinking forces a focus on corporate culture, about which there is little hard data. The use of cost/benefit analysis suffers from the lack of any accepted measure of long-term "benefit." The authors make four observations: (1) corporate culture is both part of the cause and part of the cure for healthcare; (2) long-term financial and functional measures are necessary to make evidence-based decisions; (3) valid, nationwide data must be developed regarding the corporate culture of medicine; and (4) direct (unmodified) application of management theory or practices will not achieve sustainable improvements.
Outsourcing requires staff from two organisations to work together to achieve sometimes conflicting ends. Practitioner advice suggests a matching of organisational cultures; however, whilst there is some research on the impact of national culture in offshore outsourcing, little attention has been paid to the issue of organisational culture, nor the type of interventions that may be useful. This paper discusses research on differences in organisational culture between suppliers and clients in ...
Anderson, Kathryn L
Fadiman's work of literary journalism, The Spirit Catches You and You Fall Down, was used as a case study to teach transcultural and other nursing concepts to undergraduate nursing students. Campinha-Bacote's model of cultural competence was used to organize transcultural nursing concepts in the course. Before and after the course, students completed assessments consisting of two cultural attitude questionnaires and a paper describing a personal experience with adherence and failure to adhere by a Mexican American client. After reading Fadiman's book and completing several short writing assignments examining key course concepts, student scores on the questionnaires were mostly unchanged. However, students demonstrated growth in cultural awareness and skill in their "after" papers. Results suggest that valid, reliable tools are needed to detect changes in cultural competence. Qualitative data suggest that students can begin the process of becoming culturally competent through the creative use of literature in nursing education.
Lamb, Gerri; Shraiky, James
Many universities in the United States are investing in classrooms and campuses designed to increase collaboration and teamwork among the health professions. To date, we know little about whether these learning spaces are having the intended impact on student performance. Recent advances in the identification of interprofessional teamwork competencies provide a much-needed step toward a defined outcome metric. Rigorous study of the relationship between design and student competence in collaboration also requires clear specification of design concepts and development of testable frameworks. Such theory-based evaluation is crucial for design to become an integral part of interprofessional education strategies and initiatives. Current classroom and campus designs were analyzed for common themes and features in collaborative spaces as a starting place for specification of design concepts and model development. Four major themes were identified: flexibility, visual transparency/proximity, technology and environmental infrastructure. Potential models linking this preliminary set of design concepts to student competencies are proposed and used to generate hypotheses for future study of the impact of collaborative design spaces on student outcomes.
Boroughs, Michael S.; Andres Bedoya, C.; O'Cleirigh, Conall; Safren, Steven A.
A central part of providing evidence-based practice is appropriate cultural competence to facilitate psychological assessment and intervention with diverse clients. At a minimum, cultural competence with lesbian, gay, bisexual, and transgender (LGBT) people involves adequate scientific and supervised practical training, with increasing depth and complexity across training levels. In order to further this goal, we offer 28 recommendations of minimum standards moving toward ideal training for LGBT-specific cultural competence. We review and synthesize the relevant literature to achieve and assess competence across the various levels of training (doctoral, internship, post-doctoral, and beyond) in order to guide the field towards best practices. These recommendations are aligned with educational and practice guidelines set forth by the field and informed by other allied professions in order to provide a roadmap for programs, faculty, and trainees in improving the training of psychologists to work with LGBT individuals. PMID:26279609
Fe, E.; Powell-Jackson, T.; Yip, W.
: The agency problem between patients and doctors has long been emphasised in the health economics literature, but the empirical evidence on whether patients can evaluate and respond to better quality care remains mixed and inconclusive. Using household data linked to an assessment of village doctors' clinical competence in rural China, we show that there is no correlation between doctor competence and patients' healthcare utilisation, with confidence intervals reasonably tight around zero. H...
Costa, Claudio; Roncoroni, Elisabetta; Saiani, Luisa; Stevanin, Simone; Fanton, Elena; Mantoan, Domenico
Presented here is the approach used by a multidisciplinary working group fo the drafting of the "core" competence profile of the healthcare professions manager in the Veneto Region. Defining a competence profile allows for specifying a standard for measuring the skills acquired by a professional and the gap level from what is expected by the organization, as well as orienting the preparatory education to carry out the related role.
Campbell, Alex; Sullivan, Maura; Sherman, Randy; Magee, William P
Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available Background & aim: Sexual health education is one of the responsibilities of healthcare workers at schools, which can reduce the risk of sexually transmitted diseases such as AIDS, unwanted pregnancy, abortion, substance abuse, sexual violence, and suicidal tendencies. This study aimed to investigate healthcare workers’ competence in sexual health education for female adolescents at schools. Methods:This cross-sectional study was conducted on 300 healthcare workers, responsible for sexual health education at schools in 2015. A valid and reliable researcher-made questionnaire was completed by the healthcare workers in order to assess their competence in sexual health education at healthcare centers of Khuzestan, Iran. To assess the competence of the participants (i.e., knowledge, attitude, confidence, and performance, descriptive statistics were calculated for quantitative variables. Also, mean, standard deviation, frequency, and percentage were calculated for qualitative variables. Pearson’s correlation test was performed to assess the relationship between the subjects’ knowledge, attitude, confidence, and performance. Also, the association between demographic variables and participants’ knowledge, attitude, confidence, and performance was evaluated, using analysis of variance (ANOVA. Data were analyzed, using SPSS version 21.0. Results: Knowledge, attitude, and confidence of healthcare workers in sexual health education were desirable. However, the subjects showed a poor performance in teaching students the required skills to control their emotions, instincts, homosexual tendencies, and masturbation. There was a significant correlation between performance, attitude, and confidence, knowledge and attitude, performance and confidence, and confidence, performance, and attitude (P
Venkataraman, Shruthi; Jordan, Gerald; Pope, Megan A; Iyer, Srividya N
To better understand cultural competence in early intervention for psychosis, we compared service users' and service providers' perceptions of the importance of providers being culturally competent and attentive to aspects of culture. At a Canadian early intervention programme, a validated scale was adapted to assess service user (N = 51) and provider (N = 30) perceptions of service providers' cultural competence and the importance accorded thereto. Analyses of variance revealed that the importance of service providers being culturally competent was rated highest by service providers, followed by visible minority service users, followed by white service users. Providers rated themselves as being more interested in knowing about service users' culture than service users perceived them to be. Service users accorded less import to service providers' cultural competence than providers themselves, owing possibly to varied socialization. A mismatch in users' and providers' views on providers' efforts to know their users' cultures may influence mental healthcare outcomes. © 2017 John Wiley & Sons Australia, Ltd.
The majority of students who took this general education undergraduate course in developing cross-cultural understanding at a state college in the northeastern United States reported that their level of cross-cultural competence and global awareness increased by the end of the course. The primary course objective was to help students better…
Euler, Sasha S.
This article presents a detailed methodological outline for teaching culture through project work. It is argued that because project work makes it possible to gain transferrable and applicable knowledge and insight, it is the ideal tool for teaching culture with the aim of achieving real intercultural communicative competence (ICC). Preceding the…
This article aims to define organisational culture and explain why it is important to patients, carers and those working in healthcare environments. Organisational culture is not a new concept and the literature on the subject is well-established. However, because of the changing dynamics of the NHS, there has been a shift away from 'what' the NHS stands for, often relating to its history and rituals, to 'who' it functions for, including how healthcare professionals such as nurses can develop and drive the organisational culture. The article seeks to assist nurses in understanding the role of organisational culture, as well as implementing its main principles in the workplace. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Fung, Kenneth; Andermann, Lisa; Zaretsky, Ari; Lo, Hung-Tat
As it is increasingly recognized that cultural competence is an essential quality for any practicing psychiatrist, postgraduate psychiatry training programs need to incorporate cultural competence training into their curricula. This article documents the unique approach to resident cultural competence training being developed in the Department of Psychiatry at the University of Toronto, which has the largest residency training program in North America and is situated in an ethnically diverse city and country. The authors conducted a systematic review of cultural competence by searching databases including PubMed, PsycINFO, PsycArticles, CINAHL, Social Science Abstracts, and Sociological Abstracts; by searching government and professional association publications; and through on-site visits to local cross-cultural training programs. Based on the results of the review, a resident survey, and a staff retreat, the authors developed a deliberate "integrative" approach with a mindful, balanced emphasis on both generic and specific cultural competencies. Learning objectives were derived from integrating the seven core competencies of a physician as defined by the Canadian Medical Education Directions for Specialists (CanMEDS) roles framework with the tripartite model of attitudes, knowledge, and skills. The learning objectives and teaching program were further integrated across different psychiatric subspecialties and across the successive years of residency. Another unique strategy used to foster curricular and institutional change was the program's emphasis on evaluation, making use of insights from modern educational theories such as formative feedback and blueprinting. Course evaluations of the core curriculum from the first group of residents were positive. The authors propose that these changes to the curriculum may lead to enhanced cultural competence and clinical effectiveness in health care.
Weech-Maldonado, Robert; Elliott, Marc; Pradhan, Rohit; Schiller, Cameron; Dreachslin, Janice; Hays, Ron D.
Cultural competency has been proposed as an organizational strategy to address racial/ethnic disparities in the health care system; disparities are a long-standing policy challenge whose relevance is only increasing with the increasing population diversity of the US and across the world. Using an integrative conceptual framework based on the resource dependency and institutional theories, we examine the relationship between organizational and market factors and hospitals’ degree of cultural competency. Our sample consists of 119 hospitals located in the state of California (US) and is constructed using the following datasets for the year 2006: Cultural Competency Assessment Tool of Hospitals (CCATH) Survey, California’s Office of Statewide Health Planning & Development’s Hospital Inpatient Discharges and Annual Hospital Financial Data, American Hospital Association’s Annual Survey, and the Area Resource File. The dependent variable consists of the degree of hospital cultural competency, as assessed by the CCATH overall score. Organizational variables include ownership status, teaching hospital, payer mix, size, system membership, financial performance, and the proportion of inpatient racial/ethnic minorities. Market characteristics included hospital competition, the proportion of racial/ethnic minorities in the area, metropolitan area, and per capita income. Regression analyses were conducted to assess the relationship between the CCATH overall score and organizational and market variables. Our results show that hospitals which are not-for-profit, serve a more diverse inpatient population, and are located in more competitive and affluent markets exhibit a higher degree of cultural competency. Our results underscore the importance of both institutional and competitive market pressures in guiding hospital behavior. For instance, while not-for-profit may adopt innovative/progressive policies like cultural competency simply as a function of their organizational
Chin Hoong Wong
Full Text Available Since 2013, medical students from the International Medical University (IMU in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural
Manderson, Lenore; Allotey, Pascale
Medical competence is demonstrated in multiple ways in clinical settings, and includes technical competence, both in terms of diagnosis and management, and cultural competence, as demonstrated in communication between providers and clients. In cross-cultural contexts, such communication is complicated by interpersonal communication and the social and cultural context. To illustrate this, we present four case studies that illustrate the themes from interviews with immigrant women and refugees from Middle Eastern and Sahel African backgrounds, conducted as part of a study of their reproductive health. In our analysis, we highlight the limitations of conventional models of communication. We illustrate the need for health providers to appreciate the possible barriers of education, ethnicity, religion and gender that can impede communication, and the need to be mindful of broader structural, institutional and inter-cultural factors that affect the quality of the clinical encounter.
Lo, Ming-Cheng M; Stacey, Clare L
In response to widely documented racial and ethnic disparities in health, clinicians and public health advocates have taken great strides to implement 'culturally competent' care. While laudable, this important policy and intellectual endeavour has suffered from a lack of conceptual clarity and rigour. This paper develops a more careful conceptual model for understanding the role of culture in the clinical encounter, paying particular attention to the relationship between culture, contexts and social structures. Linking Bourdieu's (1977) notion of 'habitus' and William Sewell's (1992) axioms of multiple and intersecting structures, we theorise patient culture in terms of 'hybrid habitus'. This conceptualisation of patient culture highlights three analytical dimensions: the multiplicity of schemas and resources available to patients, their specific patterns of integration and application in specific contexts, and the constitutive role of clinical encounters. The paper concludes with a discussion of directions for future research as well as reforms of cultural competency training courses.
This article introduces a Taiwan Study Abroad program on aging, culture, and healthcare. The program is a short-term academic summer program (6 credits) to bring U.S. students to Taiwan. During 2011 ~ 2015, a total of four groups including over 54 students and faculty members participated. This program partnered with multiple universities,…
Full Text Available The globalization of medical practice using accepted evidence-based approaches is matched by a growing trend for shared curricula in medicine and other health professions across international boundaries. Interest in the common challenges of curricular design, delivery and assessment is expressed in conferences and dialogues focused on topics such as teaching of professionalism, humanism, integrative medicine, bioethics and cultural competence. The spirit of collaboration, sharing, acknowledgment and mutual respect is a guiding principle in cross-cultural teaching. This paper uses the Tool for Assessing Cultural Competency Training to explore methods for designing and implementing cultural competency curricula. The intent is to identify elements shared across institutional, national and cross-cultural borders and derive common principles for the assessment of learners and the curricula. Two examples of integrating new content into existing clerkships are provided to guide educators interested in an integrated and learner-centered approach to assimilate cultural competency teaching into existing required courses, clerkships and elective experiences. The paper follows an overarching principle that “every patient–doctor encounter is a cross-cultural encounter”, whether based on ethnicity, age, socioeconomic status, sex, religious values, disability, sexual orientation or other differences; and whether the differences are explicit or implicit.
Mobula, Linda M; Okoye, Mekam T; Boulware, L Ebony; Carson, Kathryn A; Marsteller, Jill A; Cooper, Lisa A
Community health worker (CHW) interventions improve health outcomes of patients from underserved communities, but health professionals' perceptions of their effectiveness may impede integration of CHWs into health care delivery systems. Whether health professionals' attitudes and skills, such as those related to cultural competence, influence perceptions of CHWs, is unknown. A questionnaire was administered to providers and clinical staff from 6 primary care practices in Maryland from April to December 2011. We quantified the associations of self-reported cultural competence and preparedness with attitudes toward the effectiveness of CHWs using logistic regression adjusting for respondent age, race, gender, provider/staff status, and years at the practice. We contacted 200 providers and staff, and 119 (60%) participated. Those reporting more cultural motivation had higher odds of perceiving CHWs as helpful for reducing health care disparities (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 3.48-28.80). Those reporting more frequent culturally competent behaviors also had higher odds of believing CHWs would help reduce health disparities (OR = 3.58, 95% CI = 1.61-7.92). Attitudes toward power and assimilation were not associated with perceptions of CHWs. Cultural preparedness was associated with perceived utility of CHWs in reducing health care disparities (OR = 2.33, 95% CI = 1.21-4.51). Providers and staff with greater cultural competence and preparedness have more positive expectations of CHW interventions to reduce healthcare disparities. Cultural competency training may complement the use of CHWs and support their effective integration into primary care clinics that are seeking to reduce disparities. © The Author(s) 2014.
Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.
Allen, Carol B; Smart, Denise A; Odom-Maryon, Tamara; Swain, Deborah
International immersion experiences for health-care students have increased over the past 10 years. Students and faculty expect these experiences to increase cultural competency; however, research on outcomes of these programs has lacked rigor. Over a 4-year period, groups of nursing and other health professions students spent 3 weeks in Peru providing primary care and health education. Students attended pre-departure seminars addressing personal travel health and safety, culture and health care in Peru, working with interpreters, and ethics of international health care. Student participants (N=77) completed an instrument assessing self-perceived cultural competency before and after the experience. Results of pre- and post-immersion scores showed significant increases in perceived cultural competency and increased self-efficacy in cultural knowledge, skills, and attitudes for four groups of students. Implications and future directions are discussed and recommended.
Gertner, Eric J; Sabino, Judith N; Mahady, Erica; Deitrich, Lynn M; Patton, Jarret R; Grim, Mary Kay; Geiger, James F; Salas-Lopez, Debbie
The number of cultural competency initiatives in healthcare is increasing due to many factors, including changing demographics, quality improvement and regulatory requirements, equitable care missions, and accreditation standards. To facilitate organization-wide transformation, a hospital or healthcare system must establish strategic goals, objectives, and implementation tasks for culturally competent provision of care. This article reports the largely successful results of a cultural competency program instituted at a large system in eastern Pennsylvania. Prior to the development of its cultural competency initiative, Lehigh Valley Health Network, Allentown, Pennsylvania, saw isolated activities producing innovative solutions to diversity and culture issues in the provision of equitable care. But it took a transformational event to support an organization-wide program in cultural competency by strengthening leadership buy-in and providing a sense of urgency, excitement, and shared vision among multiple stakeholders. A multidisciplinary task force, including senior leaders and a diverse group of employees, was created with the authority and responsibility to enact changes. Through a well-organized strategic planning process, existing patient and community demographic data were reviewed to describe existing disparities, a baseline assessment was completed, a mission statement was created, and clear metrics were developed. The strategic plan, which focused on five key areas (demographics, language-appropriate services, employees, training, and education/communication), was approved by the network's chief executive officer and senior managers to demonstrate commitment prior to implementation. Strategic plan implementation proceeded through a project structure consisting of subproject teams charged with achieving the following specific objectives: develop a cultural material repository, enhance employee recruitment/retention, establish a baseline assessment
Pellegrin, Karen L; Currey, Hal S
Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.
Mark A Strand
Full Text Available Career service in cross-cultural healthcare mission work is the ambition of many people around the world. However, premature termination of this expected long-term service mitigates against achieving the goals of the individual and the organization. The lingering challenge of high rates of missionary attrition impacts the long-term effectiveness of the work and the health and well-being of the workers. One of the keys to reducing premature attrition is cross-cultural training for these individuals, provided it offers the right content, through the best medium, at the time of greatest perceived need by the missionary. This paper applies the Dreyfus Model of skills acquisition to the process of mentoring career healthcare missionaries in a progressive manner, utilizing a mentoring method. These missionaries can flourish in their work and more effectively achieve their individual and organizational goals through strategic mentorship that clearly defines a pathway for growing their cross-cultural skills.
Khan, Kamran; Ramachandran, Sankaranarayanan
The definitions of performance, competence and competency are not very clear in the literature. The assessment of performance and the selection of tools for this purpose depend upon a deep understanding of each of the above terms and the factors influencing performance. In this article, we distinguish between competence and competency and explain the relationship of competence and performance in the light of the Dreyfus model of skills acquisition. We briefly critique the application of the principles described by Miller to the modern assessment tools and distinguish between assessment of actual performance in workplace settings and the observed performance, demonstrated by the candidates in the workplace or simulated settings. We describe a modification of the Dreyfus model applicable to assessments in healthcare and propose a new model for the assessment of performance and performance rating scale (PRS) based on this model. We propose that the use of adapted versions of this PRS will result in benchmarking of performance and allowing the candidates to track their progression of skills in various areas of clinical practice.
Seeleman, Conny; Hermans, Jessie; Lamkaddem, Majda; Suurmond, Jeanine; Stronks, Karien; Essink-Bot, Marie-Louise
Background Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper describes the outcomes of an assessment of knowledge, reflection ability and self-reported culturally competent consultation behaviour, the relation between these assessments and self-percei...
Johnson, W. Lewis
Cultural knowledge and skills are critically important for military operations, emergency response, or any job that involves interaction with a culturally diverse population. However, it is not obvious what cultural knowledge and skills need to be trained, and how to integrate that training with the other training that trainees must undergo. Cultural training needs to be broad enough to encompass both regional (culture-specific) and cross-cultural (culture-general) competencies, yet be focused enough to result in targeted improvements in on-the-job performance. This paper describes a comprehensive instructional development methodology and training technology framework that focuses cultural training on operational needs. It supports knowledge acquisition, skill acquisition, and skill transfer. It supports both training and assessment, and integrates with other aspects of operational skills training. Two training systems will be used to illustrate this approach: the Virtual Cultural Awareness Trainer (VCAT) and the Tactical Dari language and culture training system. The paper also discusses new and emerging capabilities that are integrating cultural competence training more strongly with other aspects of training and mission rehearsal.
Health care providers are members of a helping profession and need to provide quality care to all members of society. As a result of current and projected demographic changes within the United States (U.S.), health care professionals are faced with the challenges of providing culturally competent care and fulfilling the role as the "helping profession." In the past 10 years, minority populations have increased in the U.S. For example, the African American population experienced an approximate 12.3% increase, and the Hispanic population increased by 43%. Just as it is necessary for health care professionals to respond to the increase in the geriatric population as a result of the Baby Boomer generation, it is crucial to address the needs of an increasingly culturally diverse population in the U.S. Preparing to care for a culturally diverse population begins during the teaching and learning process in the nursing curriculum. This study intended to identify the methods in which nursing programs are integrating cultural concepts in their plan of study. Josepha Campinha-Bacote's model titled "The Process of Cultural Competence in the Delivery of Health Care Services" was used as the theoretical framework to guide this study. Campinha-Bacote has studied transcultural nursing and has added to the current body of nursing knowledge with regard to incorporating cultural concepts in the nursing curriculum. This model requires health care professionals to see themselves as becoming culturally competent rather than being culturally competent and involves the integration of cultural awareness, cultural skill, cultural knowledge, cultural encounters, and cultural desire. An electronic survey was sent using Survey Monkey to 298 schools in the Northeast and Southern regions of the United States. The survey was sent on January 19, 2012 and remained open for 20 days. Once the survey closed, statistical analyses were conducted using frequencies and cross-tabluations, and the findings
Arvonio, Maria Marra
The use of complementary and alternative medicines (CAM) such as Reiki is on the rise in healthcare centers. Reiki is associated with a spirituality that conflicts with some belief systems. Catholic healthcare facilities are restricted from offering this therapy because it conflicts with the teachings of the Catholic Church. However, hospitals are offering it without disclosing the spiritual aspects of it to patients. This article will address the ethical concerns and possible legal implications associated with the present process of offering Reiki. It will address these concerns based on the Joint Commission's Standard of Cultural Competency and the ethical principles of autonomy and informed consent. A proposal will also be introduced identifying specific information which Reiki/CAM practitioners should offer to their patients out of respect of their autonomy as well as their cultural, spiritual, and religious beliefs. PMID:24899738
This paper presents the findings of a six-week telecollaborative project between sixteen American students enrolled in a second-semester German class at an American university and sixteen German students enrolled in an advanced English course at a high school in Germany. Students discussed various cultural topics with their partner in two e-mails…
Nuttbrock, Larry A
Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.
Kamaka, Martina L
The design of a cultural competency curriculum can be challenging. The 2002 Institute of Medicine report, Unequal Treatment, challenged medical schools to integrate cross-cultural education into the training of all current and future health professionals. However, there is no current consensus on how to do this. The Department of Native Hawaiian Health at the John A. Burns School of Medicine formed a Cultural Competency Curriculum Development team that was charged with developing a curriculum for the medical school to address Native Hawaiian health disparities. By addressing cultural competency training of physicians, the team is hoping to help decrease the health disparities found in Native Hawaiians. Prior attempts to address culture at the time consisted of conferences sponsored by the Native Hawaiian Center of Excellence for faculty and clinicians and Problem Based Learning cases that have imbedded cultural issues. Gather ideas from focus groups of Native Hawaiian stake- holders. The stakeholders consisted of Native Hawaiian medical students, patients and physicians. Information from the focus groups would be incorporated into a medical school curriculum addressing Native Hawaiian health and cultural competency training. Focus groups were held with Native Hawaiian medical students, patients and physicians in the summer and fall of 2006. Institutional Review Board approval was obtained from the University of Hawaii as well as the Native Hawaiian Health Care Systems. Qualitative analysis of tape recorded data was performed by looking for recurrent themes. Primary themes and secondary themes were ascertained based on the number of participants mentioning the topic. Amongst all three groups, cultural sensitivity training was either a primary theme or secondary theme. Primary themes were mentioned by all students, by 80% of the physicians and were mentioned in all 4 patient groups. Secondary themes were mentioned by 75% of students, 50% of the physicians and by 75
Maulitz, Russell; Santarelli, Thomas; Barnieu, Joanne; Rosenzweig, Larry; Yi, Na Yi; Zachary, Wayne; OConnor, Bonnie
Personnel from diverse ethnic and demographic backgrounds come together in both civilian and military healthcare systems, facing diagnoses that at one level are equalizers: coronary disease is coronary disease, breast cancer is breast cancer. Yet the expression of disease in individuals from different backgrounds, individual patient experience of disease as a particular illness, and interactions between patients and providers occurring in any given disease scenario, all vary enormously depending on the fortuity of the equation of "which patient happens to arrive in whose exam room." Previously, providers' absorption of lessons-learned depended on learning as an apprentice would when exposed over time to multiple populations. As a result, and because providers are often thrown into situations where communications falter through inadequate direct patient experience, diversity in medicine remains a training challenge. The questions then become: Can simulation and virtual training environments (VTEs) be deployed to short-track and standardize this sort of random-walk problem? Can we overcome the unevenness of training caused by some providers obtaining the valuable exposure to diverse populations, whereas others are left to "sink or swim"? This paper summarizes developing a computer-based VTE called TEACH (Training to Enable/Achieve Culturally Sensitive Healthcare). TEACH was developed to enhance healthcare providers' skills in delivering culturally sensitive care to African-American women with breast cancer. With an authoring system under development to ensure extensibility, TEACH allows users to role-play in clinical oncology settings with virtual characters who interact on the basis of different combinations of African American sub-cultural beliefs regarding breast cancer. The paper reports on the roll-out and evaluation of the degree to which these interactions allow providers to acquire, practice, and refine culturally appropriate communication skills and to
Pecukonis, Edward; Doyle, Otima; Bliss, Donna Leigh
The need to train health professionals who can work across disciplines is essential for effective, competent, and culturally sensitive health care delivery. By its very nature, the provision of health service requires communication and coordination between practitioners. However, preparation for interdisciplinary practice within the health care setting is rare. The authors argue that the primary reason students are not trained across disciplines is related to the diverse cultural structures that guide and moderate health education environments. It is further argued that this profession specific "cultural frame" must be addressed if there is any hope of having interprofessional education accepted as a valued and fully integrated dimension of our curriculum. Each health discipline possess its own professional culture that shapes the educational experience; determines curriculum content, core values, customs, dress, salience of symbols, the meaning, attribution, and etiology of symptoms; as well as defines what constitutes health, wellness and treatment success. Most importantly, professional culture defines the means for distributing power; determines how training should proceed within the clinical setting; and the level and nature of inter-profession communication, resolution of conflicts and management of relationships between team members and constituents. It might be said that one factor limiting interdisciplinary training is profession-centrism. If we are to achieve effective and fully integrated interdisciplinary education, we must decrease profession-centrism by crafting curriculum that promotes interprofessional cultural competence. The article explores how to promote interprofessional cultural competence within the health education setting.
The purpose of this paper is to identify if aspects of organizational culture may indicate a new terrain in the cultural influences-quality healthcare relationship. This research stems from the author's belief that viewing the role of head of department or directorate as pivotal to health care management is critical to health care planning and quality healthcare delivery. Interviews were undertaken among 50 professional clinician and non-clinician managers working in the role of head of department, in acute care hospitals in Ireland. The sample was drawn from the total population of 850 managers, utilized in a previous survey study. Organizational culture is more complex than was previously thought. Several cultural influences such as excellence in care delivery, ethical values, involvement, professionalism, value-for-money, cost of care, commitment to quality and strategic thinking were found to be key cultural determinants in quality care delivery. Health care managers perceive that in order to deliver quality focused care they need to act in a professional, committed manner and to place excellence at the forefront of care delivery, whilst at the same time being capable of managing the tensions that exist between cost effectiveness and quality of care. These tensions require further research in order to determine if quality of care is affected in a negative manner by those tensions. Originality relates to the new cultural terrain presented in this paper that recognizes the potential of health service managers to influence the organizations' culture and through this influence to take a greater part in ensuring that quality health care is delivered to their patients. It also seems to be important that value-for-money is viewed as an ethical means of delivering healthcare, and not as a conflict between quality and cost.
Fe, Eduardo; Powell-Jackson, Timothy; Yip, Winnie
The agency problem between patients and doctors has long been emphasised in the health economics literature, but the empirical evidence on whether patients can evaluate and respond to better quality care remains mixed and inconclusive. Using household data linked to an assessment of village doctors' clinical competence in rural China, we show that there is no correlation between doctor competence and patients' healthcare utilisation, with confidence intervals reasonably tight around zero. Household perceptions of quality are an important determinant of care-seeking behaviour, yet patients appear unable to recognise more competent doctors - there is no relationship between doctor competence and perceptions of quality. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Natalie S. Mikhaylov
Full Text Available This study explores the role of educational programs in promoting students’ cross-cultural competence (CCC development in international business education. Using constructivist grounded theory methodology (GTM, a comparative analysis of four extensive case studies was conducted within four schools, all of which offer international management education in English for local and international students. This study examines institutional contributions to an environment that supports students’ CCC development. A typology model consisting of four educational approaches to students’ CCC development is presented based on student experiences. The study provides recommendations regarding the steps that higher educational institutions (HEIs can take to promote educational environments that support cross-cultural exchange, cultural knowledge creation, and individual and organizational cross-cultural competence development.
Young, Susan; Guo, Kristina L
The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.
Full text: Safety is based on preventive actions where the ability of a regulatory body to fulfill its responsibilities depends largely on the competence of its staff. Building employees’ skills and knowledge is an investment for each employee and in the future of the organization. This building must be the competence of its staff integration with their safety culture, the essential to ensure competent human resources as required in the IAEA safety standards and other documents, in which the need and importance of ensuring regulatory competence is emphasized. As it involves both operational and management issues, safety culture is a sensitive topic for regulators whose role is to ensure compliance with safety requirements and not to intervene in management decisions. A number of embarking States are aspiring to develop nuclear power generation and this means that, among other things, regulatory bodies have to be established and rapidly expanded. This paper reports major considerations on the integration of safety culture with an adequate competence management system for regulators in embarking states. (author
Betancourt, Joseph R
The goal of this paper is to define cultural competence and present a practical framework to address crosscultural challenges that emerge in the clinical encounter, with a particular focus on the issue of nonadherence. English-language literature, both primary and reports from various agencies, and the author's personal experiences in clinical practice. Relevant literature on patient-centered care and cultural competence. There is a growing literature that delineates the impact of sociocultural factors, race, ethnicity, and limited-English proficiency on health and clinical care. The field of cultural competence focuses on addressing these issues. Health care providers need a practical set of tools and skills that will enable them to provide quality care to patients during a brief encounter, whatever differences in background that may exist. Cultural competence has evolved from the gathering of information and making of assumptions about patients on the basis of their sociocultural background to the development of skills to implement the principles of patient-centered care. This patient-based approach to cross-cultural care consists of first, assessing core cross-cultural issues; second, exploring the meaning of the illness to the patient; third, determining the social context in which the patient lives; and fourth, engaging in negotiation with the patient to encourage adherence. Addressing adherence is a particularly challenging issue, the determinants of which are multifactorial, and the ESFT (explanatory/social/fears/treatment) model--derived from the patient-based approach--is a tool that identifies barriers to adherence and provides strategies to address them. It obviously is impossible to learn everything about every culture and that should not be expected. Instead, we should learn about the communities we care for. More important, we should have a framework that allows us to provide appropriate care for any patient--one that deals with issues of adherence
André, Beate; Sjøvold, Endre; Rannestad, Toril; Holmemo, Marte; Ringdal, Gerd I
Understanding and assessing health care personnel's work culture in palliative care is important, as a conflict between "high tech" and "high touch" is present. Implementing necessary changes in behavior and procedures may imply a profound challenge, because of this conflict. The aim of this study was to explore the work culture at a palliative medicine unit (PMU). Healthcare personnel (N = 26) at a PMU in Norway comprising physicians, nurses, physiotherapists, and others filled in a questionnaire about their perception of the work culture at the unit. The Systematizing Person-Group Relations (SPGR) method was used for gathering data and for the analyses. This method applies six different dimensions representing different aspects of a work culture (Synergy, Withdrawal, Opposition, Dependence, Control, and Nurture) and each dimension has two vectors applied. The method seeks to explore which aspects dominate the particular work culture, identifying challenges, limitations, and opportunities. The findings were compared with a reference group of 347 ratings of well-functioning Norwegian organizations, named the "Norwegian Norm." The healthcare personnel working at the PMU had significantly higher scores than the "Norwegian Norm" in both vectors in the "Withdrawal" dimension and significant lower scores in both vectors in the "Synergy," "Control," and "Dependence" dimensions. Healthcare personnel at the PMU have a significantly different perception of their work culture than do staff in "well-functioning organizations" in several dimensions. The low score in the "Synergy" and "Control" dimensions indicate lack of engagement and constructive goal orientation behavior, and not being in a position to change their behavior. The conflict between "high tech" and "high touch" at a PMU seems to be an obstacle when implementing new procedures and alternative courses of action.
Rubin, Richard W
Dental student development of cultural competence and social responsibility is recognized by educators as an important element in the overall shaping of minds and attitudes of modem dental practitioners. Yet training modalities to achieve these competencies are not clearly defined, and outcome measurements are elusive. This article shows an effective method to meet these desired outcomes. Sixty-one freshmen (class of 2005) participated in forty hours of nondental community service, and reflective journals were completed by the end of second year. Competency outcomes were measured by selecting key words and phrases found in the individual journals. Key phrases were related to compassion, righteousness, propriety, and wisdom. Also, phrases had to be accompanied by written indications of direct program causation. The combination of active-learning (based upon service learning models) in public health settings outside of the dental realm, accompanied by reflective journaling, enhanced cultural understanding and community spirit in the majority of students.
Stefanenko, Tatiana; Kupavskaya, Aleksandra
The importance of success in cross-cultural communication in the modern world is growing every day. However, because of the lack of a coherent methodological framework and common terminology, there is eclecticism in the practical concepts of successful intercultural communication. This article presents the integration of Russian and western social-psychological knowledge and creates a model of the ethno-cultural competence. Thus, in accordance with Russian social psychology, the socio-percept...
Evans, Lorraine; Hanes, Philip J
Teaching cultural competence is now an educational requirement for U.S. dental curricula to meet 2013 accreditation standards. The question now is, given time restrictions, limited resources, and budget constraints faced by the majority of dental schools, how can they provide effective cultural competency education to prepare future dental professionals? An additional concern regarding instruction is the recent focus on techniques to engage Millennial learners since this generation is characterized as technologically savvy with a preference for multimedia and general dislike of traditional lectures. With these issues in mind, Georgia Regents University developed Healthy Perspectives, an online, interactive course in cultural competence designed to engage Millennial students. Both before and after the course, the students were asked to complete a modified version of the Clinical Cultural Competency Questionnaire. Of the eighty-eight students in the course (eighty-one first-year dental students and seven entering radiology students), seventy-one completed the questionnaire both before and after the course, for an 81 percent response rate. Seventy-five students also completed the course evaluation. The pre and post questionnaires showed statistically significant gains for students across the four primary areas of self-awareness, knowledge, attitudes, and skills. Student evaluations of the course were generally positive, particularly regarding content, but somewhat surprisingly their assessment of the interactive components (which were designed to meet generational expectations) was ambivalent.
Earnest, David R.; Rosenbusch, Katherine; Wallace-Williams, Devin; Keim, Alaina C.
Despite the prominence of study abroad programs, few are offered in the field of psychology. The current study sought to investigate the impact of study abroad programs in psychology through a comparison of study abroad and domestic student cultural competencies. Participants included 104 undergraduate students enrolled in either a psychology…
Vega, Desireé; Lasser, Jon; Plotts, Cynthia
Never before have more children lived away from their home countries. Given the unique social, emotional, and academic needs of children who have migrated, school psychologists must be well prepared to meet these growing demands. Consequently, school psychology training programs must invest in the preparation of culturally competent future school…
conducted to determine if there were any additional competencies relevant for intercultural interactions that were missing from the initial framework and...1), 101-120. Haskins, C. (2010). A practical approach to cultural insight. Military Review, 79-87. Jansenns, M. (1995). Intercultural
Friedman, Audrey; Herrmann, Brian
This study addresses the following research question: How does telementoring urban high school students by English teacher candidates develop candidates' cultural competence and impact mentees' cultural identity development? Mentee-mentor exchanges were analyzed to uncover how mentees used writing to develop cultural identity, how mentors'…
Nunez, Ana E.
Discusses the importance of changing cross cultural competence to cross cultural efficacy in the context of addressing health care needs, including those of women. Explores why cross cultural education needs to expand the objectives of women's health education to go beyond traditional values and emphasizes the importance of training for real-world…
Riley-Jacome, Mary; Parker, Blanca Angelica Gonzalez; Waltz, Edward C
The New York • New Jersey Preparedness and Emergency Response Learning Center (NY•NJ PERLC) is one of 14 Centers funded by the Centers for Disease Control and Prevention designed to address the preparedness and response training and education needs of the public health workforce. One of the important niches, or focus areas for the Center, is training to improve the capacity of public health workers to respond with competence to the needs of vulnerable populations. During every phase of a disaster, racial and ethnic minorities, including Latinos, suffer worse outcomes than the general population. Communities with diverse cultural origins and limited English speakers often present more complex issues during public health emergencies. Training that incorporates cultural concepts into the Preparedness Core Competencies may improve the ability of public health workers to engage the Latino community in preparedness activities and ultimately improve outcomes during disasters. This article describes initiatives undertaken by the NY•NJ PERLC to improve the capacity of the public health workforce to respond competently to the needs of Latino populations. In 2012, the Center collaborated with national, state, and local partners to develop a nationwide broadcast founded on the Preparedness Core Competencies, Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness. The widely viewed broadcast (497 sites in 47 states and 13 nations) highlighted the commonalities and differences within Latino culture that can impact emergency preparedness and response and outlined practical strategies to enhance participation. The success of the broadcast spurred a number of partner requests for training and technical assistance. Lessons learned from these experiences, including our "undercover" work at local Points of Dispensing, are incorporated into subsequent interactive trainings to improve the competency of public health workers. Participants recommended
Kouri, Pirkko; Rissanen, Marja-Liisa; Weber, Patrick; Park, Hyeoun-Ae
In today's life, social media offer new working ways. People are increasingly expanding interactions from face-to-face meetings to online ways of communication, networking, searching, creating and sharing information, and furthermore taking care of patients/citizens via tweeting care, Facebook care, blogging care, vlogging care, infotainment care, gamification-care, infographic care, for instance. This chapter discusses the utilisation of social media in the healthcare domain including nursing education, practice and research. When in the current healthcare era, social media is used effectively and purposefully, it can give all of us a greater choice in how we live, how we take care of our health and how we learn and build both our professional competences and produce evidence-based, qualified data. Nurses need continuous education and proper tools to take the most of the benefits of social media, not forgetting privacy and ethical issues. This use of social media in professional nursing generates the need for new competences.
Tavallali, Azar G; Kabir, Zarina Nahar; Jirwe, Maria
Sweden has a population of a little more than 9.4 million. The rapid growth of immigration in Sweden has resulted in an increased number of minority ethnic patients and minority ethnic nurses in the Swedish healthcare system. This also applies to paediatric care. The purpose of this study was to explore how parents with ethnic Swedish backgrounds experience minority ethnic nurses' cultural competence and the care the nurses provide in a Swedish paediatric care context. This exploratory qualitative study is of 14 parents with an ethnic Swedish background whose child was in a ward at a children's hospital in Stockholm County Council. Data were collected using semi-structured interviews to identify parents' perceptions and experiences of minority ethnic nurses' cultural competence. The interviews were analysed by qualitative content analysis. The analyses of the interviews led to four main categories: influence of nurses' ethnicity; significance of cross-cultural communication; cross-cultural skills; and the importance of nursing education. Nurses' ethnicity did not have much impact on parents' satisfaction with their child's care. The parents attached importance to nurses' language skills and to their adaptation and awareness of Swedish culture. They also attached weight to nurses' professional knowledge and personal attributes. The role of nursing education to increase nurses' cultural awareness was highlighted too. © 2013 Nordic College of Caring Science.
Liu, Yi-Fen Cecilia
This reflective study explores a different perspective of intercultural communicative competency (ICC) by focusing on the speech acts that nonnative speakers of Spanish from diverse linguistic and cultural backgrounds find difficult to perform competently in various contexts in Colombia. This article covers a qualitative case study using…
Recognition of the importance of 'cultural competence' is now central to health care policy and to nurse education and training across the international spectrum. Detailed engagement with models of cultural competence is comparatively recent in palliative care nursing. This article presents the findings from a development project on elders and carers from 'minority ethnic' groups, funded by the Department of Health, to increase awareness of palliative care and to improve understanding of the needs of these groups of service users. The article describes the experiences of nurses involved in the delivery of palliative care who were interviewed in focus groups as a part of the project. It draws attention to the complicated relationships between cultural knowledge and practice and to the non-rational and visceral dimensions of intercultural care. These aspects of nursing are marginalised in current approaches to cultural competence, which emphasise the rational acquisition and application of cultural knowledge and skills by practitioners. It is suggested that recognition of these marginalised experiences can contribute to the development of new approaches to intercultural nursing that are also more attuned to the ethos and values of palliative care.
Full Text Available Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by ‘standardization’ and ‘customization’ in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics – the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery.
Contemporary discussions of nursing knowledge, skill, patient safety and the associated ongoing education are usually combined with the term competence. Ensuring patient safety is considered a fundamental tenet of clinical competence together with the ability to problem solve, think critically and anticipate variables which may impact on patient care outcomes. Nurses are ideally positioned to identify, analyse and act on deteriorating patients, near-misses and potential adverse events. The absence of competency may lead to errors resulting in serious consequences for the patient. Gaining and maintaining competence are especially important in a climate of rapid evidence availability and regular changes in procedures, systems and products. Quality and safety issues predominate highlighting a clear need for closer inter-professional collaboration between education and clinical units. Educators and coaches are ideally placed to role model positive leadership and resilience to develop capability and competence. With contemporary guidance and support from educators and coaches, nurses can participate in life-long learning to create and enhance a culture of safety. The added challenge for nurse educators is to modernise, rationalise and integrate education delivery systems to improve clinical learning. Investing in evidence-based, contemporary education assists in building a capable, resilient and competent workforce focused on patient safety. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Health sciences educators are faced with creating meaningful, effective and satisfying experiences in interprofessional education (IPE) and cultural competence (CC) required of both students and professionals in practice. This study evaluated the experience and attitudes of the participants in a course combining IPE and CC. A novel, interprofessional course in the Russian language and culture was developed and delivered to a group of medical, nursing, and pharmacy students. One year after the completion of the course, an anonymous, online survey was sent to the participants. Attitudes, comfort, self-efficacy in working with other cultures/healthcare professionals, and comparison of the course to other IPE activities were assessed. The survey suggested that the course was a satisfying and effective combination of IPE and CC in a pre-professional health educational setting. Further work could be undertaken to evaluate the experiences of similar activities in the professional and continuing education arenas.
Teal, Cayla R; Street, Richard L
Increasing the cultural competence of physicians is one means of responding to demographic changes in the USA, as well as reducing health disparities. However, in spite of the development and implementation of cultural competence training programs, little is known about the ways cultural competence manifests itself in medical encounters. This paper will present a model of culturally competent communication that offers a framework of studying cultural competence 'in action.' First, we describe four critical elements of culturally competent communication in the medical encounter--communication repertoire, situational awareness, adaptability, and knowledge about core cultural issues. We present a model of culturally competent physician communication that integrates existing frameworks for cultural competence in patient care with models of effective patient-centered communication. The culturally competent communication model includes five communication skills that are depicted as elements of a set in which acquisition of more skills corresponds to increasing complexity and culturally competent communication. The culturally competent communication model utilizes each of the four critical elements to fully develop each skill and apply increasingly sophisticated, contextually appropriate communication behaviors to engage with culturally different patients in complex interactions. It is designed to foster maximum physician sensitivity to cultural variation in patients as the foundation of physician-communication competence in interacting with patients.
Schrooten, Iete; de Jong, Menno D.T.
This article investigates the relationship between healthcare providers’ empathic and communicative competencies and clients’ overall satisfaction with consultations. Two aspects of empathy were included: empathic attitude (sensitivity to the clients’ perspective) and empathic skills (ability to
Liwen, J. (Jiang)
Abstract Due to globalization, there are more and more families are bringing their children abroad due to different reasons (Cockburn 2002, 475–476). Third culture kids (TCKs) have gradually become well known to people and the society. The aim of this research is to discuss TCKs’ intercultural learning and competence during their significant years of development and what this experience means to them in terms of their educa...
Carter, Kimberly F; Xu, Yu
The authors describe a cultural competence quality enhancement process to address the retention challenge of students who speak English as second language and international students as part of a school of nursing's continuous program quality improvement to achieve excellence. The process, strategies, outcomes, and evaluation of the training program are detailed within the given geographical, institutional, and curriculum context. Lessons and continuing challenges are also specified.
The purpose of this study was to increase understanding of the subjective experience of 13 white, female occupational therapists in Louisiana as they participated in a 6-hour workshop on cultural competency. The study employed a mixed method design using qualitative data, obtained from structured reflection questions, and quantitative data, obtained from two objective outcome measures. Three themes emerged from the qualitative data regarding the participants' conflicting attitudes towards African American clients. Therapists believed that: (1) healthcare disparities are not due to racial discrimination; (2) therapists should listen to and educate African American clients; and (3) racial bias and stress contribute to health issues in African American clients. Results from the two outcome measures, the Racial Argument Scale and the Racial Attitude Implicit Association Test, indicate that overall, the study participants held significantly negative attitudes towards African Americans which was not ameliorated by the intervention. The small convenience sample in this study precludes generalization to a broader population, and further investigation into the attitudes of healthcare professionals in Louisiana is needed. Future instructional interventions should take into account the participants' developmental stage of cultural competence. Copyright 2010 John Wiley & Sons, Ltd.
Pearson, Alan; Srivastava, Rani; Craig, Dianna; Tucker, Donna; Grinspun, Doris; Bajnok, Irmajean; Griffin, Pat; Long, Leslye; Porritt, Kylie; Han, Thuzar; Gi, Aye A
Objectives The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological
Silverglate, Daniel S.; Sims, Edward M.; Glover, Gerald; Friedman, Harris
Modern Warfighters often find themselves in a variety of non-combat roles such as negotiator, peacekeeper, reconstruction, and disaster relief. They are expected to perform these roles within a culture alien to their own. Each individual they encounter brings their own set of values to the interaction that must be understood and reconciled. To navigate the human terrain of these complex interactions, the Warfighter must not only consider the specifics of the target culture, but also identify the stakeholders, recognize the influencing cultural dimensions, and adapt to the situation to achieve the best possible outcome. Vcom3D is using game-based scenarios to develop culturally adaptive competency. The avatars that represent the stakeholders must be able to portray culturally accurate behavior, display complex emotion, and communicate through verbal and non-verbal cues. This paper will discuss the use of emerging game technologies to better simulate human behavior in cross-cultural dilemmas. Nomenclature: culture, adaptive, values, cultural values dimensions, dilemmas, virtual humans, non-verbal communications
Meskó, Bertalan; Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna
Under the term "digital health", advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; the reluctance of stakeholders in healthcare to change; and ignoring the importance of cultural changes and the human factor in an increasingly technological world. With access and adoption of technology getting higher, the risk of patients primarily turning to an accessible, but unregulated technological solution for their health problem is likely to increase. In this paper, we discuss how the old paradigm of the paternalistic model of medicine is transforming into an equal level partnership between patients and professionals and how it is aided and augmented by disruptive technologies. We attempt to define what digital health means and how it affects the status quo of care and also the study design in implementing technological innovations into the practice of medicine.
Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna
Under the term “digital health”, advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; the reluctance of stakeholders in healthcare to change; and ignoring the importance of cultural changes and the human factor in an increasingly technological world. With access and adoption of technology getting higher, the risk of patients primarily turning to an accessible, but unregulated technological solution for their health problem is likely to increase. In this paper, we discuss how the old paradigm of the paternalistic model of medicine is transforming into an equal level partnership between patients and professionals and how it is aided and augmented by disruptive technologies. We attempt to define what digital health means and how it affects the status quo of care and also the study design in implementing technological innovations into the practice of medicine. PMID:29184890
Full Text Available Resumen:El ensayo nace como parte de una investigación mayor que se publicará sobre la inserción profesional docente en la Universidad de Costa Rica. Su finalidad en la investigación en curso es la de explorar los aportes de los estudios sobre competencia cultural e inteligencia cultural, para identificar planteamientos teóricos que fortalezcan nuevos espacios para la mediación cultural docente en la Universidad. Se concluye que el concepto de competencia cultural representa un aporte importante, si se revisa la idea de cultura que subyace y se le transforma en “competencia intercultural”. Luego, se define mediación cultural, evidenciándose la importancia de la nueva figura profesional en el contexto actual, los ámbitos de acción donde se ha empleado y se manifiesta la necesidad de promover mediadores y mediadoras culturales en Costa Rica también.Abstract: The essay comes as part of a larger investigation to be published about teachers’ professional integration at the University of Costa Rica. His purpose in the ongoing investigation is to explore the contributions of studies on cultural competency and cultural understanding, to identify new theoretical approaches and strengthen new cultural spaces for teaching mediation at the University. We conclude that the concept of cultural competence represents an important contribution, if we review the underlying idea of culture and it is transformed into "intercultural competence". The definition of cultural mediation points to the importance of the new professional figure in the current context, evidencing the areas of action where it has been used and showing the need to promote cultural mediators in Costa Rica as well.
Miller, Elizabeth; Green, Alexander R
Medical schools use OSCEs (objective structured clinical examinations) to assess students' clinical knowledge and skills, but the use of OSCEs in the teaching and assessment of cross-cultural care has not been well described. To examine medical students' reflections on a cultural competence OSCE station as an educational experience. Students at Harvard Medical School in Boston completed a 'cultural competence' OSCE station (about a patient with uncontrolled hypertension and medication non-adherence). Individual semi-structured interviews were conducted with a convenience sample of twenty-two second year medical students, which were recorded, transcribed, and analysed. Students' reflections on what they learned as the essence of the case encompassed three categories: (1) eliciting the patient's perspective on their illness; (2) examining how and why patients take their medications and inquiring about alternative therapies; and (3) exploring the range of social and cultural factors associated with medication non-adherence. A cultural competence OSCE station that focuses on eliciting patients' perspectives and exploring medication non-adherence can serve as a unique and valuable teaching tool. The cultural competence OSCE station may be one pedagogic method for incorporating cross-cultural care into medical school curricula.
Full Text Available ‘Whistleblowing’ has come to increased prominence in many health systems as a means of identifying and addressing quality and safety issues. But whistleblowing – and the reactions to it – have many complex and ambiguous aspects that need to be considered as part of the broader (organisational cultural dynamics of healthcare institutions.
Mannion, Russell; Davies, Huw To
'Whistleblowing' has come to increased prominence in many health systems as a means of identifying and addressing quality and safety issues. But whistleblowing - and the reactions to it - have many complex and ambiguous aspects that need to be considered as part of the broader (organisational) cultural dynamics of healthcare institutions. © 2015 by Kerman University of Medical Sciences.
Gupta, Vidya Bhushan
Healthcare seeking behavior is a dynamic process that evolves through the stages of self evaluation of symptoms, self treatment, seeking professional advice and acting on professional advice. (Weaver, 1970) This article explores the influence of culture at each of these stages in the context of Asian Indian culture. Although Asian-Indians constitute only 1.5% of the US population they are among the fastest growing minorities in the United States. Through the example of Asian Indian culture this article informs the clinicians that at the initial visit they should explore what the symptoms mean to the patient and what modalities including complementary and alternative (CAM) were used by the patient to address them and at subsequent visits they should explore how their advise was filtered through the prism of the patient's culture and what was adhered to and what was not. In the case of disability and death the clinicians should explore religious beliefs such as karma that help the patient in coping.
Han, Sang Min; Kim, Ar Ryum; Seong, Poong Hyun
In this study, team safety culture competency of a team was estimated through SNA, as a team safety culture index. To overcome the limit of existing safety culture evaluation methods, the concept of competency and SNA were adopted. To estimate team safety culture competency, we defined the definition, range and goal of team safety culture competencies. Derivation of core team safety culture competencies is performed and its behavioral characteristics were derived for each safety culture competency, from the procedures used in NPPs and existing criteria to assess safety culture. Then observation was chosen as a method to provide the input data for the SNA matrix of team members versus insufficient team safety culture competencies. Then through matrix operation, the matrix was converted into the two meaningful values, which are density of team members and degree centralities of each team safety culture competency. Density of tem members and degree centrality of each team safety culture competency represent the team safety culture index and the priority of team safety culture competency to be improved
Han, Sang Min; Kim, Ar Ryum; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)
In this study, team safety culture competency of a team was estimated through SNA, as a team safety culture index. To overcome the limit of existing safety culture evaluation methods, the concept of competency and SNA were adopted. To estimate team safety culture competency, we defined the definition, range and goal of team safety culture competencies. Derivation of core team safety culture competencies is performed and its behavioral characteristics were derived for each safety culture competency, from the procedures used in NPPs and existing criteria to assess safety culture. Then observation was chosen as a method to provide the input data for the SNA matrix of team members versus insufficient team safety culture competencies. Then through matrix operation, the matrix was converted into the two meaningful values, which are density of team members and degree centralities of each team safety culture competency. Density of tem members and degree centrality of each team safety culture competency represent the team safety culture index and the priority of team safety culture competency to be improved.
Jones, Catriona; Hayter, Mark; Jomeen, Julie
To provide a contemporary overview of asexuality and the implications this has for healthcare practice. Individuals belonging to sexual minority groups face many barriers in accessing appropriate health care. The term "sexual minority group" is usually used to refer to lesbian women, gay, bisexual and transgender individuals. Anecdotal and research evidence suggests that those who identify as asexual have similar poor experiences. Systematic review and qualitative analysis. This work uses a systematic review and qualitative analysis of the existing interview data from self-identified asexuals, to construct features of the asexual identity. The findings will help practitioners and health professionals develop an understanding of this poorly understood construct. Ultimately this work is aimed at facilitating culturally competent care in the context of asexuality. Qualitative analysis produced three themes, which can be used, not only to frame asexuality in a positive and normalising way, but also to provide greater understanding of asexuality, "romantic differences coupled with sexual indifference," "validation through engagement with asexual communities" and "a diversity of subasexual identities." Having some understanding of what it means to identify as asexual, and respecting the choices made by asexuals can markedly improve the experiences of those who embrace an asexual identity when engaging with health care. Anecdotal evidence, taken from one of the largest asexual online forums, suggests that a number of self-identified asexuals choose not to disclose their identity to healthcare professionals through fear of their asexual status being pathologised, problematised or judged. Given that asexuality is a poorly understood concept, this may be due to lack of understanding on behalf of healthcare providers. The review provides health professionals and practitioners working in clinical settings with some insights of the features of an asexual identity to facilitate
Hawala-Druy, Souzan; Hill, Mary H
The increasingly diverse multicultural and multigenerational student population in the United States requires that educators at all levels develop cultural knowledge, awareness, and sensitivity to help diverse learners fulfill their potential and to avoid cultural misunderstandings that can become obstacles or barriers to learning. The purpose of this study was to design and implement eclectic, creative, evidence-based interdisciplinary educational activities, along with culturally congruent teaching strategies, within a semester-long university course that promoted positive and culturally competent learning outcomes for culturally diverse, largely millennial students. The interdisciplinary course would prepare health professional students with the requisite knowledge and skills, through transformative learning that produces change agents, to provide culturally congruent and quality team-based care to diverse populations. This was a qualitative and quantitative study, which measured students' level of cultural awareness, competence, and proficiency pre and post the educational intervention. Instruments used for data collection included the Inventory for Assessing The Process of Cultural Competence-Student Version (IAPCC-SV) by Campinha-Bacote, course evaluations, students' feedback, and portfolio reflections. The study was conducted at a private academic institution located in the Mid-Atlantic region and the sample population included inter-professional students (N=106) from various health professions including nursing, pharmacy, and allied health sciences. Results from the pre- and post-test IAPCC-SV survey revealed that mean scores increased significantly from pre-test (60.8) to post-test (70.6). Thus, students' levels of cultural competency (awareness, knowledge, skills, desire, encounter) improved post-educational intervention, indicating that the teaching methods used in the course might be applied on a larger scale across the university system to cater to the
Full Text Available The EU’s cultural initiative ‘the European Capital of Culture’ (ECOC includes high identity political aims. It requires the designated cities to introduce and foster local, regional, and European cultural identities. In addition, the cities have used the designation as an opportunity to promote national cultural identity. Audiences of the ECOC events recognize and interpret different kinds of representations of territorial cultural identities from what the cities have to offer in culture. However, the contents of these interpretations vary drastically in the ECOCs. The article discusses whether the competence of interpreting the representations of territorial cultural identities is related to some social determinants of the audiences. Based on a questionnaire study conducted in recent ECOCs-Pécs (Hungary, Tallinn (Estonia, and Turku (Finland-the study indicates that, for example, education, source of livelihood, and active cultural participation impact the interpretations of the representations of territorial cultural identities.
Bokhour, Barbara G; Fix, Gemmae M; Mueller, Nora M; Barker, Anna M; Lavela, Sherri L; Hill, Jennifer N; Solomon, Jeffrey L; Lukas, Carol VanDeusen
Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Transforming healthcare systems to focus on patient-centered care and better serve the "whole" patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the
Daniel, Jessica Henderson; Roysircar, Gargi; Abeles, Norman; Boyd, Cyndy
The Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology was held in Arizona in November 2002. One of the workshops, Individual and Cultural Differences (ICD), focused on racism, homophobia, and ageism. The consensus was that self-awareness and knowledge about the three "isms" are critical components in the education and training of psychologists. This article, authored by four of the workshop attendees, is a review of the current research and theoretical literature. Implications that address both content and context in graduate programs and training sites are presented. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist. Copyright 2004 Wiley Periodicals, Inc.
Niedbala, Elizabeth M.; Feinberg, Jessica
One of the principles that NASA upholds is to cooperate with other nations to advance science, exploration, and discovery for all. Effective cooperation across cultures, however, requires a certain level of skill. A construct called cross-cultural competency (CCC) emphasizes that individuals are capable of acquiring skills that facilitate positive and cooperative interaction with people of another culture. While some aspects of CCC stem from stable individual traits such as personality (i.e., extraversion, tolerance for ambiguity), most components can be learned and strengthened over time (i.e., empathy, mindfulness, trust). Because CCC is such a vital part of international cooperation, this summer we will design a training program to cultivate these skills between student interns, their mentors, and the Ames community as a whole. First, we will research what specific competencies are valuable for anyone to have when working in an international setting. We will then design a series of activities, events, workshops, and discussions that target and strengthen those skills. Finally, we will use both qualitative and quantitative evaluation methods to measure the success of the pilot program. This summer, the current international student interns will serve as our trial population for the program, while our goal is to launch the full program in Fall 2017. Overall, we hope to contribute to NASAs mission of optimizing international collaboration for everyone involved.
Perlin, Michael L.; McClain, Valerie
Cultural competency is critical in criminal forensic evaluations. Cultural competency eschews reliance on stereotypes, precluding the mistake of assuming that cultural dictates apply with equal force to all who share a cultural background, thus allowing the forensic examiner to provide a
Approaches to the concept of culture and teaching cultural competence in a foreign language classroom have been changing over the last decades. The paper summarises, compares, contrasts and evaluates four major approaches to teaching cultural competence in foreign language teaching, that is, knowledge-based approach, contrastive approach,…
Beveridge, R N
Value is created through the delivery of high-quality, cost--effective healthcare services. The ability to create value from the providers' perspective is facilitated through the development and implementation of essential, customer-focused core competencies. These core competencies include customer relationship management, payer/provider relationship management, disease management, outcomes management, financial/cost management, and information management. Customer relationship management is the foundation upon which all core competencies must be built. All of the core competencies must focus on the needs of the customers, both internal and external. Structuring all processes involved in the core competencies from the perspective of the customer will ensure that value is created throughout the system. Payer/provider relationship management will become a crucial pillar for healthcare providers in the future. As more vertical integration among providers occurs, the management of the relationships among providers and with payers will become more important. Many of the integration strategies being implemented across the country involve the integration of hospitals, physicians, and payers to form accountable health plans. The relationships must be organized to form "win/win" situations, where all parties are focused on a shared vision of creating value and none of the parties benefits at the expense of the others. Disease management in creating value requires that we begin examining the disease process along the entire continuum. Not only must providers be able to provide high-quality acute and chronic care, but they must also begin to focus more heavily on programs of prevention. Value is created throughout the system through reducing the prevalence and incidence of disease. Only through managing the full continuum of health will value be created throughout the healthcare delivery system. Outcomes management ensures that the outcomes are the highest quality at a cost
Mannion, Russell; Exworthy, Mark
Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Fàbregas Ma Jose
Full Text Available Abstract Background The practice of Female Genital Mutilation (FGM, a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature. Methods The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM. A transversal, descriptive study was performed with a self-administered questionnaire to family physicians, paediatricians, nurses, midwives and gynaecologists. Trends towards changes in the two periods studied (2001 and 2004 were analysed. Results A total of 225 (80% professionals answered the questionnaire in 2001 and 184 (62% in 2004. Sixteen percent declared detection of some case in 2004, rising three-fold from the number reported in 2001. Eighteen percent stated that they had no interest in FGM. Less than 40% correctly identified the typology, while less than 30% knew the countries in which the practice is carried out and 82% normally attended patients from these countries. Conclusion Female genital mutilations are present in primary healthcare medical offices with paediatricians and gynaecologists having the closest contact with the problem. Preventive measures should be designed as should sensitization to promote stands against these practices.
Whitman, Marilyn V; Valpuesta, Domingo
The increasing diversification of the nation's population poses significant challenges in providing care that meets the needs of culturally diverse patients. Human resource management plays a vital role in developing a more culturally competent workforce. This exploratory study examines current efforts by human resource directors (HRDs) in Alabama's general hospitals to recruit more diverse candidates, train staff, and make language access resources available. A questionnaire was developed based on the Office of Minority Health's Culturally and Linguistically Appropriate Services standards. The HRDs of the 101 Alabama general hospitals served as the study's target population. A sample of 61 responses, or 60.4% of the population, was obtained. The findings indicate that most HRDs are focusing their efforts on recruiting racially/ethnically diverse candidates and training clerical and nursing staff to care for culturally and linguistically diverse patients. Less effort is being focused on recruiting candidates who speak a different language, and only 44.3% have a trained interpreter on the staff. The HRDs who indicated that they work closely with organizations that provide support to diverse groups were more likely to recruit diverse employees and have racially/ethnically and linguistically diverse individuals in leadership positions. It is crucial that health care organizations take the necessary steps to diversify their workforce to broaden access, improve the quality and equity of care, and capture a greater market share.
Kutob, Randa M; Bormanis, John; Crago, Marjorie; Harris, John M; Senf, Janet; Shisslak, Catherine M
Although numerous studies have examined cultural competence training, debate still exists about efficacious approaches to this training. Furthermore, little focus has been placed on training and evaluating practicing physicians. A skills-based course on culturally competent diabetes care was developed and subsequently tested in a controlled trial of primary physicians caring for patients enrolled in one state's Medicaid program. We hypothesized that physicians completing the course would show higher levels of self-reported cultural competence as measured by a Cultural Competence Assessment Tool (CCAT) than those in the control group. Differences in CCAT subscale scores were also compared. Ninety physicians completed the study, with 41 in the control and 49 in the intervention group. Most were female (66%), with an average age of 44, and 12 years in practice. There were no significant differences on total CCAT score (212.7 ± 26.7 for control versus 217.2 ± 28.6 for intervention, p = .444) or subscales measuring cultural knowledge. There were significant positive differences on the subscales measuring physicians' nonjudgmental attitudes/behaviors (subscale score 2.38 ± 0.46 for control versus 2.69 ± 0.52 for intervention, p = .004) and future likelihood of eliciting patients' beliefs about diabetes and treatment preferences (3.11 ± 0.53 for control versus 3.37 ± 0.45 for intervention, p = .014). There was, however, a significant negative difference on the subscale measuring cultural self-awareness (3.48 ± 0.36 for control versus 3.26 ± 0.48 for intervention, p = .018). A predominantly skills-based approach to training physicians did not change aggregate measures of cultural competence, but did affect key attitudes and behaviors, which may better reflect the goals of cultural competence training. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME
Zwijnenberg, Nicolien C.; Hendriks, Michelle; Hoogervorst-Schilp, Janneke; Wagner, Cordula
Background By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals? views on the feedback of a patient safety culture assessment. Methods Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a websi...
McElfish, Pearl Anna; Moore, Ramey; Buron, Bill; Hudson, Jonell; Long, Christopher R; Purvis, Rachel S; Schulz, Thomas K; Rowland, Brett; Warmack, T Scott
Many U.S. medical schools have accreditation requirements for interprofessional education and training in cultural competency, yet few programs have developed programs to meet both of these requirements simultaneously. Furthermore, most training programs to address these requirements are broad in nature and do not focus on addressing health disparities. The lack of integration may reduce the students' ability to apply the knowledge learned. Innovative programs that combine these two learning objectives and focus on disenfranchised communities are needed to train the next generation of health professionals. A unique interprofessional education program was developed at the University of Arkansas for Medical Sciences Northwest. The program includes experiential learning, cultural exposure, and competence-building activities for interprofessional teams of medicine, nursing, and pharmacy students. The activities include (a) educational seminars, (b) clinical experiential learning in a student-led clinic, and (c) community-based service-learning through health assessments and survey research events. The program focuses on interprofessional collaboration to address the health disparities experienced by the Marshallese community in northwest Arkansas. The Marshallese are Pacific Islanders who suffer from significant health disparities related to chronic and infectious diseases. Comparison tests revealed statistically significant changes in participants' retrospectively reported pre/posttest scores for Subscales 1 and 2 of the Readiness for Interpersonal Learning Scale and for the Caffrey Cultural Competence in Healthcare Scale. However, no significant change was found for Subscale 3 of the Readiness for Interpersonal Learning Scale. Qualitative findings demonstrated a change in students' knowledge, attitudes, and behavior toward working with other professions and the underserved population. The program had to be flexible enough to meet the educational requirements and
Full Text Available Purpose : to substantiate the phenomenon of formation of physical culture of the individual in terms of theoretical and methodological approaches to the development of socio-cultural competence of future teachers. Material : 22 literary sources analyzed on the issue of formation of physical culture of the individual. Used cultural studies, axiological and competence approach. Results : define the concept of socio-cultural competence of the teacher of physical education. Competence is considered as an integrative motivational tumor - activity sphere of the individual. It determines the focus of an expert on the formation of spiritual values and is the foundation for its further self-development. Disclosed structure sociocultural competence of the teacher in the unity components: cognitive, motivational-value, behavioral. For each component defined system of spiritual values. The system covers the socio- psychological, mental and cultural values of physical culture. Conclusions : the sociocultural competence of the teacher of physical education meaningful and functionally related to the values of the physical culture of the individual. Spiritual, value the personality of the teacher - is the foundation for all of the components of socio-cultural competence. This competence provides social and cultural development of the individual.
Dunagan, Pamela B; Kimble, Laura P; Gunby, Susan Sweat; Andrews, Margaret M
The purpose of this study was to explore the relationship between attitudes of prejudice and cultural competence among nursing students. Using a mixed-methods design, a convenience sample of students (N = 129) currently enrolled in a baccalaureate nursing program was recruited via Web networking. Data regarding attitudes of prejudice, cultural competence, prior cultural experience, and integration of cultural competence were obtained via a Web-based survey. Multiple linear regression was used to predict cultural knowledge, attitudes, and consciousness. Although all three regression models were statistically significant, the significant predictors varied within each model. Greater prejudice was a significant predictor of less culturally competent attitudes toward providing nursing care. Existing prejudice among nursing students needs to be addressed to help promote positive cultural attitudes and, ultimately, cultural competent nursing care.
van den Hooff, Susanne; Buijsen, Martin
Patient's decision making competence (PDMC) is a widely discussed subject. Issues of competence, autonomy, well-being and protection of the patient come up every day. In this article we analyse what role PDMC plays in Dutch legislation and what dilemmas healthcare professionals may experience, notably in patients suffering from Korsakoff's syndrome. Dilemmas emerge if professionals want to meet the requirements mentioned in Dutch law and the desires of their patients. The autonomy of the patient and the healthcare professionals' duty to take care of their patient's best interests, create a tension and lead to uncomfortable situations. Healthcare professionals describe difficulty finding a balance between these issues and assessing the degree of mental competence still present. In long term care situations, quality of the relationship between healthcare professionals and their patients seems to be of much more importance in decision making on minor issues of competence than simply relying on legal or house rules. In being committed to their cases, professionals will be more sensitive to individuals habits, abilities, welfare and dignity, which will make it easier to decide on issues of competence, and to find creative solutions to their dilemmas.
Cherner, Rebecca; Olavarria, Marcela; Young, Marta; Aubry, Tim; Marchant, Christina
Cultural competence is an important component of client-centered care in health promotion and community health services, especially considering the changing demographics of North America. Although a number of tools for evaluating cultural competence have been developed, few studies have reported on the results of organizational cultural competence evaluations in health care or social services settings. This article aims to fill this gap by providing a description of a cultural competence evaluation of a community health center serving a diverse population. Data collection included reviewing documents, and surveying staff, management, and the Board of Directors. The organization fully met 28 of 53 standards of cultural competence, partially met 21 standards, and did not meet 2 standards, and 2 standards could not be assessed due to missing information. The advantages and lessons learned from this organizational cultural competence evaluation are discussed. © 2014 Society for Public Health Education.
Full Text Available In the present paper, I aim to shed light on the importance of cultural competence from three perspectives. First, in my capacity as a sociolinguist, I will talk about how Hungarian culture is incorporated in the textbook "Colloquial Hungarian" (Rounds and Sólyom 2011, providing particular examples from various dialogues and cultural notes from the book. I believe that linguistic competence, communicative competence, and cultural competence are equally important parts of foreign language teaching and foreign language learning. Second, as a foreign language instructor at U.S. study abroad programs, I plan to discuss the importance of cultural norms of the speakers of the local language in the host country. Third, as a director of an American cultural and resource center in Budapest, I will talk about the importance of building bridges between two cultures, describing the goals and missions of the center as well as giving specific examples of the activities of the American Corner Budapest.
Seeleman, Conny; Hermans, Jessie; Lamkaddem, Majda; Suurmond, Jeanine; Stronks, Karien; Essink-Bot, Marie-Louise
Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper describes the outcomes of an assessment of knowledge, reflection ability and self-reported culturally competent consultation behaviour, the relation between these assessments and self-perceived cultural competence, and the applicability of the results in the light of developing a cultural competence educational programme. 392 medical students, Youth Health Care (YHC) Physician Residents and their Physician Supervisors were invited to complete a web-based questionnaire that assessed three domains of cultural competence: 1) general knowledge of ethnic minority care provision and interpretation services; 2) reflection ability; and 3) culturally competent consultation behaviour. Additionally, respondents graded their overall self-perceived cultural competence on a 1-10 scale. 86 medical students, 56 YHC Residents and 35 YHC Supervisors completed the questionnaire (overall response rate 41%; n= 177). On average, respondents scored low on general knowledge (mean 46% of maximum score) and knowledge of interpretation services (mean 55%) and much higher on reflection ability (80%). The respondents' reports of their consultation behaviour reflected moderately adequate behaviour in exploring patients' perspectives (mean 64%) and in interaction with low health literate patients (mean 60%) while the score on exploring patients' social contexts was on average low (46%). YHC respondents scored higher than medical students on knowledge of interpretation services, exploring patients' perspectives and exploring social contexts. The associations between self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour were weak. Assessing the cultural
Olson, Rebecca; Bidewell, John; Dune, Tinashe; Lessey, Nkosi
Interprofessional education and cultural competence are both necessary for health professionals working in interprofessional teams serving diverse populations. Using a pre-post-survey case series design, this study evaluates a novel learning activity designed to encourage self-reflection and cultural competence in an Australian interprofessional education context. Undergraduate health professional students in a large subject viewed three 7-15 minute videos featuring interviews with persons of a minority cultural, linguistic, or sexual group who were living with a disability or managing a health condition. Immediately afterwards, students in interprofessional groups completed a structured activity designed to promote interprofessional and cultural reflection. A localised version of a validated scale measured cultural competence before and after the learning activity. Results suggest the value of video-based learning activities based on real-life examples for improving cultural competence. Despite initially rating themselves highly, 64% of students (n = 273) improved their overall cultural competence, though only by M = 0.13, SD = 0.08, of a 5-point rating-scale interval. A nuanced approach to interpreting results is warranted; even slight increases may indicate improved cultural competence. Suggestions for improving the effectiveness of video-based cultural competence learning activities, based on qualitative findings, are provided. Overall the findings attest to the merit of group discussion in cultural competence learning activities in interprofessional education settings. However, the inclusion of group discussions within such learning activities should hinge on group dynamics.
Hemberg, Jessica Anne Viveka; Vilander, Susann
The global and multicultural society of today creates challenges that require multicultural competence among individuals, especially within caring contexts. This study assumes an intercultural perspective, and the aim is to uncover a new understanding of the caring community between nurses and patients when these do not speak the same language. The research question is: What is the significance of communication in a caring community when nurses and patients do not speak the same language? This qualitative study uses a hermeneutical approach. The material was collected through questionnaires with eight nurses and two adults from another culture. The texts were analysed through latent content analysis. Study participation, data storage and handling for research purposes were approved by the participants when they provided their informed consent. Permission to conduct the study was granted by an ethical committee of a hospital organisation. Human love is the basis for a caring relationship since it reaches beyond the limits of cultural differences. Integrity is vital for cultural respect and especially for the consideration of spiritual needs in the caring relationship. An affirming presence is essential for communion. Creative courage is fundamental for communication, and continuous information is vital for establishing trust within the caring relationship. One limitation to this study might be the limited number of participants (ten). Caring for a patient from another culture requires that nurses are open-minded and have the courage to encounter new challenges. It is essential for nurses to respect the patient's integrity but also to acquire knowledge in order to improve their cultural competence. Further research within this area should focus on the role of next of kin in intercultural caring and on how leadership may contribute to improving cultural competence within health organisations. © 2017 Nordic College of Caring Science.
Karcanes, James A
The term "cultural awareness" serves as the new favorite Department of Defense buzzword but fails in its definition to adequately articulate the complexity of culture and the high level of cultural...
Umit I. Kopzhasarova
Full Text Available The article deals with the problem of socio-cultural competence development on the basis of using English and Russian phraseological units. The authors specify the essence of the socio-cultural competence, define socio-cultural component of foreign language teaching. The authors justify their viewpoint that phraseological units, being the most valuable source of cultural information, exposing background knowledge and culture specific vocabulary, are the effective means of socio-cultural competence development. The set of exercises on socio-cultural competence development on the material of English and Russian phraseological units, developed by authors, include language and speech tasks; tasks based on project and creative research activity methods, which are the basis of development of the main socio-cultural skills that are necessary in intercultural communication
Hunter, Jennifer L
A graduate course on culture, diversity, and cultural competence was developed based on constructivist learning theory and Campinha-Bacote's constructs of cultural awareness, knowledge, skill, and encounters. The epistemology, structure, assignments, and activities used in both online and classroom courses were highly effective and well received by the students. Student course evaluations and outcome assessments of students' cultural competence levels, as compared to precourse levels, provided supportive evidence that the course design produced intended outcomes. Course resources are shared, making them available for use by others in cultural competence education.
Montagnini, Marcos; Smith, Heather M; Price, Deborah M; Ghosh, Bidisha; Strodtman, Linda
In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. To assess health-care professionals' self-perceived competencies regarding the provision of EOL care in hospitalized patients. Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.
Divya Sood OTD, OTR/L
Full Text Available Occupational therapy (OT educators recognize a need to ensure that OT students are culturally competent. The researchers developed the International Collaborative Project on Cultural Competence (ICPCC to help students understand the impact of cultural context on client care. Entry-level MOT students from a university in the US (N = 18 collaborated with BOT students (N = 4 and advanced MOT students (N = 9 from two universities in India using an online course management system WebCT. The study explored the impact of the ICPCC on OT students’ cultural competence and discusses students’ perceptions of culture on the OT process. The Inventory for Assessing the Process of Cultural Competence Among Health Care Professionals Revised© measured students’ cultural competence at baseline and immediately after participation in the ICPCC. Qualitative data was collected using a Self-Reflection Form. There was an increase in the cultural competence scores among all three groups of students after participating in the ICPCC at p value < .05. Three themes emerged from the qualitative data analysis: meaning of the term culture, impact of cultural on client- centered practice, and impact of cultural on OT outcomes. OT students recognized the role that cultural differences play in OT evaluation and intervention.
Kim, Myoung Soo
The purpose of this study was to identify the moderating and mediating effects of self-leadership in the relationship between organizational culture and nurses' informatics competency. Participants in this study were 297 nurses from the cities of Busan and Ulsan. The scales of organizational culture, self-leadership and informatics competency for nurses were used in this study. Descriptive statistics, Pearson correlation coefficient, stepwise multiple regression were used for data analysis. Nursing informatics competency of the participants was relatively low with a mean score 3.02. There were significant positive correlations between subcategories of perceived organizational culture, self-leadership and nursing informatics competency. Self-leadership was a moderator and a mediator between organizational culture and informatics competency. Based on the results of this study, self-leadership promotion strategies to improve nursing informatics competency are needed.
Teasley, Martell L.; Baffour, Tiffany D.; Tyson, Edgar H.
This exploratory study examined the contribution of social work experience and licensure to self-reported levels of cultural competence of social workers in urban public school systems. In addition, it examined the influence of practitioners race or ethnicity on perceived levels of culturally competent practice in urban schools. Using survey…
Hill, Renee Franklin; Kumasi, Kafi
School library and youth services professionals must develop and display a strong sense of cultural competence to effectively serve their patrons. Cultural competence is defined here as one's ability to understand the needs of populations different from their own. This paper reports on the perceptions of school library and youth services students…
Seeberg, Vilma; Minick, Theresa
Teacher education needs to engage teacher candidates in developing cross-cultural competence so that they may be able to transmit global learning to their future students. This study theorizes cross-cultural competence (CCC) from the perspectives of multicultural and global education. During a four-year project at a mid-western US university,…
Vesely, Colleen K.; Ewaida, Marriam; Anderson, Elaine A.
The cultural competence of 13 parenting education programs for Latino families with young children was examined in this study. Based on our analyses, we make several recommendations for improving the cultural competence and effectiveness of parenting education programs for Latino families with young children. Specifically, we recommend the…
Jani, Jayshree S.; Osteen, Philip; Shipe, Stacy
Social work educators are responsible for ensuring that future practitioners are culturally competent and have the ability to work effectively with people from different backgrounds. The purpose of this article is to address the current limitations in measuring cultural competence and to report the results of a qualitative study examining…
Heppner, P. Paul
The central thesis of this article is that focusing on cross-cultural competence will enhance both the science and the practice of counseling psychology. Developing cross-cultural competence is a lifelong journey, replete with many joys and challenges, that will (a) increase the sophistication of our research, (b) expand the utility and…
Elwyn, G; Edwards, A; Kinnersley, P; Grol, R
Involving patients in healthcare decisions makes a potentially significant and enduring difference to healthcare outcomes. One difficulty (among many) is that the 'involvement' of patients in decisions has been left undefined. It is usually conceptualised as 'patient centredness', which is a broad and variably interpreted concept that is difficult to assess using current tools. This paper attempts to gauge general practitioners' (GPs') attitudes to patient involvement in decision making and their views about the contextual factors, competences, and stages required to achieve shared decisions within consultations. To explore and understand what constitutes the appropriate involvement of patients in decision making within consultations, to consider previous theory in this field, and to propose a set of competences (skills) and steps that would enable clinical practitioners (generalists) to undertake 'shared decision making' in their clinical environment. Qualitative study using focus group interviews of key informants. Experienced GPs with educational roles have positive attitudes to the involvement of patients in decisions, provided the process matches the role individuals wish to play. They perceive some clinical problems as being more suited to a cooperative approach to decision making and conceptualised the existence of professional equipoise towards the existence of legitimate treatment options as an important facilitative factor. A sequence of skills was proposed as follows: 1) implicit or explicit involvement of patients in the decision-making process; 2) explore ideas, fears, and expectations of the problem and possible treatments; 3) portrayal of equipoise and options; 4) identify preferred data format and provide tailor-made information; 5) checking process: understanding of information and reactions (e.g. ideas, fears, and expectations of possible options); 6) acceptance of process and decision making role preference; 7) make, discuss or defer decisions; 8
Okoro, Olihe N; Odedina, Folakemi T; Reams, Romonia R; Smith, W Thomas
To evaluate the level of competency and knowledge about health disparities among third-year doctor of pharmacy (PharmD) students at 2 Florida public colleges of pharmacy and to explore the demographic correlates of these variables. A cross-sectional survey study design was used to collect data from participants. The students had low health-disparities knowledge and moderate skills in dealing with sociocultural issues and cross-cultural encounters. Speaking a language(s) other than English and having exposure to cultural-competency instruction were the demographic variables found to be most significantly associated with clinical cultural competency and/or knowledge of health disparities. Clinical cultural competency and health-disparities instruction may not be adequately incorporated into the pharmacy school curricula in the institutions studied. Relevant education and training are necessary to enhance cultural competency among pharmacy students.
Blenkinsopp, John; Snowden, Nicholas
In their valuable discussion of whistleblowing in healthcare organisations, Mannion and Davies highlight the importance of organisational culture in influencing whether people raise concerns, and whether these concerns are listened to and acted upon. The role of leadership in shaping organisational culture is well-established and in this commentary, we will examine the influence of leaders in creating cultures of silence or cultures of voice. © 2016 by Kerman University of Medical Sciences.
Olga A. Andreyeva
Full Text Available In this article authors made an attempt to consider a question of cross-cultural communication as a way of achievement of cross-cultural communicative competence. In the process of Kazakhstan entry into the world community in several plans at once – economic, social and cultural – the need for the highly qualified specialists who know foreign language at the productive level, i.e. capable to conduct communication in foreign language and who have linguocultural knowledge increases. For achievement of this purpose it is necessary to consider features of students’ training which are determined by the needs of society for the improvement of their education quality, and dynamism of social phenomena demands from the future specialists constant increment of knowledge.
Choi, 2005; Matsumoto , Yoo, Hirayama, & Petrova, 2005) or attitudes toward specific cultural groups using Implicit Association Tests (e.g., Park, Felix...findings, Ward et al. (2009) found that CQ failed to show incremental validity beyond emotional intelligence in predicting psychological , socio- cultural ...Cracking the nonverbal code: Intercultural competence and gesture recognition across cultures . Journal of Cross- Cultural Psychology , 36, 380-395
Relativism . .......................................................................................................... 13 Cultural Acuity...Factor Cronbach’s α Number of items Cultural Interest 0.73 6 Cultural Relativism 0.80 10 Cultural Acuity 0.70 8 Relationship Orientation 0.71 7...The factors were labeled as Cultural Interest (CI), Cultural Relativism (CR), Cultural Acuity (CA), Relationship Orientation (RO), and Interpersonal
Halabi, Jehad O; de Beer, Jennifer
To explore the cultural competence of undergraduate nursing students at a college of nursing, Saudi Arabia. A descriptive exploratory design was used to explore the Saudi undergraduate nursing students' level of cultural competency. The convenience sample included 205 nursing students affiliated with a college of nursing at a health science university in Jeddah, Saudi Arabia. Data was collected using the Inventory for Assessing the Process of Cultural Competence-Revised (IAPCC-R) consisting of 25 items. The tool reported acceptable reliability of Cronbach alpha 0.89. The majority of students were culturally aware and dealt with people from different cultures. One-third preferred to have training on culture over a period of time. Half the students preferred studying a special course related to working with people from different cultures. Cultural desire reported the highest mean while cultural knowledge scored the lowest among the cultural competence subscales despite students being exposed to some cultural knowledge content in their training. Implementing the guidelines for culturally competent care assure covering all aspects of care with consideration of cultural heritage as a main concept. Comparative study of nurses' and students' perception is further recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lyudmila V. Astakhova
Full Text Available Introduction: problems of cultural competence development among higher school students are becoming increasingly important against a decline in a cultural level of an individual in a post-industrial society. Their relevance is determined by low level of effectiveness in the use of competence-based approach in higher education, debatable nature of the culture concept in scholarship, and evolution of axiological dominants in different cultures, specificity of dominant values in post-industr ial culture. Materials and Methods: the author uses a competence-based approach to determine the cultural competence of students. A cultural approach is applied to determine various approaches to culture. A capital approach is established as the approach enabling to take into account the cultural and axiological dominants of post-industrial society. Analytic-synthetic methods are used in the search and analysis of literature on the topic; the method of comparative analysis in the determination of essence of concepts of cultural competence: method of sociological survey to discover the level of cultural competence of graduates. Results: the sociological survey of employers revealed the insufficient level of cultural competence among graduates; the concept of cultural competence in pedagogical science was examined; the limitations of approaches to this concept were identified, the author’s definition of cultural competence of personality in a postindustrial society is substantiated. Based on the author’s informed definition of cultural competence, as well as the notion of cultural capital, the author substantiates the definition of “cultural-capital competence of a student in a post-industrial society” as a structural part of his / her cultural competence, which takes into account the requirements of a post-industrial society. Discussion and Conclusions: given the evolution of value priorities in a post-industrial culture, the author substantiates the
. The evolution of the assessment and development of nursing competences in the Italian health-care system. The issue of the skills, in health care organizations, received a boost in the last 15 years as a result of contractual innovations that recognized different career levels in the nursing profession, and of the widespread dissemination of quality systems for certification or accreditation for excellence. These events prompted organizations to assess the competence of their professionals. A further stimulus was given by the recent debate on nursing sensitive outcomes, by the changes in patients' needs and by the increased production of knowledge from the nursing profession which contributed to an increase of competences and to their expanded role. To improve patients' care and avoid conflicts, and to maximize the benefits to users, professionals need to learn to work together, integrating and respecting roles and competences.
Meskó, Bertalan; Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna
Under the term “digital health”, advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; th...
Azzolini, Elena; Ricciardi, Walter; Gray, Muir
An organization may be considered as having three components: a structure, systems and culture. Culture is the most difficult part of the organization to affect. After all, culture has the key role in impacting and improving organizational performance. The leadership of an organization and its key operations are paramount in shaping the culture. Leadership and organizational culture are inextricably intertwined. They are two sides of the same coin. Culture is a medium through which leadership travels and impacts organizational performance. If leaders are to fulfil the challenges of the 21st century, they must first understand the dynamics of culture and their role as sculptors through behavioural and cognitive ways.
Mills, Stacia; Xiao, Anna Q; Wolitzky-Taylor, Kate; Lim, Russell; Lu, Francis G
The objective of this study was to assess whether a 1-hour didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves the cultural competence of general psychiatry residents. The main hypothesis was that teaching adult psychiatry residents a 1-hour session on the CFI would improve cultural competence. The exploratory hypothesis was that trainees with more experience in cultural diversity would have a greater increase in cultural competency scores. Psychiatry residents at a metropolitan, county hospital completed demographics and preintervention questionnaires, were exposed to a 1-hour session on the CFI, and were given a postintervention questionnaire. The questionnaire was an adapted version of the validated Cultural Competence Assessment Tool . Paired samples t tests compared pre- to posttest change. Hierarchical linear regression assessed whether pretraining characteristics predicted posttest scores. The mean change of total pre- and posttest scores was significant ( p = .002), as was the mean change in subscales Nonverbal Communications ( p < .001) and Cultural Knowledge ( p = .002). Demographic characteristics did not predict higher posttest scores (when covarying for pretest scores). Psychiatry residents' cultural competence scores improved irrespective of previous experience in cultural diversity. More research is needed to further explore the implications of the improved scores in clinical practice.
Dominique Van de Velde
Full Text Available Over the past decades, there has been a paradigm shift from a purely biomedical towards a bio-psycho-social (BPS conception of disability and illness, which has led to a change in contemporary healthcare. However, there seems to be a gap between the rhetoric and reality of working within a BPS model. It is not clear whether healthcare professionals show the necessary skills and competencies to act according to the BPS model.The aim of this study was (1 to develop a scale to monitor the BPS competencies of healthcare professionals, (2 to define its factor-structure, (3 to check internal consistency, (4 test-retest reliability and (5 feasibility.Item derivation for the BPS scale was based on qualitative research with seven multidisciplinary focus groups (n = 58 of both patients and professionals. In a cross-sectional study design, 368 healthcare professionals completed the BPS scale through a digital platform. An exploratory factor analysis was performed to determine underlying dimensions. Statistical coherence was expressed in item-total correlations and in Cronbach's α coefficient. An intra-class-correlation coefficient was used to rate the test-retest reliability.The qualitative study revealed 45 items. The exploratory factor analysis showed five underlying dimensions labelled as: (1 networking, (2 using the expertise of the client, (3 assessment and reporting, (4 professional knowledge and skills and (5 using the environment. The results show a good to strong homogeneity (item-total ranged from 0.59 to 0.79 and a strong internal consistency (Cronbach's α ranged from 0.75 to 0.82. ICC ranged between 0.82 and 0.93.The BPS scale appeared to be a valid and reliable measure to rate the BPS competencies of the healthcare professionals and offers opportunities for an improvement in the healthcare delivery. Further research is necessary to test the construct validity and to detect whether the scale is responsive and able to detect changes over time.
Elnashar, Maha; Abdelrahim, Huda; Fetters, Michael D
The authors describe the factors that led Weill Cornell Medical College in Qatar (WCMC-Q) to establish the Center for Cultural Competence in Health Care from the ground up, and they explore challenges and successes in implementing cultural competence training.Qatar's capital, Doha, is an extremely high-density multicultural setting. When WCMC-Q's first class of medical students began their clinical clerkships at the affiliated teaching hospital Hamad Medical Corporation in 2006, the complicated nature of training in a multicultural and multilingual setting became apparent immediately. In response, initiatives to improve students' cultural competence were undertaken. Initiatives included launching a medical interpretation program in 2007; surveying the patients' spoken languages, examining the effect of an orientation program on interpretation requests, and surveying faculty using the Tool for Assessing Cultural Competence Training in 2008; implementing cultural competence training for students and securing research funding in 2009; and expanding awareness to the Qatar community in 2010. These types of initiatives, which are generally highly valued in U.S. and Canadian settings, are also apropos in the Arabian Gulf region.The authors report on their initial efforts, which can serve as a resource for other programs in the Arabian Gulf region.
Lim, Russell F; Diamond, Ronald J; Chang, Jacquelyn B; Primm, Annelle B; Lu, Francis G
Feature films have been used for teaching in psychiatry for many years to demonstrate diagnoses, but the use of documentary and instructional films in resident and staff cultural competence training have not been extensively written about in the medical and psychological literature. This article will describe the films that have been used by the authors and suggest methods for their use in cultural competence and diversity training. A literature search was done using MEDLINE and PsychINFO and the authors were asked to describe their teaching methods. One article was found detailing the use of videotapes as a stimulus but not for cultural competence education, and two articles were found documenting the use of The Color of Fear as a stimulus for the discussion of racism. However, many educators use these films all across the country for the purpose of opening discussion about racism. Documentary, instructional, and public service announcements can be useful in teaching culturally competent assessment and treatment.
Truong, Mandy; Gibbs, Lisa; Pradel, Veronika; Morris, Michal; Gwatirisa, Pauline; Tadic, Maryanne; de Silva, Andrea; Hall, Martin; Young, Dana; Riggs, Elisha; Calache, Hanny; Gussy, Mark; Watt, Richard; Gondal, Iqbal; Waters, Elizabeth
Cultural competence is an important aspect of health service access and delivery in health promotion and community health. Although a number of frameworks and tools are available to assist health service organizations improve their services to diverse communities, there are few published studies describing organizational cultural competence assessments and the extent to which these tools facilitate cultural competence. This article addresses this gap by describing the development of a cultural competence assessment, intervention, and evaluation tool called the Cultural Competence Organizational Review (CORe) and its implementation in three community sector organizations. Baseline and follow-up staff surveys and document audits were conducted at each participating organization. Process data and organizational documentation were used to evaluate and monitor the experience of CORe within the organizations. Results at follow-up indicated an overall positive trend in organizational cultural competence at each organization in terms of both policy and practice. Organizations that are able to embed actions to improve organizational cultural competence within broader organizational plans increase the likelihood of sustainable changes to policies, procedures, and practice within the organization. The benefits and lessons learned from the implementation of CORe are discussed.
Suk, Min Hyun; Oh, Won-Oak; Im, YeoJin
With the recent growth of multicultural families in the Korean society, the importance of the role of qualified visiting nurses in the delivery of culturally sensitive health care has grown dramatically. As the primary health care provider for multicultural families enrolled in public community-based health care centers, the cultural competence of visiting nurses is an essential qualification for the provision of quality health care for multicultural families, especially in rural areas. Cultural competence of visiting nurses is based on their cultural awareness and empathetic attitude toward multicultural families. This study aimed to examine the levels of cultural competence, empowerment, and empathy in visiting nurses, and to verify the factors that affect the cultural competence of visiting nurses working with rural multicultural families in South Korea. Employing a cross-sectional descriptive study design, data from 143 visiting nurses working in rural areas were obtained. Data collection took place between November 2011 and August 2012. The measurement tools included the modified Korean version of the Cultural Awareness Scale, the Text of Items Measuring Empowerment, and the Interpersonal Reactivity Index to measure the level of empathy of visiting nurses. Analyses included descriptive statistics, a t-test, an ANOVA, a Pearson correlation coefficient analysis, and a multiple linear regression analysis. The cultural competence score of the visiting nurses was 3.07 on a 5-point Likert scale (SD = 0.30). The multiple regression analysis revealed that the cultural competence of visiting nurses was significantly influenced by experience of cultural education, empathy, and scores on the meaning subscale of the empowerment tool (R 2 = 10.2%). Institutional support to enhance visiting nurses' empowerment by assuring the significance of their job and specific strategies to enhance their empathy would be helpful to improve the cultural competence of visiting
Daugherty, Heather N; Kearney, Rachel C
Purpose: The purpose of this study was to measure the change in levels of knowledge of providing culturally competent care and self-assessed cultural competence of senior level dental hygiene students after the implementation of an online cultural competence training module. Methods: Twenty-eight members of the senior class of 31 dental hygiene students (N=28) volunteered to participate in this IRB approved study at the Ohio State University School of Dentistry. The students took the online Inventory for Assessing the Process of Cultural Competence- Student Version (IAPCC-SV), to assess their self-perceived cultural competence. Upon completion of the pre-test, students then completed the United States Department of Health and Human Services (HHS) Office of Minority Health (OMH) Cultural Competency Program for Oral Health Professionals; a three-module online training program designed to measure increased knowledge of cultural competence. Three weeks following the initial pre-test and upon completion of the Cultural Competency Program for Oral Health Professionals online learning modules, students re-took the IAPCC-SV. Results: Twenty-eight senior dental hygiene students completed the IAPCC-SV pre-test, the OMH e-learning modules and the IAPCC-SV post-test. The average score on the pre-test was 55.14±7.54 and the average score on the post-test was 61.33±7.86. There was a significant difference in pre-test and post-test scores (pdental hygiene students' levels of knowledge of cultural competence. Copyright © 2017 The American Dental Hygienists’ Association.
Jenny Hsin-Chun Tsai
Full Text Available There is a growing awareness and interest in the development of culturally competent health knowledge. Drawing on experience using a qualitative approach to elicit information from Mandarin- or Cantonese-speaking participants for a colorectal cancer prevention study, the authors describe lessons learned through the analysis process. These lessons include benefits and drawbacks of the use of coders from the studied culture group, challenges posed by using translated data for analysis, and suitable analytic approaches and research methods for cross-cultural, cross-language qualitative research. The authors also discuss the implications of these lessons for the development of culturally competent health knowledge.
This article attempted to examine the relationship between cultural competence education and increasing diversity in nursing schools and practice settings. In addition to the review of the literature, a panel of experts was interviewed regarding institutional practices in response to the challenge of increasing diversity and cultural competence education. Evidence of positive outcomes of cultural competent care and impact of race and ethnic concordance between patients and providers are presented. The challenge of increasing underrepresented minorities in health care professions remains elusive. An ecological analysis is recommended to address the social and cultural barriers that transcend the micro system of the school and the macro system of the society. The challenge of increasing diversity and realizing outcomes of cultural competence education requires social and comprehensive remedies to level life inequities that perpetuate a history of disadvantages in some groups.
Sobel, Linda L; Metzler Sawin, Erika
To explore nursing care actions that lead to culturally competent care for Hispanic patients. Nurses report apprehension when delivering nursing care because of language barriers and a lack of Hispanic cultural understanding. Research is needed to inform culturally aware nursing practice actions for Hispanic patients. The study used a qualitative, grounded theory design to address the questions: (a) What cultural knowledge should nurses have when caring for Hispanic patients and families and (b) What nursing actions should nurses take to provide culturally competent care? Hispanic lay health promoters and Hispanic community members were interviewed to make recommendations for care. A model was identified that informs culturally competent nursing care. "Connectedness," the central phenomenon, describes nursing actions and contains subthemes explaining influences on nursing care. "Up to You" and "At the Mercy of the System" are descriptive themes influencing connectedness. Connectedness is central to culturally well-informed nurse-patient interactions. © The Author(s) 2014.
Stough-Hunter, Anjel; Guinan, Jill; Hart, Julie P
This study examines students' levels of cultural competency before and after taking three different semester-long courses dealing with diversity and cultural competence with each course representing a different teaching methodology. A new 20-item survey, designed for students across disciplines, was used to measure cultural competency among 226 students from the fall of2012 to the spring of2 015. Differences were examined between scores before and after taking each class, as well as differences between classes. There were significant improvements in all three groups, and a significant difference between two of the three classes in the improvement of scores.
Swanberg, Stephanie M; Abuelroos, Dena; Dabaja, Emman; Jurva, Stephanie; Martin, Kimberly; McCarron, Joshua; Reed-Hendon, Caryn; Yeow, Raymond Y; Harriott, Melphine M
Fostering cultural competence in higher education institutions is essential, particularly in training future health care workers to care for diverse populations. The opportunity to explore techniques to address diversity and cultural competence at a new medical school was undertaken by a multidisciplinary team of librarians, faculty, staff, and medical students. From 2011 to 2015, the team sponsored a voluntary programming series to promote cultural competence and raise awareness of health care disparities for the medical school. Thirteen events were hosted with 562 participants across all. This approach to diversity proved effective and could be adapted in any higher education setting.
Gershon, Robyn R M; Stone, Patricia W; Bakken, Suzanne; Larson, Elaine
Although there is increasing interest in the relationship between organizational constructs and health services outcomes, information on the reliability and validity of the instruments measuring these constructs is sparse. Twelve instruments were identified that may have applicability in measuring organizational constructs in the healthcare setting. The authors describe and characterize these instruments and discuss the implications for nurse administrators.
Truong, Mandy; Bentley, Sharon A; Napper, Genevieve A; Guest, Daryl J; Anjou, Mitchell D
This study is an investigation of how Australian and New Zealand schools of optometry prepare students for culturally competent practice. The aims are: (1) to review how optometric courses and educators teach and prepare their students to work with culturally diverse patients; and (2) to determine the demographic characteristics of current optometric students and obtain their views on cultural diversity. All Australian and New Zealand schools of optometry were invited to participate in the study. Data were collected with two surveys: a curriculum survey about the content of the optometric courses in relation to cultural competency issues and a survey for second year optometry students containing questions in relation to cultural awareness, cultural sensitivity and attitudes to cultural diversity. Four schools of optometry participated in the curriculum survey (Deakin University, Flinders University, University of Melbourne and University of New South Wales). Sixty-three students (22.3 per cent) from these four schools as well as the University of Auckland participated in the student survey. Cultural competency training was reported to be included in the curriculum of some schools, to varying degrees in terms of structure, content, teaching method and hours of teaching. Among second year optometry students across Australia and New Zealand, training in cultural diversity issues was the strongest predictor of cultural awareness and sensitivity after adjusting for school, age, gender, country of birth and language other than English. This study provides some evidence that previous cultural competency-related training is associated with better cultural awareness and sensitivity among optometric students. The variable approaches to cultural competency training reported by the schools of optometry participating in the study suggest that there may be opportunity for further development in all schools to consider best practice training in cultural competency. © 2014 The
Gainsbury, Sally M
Culturally and linguistically diverse (CALD) populations often have high rates of addictive disorders, but lower rates of treatment seeking and completion than the mainstream population. A significant barrier to treatment is the lack of culturally relevant and appropriate treatment. A literature review was conducted to identify relevant literature related to cultural competence in mental health services delivery and specifically treatment for addictive disorders. Several theoretical models of cultural competence in therapy have been developed, but the lack of rigorous research limits the empirical evidence available. Research indicates that culturally competent treatment practices including providing therapy and materials in the client's language, knowledge, understanding and appreciation for cultural perspectives and nuances, involving the wider family and community and training therapists can enhance client engagement, retention and treatment outcomes for substance use and gambling. Further methodologically rigorous research is needed to isolate the impact of cultural competence for the treatment of addictions and guide research to determine treatment efficacy within specific CALD populations. Training therapists and recruiting therapists and researchers from CALD communities is important to ensure an ongoing focus and improved outcomes for CALD populations due to the importance of engaging these populations with addiction treatment. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message: The treatment needs of culturally diverse individuals with addictions are often not met. Theoretical models can guide therapists in incorporating cultural competence. Culturally targeted treatments increase recruitment, retention and treatment outcomes. Cultural competence includes matching clinicians and clients on linguistic and cultural backgrounds as well as being mindful of the impact of culture on client's experience of addiction problems. Few methodologically
A survey of cultural competence of critical care nurses in ... Nurses are primary caregivers and have a key role in providing care in a culturally ... relating to culture, gender or sexual orientation. ... concerning the population they work with, and although a ... lead to conflict, increased levels of anxiety, and stress among nurses,.
Bradford, Althea Betty
A short-term intervention on participants' knowledge of cultural competence was provided to 38 students in a baccalaureate nursing program at Winston-Salem State University (WSSU). The study examined the effectiveness of this intervention. Although WSSU is a Historically Black University, the majority of students in this program were White. Six tools were used for data collection. The Cultural Competence Survey consisted of 19 Likert Scale items that also gave participants an opportunity to elaborate on each response. Four tools allowed participants to provide written answers to prompts related to cultural competence. The final tool made it possible for the investigator to record impressions and reflections regarding various aspects of the study. Results showed that the students are familiar with cultural competence and want to avoid stereotypical behavior in their nurse-patient encounters. The study suggests a need for education in cultural competence in three areas: 1) accepting that cultural competence is a lifelong endeavor, 2) understanding patients from a holistic perspective, and 3) recognizing that all people have biases; however, the competent nurse is self-aware and has been educated to recognize biased behavior.
Full Text Available bstract Background: Occupational therapists increasingly encounter clients from diverse cultural backgrounds and need to meet their professional obligation of delivering culturally competent practice. Yet the process of cultural competency is poorly understood in occupational therapy practice. There is a need for a clear understanding of the meaning and process of cultural competency as it is enacted in practice with a wide range of individuals from culturally diverse backgrounds. Aim: To investigate the process, stages, characteristics, and requirements of cultural competency as practiced by experienced occupational therapists. Method: Semi-structured interviews were carried out with 13 community occupational therapists experienced in delivering occupational therapy services in clients’ homes in a culturally diverse area in London, England. Findings: Interview data were analyzed and ordered into the format of a conceptual process model where cultural competency formed the core concept. The model of cultural competency that emerged from this study comprised six stages: cultural awareness, cultural preparedness, a cultural picture of the person, cultural responsiveness, cultural readiness, and cultural competence. Conclusion: Cultural competency is a complex process that needs to be based on underpinning occupational theory and actualized at the level of practice. Further research is needed to test out the model and illuminate the process of cultural competency in different areas of occupational therapy practice.
Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.
This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…
Hang, S. M.; Seong, P. H.; Kim, A. R.
Safety culture has received attention in safety-critical industries, including nuclear power plants (NPPs), due to various prominent accidents such as concealment of a Station Blackout (SBO) of Kori NPP unit 1 in 2012, the Sewol ferry accident in 2014, and the Chernobyl accident in 1986. Analysis reports have pointed out that one of the major contributors to the cause of the accidents is ‘the lack of safety culture’. The term, nuclear safety culture, was firstly defined after the Chernobyl accident by the IAEA in INSAG report no. 4, as follows “Safety culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted their significance.” Afterwards, a wide consensus grew among researchers and nuclear-related organizations, that safety culture should be evaluated and managed in a certain manner. Consequently, each nuclear-related organization defined and developed their own safety culture definitions and assessment methods. However, none of these methods provides a way for an individual or a team to enhance the safety culture of an organization. Especially for a team, which is the smallest working unit in NPPs, team members easily overlook their required practices to improve nuclear safety culture. Therefore in this study, we suggested a method to estimate nuclear safety culture of a team, by approaching with the ‘competency’ point of view. The competency is commonly focused on individuals, and defined as, “underlying characteristics of an individual that are causally related to effective or superior performance in a job.” Similar to safety culture, the definition of competency focuses on characteristics and attitudes of individuals. Thus, we defined ‘safety culture competency’ as “underlying characteristics and outward attitudes of individuals that are causally related to a healthy and strong nuclear safety
Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan
One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p organizational communication interventions might protect HIV health-care providers from burnout.
Polacek, Georgia N L J; Martinez, Rubén
Cultural competence in health care has come to the forefront with the changing demographics in the United States. Standards have been created by the Office of Minority Health for culturally appropriate health care. This article presents the findings of one hospital system's cultural competency assessment. Employee surveys and patient and physician focus groups were conducted to gain insight into cultural differences and challenges encountered in this system. Statistically significant effects of ethnicity and gender on language skills and awareness, as well as differences in awareness and knowledge by the respondent's employment position, were found. Patient concerns included access to care and respect from staff. The need for cross-cultural education and training for all health care delivery personnel was reinforced. Cultural competency will not be achieved if education, attention to diversity, trained interpreters, and the understanding that social factors have a profound influence on health and health outcomes are not considered.
Cai, Duanying; Kunaviktikul, Wipada; Klunklin, Areewan; Sripusanapan, Acharaporn; Avant, Patricia Kay
This qualitative study using semi-structured interviews was conducted to identify the essential components of cultural competence from the perspective of Chinese nurses. A purposive sample of 20 nurse experts, including senior clinical nurses, nurse administrators, and educators in transcultural nursing, was recruited. Using thematic analysis, four themes: awareness, attitudes, knowledge, and skills, with two subthemes for each, were identified. Notably, culture in China was understood in a broad way. The participants' responses focused upon demographic attributes, individuality, and efforts to facilitate quality care rather than on the cultural differences of ethnicity and race and developing the capacity to change discrimination or health disparities. A greater understanding of cultural competence in the Chinese nursing context, in which a dominant cultural group exists, is essential to facilitate the provision of culturally competent care to diverse populations. © 2016 John Wiley & Sons Australia, Ltd.
Keene, Sean T
.... Thousands of years ago, the writer of The Art of War highlighted the critical nature of cultural competence when he asserted his formula for military success, "know the enemy and know yourself...
S.R.M. Indah Permata Sari
Full Text Available The purpose of this research is to comprehensively about the effect of learning culture, empowerment, and cyber skill competence on self engagement of the employee in Directorate General of Potential for Defense Ministry of Defense Republic of Indonesia. The research methodology was survey with path analysis applied in testing hypothesis. It was conducted to 150 employees from population 241 employee who was selected in simple random way.Analysis and interpretation of data indicate that (1 learning culture has a positive direct effect in self engagement, (2 empowerment has a positive direct effect in self engagement, (3 cyber skill competence has a positive direct effect in self engagement, (4 learning culture has a positive direct effect in cyber skill competence, (5 empowerment has a positive direct effect in cyber skill competence, and (6 learning culture has a positive direct effect in empowerment
Conclusion: our study has allowed us to conclude that all dimensions of patients' safety culture need to be improved among our establishment's professionals. Therefore, more efforts are necessary in order to develop a security culture based on confidence, learning, communication and team work and rejecting sanction, ...
Y. V. Orlova
Full Text Available The paper is devoted to the communicative competence approach in professional training of physicians on the undergraduate level. The main emphasis is on developing linguistic, sociolinguistic and pragmatic competences while teaching the Russian language and the culture of speech. The paper is aimed at analyzing the requirements of federal state educational standards of the 3rd generation concerning the competences in the humanities which should be developed by medical students in the course of the Russian language and the culture of speech; defining the contents of the «communicative competence» term based on consideration of general European competences in mastering the language and the analysis of lingua-didactic works of modern Russian scientists; identifying the component content of linguistic, sociolinguistic and pragmatic competences of the Russian language and the culture of speech course for medical schools. The research results regarding the analysis and component content of linguistic, sociolinguistic and pragmatic competences of the Russian language and the culture of speech course have been applied while designing the Russian and the culture of speech curriculum, as well as electronic textbooks and manuals for medical students.
This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.
The aim of this study was to explore and analyse through literature review, the cultural competence of Nurse. The purpose of this study was to provide information to both nursing students and nurses on how to enhance their cultural competence,and answering the future needs of social and health care services, in a multicultural environment. The method used in conducting this research is the review of literature;data for the research was acquired from electronic databases such as CINAHL and...
Cook, Catherine; Brunton, Margaret
Moral emotions shape the effectiveness of culturally diverse teams. However, these emotions, which are integral to determining ethically responsive patient care and team relationships, typically go unrecognised. The contribution of emotions to moral deliberation is subjugated within the technorational environment of healthcare decision-making. Contemporary healthcare organisations rely on a multicultural workforce charged with the ethical care of vulnerable people. Limited extant literature examines the role of moral emotions in ethical decision-making among culturally diverse healthcare teams. Moral emotions are evident in ethnocentric moral perspectives that construct some colleagues' practices as 'other'. This article examines how moral emotions are evoked when cultural dissonance influences nurses' moral perceptions. We use a qualitative investigation of teamwork within culturally diverse healthcare organisations. We use Haidt's () account of moral emotions to examine practice-based accounts of 36 internationally educated and 17 New Zealand educated nurses practising in New Zealand. The study provides evidence that moral emotions are frequently elicited by communication and care practices considered 'foreign'. The main implication is that although safe practice in healthcare organisations is reliant on highly functioning teams, collaboration is challenged by interprofessional power relations of contested culturally shaped values. We address practice-based strategies that enable engagement with moral emotions to enhance effective teamwork. © 2017 John Wiley & Sons Ltd.
Cuevas, Adolfo G; O'Brien, Kerth; Saha, Somnath
To gain a better understanding as to whether disparities in patient-provider relationships arise from ethnic minority patients being treated differently than European American patients while they would prefer to be treated the same, or whether disparities arise when ethnic minority patients are treated the same as European American patients while they would prefer to be treated differently. African-American, Latina/Latino and European American community members were recruited to participate in one of 27 focus group discussions. Topics included what made a good or bad relationship with a doctor and what led one to trust a doctor. A thematic analysis was conducted using NVivo 10. Patients of all groups described experiences that reflected the concepts of patient-centred care, such as wanting a clinician who is attentive to patients' needs. African-American patients reported experiences they viewed as discriminatory. Some African-American patients felt it was appropriate to racially/ethnically contextualise their care, and most Latina/Latino patients preferred language/culturally concordant clinicians. Health care disparities might be reduced through a patient-centred approach to cultural competency training, general knowledge of the cultural context of clinicians' patient population, and attention to the effects of racial bias and discrimination among both clinicians and non-clinical staff.
Guerrero, Erick G
The field of cultural competence is shifting its primary emphasis from enhancement of counselors' skills to management, organizational policy, and processes of care. This study examined managers' characteristics associated with adoption of culturally competent practices in the nation's outpatient substance abuse treatment field. Findings indicate that in 1995, supervisors' cultural sensitivity played the most significant role in adopting practices, such as matching counselors and clients based on race and offering bilingual services. Staff's exposure to cross-cultural training increased from 1995 to 2005. In this period, positive associations were found between managers' cultural sensitivity and connection with the community and staff receiving cross-cultural training and the number of training hours completed. However, exposure to and investment in this training were negatively correlated with managers' formal education. Health administration policy should consider the extent to which the decision makers' education, community involvement, and cultural sensitivity contribute to building culturally responsive systems of care. Copyright © 2010 Elsevier Inc. All rights reserved.
Moon, Kwangsu; Kim, Sa Kil; Oh, Yeon Ju; Shin, Youmin; Lee, Yong-Hee; Jang, Tong Il
The term of safety competency in nuclear field was presented in the OECD/NEA workshop held in 1999. A model of the safety culture competencies in nuclear power plants was developed by KAERI (Korea Atomic Energy Research Institute). In general, a competency (competence) is defined as 'cluster of employee's attribute, knowledge, skill, ability or other characteristic that contributes to successful job performance'. We also defined safety culture competency as 'cluster of various internal characteristics (e.g., knowledge, skill, ability, motive, attitude and etc.) of employee that contribute to perform job safely and shape a healthy and strong safety culture.' By this definition, the safety culture competency is the broader construct including job competency. An employee having high level of safety culture competency shows extra discretionary effort to improve safety of peer, team and organization in addition to the individual's successful and safe job accomplishment. The behavioral indicators for each of the competencies are focal points of conversations on progress and are monitored continuously by self-assessment and managers or supervisors' intervention. Deficiencies in any of these indicators can point to coaching, training or other learning opportunities that employees may be required in order to improve. The purpose of this study was to derive a model of safety competencies for improving safety culture of NPPs and develop a set of behavioral indicators of each competency. In addition, the method of measuring behavioral indicators was suggested. For the application of developed safety culture competences and behavioral indicators, the most suitable measuring method for behavioral indicators must be developed. In the case of behavioral observations, behavioral dimensions (frequency, persistence and latency), observation possibility, occurrence basis of behavior (daily job performance, situational dependent) are considered to
Moon, Kwangsu; Kim, Sa Kil; Oh, Yeon Ju; Shin, Youmin; Lee, Yong-Hee; Jang, Tong Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The term of safety competency in nuclear field was presented in the OECD/NEA workshop held in 1999. A model of the safety culture competencies in nuclear power plants was developed by KAERI (Korea Atomic Energy Research Institute). In general, a competency (competence) is defined as 'cluster of employee's attribute, knowledge, skill, ability or other characteristic that contributes to successful job performance'. We also defined safety culture competency as 'cluster of various internal characteristics (e.g., knowledge, skill, ability, motive, attitude and etc.) of employee that contribute to perform job safely and shape a healthy and strong safety culture.' By this definition, the safety culture competency is the broader construct including job competency. An employee having high level of safety culture competency shows extra discretionary effort to improve safety of peer, team and organization in addition to the individual's successful and safe job accomplishment. The behavioral indicators for each of the competencies are focal points of conversations on progress and are monitored continuously by self-assessment and managers or supervisors' intervention. Deficiencies in any of these indicators can point to coaching, training or other learning opportunities that employees may be required in order to improve. The purpose of this study was to derive a model of safety competencies for improving safety culture of NPPs and develop a set of behavioral indicators of each competency. In addition, the method of measuring behavioral indicators was suggested. For the application of developed safety culture competences and behavioral indicators, the most suitable measuring method for behavioral indicators must be developed. In the case of behavioral observations, behavioral dimensions (frequency, persistence and latency), observation possibility, occurrence basis of behavior (daily job performance, situational dependent) are considered to
Notten, N.; Bol, Th.; van de Werfhorst, H.G.; Ganzeboom, H.B.G.
This article examines educational stratification in highbrow cultural participation. There are two contrasting explanations of why cultural participation is stratified. The status hypothesis predicts that people come to appreciate particular forms of art because it expresses their belonging to a
Notten, N.; Lancee, B.; van de Werfhorst, H.G.; Ganzeboom, H.B.G.
This article examines educational stratification in highbrow cultural participation. There are two contrasting explanations of why cultural participation is stratified. The status hypothesis predicts that people come to appreciate particular forms of art because it expresses their belonging to a
It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare Comment on "(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare".
Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn
The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics. Mannion and Exworthy's call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hepburn, Larry; Shin, Masako
This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on food service. This program is designed to run 24 weeks and cover 15 instructional areas: orientation, sanitation, management/planning, preparing food for cooking, preparing beverages, cooking eggs, cooking meat, cooking vegetables,…
Hepburn, Larry; Shin, Masako
This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on automotive mechanics. This program is designed to run 36 weeks and cover 10 instructional areas: the engine; drive trains--rear ends/drive shafts/manual transmission; carburetor; emission; ignition/tune-up; charging and starting;…
Portz, Jennifer Dickman; Retrum, Jessica H.; Wright, Leslie A.; Boggs, Jennifer M.; Wilkins, Shari; Grimm, Cathy; Gilchrist, Kay; Gozansky, Wendolyn S.
This qualitative, interview-based study assessed the cultural competence of health and social service providers to meet the needs of LGBT older adults in an urban neighborhood in Denver, Colorado, known to have a large LGBT community. Only 4 of the agencies were categorized as “high competency” while 12 were felt to be “seeking improvement” and 8 were considered “not aware.” These results indicate significant gaps in cultural competency for the majority of service providers. Social workers are well-suited to lead efforts directed at improving service provision and care competencies for the older LGBT community. PMID:24798180
Mannion, Russell; Brown, Sally; Beck, Matthias; Lunt, Neil
The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care
One of the core strategies to transform the United States national healthcare system is the implementation of key technologies such as the electronic patient medical record. Such key technologies improve patient care and help the organization gain competitive advantage. With a high demand for strategic and operational change, healthcare providers…
Finotto, Stefano; Cantarelli, William
For some years, the clinical performance of new-graduate nurses, has been a leading topic in international scientific literature. In Italy there are many criticisms to basic education; ever since the basic education moved from the regional schools to the university, the main question that the teachers, the clinical nurses and the nursing managers are asking is whether the level of competence of new-graduates is appropriate to the demands of the world of work. Many criticisms have been addressed to the gap between theory and practice and between education and clinic. In Italy this has stimulated a debate towards a shared definition of competence and especially towards defining indicators that can assess/measure this phenomenon. The purposes of this study are: translating the indicators of Nurse Competence Scale (NCS) in the Italian language and test its validity and reliability; provide a tool for evaluating competence in Italian in order to use it in the context of our country. after a research on the Medline and Cinhal electronic data base, the NCS was identified and submitted to a process of linguistic translation (English-Italian-English) and to a process of validation using the test-retest methodology (test of Wilcoxon), the Intraclass Correlation Coefficient (ICC) and Cronbach's alpha. the evaluation given by nurses in the first administration does not differ significantly with those of the second one. For all sections of the NCS the ICC reports values greater than 0.85. the Nurse Competence Scale appears valid in its Italian version and it might be used to measure the competences of Italian nurses.
Theander, Kersti; Wilde-Larsson, Bodil; Carlsson, Marianne; Florin, Jan; Gardulf, Ann; Johansson, Eva; Lindholm, Christina; Nordström, Gun; Nilsson, Jan
Nursing competence is of significant importance for patient care. Newly graduated nursing students rate their competence as high. However, the impact of different designs of nursing curricula on nursing students' self-reported nursing competence areas is seldom reported. To compare newly graduated nursing students' self-reported professional competence before and after the implementation of a new nursing curriculum. The study had a descriptive comparative design. Nursing students, who graduated in 2011, having studied according to an older curriculum, were compared with those who graduated in 2014, after a new nursing curriculum with more focus on person-centered nursing had been implemented. A higher education nursing program at a Swedish university. In total, 119 (2011 n=69, 2014 n=50) nursing students responded. Nursing students' self-reported professional competencies were assessed with the Nurse Professional Competence (NPC) scale. There were no significant differences between the two groups of nursing students, who graduated in 2011 and 2014, respectively, with regard to age, sex, education, or work experience. Both groups rated their competencies as very high. Competence in value-based nursing was perceived to be significantly higher after the change in curriculum. The lowest competence, both in 2011 and 2014, was reported in education and supervision of staff and students. Our findings indicate that newly graduated nursing students - both those following the old curriculum and the first batch of students following the new one - perceive that their professional competence is high. Competence in value-based nursing, measured with the NPC scale, was reported higher after the implementation of a new curriculum, reflecting curriculum changes with more focus on person-centered nursing. Copyright © 2015 Elsevier Ltd. All rights reserved.
Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise
Abbott, Penelope; Reath, Jennifer; Gordon, Elaine; Dave, Darshana; Harnden, Chris; Hu, Wendy; Kozianski, Emma; Carriage, Cris
General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar's generic communication and consultation skills, only 72% referred to culture or to the patient's Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the
Full Text Available Background: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care. Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1 student knowledge and confidence pertaining to cultural competency concepts, (2 attitudes and perceptions towards being a culturally competent pharmacist, and (3 academic performance related to cultural competency case studies. Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25 and the University of Saskatchewan in Saskatoon, Canada (n=85 participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85 worked collaboratively (via video conference with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1 a pre and post session survey measuring student knowledge and confidence; (2 pre and post session student self-reflections; and, (3 student academic performance on care plans and an observed structured clinical exam (OSCE. Results: The survey identified small but statistically significant (p<0.05 improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81 of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the
and culture specific. A culture general approach seeks to develop a strategic attribute, which will allow personnel to rapidly adapt to unfamiliar...understanding “the story behind the situation.”15 † Military leaders should not expect to become cultural chameleons that can blend seamlessly into another...and beliefs of the receiver, evaluate the receiver’s understanding of the message, and adapt as the situation and message continually evolve
Gonser, P A
Culture has historically been interpreted as the beliefs, mores, and lifeways of groups of people primarily related to race and ethnicity. However, individuals who self identify as being lesbian, gay, bisexual and/or transgendered experience ethnocentrism when seeking care from medical and health professionals. Using the principles and concepts of Lenninger's theory of Culture Care Diversity and Universality, members of sexual minorities can assist their health care providers to provide culturally sensitive and ethical care.
Pantic, Natasa; Wubbels, Theo
This paper explores the substance of competence-driven changes in teacher education curricula by testing the possibility of using a framework distinguishing between the German pedagogical culture of "Didaktik" and the Anglo-Saxon Curriculum culture to describe the substance of these changes. Data about the perceptions of…
A model of social work education for undergraduates from primarily privileged backgrounds links postmodern perspectives of cultural competence, diversity, social constructionism, and a generalist strengths-based orientation for work with families. Four steps for helping students recognize the role of culture in generating a worldview and develop a…
This paper analyzes the main problems and difficulties in current college English oral English teaching practice, illustrates the relationship between oral English teaching and cross-cultural communication competence. On the one hand, cross-cultural communication plays an essential role in oral English teaching; besides, oral English teaching…
Musamali, Kennedy; Martin, Barbara N.
Examined within this paper are effective leadership practices across two cultures. Specifically, this study examined the relationship between cultural competency and effective leadership practices in higher education institutions. A quantitative design was used to investigate and compare effective practices of educational leaders in two distinct…
Ngo, Hieu V.
Complex linguistic, acculturative, and social needs of English-as-a-second-language (ESL) learners challenge the K-12 education system to develop cultural competence in working with culturally diverse families. This study surveyed 242 self-identified ESL students and their parents from four of Alberta's major school boards. Results of the survey…
Roskam, Isabelle; Hoang, Thi Vân; Schelstraete, Marie-Anne
Children's social competence and behavioral adjustment are key issues for child development, education, and clinical research. Cross-cultural analyses are necessary to provide relevant methods of assessing them for cross-cultural research. The aim of the current study was to contribute to this important line of research by validating the 3-factor…
Paul, David; Ewen, Shaun C; Jones, Rhys
The concept of cultural competence has become reified by inclusion as an accreditation standard in the US and Canada, in New Zealand it is demanded through an Act of Parliament, and it pervades discussion in Australian medical education discourse. However, there is evidence that medical graduates feel poorly prepared to deliver cross-cultural care (Weissman et al. in J Am Med Assoc 294(9):1058-1067, 2005) and many commentators have questioned the effectiveness of cultural competence curricula. In this paper we apply Hafferty's taxonomy of curricula, the formal, informal and hidden curriculum (Hafferty in Acad Med 73(4):403-407, 1998), to cultural competence. Using an example across each of these curricular domains, we highlight the need for curricular congruence to support cultural competence development among learners. We argue that much of the focus on cultural competence has been in the realm of formal curricula, with existing informal and hidden curricula which may be at odds with the formal curriculum. The focus of the formal, informal and hidden curriculum, we contend, should be to address disparities in health care outcomes. In conclusion, we suggest that without congruence between formal, informal and hidden curricula, approaches to addressing disparity in health care outcomes in medical education may continue to represent reform without change.
Hardacker, Cecilia T; Rubinstein, Betsy; Hotton, Anna; Houlberg, Magda
In 2009, the Howard Brown Health Center received funding from the US Department of Health and Human Services, and Health Resources and Services Administration to develop and disseminate a peer-reviewed, six-module curriculum entitled, Health Education about LGBT (lesbian, gay, bisexual and transgender) Elders (HEALE). The HEALE curriculum targets nurses and health-care staff and is focused on the treatment of LGBT elders, a population that is largely misunderstood and discriminated against in health-care settings. The HEALE curriculum was presented in hospital academic centres, community-based clinics and nursing homes over a three-year period, and training staff provided education to over 500 nurses and health-care providers. A pre-test and post-test was administered to participants, and all data were collected and archived to measure knowledge gained. Participants also completed an evaluation at the conclusion of the training to report change in personal attitude and individual response to the curriculum. From March 2011 to June 2012, 848 individuals attended HEALE curriculum sessions at 23 locations in Chicago and surrounding areas. Participants were 40% white, 25% black, 9% Hispanic/Latino and 25% Asian race/ethnicity. The majority of participants were female and approximately 25% were under the age of 30 years. There were statistically significant gains in knowledge in each of the six modules both in nursing home/home health-care settings and in hospital/educational settings, although participants in nursing home/home health care settings had lower pre-test scores and smaller knowledge gains in each of the six modules than those in hospital/educational settings. Mean increases ranged from 6.4 points (an 8.7% increase) in module 1-14.6 points (a 26.2% increase) in Module 6 (P LGBT cultural competency in geriatric education. As such, implementation of this cultural competency training will go a long way to establish fundamental concepts regarding LGBT elder care
Nikolsky Evgeny Vladimirovich
Full Text Available The article provides a clear definition of general cultural competence of the future specialist, it is shown that they represent a social expectation of the fact that a graduate student entering into the social life, shares the values that prevail in this society: high moral characteristics and values of humanism, has a common language, legal culture. In this context, religious literacy is considered, in the presentation we prove that it is an organic part of the composition of the general cultural competences, complements and reveals their content. The article specifically states that religious education is a necessary and relevant part in the socialization of young people.
Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim
Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve
Salmona, Michelle; Partlo, Margaret; Kaczynski, Dan; Leonard, Simon N.
This study offers a theoretical construct for better understanding how experiential learning enables student teachers to acquire social and cultural variation skills, develop cultural empathy in the K-12 classroom, and the transference of these skills to new educational situations. An Australian and United States research team used a…
Gargalianou, Vasiliki; Urbig, Diemo; Van Witteloostuijn, Arjen
Purpose - The purpose of this paper is to study the effect of using foreign languages on cooperative behavior in a prisoner's dilemma setting. The cultural accommodation hypothesis suggests that people are less cooperative in English, associated with the Anglophone cultural cluster, than in French,
Gargalianou, Vasiliki; Urbig, D.; van Witteloostuijn, Arjen
Purpose The purpose of this paper is to study the effect of using foreign languages on cooperative behavior in a prisoner’s dilemma setting. The cultural accommodation hypothesis suggests that people are less cooperative in English, associated with the Anglophone cultural cluster, than in French,
Mindt, Monica Rivera; Byrd, Desiree; Saez, Pedro; Manly, Jennifer
US demographic and sociopolitical shifts have resulted in a rapidly growing need for culturally competent neuropsychological services. However, clinical neuropsychology as a field has not kept pace with the needs of ethnic minority clients. In this discussion we review: historical precedents and the limits of universalism in neuropsychology; ethical/professional guidelines pertinent to neuropsychological practice with ethnic minority clients; critical cultural considerations in neuropsychology; current disparities germane to practice; and challenges to the provision of services to racial/ethnic minority clients. We provide a call to action for neuropsychologists and related organizations to advance multiculturalism and diversity within the field by increasing multicultural awareness and knowledge, multicultural education and training, multicultural neuropsychological research, and the provision of culturally competent neuropsychological services to racial/ethnic minority clients. Lastly, we discuss strategies for increasing the provision of culturally competent neuropsychological services, and offer several resources to meet these goals. PMID:20373222
Full Text Available The article is devoted to the problem of socio-cultural competence formation by means of translation / interpretation and the necessity of foreign language communicative competence formation in the process of inclusive education. The question of training of young generation for life in a multi-ethnic and multicultural society, forming skills of communication and cooperation with people of different nationalities, the foreign language learning, the formation of the communicative and socio-cultural competence is one of the main tasks of modern school to meet educational needs persons with disabilities. Today’s realities require that students with special educational needs should study a foreign language and use it in the process of learning. In turn, the use of translation in the process of learning a foreign language helps students to get new skills, to form general and specific competences, including socio-cultural competence, which promotes socialization of children with special needs, and integrating them into a comprehensive system of Ukraine. The article raises the problem of modernization of the educational system. It was established that the formation of socio-cultural competence by means of written translation is done by means of a system of exercises. Based on this system, subsystems, groups and types of exercises their systems can be developed in accordance with human activity, objectives and learning environment. It shows that the development of an inclusive approach to learning demands new solutions towards learning a foreign language at different levels of education.
Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R
No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.
Full Text Available Objective. We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers’ (HCWs compliance with hand hygiene (HH. Settings. Medical and postoperative cardiac surgery units. Design. Prospective cohort study. Subject. The study included 40 HCWs. Intervention. Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results. There was a significant improvement in HH compliance following handprint culture interview (p<0.001. The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p=0.001; wound cultures: p = 0,003; sputum cultures: p=0.005. Conclusion. The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.
Lenchuk, Iryna; Ahmed, Amer
Pragmatic competence is one of the essential competences taught in the second language classroom. The Canadian Language Benchmarks (CCLB, 2012a), the standard document referred to in any federally funded program of ESL teaching in Canada, acknowledges the importance of this competence, yet at the same time notes the limited resources available to…
Ross, K. G; Thornson, C. A
This task, the first of five tasks in a project to support Cultural Readiness for the Department of Defense, represents the first step in the development of a "paper and pencil" questionnaire measure...
Health services administrators need a range of competencies to manage diverse workers and serve diverse patients. This article describes cutting edge research used to create the theoretical foundation for a competency-based approach to diversity management education in the health services administration curriculum. Detailed implementation steps of the course pilot are provided, including pedagogical methods and outcome evaluations, which are largely absent from the diversity management education literature. Recommendations for refinement and replication of the class are also discussed.
Jiang, J.; Kandachar, P.V.; Freudenthal, A.
Design culture is usually considered as one of the important aspects that influence designers’ decisions and actions, especially in Design for Base of the Pyramid projects including ICT Healthcare Product Design in Rural China (IHDRC). There are two research questions in this issue: what are the
Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P
Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and
Grandpierre, Viviane; Milloy, Victoria; Sikora, Lindsey; Fitzpatrick, Elizabeth; Thomas, Roanne; Potter, Beth
There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner
Jenny Hsin-Chun Tsai; John H. Choe; Jeanette Mu Chen Lim; Elizabeth Acorda; Nadine L. Chan; Vicky Taylor; Shin-Ping Tu
There is a growing awareness and interest in the development of culturally competent health knowledge. Drawing on experience using a qualitative approach to elicit information from Mandarin- or Cantonese-speaking participants for a colorectal cancer prevention study, the authors describe lessons learned through the analysis process. These lessons include benefits and drawbacks of the use of coders from the studied culture group, challenges posed by using translated data for analysis, and suit...
Pozo Muñoz, F; Padilla Marín, V
1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement. A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results. A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: «Teamwork within the units» (80.82%) and «Supervisor/manager expectations and actions» (80.54%). Dimensions identified for potential improvement included: «Staffing» (37.93%), «Non-punitive response to error» (41.67%), and «Frequency of event reporting» (49.05%). Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
Weech-Maldonado, Robert; Dreachslin, Janice L; Brown, Julie; Pradhan, Rohit; Rubin, Kelly L; Schiller, Cameron; Hays, Ron D
The U.S. national standards for culturally and linguistically appropriate services (CLAS) in health care provide guidelines on policies and practices aimed at developing culturally competent systems of care. The Cultural Competency Assessment Tool for Hospitals (CCATH) was developed as an organizational tool to assess adherence to the CLAS standards. First, we describe the development of the CCATH and estimate the reliability and validity of the CCATH measures. Second, we discuss the managerial implications of the CCATH as an organizational tool to assess cultural competency. We pilot tested an initial draft of the CCATH, revised it based on a focus group and cognitive interviews, and then administered it in a field test with a sample of California hospitals. The reliability and validity of the CCATH were evaluated using factor analysis, analysis of variance, and Cronbach's alphas. Exploratory and confirmatory factor analyses identified 12 CCATH composites: leadership and strategic planning, data collection on inpatient population, data collection on service area, performance management systems and quality improvement, human resources practices, diversity training, community representation, availability of interpreter services, interpreter services policies, quality of interpreter services, translation of written materials, and clinical cultural competency practices. All the CCATH scales had internal consistency reliability of .65 or above, and the reliability was .70 or above for 9 of the 12 scales. Analysis of variance results showed that not-for-profit hospitals have higher CCATH scores than for-profit hospitals in five CCATH scales and higher CCATH scores than government hospitals in two CCATH scales. The CCATH showed adequate psychometric properties. Managers and policy makers can use the CCATH as a tool to evaluate hospital performance in cultural competency and identify and target improvements in hospital policies and practices that undergird the provision
This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.
Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P
Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of
provides insight into the way practitioners in an international software company construct their experiences with culture and intercultural encounters in the workplace. On the basis of the discursive analysis of ten semi-structured interviews, the presentation details how practitioners make sense...... of their work experiences through the adoption of different approaches, ranging from what may be termed a ‘functionalist’ approach that constructs culture as a relatively fixed, homogeneous entity which can be ‘managed’ or ‘overcome’, to an approach based on situational adaptation and diversity. In doing so...... – An Advanced Resource Book. London: Routledge Trompenaars, Fons and Charles Hampden-Turner. 1997. Riding the Waves of Culture: Understanding Diversity in Global Business. London: Nicholas Brealey...
Full Text Available It is shown the structural components of the functional competence of professional teachers of physical education: motivational, cognitive and action-practical. We used the following methods of scientific knowledge, as the analysis of psychological, educational and methodological literature, synthesis, comparison, generalization, specification, classification, ordering Criteria and levels of occupational functional competence of future teachers of physical education. It is determined that the high level of professional formation of the functional competence of future teachers of physical culture is characterized by the motivation to perform professional functions of a teacher of physical culture, fundamental knowledge required to perform professional functions of a teacher of physical culture, a high level of general physical fitness, pronounced specific motor abilities and skills.
Reibel, Tracy; Walker, Roz
Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics
Chun, Maria B J; Young, Keane G M; Jackson, David S
In response to the growing diversity of the United States population and concerns with health disparities, formal training in cross-cultural care has become mandatory for all medical specialties, including surgery. The aim of this study was to assess the readiness of a general surgery residency program to incorporate cultural competency initiatives into its curriculum. Eighteen surgical teaching faculty (at a community-based hospital with a university affiliation) voluntarily participated in a qualitative study to share their views on cultural competency and to discuss ways that it could potentially be incorporated into the curriculum. Reflective of current definitions of cultural competency, faculty viewed the term culture broadly (i.e., beyond race and ethnicity). Suggested instructional methods varied, with some noting that exposure to different cultures was helpful. Others stated the importance of faculty serving as role models. Most faculty in this study appear open to cultural training, but desire a clear understanding of what that would entail and how it can be taught. They also acknowledged the lack of time to address cultural issues. Taking into consideration these and other concerns, planned curricular interventions are also presented.
Almutairi, Adel F; McCarthy, Alexandra; Gardner, Glenn E
In Saudi Arabia, the health system is mainly staffed by expatriate nurses from different cultural and linguistic backgrounds. Given the potential risks this situation poses for patient care, it is important to understand how cultural diversity can be effectively managed in this multicultural environment. The purpose of this study was to explore notions of cultural competence with non-Saudi Arabian nurses working in a major hospital in Saudi Arabia. Face-to-face, audio-recorded, semistructured interviews were conducted with 24 non-Saudi Arabian nurses. Deductive data collection and analysis were undertaken drawing on Campinha-Bacote's cultural competence model. The data that could not be explained by this model were coded and analyzed inductively. Nurses within this culturally diverse environment struggled with the notion of cultural competence in terms of each other's cultural expectations and those of the dominant Saudi culture. The study also addressed the limitations of Campinha-Bacote's model, which did not account for all of the nurses' experiences. Subsequent inductive analysis yielded important themes that more fully explained the nurses' experiences in this environment. The findings can inform policy, professional education, and practice in the multicultural Saudi setting. © The Author(s) 2014.
The objective of this study was to compare the developmental competence of bovine in vitro fertilized embryos in three different culture methods; microdrop method (50 µl of medium under mineral oil in petri dishes) compared to tube methods (1 ml of medium in tubes) with or without oil overlay, and t...
Full Text Available Mannion and Davies’ article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While ‘voice’ is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain ‘truths.’ By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem.
Mannion and Davies' article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While 'voice' is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain 'truths.' By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem. © 2016 by Kerman University of Medical Sciences.
Klein, 1997). Specifically, Cognitive Task Analysis protocols were used in interviews with both subject matter experts and potential end user...populations. Critical incidents elicited were enhanced via Critical Decision Method and Knowledge Audit protocols (Klein, Calderwood & MacGregor, 1989...Total inability to assess cultural encounters *Willing to interact with counterparts *Very slow to “pick up on etiquette issues” *Need
Moore-Thomas, Cheryl; Day-Vines, Norma L.
Religion and spirituality are deeply rooted in traditional African American culture. Data suggest that African American adolescents maintain higher baseline rates of religious activities and beliefs than their peers (Bachman, Johnston, & O'Malley, 2005; Smith, Faris, Denton, & Regnerus, 2003). Recognizing these data, this article examines…
Cohen, Elena P.
Provides a framework for understanding the cultural, social, political, and economic factors that affect decision making when working with ethnically and racially diverse families in the child welfare system. Describes external factors affecting the decision- making process, including community environment, agency structure, and family…
Doering, E. Jane
Printed advertisements from magazines and billboards, stored on slides, are recommended as fertile sources of cultural information for French language instruction. They create a simultaneous visual impact on all students, are easily stored and used, can be kept current, and promote communicative activities in the classroom. (11 references) (MSE)
West-Olatunji, Cirecie; Goodman, Rachael D.; Mehta, Sejal; Templeton, Laura
With disasters on the rise, counselors need to increase their cultural awareness, knowledge, and skills to work with affected communities. This study reports outcomes of a four-week immersion experience in southern Africa with six counselor-trainees. Data sources for this qualitative study were: daily journals and demographic forms. Outcomes…
Carolyn M. Tucker
Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.
Olavarria, Marcela; Beaulac, Julie; Bélanger, Alexandre; Young, Marta; Aubry, Tim
In an effort to address the significant socio-cultural changes in the population demographics of the United States (US) and Canada, organizations are increasingly seeking ways of improving their level of cultural competence. Evaluating organizational cultural competence is essential to address the needs of ethnic and cultural minorities. Yet, research related to organizational cultural competence is relatively new. The purpose of this paper is to review the extant literature with a specific focus on: (1) identifying the key standards that define culturally competent community health and social service organizations; and (2) outlining the core elements for evaluating cultural competence in a health and social service organization. Furthermore, issues related to choosing self-assessment tools and conducting an evaluation will be explored.
Prieto Rodríguez, M Ángeles; Danet Danet, Alina; Escudero Carretero, María J; Ruiz Azarola, Ainhoa; Pérez Corral, Olivia; García Toyos, Noelia
To identify the attributes used by chronically-ill patients to describe physicians' competence in the public healthcare system in Andalucia. A total of 147 chronically-ill patients and their relatives were included in this qualitative study. Focal groups and in-depth interviews were performed in health centers and outpatient centers in Granada, Malaga, Seville, Cadiz and Cordoba between 2007 and 2008. Content analysis was carried out using Nudist Vivo. The participants defined medical competence as combining elements of technical ability and knowledge (awareness of and interest in the disease, continuity of follow-up and requesting specific tests) with interpersonal skills related to communication, information (informing, listening, trust, prompting questions) and attention (courtesy, cordiality, respect, interest and approachability). Primary care was expected to provide a close relationship, personalized treatment, information, drug prescription, and referral to specialized care. Specialized care was expected to provide an accurate diagnosis and appropriate treatment, information and follow-up. Highly valued aspects of emergency care were symptom relief, accurate diagnosis, referral to specialists and courtesy. Chronically-ill patients based their evaluation of medical competence on technical and interpersonal skills. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.
Houwelingen, van C.T.M.; Moerman, A.H.; Kort, H.S.M.; Cate, ten Th.J.
Introduction: eHealth, the use of IT to enhance patients’ health and well-being, is seen as a possible solution to meet the increasing demand for care1. Unfortunately, several barriers impede the full implementation and potential of this healthcare technology2. The current study focuses on one
Osman Ferda BEYTEKİN
Full Text Available In this study, higher education administrators, administrative behaviors; as educator, leader and manager, emotional competency; as self awareness and self management and social competency; as social awareness and social skills were compared according to two different cultures. The data was collected by inventories from 165 educators, and head of the departments Istanbul, and Helsinki Universities in 2008-2009 educational year. Elkins' administrative behaviors of higher education administrators inventory and Goleman's emotional and social competence inventory were conducted to test the differences. The manager behaviors of Istanbul University administrators are significantly higher than University of Helsinki administrators. The emotional competences of University of Helsinki administrators are significantly higher than the administrators of Istanbul University in the dimensions of self-awareness, self management, emotional selfcontrol, achievement orientation and positive outlook. The social competencies of University of Helsinki administrators are significantly higher than the administrators of Istanbul University in the dimensions of social awareness, empathy, and conflict management. On the other hand, the social competencies of Istanbul University administrators are significantly higher than the administrators of University of Helsinki in the dimensions of organizational awareness, coach and mentor, influence and teamwork. There is a significant positive relationship between the leadership behaviors and emotional and social competencies administrators in both Istanbul University and University of Helsinki. Significant differences are found between faculties and administrators about the administrative behaviors and emotional and social competences of administrators both at İstanbul University and University of Helsinki.
Mander, Sarah; Miller, Yvette D
Various policies, plans and initiatives have been implemented to provide safe, quality and culturally competent care to patients within Queensland's health care system. A series of models of maternity care are available in Queensland that range from standard public care to private midwifery care. The current study aimed to determine whether identifying as culturally or linguistically diverse (CALD) was associated with the perceived safety, quality and cultural competency of maternity care from a consumer perspective, and to identify specific needs and preferences of CALD maternity care consumers. Secondary analysis of data collected in the Having a Baby in Queensland Survey 2012 was used to compare the experiences of 655 CALD women to those of 4049 non-CALD women in Queensland, Australia, across three stages of maternity care: pregnancy, labour and birth, and after birth. After adjustment for model of maternity care received and socio-demographic characteristics, CALD women were significantly more likely than non-CALD women to experience suboptimal staff technical competence in pregnancy, overall perceived safety in pregnancy and labour/birth, and interpersonal sensitivity in pregnancy and labour/birth. Approximately 50 % of CALD women did not have the choice to use a translator or interpreter, or the gender of their care provider, during labour and birth. Thirteen themes of preferences and needs of CALD maternity care consumers based on ethnicity, cultural beliefs, or traditions were identified; however, these were rarely met. Findings imply that CALD women in Queensland experience disadvantageous maternity care with regards to perceived staff technical competence, safety, and interpersonal sensitivity, and receive care that lacks cultural competence. Improved access to support persons, continuity and choice of carer, and staff availability and training is recommended.
Vitaly Vyacheslavovich Tomin
Full Text Available Knowledge of foreign languages is becoming an integral feature of competitive persona-lity, ability to engage in cross-cultural communication and productive cross-cultural inte-raction, characterized by an adequate degree of tolerance and multi-ethnic competence, the ability for cross-cultural adaptation, critical thinking and creativity. However, the concept of foreign language competence has so far no clear, unambiguous definitions, thereby indicating the complexity and diversity of the phenomenon, which is an integrative, practice-oriented outcome of the wish and ability for intercultural communication. There have been mentioned a variety of requirements, conditions, principles, objectives, means and forms of foreign language competence forming, among which special attention is paid to non-traditional forms of practical training and information field in a cross-cultural interaction. There have been explained the feasibility of their application, which allows solving a complex of series of educational and teaching tasks more efficiently. There have been clarified the term «information field» in cross-cultural interaction, which is a cross-section of internally inherent in every individual «sections» of knowledge, skills, and experience, arising in certain given educational frameworks and forming a communication channel. The resultative indicators of the formation of foreign language competence and ways to improve its effectiveness are presented.
Michalopoulou, Georgia; Falzarano, Pamela; Butkus, Michael; Zeman, Lori; Vershave, Judy; Arfken, Cynthia
Minorities in the United States have well-documented health disparities. Cultural barriers and biases by health care providers may contribute to lower quality of services which may contribute to these disparities. However, evidence linking cultural competency and health outcomes is lacking. This study, part of an ongoing quality improvement effort, tested the mediation hypothesis that patients' perception of provider cultural competency indirectly influences patients' health outcomes through process of care. Data were from patient satisfaction surveys collected in seven mental health clinics (n=94 minority patients). Consistent with our hypothesis, patients' perception of clinicians' cultural competency was indirectly associated with patients' self-reported improvements in social interactions, improvements in performance at work or school, and improvements in managing life problems through the patients' experience of respect, trust, and communication with the clinician. These findings indicate that process of care characteristics during the clinical encounter influence patients' perceptions of clinicians' cultural competency and affect functional outcomes. © 2013 National Medical Association. Published by Elsevier Inc. All rights reserved.
Gonçalves, Mariana; Matos, Marlene
Cultural diversity places increased demands on services to multicultural populations, so the development of cultural competence by help professionals is currently a concern in institutional practices. This study evaluated the perception of cultural competence of help professional of three distinct areas: health services, social services and criminal police. Through an online questionnaire, we questioned the perception of cultural competence, at four dimensions: cultural awareness, cultural knowledge, technical skills, and organizational support. There were 610 participants, mostly female (58%), with a mean age of 39.74 years, developing activity in the social area (37%), health (33%) or the police (30%). The professionals showed, in general, a positive perception of their cultural competence. Those who had formative experiences on the subject and had more time service, perceived themselves, significantly, as more culturally competent. Significant differences were found between professionals from different areas: health professionals were more effective in terms of technical skills, the social workers at the level of cultural knowledge and polices at the level of cultural awareness. Health professionals were the ones that showed a lower perception at the level of organizational support. Despite the positive perception that technicians have about their awareness and knowledge of the values, norms and customs of immigrant communities, they realize technical aptitude as less positive, showing difficulty in practical application of their knowledge. Cultural competence has implications for good professional practice in serving multicultural populations, being urgent to invest in the development of culturally competent interventions to ensure more effective services, namely in hospitals and health centres.
Anne M Koponen
Full Text Available This study showed, in line with self-determination theory, that glycemic control among patients with type 2 diabetes ( n = 2866 was strongly associated with perceived self-care competence, which in turn was associated with autonomous motivation and autonomy-supportive health-care climate. These associations remained after adjusting for the effect of important life-context factors. Autonomous motivation partially mediated the effect of health-care climate on perceived competence, which fully mediated the effect of autonomous motivation on glycemic control. The results of the study emphasize health-care personnel’s important role in supporting patients’ autonomous motivation and perceived self-care competence.
Barnes, Lisa Jayroe
With the growing multicultural population within the United States, healthcare providers need to be prepared to care for and educate adult clients from various cultural backgrounds. The purpose of the study was to examine the teaching and assessment methods being used by faculty in the education of future physical therapists in teaching the…
Klein, Elizabeth W; Nakhai, Maliheh
This article summarizes the components of a curriculum used to teach family medicine residents and faculty about LGBTQ patients' needs in a family medicine residency program in the Pacific Northwest region of the United States. This curriculum was developed to provide primary care physicians and physicians-in-training with skills to provide better health care for LGBTQ-identified patients. The curriculum covers topics that range from implicit and explicit bias and appropriate terminology to techniques for crafting patient-centered treatment plans. Additionally, focus is placed on improving the understanding of specific and unique barriers to competent health care encountered by LGBTQ patients. Through facilitated discussion, learners explore the health disparities that disproportionately affect LGBTQ individuals and develop skills that will improve their ability to care for LGBTQ patients. The goal of the curriculum is to teach family medicine faculty and physicians in training how to more effectively communicate with and treat LGBTQ patients in a safe, non-judgmental, and welcoming primary care environment. © The Author(s) 2016.
Full Text Available The purpose of this quantitative, correlational study, based on the theoretical framework of transformational leadership, was to examine the relationships between leadership style, organizational culture, and job satisfaction in the U.S. healthcare industry. The study addressed a problem faced by U.S. healthcare leaders, who are currently unaware as to how transformational leadership and organizational culture can impact job satisfaction in an industry with high burnout and low satisfaction levels. The following research questions were posed: (1 Is there a statistically significant relationship between transformational leadership and job satisfaction in the U.S. healthcare industry? (2 Is there a statistically significant relationship between organizational culture and job satisfaction in the U.S. healthcare industry? (3 Is the relationship between transformational leadership and job satisfaction in the U.S. healthcare industry mediated by organizational culture? Data to answer the research questions were collected through simple random sampling processes that resulted in a sample of 111 American healthcare employees and analyzed with Stata software. The main finding of the study was that an apparent effect of transformational leadership on job satisfaction disappeared when organizational culture variables were taken into consideration. The results suggest that healthcare organizations should attempt to move away from externally focused cultures in order to increase job satisfaction. Such a move could improve social outcomes by improving the quality of work for millions of stressed American healthcare employees.
Manuel Lillo Crespo
Full Text Available La Competencia cultural como conocimiento aplicado a la Enfermería será uno de los temas de investigación mas significativos para las próximas décadas y el desarrollo de sus teorías y modelos representa el camino de progreso hacia la consecución de unos cuidados de calidad. El objetivo principal de este trabajo es mostrar las características del equipo de investigación en Enfermería a la hora de profundizar en el terreno de los cuidados, siempre desde la perspectiva de la Competencia cultural y obviamente mediante una metodología de investigación cualitativa. En el desarrollo del trabajo se define el área estudiada así como los componentes de la Competencia cultural aplicada a la investigación que son tres: el conocimiento cultural, la sensibilidad cultural y la colaboración cultural. Es a partir del desarrollo de estos tres puntos cuando podemos llegar a entender el papel del equipo investigador dentro de la metodología cualitativa aplicada a los cuidados de Enfermería, siempre teniendo como referencia la calidad en cuanto a la relación que se establezca entre el investigador y el individuo. Resulta necesario concluir afirmando que siempre que se de un relación de calidad habrá una posibilidad de llevar a cabo un investigación cualitativa de calidad que genere conocimiento enfermero.Cultural competence as a Nursing applied knowledge will be one of the most significant research areas for the next decades. Development of theories and models in Cultural competence shows a way of progress towards quality in cares. The aim of this article is to show the Nursing research team characteristics when going deepper into the Care research area from the view of Cultural competence and Qualitative research. This study gives a concept of Cultural competence as well as its three components such as: cultual knowledge, cultual sensitivity and cultural collaboration. These components help us to understand the role of the research team inside
Bobby C. Vaught
Full Text Available Most research and theories of interpersonal communication reflect mainstream U.S. culture. In an attempt to better understand the communication practices of Spanish-speaking cultures, an exploratory study of interpersonal communication was conducted involving Puerto Rican managers. The Index of Interpersonal Communication Competence (IICC was translated into Spanish and administered in two large international pharmaceutical companies in Puerto Rico. The results of the study are discussed in terms of implications for communication theory and applied communication research.
Andersen, Bjorn; Fradinho, Manuel; Lefrere, Paul; Niitamo, Veli-Pekka
Approaches to competence development have tended to focus on training to reach a required level of performance in simple and reproducible contexts, rather than in the more complex and hard-to-replicate contexts that characterize real-world projects, especially projects that involve people from other cultures. This paper explores how the Serious Games approach can be exploited to create skills in dealing with cross-cultural issues in project management. The degree of difference this can make t...
Army. (2009). Army Culture and Foreign Language Strategy. Dunne, J. P. (2009). Maslow is non-deployable: Modifying Maslow’s hierarchy for contemporary...be destroyed when it is no longer needed . Please do not return it to the U.S. Army Research Institute for the Behavioral and Social Sciences. NOTE...efforts are addressing the need for general cross-cultural competence (3C). To support these efforts, this research aimed to identify the critical
Wang, Shihwe; Kim, Bryan S K
Asian Americans drop out of mental health treatment at a high rate. This problem could be addressed by enhancing therapists' multicultural competence and by examining clients' cultural attitudes that may affect the counseling process. In the present study, we used a video analogue design with a sample of 113 Asian American college students to examine these possibilities. The result from a t test showed that the session containing therapist multicultural competencies received higher ratings than the session without therapist multicultural competence. In addition, correlational analyses showed that participant values acculturation was positively associated with participant ratings of counseling process, while the value of emotional self-control was negatively correlated. The results of a hierarchical multiple regression analysis did not support any interaction effects among the independent variables on counseling process. All of these findings could contribute to the field of multicultural competence research and have implications for therapist practices and training.
Full Text Available Changing demographics and an emphasis on competency-based social work education call for innovative approaches to the delivery of curricular content. In an effort to introduce BSW students to the socio-political issues facing the local Latino immigrant community, a service-learning project was developed in collaboration with the Spanish Language Department and a local middle school. An analysis of outcomes from social work student evaluations showed that students engaged with the community and issues in new and unexpected ways. Through their engagement in a cross-cultural group project, students developed greater cultural competency, honed their group practice skills in an unfamiliar context, provided a needed service to the community, and raised their awareness about the working conditions of new immigrants as part of a developing framework for social action. Details and implications of the project as a means to build student competencies are described.
This paper explores the reception of Indigenous perspectives and knowledges in university curricula and educators' social responsibility to demonstrate cultural competency through their teaching and learning practices. Drawing on tenets of critical race theory, Indigenous standpoint theory and critical pedagogies, this paper argues that the…
Jung-Won Ahn, PhD
Conclusion: Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved.
Ren, Yonggang; Wyver, Shirley
This study investigated whether host and heritage cultural orientations were associated with Chinese preschoolers' social competence and whether such associations varied across gender in Western contexts. Ninety-six Chinese-Australian children aged 36-69 months from 15 childcare centres in Sydney participated in the study. The General Ethnicity…
Plangsorn, Boonrat; Na-Songkhla, Jaitip; Luetkehans, Lara M.
The purpose of this study was to study undergraduate students' opinions with regard to the ubiquitous massive open online course (MOOC) for enhancing cross-cultural competence. This descriptive research applied a survey method. The survey data were collected by using survey questionnaires and online questionnaires from 410 undergraduate students…
Feldman, Ruth; Masalha, Shafiq
Guided by theories of cultural participation, the authors examined mother-child, father-child, and triadic interactive behaviors in 141 Israeli and Palestinian couples and their firstborn child at 5 and 33 months as antecedents of children's social competence. Four parent-child measures (parent sensitivity, child social engagement, parental…
Gipson, Leah R.
This viewpoint examines the limitations of cultural competency in art therapy education through personal reflection, calling for an immersive engagement with social justice practices of naming difference, asserting counter narratives, and following the leadership of people impacted by systemic violence. The author discusses the impact of…
Verdon, Sarah; Wong, Sandie; McLeod, Sharynne
Collaboration with families and communities has been identified as one of six overarching principles to speech and language therapists' (SLTs') engagement in culturally competent practice (Verdon et al., 2015a). The aim of this study was to describe SLTs' collaboration with families and communities when engaging in practice to support the speech,…
Pantic, Natasa; Wubbels, Theo
This study explored whether and how teachers' beliefs about moral values are reflected in the student-teacher relationships (i.e. levels of control and affiliation in teachers' and students' perceptions of this relationship), and in teachers' cultural competence. A positive association was found between teachers' paternalist beliefs and their own…
Van Goethem, G.
Content of the presentation: Introduction: towards a common nuclear safety culture 2. EU Stakeholders in nuclear fission and « Nuclear Safety Directive » June 2009 3. EURATOM policy for education (from knowledge creation …) 4. EURATOM policy for training (… to competence building) 5. Examples of EFTS running under FP-7 EURATOM 6. Conclusion: EC “seed money” for effort shared with MS
Fittz, Mia Web
This study utilized the Survey of Community College Faculty (SCCF), a combined survey of the Multicultural Teaching Scale (MTS) and Pluralism and Diversity Attitude Assessment (PADAA) that framed the research. The MTS assessed self-reported cultural competencies categorized into five dimensions: (a) Content Integration, (b) Knowledge Construction,…
Radix, Asa; Maingi, Shail
To define and give an overview of the importance of lesbian, gay, bisexual, and transgender (LGBT) cultural competency and offer some initial steps on how to improve the quality of care provided by oncology nurses and other health care professionals. A review of the existing literature on cultural competency. LGBT patients experience cancer and several other diseases at higher rates than the rest of the population. The reasons for these health care disparities are complex and include minority stress, fear of discrimination, lower rates of insurance, and lack of access to quality, culturally competent care. Addressing the health care disparities experienced by LGBT individuals and families requires attention to the actual needs, language, and support networks used by patients in these communities. Training on how to provide quality care in a welcoming and non-judgmental way is available and can improve health equity. Health care professionals and institutions that acquire cultural competency training can improve the overall health of LGBT patients who currently experience significant health care disparities. Copyright © 2017 Elsevier Inc. All rights reserved.
Like, Robert C
An extensive body of literature has documented significant racial and ethnic disparities in health and health care. Cultural competency interventions, including the training of physicians and other health care professionals, have been proposed as a key strategy for helping to reduce these disparities. The continuing medical education (CME) profession can play an important role in addressing this need by improving the quality and assessing the outcomes of multicultural education programs. This article provides an overview of health care policy, legislative, accreditation, and professional initiatives relating to these subjects. The status of CME offerings on cultural competence/disparities is reviewed, with examples provided of available curricular resources and online courses. Critiques of cultural competence training and selected studies of its effectiveness are discussed. The need for the CME profession to become more culturally competent in its development, implementation, and evaluation of education programs is examined. Future challenges and opportunities are described, and a call for leadership and action is issued. Copyright © 2010 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.
An in-depth case study on children's participation in environmental management activities in a primary school in Botswana was undertaken, drawing on cultural historical activity theory (CHAT) and the action competence model. This research revealed that due to a lack of dialogue between teachers and children, teachers tended to view children's…
Casado, Banghwa Lee; Negi, Nalini Junko; Hong, Michin
Despite the growing number of language minorities, foreign-born individuals with limited English proficiency, this population has been largely left out of social work research, often due to methodological challenges involved in conducting research with this population. Whereas the professional standard calls for cultural competence, a discussion…
Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.
In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican…
Rodenborg, Nancy A.; Boisen, Laura A.
The United States remains highly segregated, and social work students are likely to live and work in segregated contexts. What implications does this have for their cultural competence? Does segregation affect social workers' ability to serve diverse clients without bias? This article reviews two social psychology theories, aversive racism…
Miller, Ryan A.; Vaccaro, Annemarie
A phenomenological study yielded rich data about the essence of being a queer student leader of Color. Six participants described a desire to be authentic, culturally competent, and collaborative leaders, but they faced challenges enacting these forms of leadership as they navigated oppression (e.g., disrespect, stereotyping, tokenization,…
Nelson, Judith; Bustamante, Rebecca M.
In collaboration with principals and other leadership team members, professional school counselors have ethical responsibilities in promoting culturally competent school environments. Pre-service training is the ideal time for school counselors and principals to develop the necessary background information, tools, and assessment skills to assist…
Maul, Christine A.
The purpose of this research was to identify specific clinical skills in speech-language pathologists (SLPs) that may constitute cultural competency, a term which currently lacks operational definition. Through qualitative interview methods, the following research questions were addressed: (1) What dominant themes, if any, can be found in SLPs'…
Wilson, Susanna; McChesney, Jane; Brown, Liz
In this article, the authors report on a small-scale study set in a context of a firstyear mathematics education course for preservice primary teachers. Professional documentation from three different sources were analysed in relation to the national document "Tataiako: Cultural Competencies for Teachers of Maori Learners," which was…
Chae, Duckhee; Lee, Jina; Asami, Keiko; Kim, Hyunlye
This study explored the experiences of public health workers (PHWs) providing health care for migrants living in Korea and clarified needs for cultural competence training. Twenty-six PHWs from five public health centers in Gwangju city, South Korea, participated in this exploratory qualitative study. Five semi-structured focus group interviews of PHWs were conducted from September to December 2016. A directed content analysis approach was conducted using four categories: perceived characteristics of migrants, interaction between PHWs and migrants, interaction between PHWs and organizations/systems, and cultural competence training needs. PHWs perceived that migrants lacked autonomy in health decisions and awareness of health behaviors. PHWs experienced difficulties in communicating and in establishing trusting relationships. They found clients hard to reach and easy to miss, a lack of continuity in health care programs, and inadequate human and material resources. They preferred passive teaching methods to activity-based simulation. PHWs believed essential training should be provided through e-learning to all PHWs, including management. PHWs reported experiencing multiple challenges from a lack of preparedness for culturally competent care and their clients' vulnerability. Development of cultural competence training is suggested through e-learning that reflects the PHWs' experiences and provides systematic support. © 2018 Wiley Periodicals, Inc.
Grant, Natalie S.; Bolin, Brien L.
Digital storytelling is explored as a method of engaging students in the development of media literacy and cultural competency. This paper describes the perceptions and experiences of 96 undergraduate students at a large Midwestern university, after completing a digital storytelling project in a semester-long diversity course. Digital storytelling…
Duckhee Chae, PhD, RN
Full Text Available Purpose: To develop and validate the short form of the Korean adaptation of the Cultural Competence Scale for Nurses. Methods: To shorten the 33-item Cultural Competence Scale for Nurses, an expert panel (N = 6 evaluated its content validity. The revised items were pilot tested using a sample of nine nurses, and clarity was assessed through cognitive interviews with respondents. The original instrument was shortened and validated through item analysis, exploratory factor analysis, convergent validity, and reliability using data from 277 hospital nurses. The 14-item final version was cross-validated through confirmatory factor analysis, convergent validity, discriminant validity, known-group comparisons, and reliability using data from 365 nurses belonging to 19 hospitals. Results: A 4-factor, 14-item model demonstrated satisfactory fit with significant factor loadings. The convergent validity between the developed tool and transcultural self-efficacy was significant (r = .55, p < .001. The convergent validity evaluated using the Average Variance Extracted and discriminant validity were acceptable. Known-group comparisons revealed significant differences in the mean scores of the groups who spent more than one month abroad (p = .002 were able to communicate in a foreign language (p < .001 and had education to care for foreign patients (p = .039. Cronbach's α was .89, and the reliability of the subscales ranged from .74 to .91. Conclusion: The Cultural Competence Scale for Nurses-Short Form demonstrated good reliability and validity. It is a short and appropriate instrument for use in clinical and research settings to assess nurses' cultural competence. Keywords: cultural competence, psychometric properties, nurse
Wall-Bassett, Elizabeth DeVane; Hegde, Archana Vasudeva; Craft, Katelyn; Oberlin, Amber Louise
The purpose of this study was to investigate an interdisciplinary international service learning program and its impact on student sense of cultural awareness and competence using the Campinha-Bacote's (2002) framework of cultural competency model. Seven undergraduate and one graduate student from Human Development and Nutrition Science…
the interpersonal skills to interact appropriately with individuals from other cultures and then when presented unfamiliar cultural cues adapt their...Maribel, Liv Egholm Feldt, and Michael Jakobsen. "If Only Cultural Chameleons Could Fly Too: A Critical Discussion of the Concept of Cultural
Johnson, M; Noble, C; Matthews, C; Aguilar, N
The presence of diverse language skills within health staff provides opportunities to better meet the needs of a multicultural population. A cross-sectional survey of all staff within the South Western Sydney Area Health Service was undertaken to compare language skills with population needs and examine the context of language use. Thirty-one per cent of staff (n = 964) were bilingual or multilingual, with the predominant languages spoken being Tagalog (Filipino), Cantonese, Hindi, Spanish, Vietnamese and Italian. Thirty-seven per cent of bilingual staff used their language skills at least weekly, predominantly in situations of simple conversation and giving directions. Bilingual staff are a valuable resource for the organisation and the presence of a similar overall proportion of bilingual and bicultural staff may engender tolerance and adaptability in providing care to a diverse population. However, supply does not directly match community demand. This mismatch will continue unless recruitment is focused towards identified language groups. The high proportion of staff who rarely used their language skills (37%) may be due to lack of opportunity or limited need, and suggests that further research needs to examine service models that locate bilingual workers close to client need. This study takes a crucial first step towards realising equitable and culturally appropriate care utilising the principles of productive diversity.
Since colonisation, the marginalisation of Indigenous Australians has adversely affected their language, culture and health. Mainstream society has failed to address social differences and establish culturally-appropriate health programmes for these groups. This paper extracts important humanistic themes within the context of health from four Indigenous Australian plays written during a period of social unrest in response to past oppression: (1) The dreamers, by Jack David; (2) Murras, by Eva Johnson; (3) Coordah, by Richard Walley; and (4) The keepers, by Bob Maza. These plays will be analysed to (a) illuminate human suffering from an indigenous perspective, based upon social and cultural planes of analysis; (b) understand the socio-cultural basis of poor health; and (c) instruct healthcare professionals that health is a social construct that can be interpreted as the product of select plays that are not solely based upon an illness narrative.
Ovseiko, Pavel V; Buchan, Alastair M
Implementing cultural change and aligning organizational cultures could enhance innovation, quality, safety, and job satisfaction. The authors conducted this mixed-methods study to assess academic physician-scientists' perceptions of the current and preferred future organizational culture at a university medical school and its partner health system. In October 2010, the authors surveyed academic physicians and scientists jointly employed by the University of Oxford and its local, major partner health system. The survey included the U.S. Veterans Affairs Administration's 14-item Competing Values Framework instrument and two extra items prompting respondents to identify their substantive employer and to provide any additional open-ended comments. Of 436 academic physicians and scientists, 170 (39%) responded. Of these, 69 (41%) provided open-ended comments. Dominant hierarchical culture, moderate rational and team cultures, and underdeveloped entrepreneurial culture characterized the health system culture profile. The university profile was more balanced, with strong rational and entrepreneurial cultures, and moderate-to-strong hierarchical and team cultures. The preferred future culture (within five years) would emphasize team and entrepreneurial cultures and-to a lesser degree-rational culture, and would deemphasize hierarchical culture. Whereas the university and the health system currently have distinct organizational cultures, academic physicians and scientists would prefer the same type of culture across the two organizations so that both could more successfully pursue the shared mission of academic medicine. Further research should explore strengthening the validity and reliability of the organizational culture instrument for academic medicine and building an evidence base of effective culture change strategies and interventions.
Moriates, Christopher; Dohan, Daniel; Spetz, Joanne; Sawaya, George F
Leaders in medical education have increasingly called for the incorporation of cost awareness and health care value into health professions curricula. Emerging efforts have thus far focused on physicians, but foundational competencies need to be defined related to health care value that span all health professions and stages of training. The University of California, San Francisco (UCSF) Center for Healthcare Value launched an initiative in 2012 that engaged a group of educators from all four health professions schools at UCSF: Dentistry, Medicine, Nursing, and Pharmacy. This group created and agreed on a multidisciplinary set of comprehensive competencies related to health care value. The term "competency" was used to describe components within the larger domain of providing high-value care. The group then classified the competencies as beginner, proficient, or expert level through an iterative process and group consensus. The group articulated 21 competencies. The beginner competencies include basic principles of health policy, health care delivery, health costs, and insurance. Proficient competencies include real-world applications of concepts to clinical situations, primarily related to the care of individual patients. The expert competencies focus primarily on systems-level design, advocacy, mentorship, and policy. These competencies aim to identify a standard that may help inform the development of curricula across health professions training. These competencies could be translated into the learning objectives and evaluation methods of resources to teach health care value, and they should be considered in educational settings for health care professionals at all levels of training and across a variety of specialties.
Melamed, Esther; Wyatt, Lacey E; Padilla, Tony; Ferry, Robert J
The diverse US population requires medical cultural competency education for health providers throughout their pre-professional and professional years. We present a curriculum to train pre-health professional undergraduates by combining classroom education in the humanities and cross-cultural communication skills with volunteer clinical experiences at the University of California, Los Angeles (UCLA) hospital. The course was open to a maximum of 15 UCLA junior and senior undergraduate students with a pre-health or humanities major and was held in the spring quarters of 2002--2004. The change in students' knowledge of cultural competency was evaluated using the Provider's Guide to Quality and Culture Quiz (QCQ) and through students' written assignments and evaluations. Trainees displayed a statistically significant improvement in scores on the QCQ. Participants' written assignments and subjective evaluations confirmed an improvement in awareness and a high motivation to continue learning at the graduate level. This is the first evaluated undergraduate curriculum that integrates interdisciplinary cultural competency training with patient volunteering in the medical field. The didactic, volunteering, and writing components of the course comprise a broadly applicable tool for training future health care providers at other institutions.
Longo, Lianne; Slater, Serena
Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.
Taylor, Rachel M; Feltbower, Richard G; Aslam, Natasha; Raine, Rosalind; Whelan, Jeremy S; Gibson, Faith
To provide international consensus on the competencies required by healthcare professionals in order to provide specialist care for teenagers and young adults (TYA) with cancer. Modified e-Delphi survey. International, multicentre study. Experts were defined as professionals having worked in TYA cancer care for more than 12 months. They were identified through publications and professional organisations. Round 1, developed from a previous qualitative study, included 87 closed-ended questions with responses on a nine-point Likert scale and further open-ended responses to identify other skills, knowledge and attitudes. Round 2 contained only items with no consensus in round 1 and suggestions of additional items of competency. Consensus was defined as a median score ranging from 7 to 9 and strength of agreement using mean absolute deviation of the median. A total of 179 registered to be members of the expert panel; valid responses were available from 158 (88%) in round 1 and 136/158 (86%) in round 2. The majority of participants were nurses (35%) or doctors (39%) from Europe (55%) or North America (35%). All 87 items in round 1 reached consensus with an additional 15 items identified for round 2, which also reached consensus. The strength of agreement was mostly high for statements. The areas of competence rated most important were agreed to be: 'Identify the impact of disease on young people's life' (skill), 'Know about side effects of treatment and how this might be different to those experienced by children or older adults' (knowledge), 'Honesty' (attitude) and 'Listen to young people's concerns' (aspect of communication). Given the high degree of consensus, this list of competencies should influence education curriculum, professional development and inform workforce planning. Variation in strength of agreement for some competencies between professional groups should be explored further in pursuit of effective multidisciplinary team working. Published by the BMJ
Mösko, Mike-Oliver; Gil-Martinez, Fernanda; Schulz, Holger
Mental healthcare services need to be sensitive towards the cultural needs of patients. Cross-cultural opening is an organizational process to fulfil these needs. This study aims to provide representative structural and procedural data regarding the use of German outpatient mental healthcare services by allochthonous patients, the diversity of psychotherapists in outpatient mental healthcare service, the cross-cultural encounters of therapists and the cross-cultural sensitivity of psychotherapists working in this healthcare area. Of all public outpatient psychotherapists in Hamburg, 81% (n = 485) participated in this survey. Regarding the distribution of the population in this metropolis, allochthonous therapists were underrepresented. Unlike the overall distribution of foreign inhabitants, the largest groups of immigrant therapists came from England, German-speaking countries and other countries within the European Union. The proportion of allochthonous patients in outpatient mental healthcare service was almost half of the proportion of the allochthonous in the general population. Psychotherapists with a migration background regarded themselves as having a higher level of cross-cultural sensitivity than their native colleagues, especially those who have had fewer cross-cultural encounters. Overall, psychotherapists named different challenges in providing cross-cultural treatment. For the German outpatient mental healthcare service to be more accessible to immigrants and their descendants, a greater number of bilingual psychotherapists must gain access to the mental healthcare service, and more advanced cross-cultural sensitivity training and supervision should be provided. German outpatient psychotherapists are culturally and linguistically diverse. Nevertheless, psychotherapists with a migration background are underrepresented in outpatient mental healthcare services. Patients with a migration background are also underrepresented in the German outpatient mental
Amerson, Roxanne; Livingston, Wade G
This qualitative descriptive study used reflexive photography to evaluate the learning process of cultural competence during an international service-learning project in Guatemala. Reflexive photography is an innovative qualitative research technique that examines participants' interactions with their environment through their personal reflections on images that they captured during their experience. A purposive sample of 10 baccalaureate nursing students traveled to Guatemala, where they conducted family and community assessments, engaged in home visits, and provided health education. Data collection involved over 100 photographs and a personal interview with each student. The themes developed from the photographs and interviews provided insight into the activities of an international experience that influence the cognitive, practical, and affective learning of cultural competence. Making home visits and teaching others from a different culture increased students' transcultural self-efficacy. Reflexive photography is a more robust method of self-reflection, especially for visual learners.
Gallagher, Ruth W; Polanin, Joshua R
Increasing professional nurses' and nursing students cultural competence has been identified as one way to decrease the disparity of care for vulnerable and minority groups, but effectiveness of training programs to increase competence remains equivocal. The purpose of this project is to synthesize educational interventions designed to increase cultural competence in professional nurses and nursing students. A systematic review and meta-analysis was conducted to synthesize all existing studies on increasing cultural competence. A comprehensive search and screen procedures was conducted to locate all cultural competence interventions implemented with professional nurses and nursing students. Two independent researchers screened and coded the included studies. Effect sizes were calculated for each study and a random-effects meta-analysis was conducted. A total of 25 studies were included in the review. Two independent syntheses were conducted given the disparate nature of the effect size metrics. For the synthesis of treatment-control designed studies, the results revealed a non-statistically significant increase in cultural competence (g¯=.38, 95% CI: -.05, .79, p=.08). Moderator analyses indicated significant variation as a function of the measurements, participant types, and funding source. The pretest-posttest effect size synthesis revealed a significant increase in overall cultural competence (g¯=.45, 95% CI: .24, .66, pcompetence have shown varied effectiveness. Greater research is required to improve these interventions and promote cultural competence. Copyright © 2014 Elsevier Ltd. All rights reserved.
Tatyana Lvovna Stenina
Full Text Available The purpose of research work – search of new ways of educational work, corresponding to requirements of federal state educational standards of higher education about formation of common cultural competences.The author suggests to use a method of social design for the solution of a task. The maintenance of social and pedagogical space of higher education institution is a complex of socially important ideas, projects and innovations. Participation in projects will allow students to seize competences which labor market demands.The author gives useful examples of use of design technologies for application in educational work of higher educational institutions.
Mahjoub, Mohamed; Bouafia, Nabiha; Cheikh, Asma Ben; Ezzi, Olfa; Njah, Mansour
This study provided an overview of healthcare professionals’ perception of patient safety based on analysis of the concept of freedom of expression and non-punitive response in order to identify and correct errors in our health system. This concept is a cornerstone of the patient safety culture among healthcare professionals and plays a central role in the quality improvement strategy..
Full Text Available This article presents the results of the fourth stage of the longitudinal research performed at Kaunas University of Medicine (since 2010 – Lithuanian University of Health Sciences and Vytautas Magnus University. The main goal of the research was to investigate educational possibilities and preconditions for the development of the education of professional intercultural communication for students in the education programs of medicine and social work. Previous stages of the study revealed the peculiarities of intercultural/interdisciplinary teamwork, and educational premises for professional education of the team members. The fourth stage of the study is focused on the analysis of the practical activity of the interdisciplinary (intercultural team, striving to improve health specialists’ and social workers’ interdisciplinary collaboration competence.
To provide sufficient information about the Manchester Patient Safety Framework (MaPSaF) to allow healthcare professionals to assess its potential usefulness. The assessment of safety culture is an important aspect of risk management, and one in which there is increasing interest among healthcare organizations. Manchester Patient Safety Framework offers a theory-based framework for assessing safety culture, designed specifically for use in the NHS. The framework covers multiple dimensions of safety culture, and five levels of safety culture development. This allows the generation of a profile of an organization's safety culture in terms of areas of relative strength and challenge, which can be used to identify focus issues for change and improvement. Manchester Patient Safety Framework provides a useful method for engaging healthcare professionals in assessing and improving the safety culture in their organization, as part of a programme of risk management.
Svetlana A. Zolotareva
Full Text Available The article is devoted to some of the issues of teaching English in a Russian university, which arouse as a result of introducing new educational standards and it discusses the ways of forming students’ general cultural competence by using authentic curricula, in order to meet the requirements of those standards. It also shows the importance of semiotics for acquisition a foreign language and culture, and reveals the worth of “personalia” as a culture language sign, as well as peculiarity of its functioning, which lies in its ability to represent social and cultural values and priorities in personal-precedential form, thus making a contribution to developingan individual’sconcept scheme and, consequently, general cultural literacy.
Jackson, Kelly E; Samuels, Gina M
According to the 2010 U.S. census, approximately 9 million individuals report multiracial identities. By the year 2050, as many as one in five Americans could claim a multiracial background. Despite this population growth, a review of recent empirical and theoretical literature in social work suggests a disproportionate lack of attention to issues ofmultiraciality. Instead, social work practice models remain embedded in traditional societal discourses of race and culture that often exclude or marginalize the experiences of multiracial individuals and families.This article summarizes recommendations following the domains of awareness, knowledge, and skills in the NASW Standards for Cultural Competence in Social Work Practice to support culturally attuned social work practice with multiracial people. The authors argue that a culturally attuned practice approach--one that is inclusive of multiraciality--is not only timely, but also consistent with the profession's ethical obligation to provide culturally relevant services to all consumers and clients.
Rising, Margaret L
Nondisclosure of terminal prognosis in the context of intercultural interactions can cause moral distress among health care providers guided exclusively by informed consent. However, cultural humility can show that revealing and withholding prognostic information are two equally valid paths to the goal of protecting the patient from harm. Assumptions and history giving rise to the preference for truth telling in the United States(US) are examined. Principles of biomedical ethics are described within the context of US, Chinese, and Latin American cultures. The process of cultural competence in the delivery of health care services is explained and introduces the concept of cultural humility. By focusing more on biases and assumptions brought forth from the dominant culture, health care providers may experience less moral distress and convey increased caring in the context of intercultural interactions and nondisclosure of prognosis of a terminal illness. © The Author(s) 2015.
Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B
To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P perceived competence was associated with greater perceived distress. There was an indirect (fully mediated) relationship between autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons
De Bono, S; Heling, G; Borg, M A
It is not uncommon for infection prevention and control (IPC) interventions to be successful in one hospital yet fail, or have significantly less success, when implemented in another healthcare institution. Organizational factors have been postulated to be a major reason. As a result, there has been an increasing drive in recent years to understand and address organizational culture (OC) in order to achieve improved healthcare performance. To examine the inter-relationship between OC and behavioural attitudes by healthcare professionals; to determine whether and how OC may impact on IPC compliance; and to highlight the potential for OC modification interventions to improve IPC practices within hospitals. Previous literature is reviewed and synthesized, using both IPC journals as well as publications focusing on human behaviour and organizational change. The article evaluates the theory of OC within healthcare settings and identifies how various elements appear to impact on IPC-related behaviour. It highlights the paucity of well-designed studies but identifies sporadic literature suggesting that well-designed and customized OC change initiatives can have a positive impact on IPC practices, such as hand hygiene. OC change appears to be a promising, albeit challenging, target for IPC improvement campaigns - both from a theoretical perspective as well as from the results of the few available studies. However, more data and quality information are needed to identify effective strategies that can elicit effective and sustained change. Published by Elsevier Ltd.
Mouhamadou Sow; Jeanie Murphy; Rosa Osuoha
The purpose of this quantitative, correlational study, based on the theoretical framework of transformational leadership, was to examine the relationships between leadership style, organizational culture, and job satisfaction in the U.S. healthcare industry. The study addressed a problem faced by U.S. healthcare leaders, who are currently unaware as to how transformational leadership and organizational culture can impact job satisfaction in an industry with high burnout and low satisfaction l...
Hutchins, Frank T; Brown, Lori DiPrete; Poulsen, Keith P
International immersion experiences do not, in themselves, provide students with the opportunity to develop cultural competence. However, using an anthropological lens to educate students allows them to learn how to negotiate cultural differences by removing their own cultural filters and seeing events through the eyes of those who are culturally different. Faculty at the University of Wisconsin-Madison's Global Health Institute believed that an embedded experience, in which students engaged with local communities, would encourage them to adopt this Cultural Competency 2.0 position. With this goal in mind, they started the Field School for the Study of Language, Culture, and Community Health in Ecuador in 2003 to teach cultural competency to medical, veterinary, pharmacy, and nursing students. The program was rooted in medical anthropology and embraced the One Health initiative, which is a collaborative effort of multiple disciplines working locally, nationally, and globally to obtain optimal health for people, animals, and the environment. In this article, the authors identify effective practices and challenges for using a biocultural approach to educating students. In a semester-long preparatory class, students study the Spanish language, region-specific topics, and community engagement principles. While in Ecuador for five weeks, students apply their knowledge during community visits that involve homestays and service learning projects, for which they partner with local communities to meet their health needs. This combination of language and anthropological course work and community-based service learning has led to positive outcomes for the local communities as well as professional development for students and faculty.
Mariño, R; Ghanim, A; Morgan, M; Barrow, S
This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught. Semi-structured one-to-one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software. A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience. For most CS, cultural competence was an important part of the clinician-patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mohn, J; Graue, M; Assmus, J
comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess......AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...
Associations Among Depressive Symptoms, Wellness, Patient Involvement, Provider Cultural Competency, and Treatment Nonadherence: A Pilot Study Among Community Patients Seen at a University Medical Center.
Hooper, Lisa M; Huffman, Lauren E; Higginbotham, John C; Mugoya, George C T; Smith, Annie K; Dumas, Tia N
Treatment nonadherence is a pernicious problem associated with increasing rates of chronic diseases, escalating healthcare costs, and rising mortality in some patients. Although researchers have suggested numerous factors related to treatment nonadherence, several understudied aspects warrant attention, such as primary-care settings, provider cultural competence, and patient involvement. Adding to the research base, the present pilot study examined 88 primarily Black American and White American community patients from a large university medical center in the southern part of the United States. The study explored two research questions: (a) To what extent are there associations among depressive symptoms, wellness, patient involvement, cultural competency, and treatment nonadherence in a racially diverse community patient population? And (b) to what extent do the study exploratory variables and background characteristics predict treatment nonadherence, both separately and jointly? Depressive symptoms, the patient's perception of a provider's cultural competence, and marital/partnered status were found to be statistically significantly associated with treatment nonadherence, but not entirely in the directions expected.
Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O
Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs. Copyright © 2016 by the American Society of Nephrology.
Full Text Available To identify and foster potential international entrepreneurs are important goals for entrepreneurship education. Based on the theory of planned behavior (TPB, we argue that International entrepreneurial intention (IEI is a predictor of international entrepreneurship (IE. In addition, cross-cultural competences are hypothesized as antecedents to IEI and moderators of the relationship between TPB elements and IEI. We integrate two elements of cross-cultural competences (global mindset and cultural intelligence in a TPB-framework to identify the drivers of students’ IEI. We analyze a sample of 84 students with OLS regression and moderation analysis. OLS regression results reveal no significant direct effects from cultural intelligence and global mindset on IEI. Moderation analyses suggest a negative, significant moderating effect of cultural intelligence on the relationship between personal attitude and IEI and on subjective norms and IEI. Therefore, simply enhancing global mindset and cultural intelligence does not contribute to students’ IEI. More is required from entrepreneurship education, such as improving the perception of international entrepreneurship as a valuable career choice.
Malka, Ariel; Soto, Christopher J; Cohen, Adam B; Miller, Dale T
This research examines the hypothesis that religiosity has two competing psychological influences on the social welfare attitudes of contemporary Americans. On the one hand, religiosity promotes a culturally based conservative identity, which in turn promotes opposition to federal social welfare provision. On the other hand, religiosity promotes a prosocial value orientation, which in turn promotes support of federal social welfare provision. Across two national samples (Ns = 1,513 and 320) and one sample of business employees (N = 710), reliable support for this competing pathways model was obtained. We argue that research testing influences of nonpolitical individual differences on political preferences should consider the possibility of competing influences that are rooted in a combination of personality processes and contextual-discursive surroundings. © 2011 The Authors. Journal Compilation © 2011, Wiley Periodicals, Inc.
Toha, Mohamad; Katoningsih, Sri
The low performance of teachers in organization is influenced many factors. Organizational culture could be the key of organization success; hence many researches were done to identify the value and the attitude norm that gave big contribution for organization success. Competency is a part of employee they perform during work as kind of behavior. Competency depends on the aspects process of teachers' performance. The purpose of this research is to know the effect of leadership, organizational culture and competency on teachers' performance. The objects of this research are leadership, organizational culture, competency and teachers' performance in Ibu Kartini vocational high school. This research is quantitative. To collect the data, questionnaire was used. Then, the data were analyzed by using Path analysis in SPPS 16. The result of this research showed that leadership, organizational culture, competency and performance run well and had significant effect on teachers' performance.
Social constructionism : a theoretical approach that has much in common with relativism. It challenges the notion of fixed and universal truths in the...1.2: Basic triadic representation of human culture. It is easy to try to identify these latter divisions as physical and social culture...formation is necessary. Harris (1979) describes culture as existing at three levels known as infrastructure, social structure, and superstructure. As
Bardid, Farid; Rudd, James R.; Lenoir, Matthieu; Polman, Remco; Barnett, Lisa M.
Motor competence in childhood is an important determinant of physical activity and physical fitness in later life. However, childhood competence levels in many countries are lower than desired. Due to the many different motor skill instruments in use, children's motor competence across countries is rarely compared. The purpose of this study was to evaluate the motor competence of children from Australia and Belgium using the Körperkoordinationstest für Kinder (KTK). The sample consisted of 244 (43.4% boys) Belgian children and 252 (50.0% boys) Australian children, aged 6–8 years. A MANCOVA for the motor scores showed a significant country effect. Belgian children scored higher on jumping sideways, moving sideways and hopping for height but not for balancing backwards. Moreover, a Chi squared test revealed significant differences between the Belgian and Australian score distribution with 21.3% Belgian and 39.3% Australian children scoring “below average.” The very low levels reported by Australian children may be the result of cultural differences in physical activity contexts such as physical education and active transport. When compared to normed scores, both samples scored significantly worse than children 40 years ago. The decline in children's motor competence is a global issue, largely influenced by increasing sedentary behavior and a decline in physical activity. PMID:26217282
Violence : physical force used to inflict injury or damage 23 24 CHAPTER 4 ANALYSIS The Ends, Ways, and Means of Cultural Competency Another aspect...operations is inferred at the individual level of this simulation but would be better maximized as a multiplayer game. The term military operations inferred... multiplayer game. As with the previous simulation of Tactical Iraqi, the term military operations inferred the actions are executed collectively as a unit
Pantic, Natasa; Wubbels, T.
This study explored whether and how teachers' beliefs about moral values are reflected in the student-teacher relationships (i.e. levels of control and affiliation in teachers' and students' perceptions of this relationship), and in teachers' cultural competence. A positive association was found between teachers' paternalist beliefs and their own perceptions of control. A negative association was found between teachers' liberal beliefs and students' perceptions of affiliation. Positive associ...
In today's era of accountability, test scores are top-in-mind for educators. Educators must do all they can to help English language learners succeed in literacy, math, science, and so much more. However, education is not just about the brain; it's about the whole child. In this article, the author describes how school district leaders can set the…
Full Text Available In their valuable discussion of whistleblowing in healthcare organisations, Mannion and Davies highlight the importance of organisational culture in influencing whether people raise concerns, and whether these concerns are listened to and acted upon. The role of leadership in shaping organisational culture is well-established1 and in this commentary, we will examine the influence of leaders in creating cultures of silence or cultures of voice.
Medical anthropology provides an excellent resource for nursing research that is relevant to clinical nursing. By expanding the understanding of ethnographic research beyond ethnicity, nurses can conduct research that explores patient's constructions and explanatory models of health and healing and how they make meaning out of chronic conditions and negotiate daily life. These findings can have applicability to culturally competent care at both the organizational or systems level, as well as in the patient/provider encounter. Individual patient care can be improved by applying ethnographic research findings to build provider expertise and then using a cultural negotiation process for individualized patient care. Copyright © 2011. Published by Elsevier Inc.
Guerrero, Erick G; Fenwick, Karissa; Kong, Yinfei
Leadership style and specific organizational climates have emerged as critical mechanisms to implement targeted practices in organizations. Drawing from relevant theories, we propose that climate for implementation of cultural competence reflects how transformational leadership may enhance the organizational implementation of culturally responsive practices in health care organizations. Using multilevel data from 427 employees embedded in 112 addiction treatment programs collected in 2013, confirmatory factor analysis showed adequate fit statistics for our measure of climate for implementation of cultural competence (Cronbach's alpha = .88) and three outcomes: knowledge (Cronbach's alpha = .88), services (Cronbach's alpha = .86), and personnel (Cronbach's alpha = .86) practices. Results from multilevel path analyses indicate a positive relationship between employee perceptions of transformational leadership and climate for implementation of cultural competence (standardized indirect effect = .057, bootstrap p climate in the implementation of cultural competence in addiction health service organizations.
Long, Carol O
Culture is a fundamental part of one's being. Spirituality is integrated with culture and both play a significant role in a person's journey through life. Yet, culture and spirituality are often misunderstood and may not seem to be important in healthcare settings. For adults with cancer and their families, this cannot be ignored. This paper reviews The Purnell Model of Cultural Competence as a framework for considering culture and spirituality in healthcare and discusses the importance of acknowledging and incorporating practices that support culture and spirituality in healthcare settings. Examples of how to include cultural and spiritual care in palliative and end-of-life care in healthcare settings are provided.
Cortese-Peske, Marisa A.
Foreign-born residents face significant challenges accessing and receiving quality healthcare in the U.S. These obstacles include a lack of information on how to access care, fear, as well as communication and cultural barriers (Portes, Fernandez-Kelly & Light, 2012). Increasing healthcare providers' knowledge regarding a patient's…
Evans, Natalie; Meñaca, Arantza; Koffman, Jonathan; Harding, Richard; Higginson, Irene J; Pool, Robert; Gysels, Marjolein
Cultural competency is increasingly recommended in policy and practice to improve end-of-life (EoL) care for minority ethnic groups in multicultural societies. It is imperative to critically analyze this approach to understand its underlying concepts. Our aim was to appraise cultural competency approaches described in the British literature on EoL care and minority ethnic groups. This is a critical review. Articles on cultural competency were identified from a systematic review of the literature on minority ethnic groups and EoL care in the United Kingdom. Terms, definitions, and conceptual models of cultural competency approaches were identified and situated according to purpose, components, and origin. Content analysis of definitions and models was carried out to identify key components. One-hundred thirteen articles on minority ethnic groups and EoL care in the United Kingdom were identified. Over half (n=60) contained a term, definition, or model for cultural competency. In all, 17 terms, 17 definitions, and 8 models were identified. The most frequently used term was "culturally sensitive," though "cultural competence" was defined more often. Definitions contained one or more of the components: "cognitive," "implementation," or "outcome." Models were categorized for teaching or use in patient assessment. Approaches were predominantly of American origin. The variety of terms, definitions, and models underpinning cultural competency approaches demonstrates a lack of conceptual clarity, and potentially complicates implementation. Further research is needed to compare the use of cultural competency approaches in diverse cultures and settings, and to assess the impact of such approaches on patient outcomes.
Mikkonen, Kristina; Elo, Satu; Kuivila, Heli-Maria; Tuomikoski, Anna-Maria; Kääriäinen, Maria
Learning in the clinical environment of healthcare students plays a significant part in higher education. The greatest challenges for culturally and linguistically diverse healthcare students were found in clinical placements, where differences in language and culture have been shown to cause learning obstacles for students. There has been no systematic review conducted to examine culturally and linguistically diverse healthcare students' experiences of their learning in the clinical environment. This systematic review aims to identify culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment. The search strategy followed the guidelines of the Centre of Reviews and Dissemination. The original studies were identified from seven databases (CINAHL, Medline Ovid, Scopus, Web of Science, Academic Search Premiere, Eric and Cochrane Library) for the period 2000-2014. Two researchers selected studies based on titles, abstracts and full texts using inclusion criteria and assessed the quality of studies independently. Twelve original studies were chosen for the review. The culturally and linguistically diverse healthcare students' learning experiences were divided into three influential aspects of learning in a clinical environment: experiences with implementation processes and provision; experiences with peers and mentors; and experiences with university support and instructions. The main findings indicate that culturally and linguistically diverse healthcare students embarking on clinical placements initially find integration stressful. Implementing the process of learning in a clinical environment requires additional time, well prepared pedagogical orientation, prior cultural and language education, and support for students and clinical staff. Barriers to learning by culturally and linguistically diverse healthcare students were not being recognized and individuals were not considered motivated; learners experienced the
Al-Khathaami, Ali M.; Alshahrani, Saeed M.; Kojan, Suleiman M.; Al-Jumah, Mohammed A.; Alamry, Ahmed A.; El-Metwally, Ashraf A.
Objectives: To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. Methods: A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i® (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Results: Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Conclusion: Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers. PMID:25630777
Full Text Available Abstract Background The evidence is mixed regarding the efficacy of cultural competence curricula in developing learners' knowledge, attitudes and skills. More research is needed to better understand both the strengths and shortcomings of existing curricula from the perspective of learners in order to improve training. Methods We conducted three focus groups with medical students in their first year of clinical training to assess their perceptions of the cultural competence curriculum at a public university school of medicine. Results Students evaluated the informal curriculum as a more important source of learning about cultural competence than the formal curriculum. In terms of bias in both self and others, the cultural competence curriculum increased awareness, but was less effective in teaching specific interventional skills. Students also noted that the cultural competence curriculum did not always sufficiently help them find a balance between group-specific knowledge and respect for individual differences. Despite some concerns as to whether political correctness characterized the cultural competence curriculum, it was also seen as a way to rehumanize the medical education experience. Conclusion Future research needs to pay attention to issues such as perceived relevance, stereotyping, and political correctness in developing cross-cultural training programs.
Swedberg, Lena; Michélsen, Hans; Chiriac, Eva Hammar; Hylander, Ingrid
To describe and analyse perceived competence and perceived responsibility among healthcare assistants (HC assistants), caring for patients with home mechanical ventilation (HMV) and other advanced caring needs, adjusted for socio-demographic and workplace background factors. A cross-sectional study was conducted including 128 HC assistants employed in Stockholm County, Sweden. The HC assistants responded to a study-specific questionnaire on perceived competence and perceived responsibility, provided socio-demographic and workplace background data, as well as information on the patient characteristics for the understanding of their work situations. Descriptive statistics and logistic regression analyses were performed. Eighty per cent of the HC assistants rated their perceived competence as high, and fifty-nine per cent rated their perceived responsibility as high. Fifty-five per cent lacked formal healthcare training, and only one in five of the HC assistants had a formal training equivalent with a licensed practical nurse (LPN) examination. Males lacked formal training to a greater extent than females and rated their competence accordingly. On-the-job training was significantly associated with high ratings on both perceived competence and perceived responsibility, and clinical supervision was associated with high rating on perceived responsibility. HC assistants with limited formal training self-reported their competence as high, and on-the-job training was found to be important. Also, clinical supervision was found important for their perception of high responsibility. In Sweden, HC assistants have a 24-hour responsibility for the care and safety of their patient with HMV and other advanced caring needs. The study results point out important issues for further research regarding formal training requirements as well as the needs for standardised workplace training and supervision of HC assistants. The consequences of transfer of responsibility by delegation from
This study was done to investigate the level of transcultural self-efficacy (TSE) and related factors and educational needs for cultural competence in nursing (CCN) of Korean hospital nurses. A self-assessment instrument was used to measure TSE and educational needs for CCN. Questionnaires were completed by 285 nurses working in four Korean hospitals. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression were used to analyze the data. Mean TSE score for all items was 4.54 and score for mean CCN educational needs, 5.77. Nurses with master's degrees or higher had significantly higher levels of TSE than nurses with bachelor's degrees. TSE positively correlated with English language proficiency, degrees of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN. The regression model explained 28% of TSE. Factors affecting TSE were degree of interest in multi-culture, degree of experience in caring for multi-cultural clients, and educational needs for CCN. The results of the study indicate a need for nurse educators to support nurses to strengthen TSE and provide educational program for TSE to provide nurses with strategies for raising interests in cultural diversity and successful experiences of cultural congruent care.
Washington, Melvin C.; Okoro, Ephraim A.; Okoro, Sussie U.
This study discusses the significance of emotional intelligence and intercultural communication competence in globally diverse classroom settings. Specifically, the research shows a correlation between degrees of emotional intelligence and human communication competence (age, gender, and culture). The dataset consists of 364 participants. Nearly…
Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim
In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.
Brborović, Hana; Brborović, Ognjen
Healthcare workers have high rates of injuries and illnesses at the workplace, and both their absence from work due to illness (absenteeism) or working ill (presenteeism) can compromise patient safety and the quality of health care delivered. Following this premise, we wanted to determine whether presenteeism and absenteeism were associated with patient safety culture (PSC) and in what way. Our sample consisted of 595 Croatian healthcare workers (150 physicians and 445 nurses) who answered the short-form WHO Health and Work Performance Questionnaire and the Hospital Survey on Patient Safety Culture. The results have confirmed the association with both presenteeism and absenteeism in several PSC dimensions, but not as we expected based on the premise from which we started. Opposite to our expectations, lower job performance (as a measure of presenteeism) was associated with higher PSC instead of lower PSC. Absenteeism, in turn, was associated with lower PSC, just as we expected. These findings suggest that it is the PSC that shapes presenteeist and absenteeist behaviour and not the other way around. High PSC leads to presenteeism, and low PSC to absenteeism. We also believe that the presenteeism questionnaires should be adjusted to health care and better define what lower performance means both quantitatively and qualitatively in a hospital setting.
Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane
Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. An exploratory mixed methods study designed to develop and test the validity of a tool to measure 'culture of care' through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless
Andrey Evgenevich Petropavlovsky
Full Text Available Purpose of the article:- analysis of the professional competence of Russian journalists in the erotic industry;- a comparison of the factors affecting the development of professionalism in the erotic themes in Russian journalism;- formulation of the criteria to be met by a modern journalist while covering an erotic theme.The novelty of this work lies in the fact that the value of erotic themes in modern journalism is a problem little studied by science.In the article the following conclusions.The importance of competence journalist on erotic themes in coverage erotic sphere is a scientific problem.The question of raising the level of training of journalists in educational institutions in view of specialization is very relevant in Russia.Covering and analysis erotic culture of modern Russia should only highly competent media professionals.In modern Russia journalism often refers to the erotic category just for economic gain. Professional and competent journalist can find a compromise between the financial side and the quality coverage of the problem.
Estrada, Carlos A; Krishnamoorthy, Periyakaruppan; Smith, Ann; Staton, Lisa; Korf, Michele J; Allison, Jeroan J; Houston, Thomas K
CME providers may be interested in identifying effective marketing strategies to direct users to specific content. Online advertisements for recruiting participants into activities such as clinical trials, public health programs, and continuing medical education (CME) have been effective in some but not all studies. The purpose of this study was to compare the impact of 2 marketing strategies in the context of an online CME cultural competence curriculum (www.c-comp.org). In an interrupted time-series quasi-experimental design, 2 marketing strategies were tested: (1) wide dissemination to relevant organizations over a period of approximately 4 months, and (2) Internet paid search using Google Ads (5 consecutive 8-week periods--control 1, cultural/CME advertisement, control 2, hypertension/ content advertisement, control 3). Outcome measures were CME credit requests, Web traffic (visits per day, page views, pages viewed per visit), and cost. Overall, the site was visited 19,156 times and 78,160 pages were viewed. During the wide dissemination phase, the proportion of visits requesting CME credit decreased between the first (5.3%) and second (3.3%) halves of this phase (p = .04). During the Internet paid search phase, the proportion of visits requesting CME credit was highest during the cultural/CME advertisement period (control 1, 1.4%; cultural/CME ad, 4.3%; control 2, 1.5%; hypertension/content ad, 0.6%; control 3, 0.8%; p advertisement periods. The incremental cost for the cultural advertisement per CME credit requested was US $0.64. Internet advertisement focusing on cultural competence and CME was associated with about a threefold increase in requests for CME credit at an incremental cost of under US $1; however, Web traffic changes were independent of the advertisement strategy. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical
Cantarero-Arévalo, Lourdes; Kassem, Dumoue; Traulsen, Janine Marie
specific ethnic minority groups compared to the majority population. OBJECTIVE: The focus of this study was on reducing medicine-related problems among Arabic-speaking ethnic minorities living in Denmark. The aim was twofold: (1) to explore the perceptions, barriers and needs of Arabic-speaking ethnic...... minorities regarding medicine use, and (2) to use an education program to enhance the knowledge and competencies of the ethnic minorities about the appropriate use of medicines. SETTINGS: Healthcare in Denmark is a tax-financed public service that provides free access to hospitals and general practitioners...... focus group interviews were conducted before and four after the education program. Thirty Arabic-speaking participants were recruited from language and job centers in Copenhagen. Participants received teaching sessions in Arabic on appropriate medicine use. The education program was evaluated by two...
Lourdes Odalys González-Núñez.
Full Text Available Under contemporary world conditions, characterized by a globalizing context in all the aspects of working, politics, economic, environmental, cultural and social life; where a constant is the dynamics with which they are carried out the changes and innovations, joined to the scientific and technological advances, all in function of work productivity increasing; the new markets searching; necessities satisfaction; new clients gaining or their preservation; utilities increasing; environment caring; organizations´ big strategic alliances, as well as the breaking of big companies with the uncertainty that goes with it in all the orders. So, man constitutes the main resource, that’s why the use and strengthening of the human capital competence is the fundamental pillar of success of any organization. In respect to us, we seek to contribute to it getting closer by means of an elaboration proposal for the managers sport organizations competence formation, allowing elevating the organization in this context.
Bolea, Patricia S.
This paper articulates a curricular approach that centers on a Native American service learning course. Social work students engaged in cross-cultural immersion on a reservation in the United States. By examination of historical United States policy impacting Indian tribes and contemporary experiences that challenge basic instruction in public…
Khaled, Salma M; Shockley, Bethany; Abdul Rahim, Hanan F
To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type. A cross-sectional survey conducted in 2012. A household survey in the State of Qatar in the Arab Gulf. A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older. General satisfaction status with Qatar's healthcare system. Citizenship status, healthcare utilization, health insurance type. Citizens were significantly less likely to be satisfied with Qatar's healthcare system than noncitizens (odds ratio (OR) = 0.30, P citizenship (P citizenship groups. These differences may stem from different expectations with respect to healthcare services. Understanding these expectations may have important policy implications for cross-cultural contexts. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Eiser, Arnold R; Ellis, Glenn
Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care. The authors identify key influences, including the legacy of slavery, Jim Crow discrimination, the Tuskegee syphilis study, religion's interaction with health care, the use of home remedies, distrust, racial concordance and discordance, and health literacy. The authors propose that the awareness of specific information pertaining to ethnicity and race enhances cross-cultural communication and ways to improve the cultural competence of physicians and other health care providers by providing a historical and social context for illness in another culture. Cultural education, modular in nature, can be geared to the specific populations served by groups of physicians and provider organizations. Educational methods should include both information about relevant social group history as well as some experiential component to emotively communicate particular cultural needs. The authors describe particular techniques that help bridge the cross-cultural clinical communication gaps that are created by patients' mistrust, lack of cultural understanding, differing paradigms for illness, and health illiteracy.
Full Text Available Motor competence in childhood is an important determinant of physical activity and physical fitness in later life. However, childhood competence levels in many countries are lower than desired. Due to the many motor skill instruments in use children’s motor competence across countries is rarely compared. The purpose of this study was to evaluate the motor competence of children from Australia and Belgium using the Körperkoordinationstest für Kinder (KTK. The sample consisted of 244 (43.4% boys Belgian children and 252 (50.0% boys Australian children, aged 6 to 8 years (Australian 7.6 ± 0.7 and Belgian 7.3 ± 0.9. MANCOVA for the motor scores showed a significant country effect (F = 14.61, p < 0.001. Belgian children scored higher on jumping sideways (F = 6.61, p = 0.01, moving sideways (F = 40.52, p < 0.001 and hopping for height (F = 8.28, p = 0.004 but not for balancing backwards (F = 2.64, p = 0.105. Moreover, a Chi squared test revealed significant differences between the Belgian and Australian score distribution with 21.3% Belgian and 39.3% Australian children scoring ‘below average’ (χ2 = 23.06, p < 0.001. The very low levels reported by Australian children may be the result of cultural differences in physical activity contexts such as physical education and active transport. When compared to normed scores, both samples scored significantly worse than children 40 years ago. The decline in children’s motor competence is a global issue, largely influenced by increasing sedentary behaviour and a decline in physical activity.
Budke, A.; Schaebitz, F.; Dittrich, S.
According to the German national education standards communication is one of the six areas in which competencies shall be conveyed in Geography classes. Special significance is given to the training of the competence to solve problems through argumentation. Argumentation has a great significance in the learning process in schools, because here the students' knowledge pools are individually linked and understood. According to modern theories of learning, learning is a constructive process. Linking existing pools of knowledge to new insights is usually triggered by communication and argumentation in the classroom. Furthermore, argumentation helps with the individual's formation of opinion as well as their identification with certain values. Argumentation is one of the central social and cultural techniques to solve conflicts peacefully, to conduct negotiations, and to act in one's own interests. Thus conveying competence in argumentation is to be seen as an interdisciplinary task in education. Recently a hypothetical model of competence in geographical argumentation was proposed, a methodical instrument for measuring competence in geographical argumentation was developed, and by analyzing textbooks it was shown that this topic is only marginally targeted by exercises. The Collaborative Research Center 806 "Our Way to Europe" (www.sfb806.uni-koeln.de), with its cross disciplinary research in the sciences as well as humanities offers an outstanding basis for developing and evaluating teaching material and concepts. The use of these diverse topics, complex systems, and the various research problems as well as findings of the CRC-806 allowed developing study units designed to promote problem solving and argumentation skills in the sciences and humanities. Here we will present the results of this study based on special teaching materials, which was tested and evaluated to support students in formulating scientific problems and promote their argumentation skills.
Goethem, Georges van
One of the main goals of the Euratom research and training programs is to contribute to the sustainability of nuclear energy by providing resources, in particular, for research and innovation in Generations II, IIII and IV (knowledge creation). Euratom training programs contribute most notably to competence building while facilitating the mutual recognition of experts and thereby continuously improving the nuclear safety culture. The Sustainable Nuclear Energy Technology Platform (SNE-TP), composed of all stakeholders of nuclear fission and radiation protection (over 75 organizations), is a driving force therein. The emphasis in this paper is on nuclear competence building under the current 7-th Euratom Framework Programme (2007 - 2013). The employers (in particular, the nuclear industry and the technical safety organisations) are naturally involved in this process. According to the IAEA definition, competence means the ability to apply knowledge, skills and attitudes so as to perform a job in an effective and efficient manner and to an established standard (S.S.S. No. RS-G-1.4 / 2001). Knowledge is usually created in higher education institutions (e.g., universities) and in (private and public) research organizations. Skills and attitudes are usually the result of specific training and on-the-job experience throughout professional life. Euratom training activities are traditionally addressed to scientists and experts with higher education. Special attention is devoted to the continuous improvement of their competencies through borderless mobility and lifelong learning in synergy with the main stakeholders. The Euratom training strategy is based on 3 objectives: 1. Analysis of the needs of society and industry with regard to a common nuclear safety culture. This issue raises important questions, for examples: What should be added to existing training schemes? How could Continuous Professional Development (CPD) be improved? Is mobility and mutual recognition of
Hordijk, Rowan; Hendrickx, Kristin; Lanting, Katja; MacFarlane, Anne; Muntinga, Maaike; Suurmond, Jeanine
Medical students need to be trained in delivering diversity-responsive health care but unknown is what competencies teachers need. The aim of this study was to devise a framework of competencies for diversity teaching. An open-ended questionnaire about essential diversity teaching competencies was sent to a panel. This resulted in a list of 74 teaching competencies, which was sent in a second round to the panel for rating. The final framework of competencies was approved by the panel. Thirty-four experts participated. The final framework consisted of 10 competencies that were seen as essential for all medical teachers: (1) ability to critically reflect on own values and beliefs; (2) ability to communicate about individuals in a nondiscriminatory, nonstereotyping way; (3) empathy for patients regardless of ethnicity, race or nationality; (4) awareness of intersectionality; (5) awareness of own ethnic and cultural background; (6) knowledge of ethnic and social determinants of physical and mental health of migrants; (7) ability to reflect with students on the social or cultural context of the patient relevant to the medical encounter; (8) awareness that teachers are role models in the way they talk about patients from different ethnic, cultural and social backgrounds; (9) empathy for students of diverse ethnic, cultural and social background; (10) ability to engage, motivate and let all students participate. This framework of teaching competencies can be used in faculty development programs to adequately train all medical teachers.
Krainovich-Miller, Barbara; Yost, Jennifer M; Norman, Robert G; Auerhahn, Carolyn; Dobal, May; Rosedale, Mary; Lowry, Melissa; Moffa, Christine
This pilot study was designed to measure nursing students' level of cultural awareness. It replicated phase II of Rew, Becker, Cookston, Khosropour, & Martinez's (2003) methodological study that developed and tested a Cultural Awareness Scale (CAS). Using a cross-sectional design, the CAS was distributed to nursing students in three nursing programs' (bachelor's, master's, doctoral) beginning and end courses. Cronbach's alpha for the CAS Total instrument was 0.869, with subscale scores ranging from 0.687 to 0.902, comparable to the findings of Rew et al. Given the limitations of this study, results must be viewed with a degree of caution. Recommendations include further educational research in the form of psychometric testing of the CAS among nursing students, including refinement of both the CAS instrument and the demographic tool. The authors also recommend that studies be conducted to determine the validity and reliability of the CAS with nurses in the health care arena.
Martin, Ardis C
Increasing the cultural competence of child and adolescent psychiatrists through the use of film, literature, and music can improve their ability to understand what African Americans experience and the impact these experiences have on mental health. It also may help clinicians recognize their own underlying biases. This understanding, in turn, could improve their ability to address effectively in treatment the issues pertinent to the African-American community and help eliminate the well-documented disparities in the health care quality and health status of minorities.
Germano Glufke Reis
Full Text Available This study investigates the simultaneous influences of culture and global mindedness on the foreign subsidiaries of Brazilian multinationals (B rMNs. Because the ability to develop competences abroad is critical for emerging multina tionals competitiveness, we proposed hypotheses and tested a model for how the competenc es of subsidiaries may be affected by the dimensions of global mindedness and culture. To do so, we conducted a multilevel survey involving the headquarters and subsidiaries of majo r BrMNs. The results suggest that global mindedness, which encompasses global orientation, g lobal knowledge, and global skills, is positively related to the development of subsidiari es ́ competences. By contrast, cultural factors, including power distance and uncertainty a voidance, are negatively related to competences development. Therefore, these dimension s may exert simultaneous and opposing stimuli and unaligned forces that affect the develo pment of competences abroad, generating a “tug of war” effect.
Denier, Yvonne; Gastmans, Chris
In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.
Worthington Roger P
Full Text Available Abstract Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural
Worthington, Roger P; Gogne, Anupriya
Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and
Full Text Available Correlation of concepts «competence» and «professional trade» is examined. More than 200 sources are studied. The necessity of account for training of athletic personnels of professional fitness and value of professional trade becomes firmly established as to the ultimate goal of forming of specialist in the field of physical culture. Negative tendencies are exposed in maintenance of preparation of specialists and higher professional athletic education in the higher institutes. Culturological and acmeological approach is offered for further strategy of perfection of professional pedagogical preparation of specialists. The stages of forming of specialist are presented on the basis of application of this approach. A necessity is marked at training of personnels oriented on the exposure of features of professional fitness of young people to the professions in the field of physical culture, its initial state and dynamics.
Hodge, David R; Nadir, Aneesah
Relatively little information exists on the provision of culturally competent services to Muslims, in spite of the growing presence of this population in the United States. Consequently, the authors discuss a number of therapeutic approaches in light of their level of congruence with common Islamic values. Psychodynamic approaches, for example, may not be as congruent as cognitive approaches. Although cognitive therapy may be relatively consistent with Islamic values, the self-statements that are central to this modality are often packaged in secular terminology that is inconsistent with Islamic norms. To provide culturally relevant services, practitioners must unwrap the secular terminology used to express the underlying therapeutic precepts and then repackage the precepts in terminology that reflects Islamic teaching. The authors conclude by offering a number of examples to illustrate the construction of statements that reflect Islamic values.
Renzaho, Andre M N; Halliday, Jennifer A; Mellor, David; Green, Julie
Although obesity among immigrants remains an important area of study given the increasing migrant population in Australia and other developed countries, research on factors amenable to intervention is sparse. The aim of the study was to develop a culturally-competent obesity prevention program for sub-Saharan African (SSA) families with children aged 12-17 years using a community-partnered participatory approach. A community-partnered participatory approach that allowed the intervention to be developed in collaborative partnership with communities was used. Three pilot studies were carried out in 2008 and 2009 which included focus groups, interviews, and workshops with SSA parents, teenagers and health professionals, and emerging themes were used to inform the intervention content. A cultural competence framework containing 10 strategies was developed to inform the development of the program. Using findings from our scoping research, together with community consultations through the African Review Panel, a draft program outline (skeleton) was developed and presented in two separate community forums with SSA community members and health professionals working with SSA communities in Melbourne. The 'Healthy Migrant Families Initiative (HMFI): Challenges and Choices' program was developed and designed to assist African families in their transition to life in a new country. The program consists of nine sessions, each approximately 1 1/2 hours in length, which are divided into two modules based on the topic. The first module 'Healthy lifestyles in a new culture' (5 sessions) focuses on healthy eating, active living and healthy body weight. The second module 'Healthy families in a new culture' (4 sessions) focuses on parenting, communication and problem solving. The sessions are designed for a group setting (6-12 people per group), as many of the program activities are discussion-based, supported by session materials and program resources. Strong partnerships and
Betancourt, Joseph R; Green, Alexander R; Carrillo, J Emilio; Ananeh-Firempong, Owusu
Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers. Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care. Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.
Erick G. Guerrero
Full Text Available Abstract Background Leadership style and specific organizational climates have emerged as critical mechanisms to implement targeted practices in organizations. Drawing from relevant theories, we propose that climate for implementation of cultural competence reflects how transformational leadership may enhance the organizational implementation of culturally responsive practices in health care organizations. Methods Using multilevel data from 427 employees embedded in 112 addiction treatment programs collected in 2013, confirmatory factor analysis showed adequate fit statistics for our measure of climate for implementation of cultural competence (Cronbach’s alpha = .88 and three outcomes: knowledge (Cronbach’s alpha = .88, services (Cronbach’s alpha = .86, and personnel (Cronbach’s alpha = .86 practices. Results Results from multilevel path analyses indicate a positive relationship between employee perceptions of transformational leadership and climate for implementation of cultural competence (standardized indirect effect = .057, bootstrap p < .001. We also found a positive indirect effect between transformational leadership and each of the culturally competent practices: knowledge (standardized indirect effect = .006, bootstrap p = .004, services (standardized indirect effect = .019, bootstrap p < .001, and personnel (standardized indirect effect = .014, bootstrap p = .005. Conclusions Findings contribute to implementation science. They build on leadership theory and offer evidence of the mediating role of climate in the implementation of cultural competence in addiction health service organizations.
Shapiro, Mina L; Miller, June; White, Kathleen
Transcultural knowledge and competency have become a critical need for nurses to accommodate the global trends in cultural diversity and health care disparities. Today, nurses are increasingly taking on leadership roles in community settings. This article addresses the application of Leininger's culture care theory with the sunrise model and Hersey and Blanchard's tri-dimensional leader effectiveness model as potential collaborating theories for capacity building and community transformation from a global, transcultural nursing perspective. The two theories, used in collaboration, view the provision of competent leadership as the delivery of effective, culturally congruent nursing care in promoting health and health equity at the community level.
Guerrero, Erick G; Song, Ahyoung; Henwood, Benjamin; Kong, Yinfei; Kim, Tina
This study investigated the association between program cultural competence and homeless individuals' drug use after treatment in Los Angeles County, California. Los Angeles County has the largest and most diverse population of homeless individuals in the nation. We randomly selected for analysis 52 drug-treatment programs and 2158 participants who identified as homeless in the Los Angeles County Participant Reporting System in 2011. We included their living arrangements (indoors and stable, indoors and unstable, and outdoors) and individual and program characteristics (particularly whether their programs used six culturally competent practices) in multilevel regression analyses. The outcome was days of primary drug use at discharge.Results showed that higher levels of staff personal involvement in minority communities (IRR=0.437; 95% CI=0.222, 0.861) and outreach to minority communities (IRR = 0.406; 95% CI=0.213, 0.771) were associated with fewer days of drug use at discharge. Homeless individuals living outdoors used their primary drug more often than any other group. Yet, compared to individuals with other living arrangements, when outdoor homeless individuals were treated by programs with the highest community resources and linkages (IRR=0.364; 95% CI=0.157, 0.844), they reported the fewest days of drug use. We discuss implications for program evaluation and community engagement policies and practices. Copyright © 2017. Published by Elsevier Ltd.
Noji, Ariko; Mochizuki, Yuki; Nosaki, Akiko; Glaser, Dale; Gonzales, Lucia; Mizobe, Akiko; Kanda, Katsuya
This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ 2 (340) = 14604.44, P differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike. © 2017 John Wiley & Sons Australia, Ltd.
Il’dus Islamovich Zailalov
Full Text Available The authors examine the competence-based approach as the most promising to date in education, requiring the introduction of new technologies, methods, systems assessment competencies.The article presents the scale of formation of competences of students of the technical University in cultural studies based on a point rating system. A point rating system made in accordance with the curriculum of the discipline «cultural Studies». Demonstrates the use of active learning methods, allowing to fully assess readiness competencies. The most effective method of practice-oriented education is situational tasks (case-methods, which aims not only to consolidate the theoretical material, but also on the development of skills of analysis, critical thinking, skills of joint discussion of problems and decision making. Presents three levels of complexity of the case objectives, to evaluate the readiness competencies in the discipline. The authors point rating scale with the modules and activities, giving a total idea of the level of mastering the discipline. In accordance with the goals of the discipline «cultural Studies» GEF lists generated by the students of oil and gas profile of General cultural and professional competences. Defined criteria of formation of competences: formed partially formed not formed. These criteria are translated into traditional assessment scale in the discipline. The conclusion about the importance of this assessment, as it allows you to identify how obtained competence differ from the expected, to represent the dynamics of the development of each student and to identify what competencies should work in the future.
Full Text Available This paper describes the design, implementation and evaluation of a course in international service learning and community engagement for pharmacy undergraduate students. The course offered students opportunities to cultivate cultural competency in an international setting foreign to their own—Sub-Saharan Africa. The experience consisted of pre-departure preparation seminars followed by subsequent community immersion to experience, explore and confront personal attitudes and perceptions. A key feature of this course was its emphasis on a continuing cycle of learning, community engagement and reflection. Three students participated, a near-maximum cohort. Their daily self-reflections were qualitatively analyzed to document the impact of their cultural learning and experiences and revealed meaningful learning in the domains of self-assessment and awareness of their personal and professional culture, exposure to a participatory health delivery model involving the patient, the community and a multidisciplinary team and opportunities to engage in patient care in a different cultural setting. This proof-of-concept course provided students with experiences that were life-changing on both personal and professional levels and confirmed the viability and relevance of international service learning for the pharmacy field within its university-wide mandate.
Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N
In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.
Kwiatkoski, Danielle Ritter; Mantovani, Maria de Fátima; Pereira, Evani Marques; Bortolato-Major, Carina; Mattei, Ângela Taís; Peres, Aida Maris
translating and transculturally adapting the Clinical Competence Questionnaire to Brazilian senior undergraduate Nursing students, as well as measuring psychometric properties of the questionnaire. a methodological study carried out in six steps: translation of the Clinical Competence Questionnaire instrument, consensus of the translations, back-translation, analysis by an expert committee, pre-testing and then presentation of the cross-cultural adaptation process to the developers. Psychometric properties were measured using Cronbach's alpha, intraclass correlation coefficient and content validity index. the instrument was translated, transculturally adapted and its final version consisted of 48 items. Cronbach's alpha coefficient was 0.90, and the agreement index of the items was 99% for students and 98% for evaluators. the Clinical Competence Questionnaire was translated and adapted to Brazilian students, and the psychometric properties of the Portuguese version of the questionnaire presented satisfactory internal consistency regarding the studied sample. traduzir e adaptar transculturalmente o Clinical Competence Questionnaire aos estudantes brasileiros concluintes da graduação em enfermagem, bem como mensurar as propriedades psicométricas do questionário. estudo metodológico realizado em seis etapas: tradução do instrumento Clinical Competence Questionnaire, consenso das traduções, retrotradução, análise pelo comitê de especialistas, pré-teste e apresentação do processo de adaptação transcultural para os desenvolvedores. As propriedades psicométricas foram mensuradas utilizando-se o alfa de Cronbach, coeficiente de correlação intraclasse e índice de validade de conteúdo. o instrumento foi traduzido, adaptado transculturalmente e sua versão final foi constituída de 48 itens. O coeficiente alfa de Cronbach foi de 0,90, e o índice de concordância dos itens foi de 99% para os estudantes e de 98% para os avaliadores. o Clinical Competence
Chang, Li-Chun; Guo, Jong Long; Lin, Hui-Ling
Cultural competence (CC) training is widely recognized as a crucial component of the professional development of healthcare providers. There is no study on the effect of Facebook (FB) as a strategy to promote continual learning to enhance CC among students in health professions. To test the effects of cultural competence education using FB as a delivery platform on knowledge, awareness, self-efficacy, and skill related to CC in health students from pre-graduation to licensed professional stages. A randomized controlled trial. We recruited students from professional nursing, pharmacy, and nutrition programs at six medical universities and randomly assigned them to study groups. Between T1 and T2 (months 1-3), the intervention group (IG) received pre-graduation education in CC while the control group (CG) received their regular educational program. Between T2 and T3 (months 6-9), IG received on-the-job education in CC while CG received the regular program. An online self-report questionnaire assessing CC knowledge, awareness, self-efficacy, and skill was analyzed at baseline, 6months, and 12months. Of 180 participants who completed the pretest, 120 (65 IG and 55 CG) completed both follow-ups. Changes over time were mixed; the only statistical difference between groups was an improvement in awareness in IG but not in CG. At 12months, intervention and control participants had different levels of awareness of CC (β=2.56, p<0.001), but other outcomes did not differ between groups. Health profession educators can adopt Facebook as an education delivery platform to offer personalized, social learning incorporating cultural competency curricula into ongoing education and training in rising awareness on CC. Copyright © 2017 Elsevier Ltd. All rights reserved.
Marie E. Ward
Full Text Available While co-design methods are becoming more popular in healthcare; there is a gap within the peer-reviewed literature on how to do co-design in practice. This paper addresses this gap by delineating the approach taken in the co-design of a collective leadership intervention to improve healthcare team performance and patient safety culture. Over the course of six workshops healthcare staff, patient representatives and advocates, and health systems researchers collaboratively co-designed the intervention. The inputs to the process, exercises and activities that took place during the workshops and the outputs of the workshops are described. The co-design method, while challenging at times, had many benefits including grounding the intervention in the real-world experiences of healthcare teams. Implications of the method for health systems research are discussed.
De Maesschalck, Stéphanie; Deveugele, Myriam; Willems, Sara
This study explores ethnic minority patients' expression of emotional cues and concerns in primary healthcare, and examines relationships with patient, provider and consultation attributes. 191 video-recorded consultations were analyzed using the VR-CoDES. Patients were interviewed before the consultation. Generalized Estimating Equations models (GEE) were used to test for associations. Psychosocial versus bio-medically oriented encounters contained significantly more cues (p≤0.05). Patients with poor versus good language proficiency expressed significantly less cues (p≤0.001). No significant correlations were found with patients' cultural values, patients' or physicians' gender or the presence of an interpreter. Female patients express more concerns (p≤0.05), female physicians have a higher number of concerns expressed by patients (p≤0.02). This study shows that independent of physician and diagnosis, patients' language proficiency has a more important impact on the number of cues expressed by the patient than cultural difference. Medical schools and Continuing Medical Education should focus on training programs for recognizing and handling linguistic barriers between physicians and patients. Patient education programs should encourage patients who experience language barriers to open up to physicians. In situations where language is a barrier, physicians and patients should be encouraged to use interpreters to enhance the expression of emotions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Newsome, Misty; Pearsall, Cynthia; Ryan, Teresa; Starlin, Pamela
Introduction: Fairfield Medical Center is a 222-bed community hospital located in Lancaster, Ohio. Organizational leadership chose to invest in the Transforming Stress Workshop, a 6-hour workshop with a 2-hour follow-up workshop, in order to improve the well-being of its staff and physicians. Special thought and consideration were given to being able to sustain any benefits and/or improvements long-term. As a result, strategies were developed to integrate the program into our culture. Methods: Four staff members from a variety of disciplines were selected and sent to HeartMath Train-the-Trainer to gain proficiency in HeartMath methodology and tools, expanding their duties to deliver the classes. Biweekly workshops were offered from August 2007 through December 2010, educating a total of 975 employees, or 48% of the staff. Other tactics providing a sustainable program included senior leadership support and championing, management team training, positive employee comments published internally, use of tools in committee and department meetings, incorporation into orientation and on-boarding processes, part of major initiative roll-outs, element in clinical ladder, expansion to include Transforming Team Workshops, sharing of Participant and Organizational Quality Assessment-Revised data, a lead HeartMath instructor who provides consulting to other organizations, provision of classes to local educators, and open workshops for employee family members. Results: Three metrics were selected to measure the success of the program: employee satisfaction, absenteeism rates, and healthcare claims cost. Statistically significant cultural and financial return on investment were demonstrated. Employees who received HeartMath training experienced a 2:1 savings on healthcare claims as compared to employees who had not received training. Employee Opinion Survey results demonstrated that employees who had HeartMath training had higher overall satisfaction scores than those who had not
Itoh, Kenji; Omata, N.; Andersen, Henning Boje
The present paper reports on a human error taxonomy system developed for healthcare risk management and on its application to evaluating safety performance and reporting culture. The taxonomy comprises dimensions for classifying errors, for performance-shaping factors, and for the maturity...
Rider, Elizabeth A; Gilligan, MaryAnn C; Osterberg, Lars G; Litzelman, Debra K; Plews-Ogan, Margaret; Weil, Amy B; Dunne, Dana W; Hafler, Janet P; May, Natalie B; Derse, Arthur R; Frankel, Richard M; Branch, William T
Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction. To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians. From January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations. Sixty eight of the 92 (74%) study participants who received the survey provided written responses. All subjects who were sent the survey had participated in a year-long small-group faculty development program to enhance humanistic practice and teaching. As humanistic leaders, subjects should have insights into motivating and inhibiting factors. Participants' responses were analyzed using the constant comparative method. Motivators included an organizational culture that enhances humanism, which we judged to be the overarching theme. Related themes included leadership supportive of humanistic practice, responsibility to role model humanism, organized activities that promote humanism, and practice structures that facilitate humanism. Impediments included top down organizational culture that inhibits humanism, along with related themes of non-supportive leadership, time and bureaucratic pressures, and non-facilitative practice structures. While healthcare has evolved rapidly, efforts to counteract the negative effects of changes in organizational and practice environments have largely focused on cultivating humanistic attributes in individuals. Our findings suggest that change at the organizational level is at least equally important. Physicians in our study described the characteristics of an organizational culture that supports and embraces humanism. We offer suggestions for organizational change that keep humanistic and compassionate patient
Full Text Available Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL, hospital survey on patient safety culture (HSOPSC and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55 and empathy 6.78 (±1.88 domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35 and "non participative decision-making" 2.84 (±0.34 domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01 and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001 predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.
Ghahramanian, Akram; Rezaei, Tayyebeh; Abdullahzadeh, Farahnaz; Sheikhalipour, Zahra; Dianat, Iman
Background: This study investigated quality of healthcare services from patients' perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz-Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients' perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients'perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.
María Luz SUÁREZ CASTIÑEIRA
Full Text Available The concept of a European culture became very complex with the enlargement of 2004 towards the East, when the EU, as Delanty pointed out, moved “beyond postnationality to an encounter with multiple civilizational forms,” multiple histories and competing visions of European integration. The “unity-in-diversity” paradigm turned into a huge challenge for the European institutions. On the one hand, achieving a European image of cultural unity without excluding all the local, regional and national cultures is a very complex, if not impossible, task. On the othe hand, culture remains an ambiguous term in European institutions due to the lack of a full-fledged European cultural policy. This paper focuses first on how in the early 1970s the EC/EU started to be concerned with defining the role of culture, and second on how since the year 2000 culture has progressively acquired a new status with potentially transformative powers to bridge the competing views of cultural integration. Programmes, such as the “2014-2020 Creative Europe” programme, focus on culture as a creative accelerator and promotor of different forms of cultural participation and production. Culture generates “smart, sustainable and inclusive growth”, and contributes to “high employment, high productivity, and high social cohesion.”
Marilyn R. McFarland PhD, RN, FNP-BC, CTN
Full Text Available Nurse anthropologist, Madeleine Leininger, developed the culture care theory and ethnonursing research method to help researchers study transcultural human care phenomena and discover the knowledge nurses need to provide care in an increasingly multicultural world. The authors propose that the ethnonursing method can be useful for research that addresses providing care in other disciplines, including education, administration, physical, occupational, and speech therapy, social work, pharmacy, medicine, and other disciplines in which research findings have implications for human care and health. The authors discuss the culture care theory and describe the ethnonursing research method's enablers, data analysis phases, and qualitative evaluation criteria. The theory is presented as a guide for using research findings to design culturally competent and congruent care to promote well-being among diverse people, groups, communities, and institutions. Resources include a reference list of key source publications, a discussion of exemplar studies, and samples of a theory-based, open-ended interview guide and data coding system.
Morell, Venita W; Sharp, Penny C; Crandall, Sonia J
Teaching medical students to recognize the need for cultural competence and accept their shortcomings in this area is a challenge. A simulated patient scenario was developed to address this challenge. The objective of the simulation is to enhance students' readiness to learn by moving them from 'unconscious incompetence' to 'conscious incompetence'. The patient scenario presents a Cherokee Indian woman with a complaint of abnormal menstrual bleeding who is resistant to gynaecologic care from male providers. A faculty member facilitates a small-group videotape review of student interviews. As students discuss their encounters, they realize they 'misdiagnose' and mishandle the interview. They are confronted by their inability to recognize cultural cues and the impact they may have on health outcomes and begin to question whether cultural beliefs are affecting the care of other patients. This simulation creates an eye-opening situation that must be handled carefully. This activity is an effective method to create awareness in students who feel they 'know all this stuff.'
Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services.
Yamada, Ann-Marie; Brekke, John S
Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.
Du Mont J
Full Text Available Janice Du Mont,1,2 Daisy Kosa,3 Sheila Macdonald,3 Robin Mason1,21Women’s College Research Institute, Women’s College Hospital, 2Dalla Lana School of Public Health, University of Toronto, 3Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, ON, CanadaHealthcare providers and trainees often lack the requisite knowledge and skills to address sexual violence in the clinical setting.1–3 To address this gap, we developed and evaluated an innovative and evidence-informed online curriculum designed to improve the competence of those working in healthcare settings to respond to the needs of women who present with past histories of sexual assault.
Chew, K S; Mohd Hashairi, F; Jusoh, A F; Aziz, A A; Nik Hisamuddin, N A R; Siti Asma, H
Although a vital test, blood culture is often plagued with the problem of contamination and false results, especially in a chaotic emergency department setting. The objectives of this pilot study is to find out the level of understanding among healthcare staffs in emergency department, Hospital Universiti Sains Malaysia (HUSM) regarding good blood culture sampling practice. All healthcare staffs in emergency department, HUSM who consented to this study were given a set of selfadministered anonymous questionnaire to fill. More than half (53.1%) of the 64 participants are emergency medicine residents. Majority of them (75%) have been working in the emergency medicine, HUSM for more than 2 years. More than half of them were able to answer correctly the amount of blood volume needed for culture in adult and pediatric patients. When asked what are the factors required to improve the true yield as well as to reduce the risk of culture contamination, the four commonest answers given were observing proper aseptic technique during blood sampling, donning sterile glove, proper hand scrubbing as well as ensuring the sterility of the equipments. This study suggests that there is a lack of proper knowledge of good blood culture sampling practice among our healthcare staffs in emergency department.
Full Text Available The proliferation of crime, especially in the South African context, has placed considerable emphasis on the private security industry. This has also increased fierce competition in the private security domain with both national and international private security companies infiltrating the South African market. Like public policing private security has an important role to play in combating crime and other transgressions, with the exception that private security owes its existence to paying customers. By using the Competing Values Framework (CVF as conceptual guide, the researchers are able to provide the managers of the company under investigation with insight on how their cultural orientation affects their functioning and ultimately their competitive advantage.
Research linking reading literary fiction to empathy supports health humanities programs in which reflective writing accompanies close readings of texts, both to explore principles of storytelling (narrative arc and concrete language) and to promote an examination of biases in care. Little attention has been paid to the possible contribution of guided fiction-writing in health humanities curricula toward enhancing cultural competence among health professionals, both clinical and community-based. Through an analysis of the short story "Pie Dance" by Molly Giles, juxtaposed with descriptions of specific writing exercises, this paper explains how the demands of writing fiction promote cultural competency.
Young, Judith S
As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.
Young, Judith S
Home care and hospice clinicians are increasingly working with patients for whom English is not their primary language. Provision of culturally respectful and acceptable patient-centered care includes both an awareness of cultural beliefs that influence the patient's health and also the ability to provide the patient with health information in the language with which he or she is most comfortable. This article identifies resources for understanding the cultural norms of Asian-born patients and appropriate patient education materials in the many languages spoken by this population. The resources have been made available free on the Web by healthcare professionals and government agencies from around the world.
Hsieh, Ming-Hong; Wu, Hui-Ching; Chou, Frank Huang-Chih; Molodynski, Andrew
The purpose of this study was to investigate East-West cultural attitudes of mental healthcare professionals (MHPs) towards Involuntary Treatment Orders (ITOs) among Taiwan, England, Wales, and New Zealand. Data on Taiwanese MHPs' views of ITO regime were collected from the National Psychiatric Disease Mandatory Assessment and Community Care Review Committee (N = 176). A national survey instrument was designed to assess the level of support for ITOs among senior clinicians and to determine their views on the importance of various factors in decision-making, the mechanisms through which coercion may work, impediments to its use, and its perceived impact on patients and therapeutic relationships. A descriptive analysis was carried out with data presented as appropriate for the distribution and a t-test was used to detect any differences by respondents. Risk reduction was ranked the most important factor in use of ITOs and reasons for discharging an order. Female respondents had higher approval ratings, with 85 % of agreeing that ITOs were of benefit to the therapeutic relationship, assured long-term stability, and increased medication compliance. The results suggest that clinicians decide the use of ITOs largely based on the risk management, both in terms of starting and ending an order. However, the use of ITOs vary which reflected in the practice. Given this variation in the use of enabling legislation, multidisciplinary input in decision-making is an essential safety mechanism.
Pollozhani, Aziz; Kosevska, Elena; Petkovski, Kostadin; Memeti, Shaban; Limani, Blerim; Kasapinov, Blasko
Aim: To examine the existing situation, barriers and consequences of the intercultural communication in health institutions and to offer training models for strengthening and improving communication skills of health professionals in the Republic of Macedonia. Methods: A cross-sectional survey was conducted to assess the relationship between patients and health professionals. A total of 813 health professionals (302 physicians and 511 other medical staff) from different healthcare institutions, and 1016 patients participated in cross-sectional survey performed in autumn 2010. Results: The research has showed that each third examined patient thought that his/her physician or the other medical personnel had no understanding for his/her emotions and gave no answer to all of his/her questions. From the other side, 60% of the physicians declare that they have a good communication with patients speaking other language than their mother tongue. Only 60% of physicians said that they know good the culture of their patient and 52% of the other medical staff said that they adjusted the treatment to the patient culture (religion, attitudes, language, life style). Conclusion: There are some gaps in current provision of health care practice in an aspect of effective interactions and communication skills of health professionals to meet patient needs in a multicultural and multilingual setting. A training model is proposed for strengthening communication skills of health professionals. PMID:24511268
Chircop, Andrea; Edgecombe, Nancy; Hayward, Kathryn; Ducey-Gilbert, Cherie; Sheppard-Lemoine, Debbie
Currently used audiovisual (AV) teaching tools to teach health and physical assessment reflect a Eurocentric bias using the biomedical model. The purpose of our study was to (a) identify commonly used AV teaching tools of Canadian schools of nursing and (b) evaluate the identified tools. A two-part descriptive quantitative method design was used. First, we surveyed schools of nursing across Canada. Second, the identified AV teaching tools were evaluated for content and modeling of cultural competence. The majority of the schools (67%) used publisher-produced videos associated with a physical assessment textbook. Major findings included minimal demonstration of negotiation with a client around cultural aspects of the interview including the need for an interpreter, modesty, and inclusion of support persons. Identification of culturally specific examples given during the videos was superficial and did not provide students with a comprehensive understanding of necessary culturally competent skills.
Ferguson, Peter C; Caverzagie, Kelly J; Nousiainen, Markku T; Snell, Linda
The current medical education system is steeped in tradition and has been shaped by many long-held beliefs and convictions about the essential components of training. The objective of this article is to propose initiatives to overcome biases against competency-based medical education (CBME) in the culture of medical education. At a retreat of the International Competency Based Medical Education (ICBME) Collaborators group, an intensive brainstorming session was held to determine potential barriers to adoption of CBME in the culture of medical education. This was supplemented with a review of the literature on the topic. There continues to exist significant key barriers to the widespread adoption of CBME. Change in educational culture must be embraced by all components of the medical education hierarchy. Research is essential to provide convincing evidence of the benefit of CBME. The widespread adoption of CBME will require a change in the professional, institutional, and organizational culture surrounding the training of medical professionals.
Simoni, Jane M.; Evans-Campbell, Teresa (Tessa); Udell, Wadiya; Johnson-Jennings, Michelle; Pearson, Cynthia R.; MacDonald, Meg M.; Duran, Bonnie
The majority of literature on mentoring focuses on mentee training needs, with significantly less guidance for the mentors. Moreover, many mentoring the mentor models assume generic (i.e. White) mentees with little attention to the concerns of underrepresented racial/ethnic minorities (UREM). This has led to calls for increased attention to diversity in research training programs, especially in the field of HIV where racial/ethnic disparities are striking. Diversity training tends to address the mentees' cultural competency in conducting research with diverse populations, and often neglects the training needs of mentors in working with diverse mentees. In this article, we critique the framing of diversity as the problem (rather than the lack of mentor consciousness and skills), highlight the need to extend mentor training beyond aspirations of cultural competency toward cultural humility and cultural safety, and consider challenges to effective mentoring of UREM, both for White and UREM mentors. PMID:27484060
Pascalev, Assya; Vidalis, Takis
The paper examines the ethical and legal challenges of making decisions for previously competent patients and the role of advance directives and legal representatives in light of the Oviedo Convention. The paper identifies gaps in the Convention that result in conflicting instructions in cases of a disagreement between the expressed prior wishes of a patient, and the legal representative. The authors also examine the legal and moral status of informally expressed prior wishes of patients unable to consent. The authors argue that positivist legal reasoning is insufficient for a consistent interpretation of the relevant provisions of the Convention and argue that ethical argumentation is needed to provide guidance in such cases. Based on the ethical arguments, the authors propose a way of reconciling the apparent inconsistencies in the Oviedo Convention. They advance a culturally sensitive approach to the application of the Convention at the national level. This approach understands autonomy as a broader, relational consent and emphasizes the social and cultural embeddedness of the individual. Based on their approach, the authors argue that there exists a moral obligation to respect the prior wishes of the patient even in countries without advance directives. Yet it should be left to the national legislations to determine the extent of this obligation and its concrete forms.
Popper-Giveon, Ariela; Liberman, Ido; Keshet, Yael
In recent years, a growing body of literature has been calling for ethnic diversity in health systems, especially in multicultural contexts. Ethnic diversity within the health care workforce is considered to play an important role in reducing health disparities among different ethnic groups. The present study explores the topic using quantitative data on participation of Arab employees in the Israeli health system and qualitative data collected through semi-structured interviews with Arab physicians working in the predominantly Jewish Israeli health system. We show that despite the underrepresentation of Arabs in the Israeli health system, Arab physicians who hold positions in Israeli hospitals do not perceive themselves as representatives of the Arab sector; moreover, they consider themselves as having broken through the 'glass ceiling' and reject stereotyping as Arab 'niche doctors.' We conclude that minority physicians may prefer to promote culturally competent health care through integration and advocacy of interaction with the different cultures represented in the population, rather than serving as representatives of their own ethnic minority population. These findings may concern various medical contexts in which issues of ethnic underrepresentation in the health system are relevant, as well as sociological contexts, especially those regarding minority populations and professions.
Dunn, Dana S; Andrews, Erin E
The American Psychological Association (APA) advocates the use of person-first language (e.g., people with disabilities) to refer to individuals with disabilities in daily discourse and to reduce bias in psychological writing. Disability culture advocates and disability studies scholars have challenged the rationale for and implications of exclusive person-first language use, promoting use of identity-first language (e.g., disabled people). We argue that psychologists should adopt identity-first language alongside person-first constructions to address the concerns of disability groups while promoting human dignity and maintaining scientific and professional rigor. We review the evolution of disability language and then discuss the major models used to characterize disability and people with disabilities. The rationale for person-first language and the emergence of identity-first language, respectively, are linked to particular models. We then discuss some language challenges posed by identity-first language and the current intent of person-first language, suggesting that psychologists make judicious use of the former when it is possible to do so. We conclude by offering five observations of ways that use of both person-first and identity-first language could enhance psychologists' cultural competence regarding disability issues in personal and scientific communications. (c) 2015 APA, all rights reserved).
This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors' suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs) literature, which has recently been applied by some scholars to healthcare settings. This commentary outlines key premises of that theoretical tradition. Finally, the commentary makes suggestions for taking this IL influenced research agenda further, along with some issues to be addressed. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Galvanese, Ana Tereza Costa; D'Oliveira, Ana Flávia Pires Lucas; Lima, Elizabeth Maria Freire de Araújo; Pereira, Lygia Maria de França; Nascimento, Ana Paula; Nascimento, Andréia de Fátima
By studying the inclusion of artistic and cultural activities in the care provided throughout the history of public mental healthcare in greater São Paulo, Brazil, we can better understand and characterize the practices adopted in the Psychosocial Care Centers in the city today. Experiments carried out between the 1920s and 1990s are investigated, based on bibliographic research. The contemporary data were obtained from research undertaken at 126 workshops at 21 Psychosocial Care Centers in the same city between April 2007 and April 2008. The findings indicate that the current trend in mental healthcare, whose clinical perspective spans the realms of art and mental health and has territorial ramifications, has maintained some of the features encountered in earlier mental healthcare experiments.
Choi, Seul Ki; Seel, Jessica S; Yelton, Brooks; Steck, Susan E; McCormick, Douglas P; Payne, Johnny; Minter, Anthony; Deutchki, Elizabeth K; Hébert, James R; Friedman, Daniela B
Prostate cancer (PrCA) is the most common cancer affecting men in the United States, and African American men have the highest incidence among men in the United States. Little is known about the PrCA-related educational materials being provided to patients in health-care settings. Content, readability, and cultural sensitivity of materials available in providers' practices in South Carolina were examined. A total of 44 educational materials about PrCA and associated sexual dysfunction was collected from 16 general and specialty practices. The content of the materials was coded, and cultural sensitivity was assessed using the Cultural Sensitivity Assessment Tool. Flesch Reading Ease, Flesch-Kincaid Grade Level, and the Simple Measure of Gobbledygook were used to assess readability. Communication with health-care providers (52.3%), side effects of PrCA treatment (40.9%), sexual dysfunction and its treatment (38.6%), and treatment options (34.1%) were frequently presented. All materials had acceptable cultural sensitivity scores; however, 2.3% and 15.9% of materials demonstrated unacceptable cultural sensitivity regarding format and visual messages, respectively. Readability of the materials varied. More than half of the materials were written above a high-school reading level. PrCA-related materials available in health-care practices may not meet patients' needs regarding content, cultural sensitivity, and readability. A wide range of educational materials that address various aspects of PrCA, including treatment options and side effects, should be presented in plain language and be culturally sensitive.
Arnold, R; van Teijlingen, E; Ryan, K; Holloway, I
To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies. Qualitative ethnographic study. A maternity hospital, Afghanistan. Doctors, midwives and care assistants. Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts. The culture of care in an Afghan maternity hospital. A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment. Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability. © 2014 Royal College of Obstetricians and Gynaecologists.
An emerging focus of teacher education courses within countries such as Australia centres on the development of cultural competency. An international practicum experience or student mobility programme embedded within pre-service teacher education programmes is one way to provide such an opportunity. In subject areas such as Health and Physical…
Hartnell, Chad A.; Ou, Amy Yi; Kinicki, Angelo
We apply Quinn and Rohrbaugh's (1983) competing values framework (CVF) as an organizing taxonomy to meta-analytically test hypotheses about the relationship between 3 culture types and 3 major indices of organizational effectiveness (employee attitudes, operational performance [i.e., innovation and product and service quality], and financial…
O'Brien, Catherine A.; Placier, Peggy
From an ethnographic case study of a state-funded residential school for the Deaf, the authors employed Critical Discourse Analysis to identify competing discourses in the talk of educators. These discourses are embedded in the historical oppression and labeling of deaf people as disabled and the development of Deaf culture as a counter-discourse.…
Full Text Available The article is devoted to the problem of formation of cross-cultural competence of foreign students in the process of learning Ukrainian as a foreign language. Theoretical and pragmatic ways of intercultural communication methods for speakers of a foreign language in four types of speech activity have been substantiated. There have been determined linguistic and didactic principles of learning the Ukrainian language as a foreign language using authorial technology of interaction of different approaches that promotes the development of effective cross-cultural competence of foreign students. The main components of the innovative technology of work with foreign language audience have been characterized; a system of tasks and exercises aimed at mastering linguistic, socio-cultural and pragmatic competences has been set. There have been determined linguistic and methodical problems of comparative methodology, which authoring technology LTIRP with the usage of authentic texts is based on. Traditional and new forms, methods and techniques of teaching foreign students in the process of formation of cross-cultural competence have been considered.
Vadivelu, Ramaswamy N.; Klein, James D.
Recent research in the areas of human performance technology (HPT), organizational development, and cross-cultural training has suggested the need for developing managerial competencies that are effective in diverse cultural settings. Some competencies such as technical proficiency, knowledge of company systems, adaptability, and the ability to…
Ruppert, Nancy; Adcock, Lee T.; Crave, Jared
Using five themes associated with a diversity intensive undergraduate course, preservice teachers in an upper level introduction to middle grade course described their knowledge of cultural competence using digital storytelling as the tool. Findings suggest digital storytelling provides a tool to explore and describe how cultural competence is…
Baldissera-Aradas, J V; Rodríguez-Villamil, L; Blanco-Fernández, R; Pérez-García, C; Viejo de la Guerra, G; González-Rodríguez, I; Mosquera-Madera, J
Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Allensworth-Davies, Donald; Leigh, Jennifer; Pukstas, Kim; Geron, Scott Miyake; Hardt, Eric; Brandeis, Gary; Engle, Ryann L; Parker, Victoria A
Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations. To examine organizational cultural competence as perceived by nursing assistants and determine if this was related to differences in job satisfaction across countries of origin and racio-ethnic groups. Primary data collected from a cross-section of 135 nursing assistants at four New England nursing homes. Demographics, perceptions of organizational cultural competence, and ratings of job satisfaction were collected. A multivariate, generalized linear model was used to assess predictors of job satisfaction. A secondary analysis was then conducted to identify the most important components of organizational cultural competency. Perception of organizational cultural competence (p = .0005) and autonomy (p = .001) were the strongest predictors of job satisfaction among nursing assistants; as these increase, job satisfaction also increases. Neither country of origin nor racio-ethnicity was associated with job satisfaction, but racio-ethnicity was associated with perceived organizational cultural competence (p = .05). A comfortable work environment for employees of different races/cultures emerged as the strongest organizational cultural competency factor (p = .04). Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a
Meade, Michelle A; Mahmoudi, Elham; Lee, Shoou-Yih
This article provides a conceptual framework for understanding healthcare disparities experienced by individuals with disabilities. While health disparities are the result of factors deeply rooted in culture, life style, socioeconomic status, and accessibility of resources, healthcare disparities are a subset of health disparities that reflect differences in access to and quality of healthcare and can be viewed as the inability of the healthcare system to adequately address the needs of specific population groups. This article uses a narrative method to identify and critique the main conceptual frameworks that have been used in analyzing disparities in healthcare access and quality, and evaluating those frameworks in the context of healthcare for individuals with disabilities. Specific models that are examined include the Aday and Anderson Model, the Grossman Utility Model, the Institute of Medicine (IOM)'s models of Access to Healthcare Services and Healthcare Disparities, and the Cultural Competency model. While existing frameworks advance understandings of disparities in healthcare access and quality, they fall short when applied to individuals with disabilities. Specific deficits include a lack of attention to cultural and contextual factors (Aday and Andersen framework), unrealistic assumptions regarding equal access to resources (Grossman's utility model), lack of recognition or inclusion of concepts of structural accessibility (IOM model of Healthcare Disparities) and exclusive emphasis on supply side of the healthcare equation to improve healthcare disparities (Cultural Competency model). In response to identified gaps in the literature and short-comings of current conceptualizations, an integrated model of disability and healthcare disparities is put forth. We analyzed models of access to care and disparities in healthcare to be able to have an integrated and cohesive conceptual framework that could potentially address issues related to access to
Kiang, Lisa; Glatz, Terese; Buchanan, Christy M
Parents from immigrant backgrounds must deal with normative parenting demands as well as unique challenges associated with acculturation processes. The current study examines the independent and interactive influences of acculturation conflict and cultural parenting self-efficacy (PSE; e.g., parents' confidence in instilling heritage, American, and bicultural values in their children) on perceptions of general parenting competence. Using data from 58 Asian American and 153 Latin American parents of children in grades 6-12, ethnic differences were also explored. Results suggest that lower acculturation conflict is associated with higher perceptions of general parenting competence for both Asian and Latin American parents. Higher cultural PSE is associated with higher perceived general parenting competence for Latino/a parents only. One significant interaction was found, and only for Asian Americans, whereby the negative association between acculturation conflict and perceptions of parenting competence was weaker for those who felt efficacious in transmitting heritage messages. Results are discussed in light of clinical implications and the need for further recognition and study of culturally relevant factors and frameworks among families from immigrant backgrounds. © 2016 Family Process Institute.
Isaac, Carol; Behar-Horenstein, Linda; Lee, Barbara; Catalanotto, Frank
To respond to widespread disparities in access to oral health care, the Institute of Medicine, the Commission on Dental Accreditation (CODA), and the U.S. surgeon general have stressed that prospective dentists should become culturally competent, socially responsible practitioners. The aim of this study was to examine linguistic differences in dental students' reflective writing assignments before and after interviewing an individual who was culturally different from themselves. The authors analyzed 160 documents from 80 first-year dental students at the University of Florida in 2012. This cohort consisted of 36 male (45%) and 44 female (55%) students; 26 (32%) were from underrepresented minority (URM) groups and 54 (68%) were identified as white non-minority. Text analysis software identified word counts, categories, frequencies, and contexts. Significantly positive differences occurred for interviews between assignments 1 and 2 (p=0.005 to pcultural diversity. Differences were observed for Factor 1 ("important others' influence") between assignments (p<0.001), assignments by interview categories (p=0.033), and URM/majority participants by assignments by interview category (p=0.018). Factor 4 ("my social world in relation to others") was statistically different between assignments for URM/majority participants (p=0.019). Factor 5 ("wrong because") was statistically different for gender (p=0.041), suggesting that males may have experienced a rebound effect from stereotype suppression. The findings suggest that the use of reflective writing and interviews affected the students' awareness of how important others had influenced their lives and attitudes and facilitated their questioning preconceived assumptions. Reactions to coursework focusing on social and personal domains warrant further investigation.
Adam VAKHTANG AKHALADZE
Full Text Available In this study we analyze the biographical and hagiographical life and multifaceted activities of St. Anthim the Iberian in cross-cultural communicative dimension. Modern Post-Global world and its Weltanschauung need not onlytrans(cross-cultural, but also trans-historical contexts. We have designated the existence of trans-cultural polylogue (dialogue of many between all historical eras and ethnicities with their cultural codes and symbols. Our research enabled us to identify the following parameters of trans-cultural communicative competence: (i adequately assess the communicative situation; (ii possession of a certain body of knowledge about the native and other cultures; (iii to put into practice intercultural communicative intentions; (iv presence of not only the ability to understand other cultures, as well as members of their own culture, but also the ability to build new patterns of behavior, based on the values and norms of different cultures; (v strive to mix our own and others' cultural identity and as a result of the exchange of positive examples of actions and patterns of decision-making to go to a qualitatively new synthesis of action; (vi check the communication results with the help of feedback. We also identified the following aspects and facts of life and activity of Anthim the Iberian in the context of cross-cultural communicative competence: (a getting a wonderful upbringing (social intercultural communicative abilities and skills, and education (the possession of a certain body of knowledge about both native and other cultures, understanding and respect for diverse cultural values; (b the forced emigration of the native culture medium (communicative and behavioral adaptation to the behavior of other cultures; (c the experience of cruelty trafficking – the kidnapping and slavery sale (the religious-spiritual, social and cross-cultural communicative negative experience and its interpretation in a truly constructive manner that
Ludeke, Melissa; Puni, Ronald; Cook, Lynley; Pasene, Maria; Abel, Gillian; Sopoaga, Faafetai
Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. Pacific participants were recruited through Pacific networks known to Pegasus Health and via 'snowball' sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants' views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacif