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Cultural competence in health care: expert perspectives

Cultural competence in health care: expert perspectives

What is cultural competence and how does it fit into health care? A recent survey among physicians in the US shows that cultural competence is a major issue for both healthcare practitioners and their patients, so what are the barriers to effective cross-cultural communication in a healthcare setting?

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Why is cultural competence so important in healthcare? Designed by MNT; Photography by PER Images / Stocksy & FS Productions / Getty Images.

Since the time of the ancient Greeks, medical professionals have taken the Hippocratic Oath, by which they commit themselves to providing their patients with the best possible care. This includes patients of all different ethnic groups, religions, sexual orientations, and cultures.

But not all people feel that the medical community understands their unique needs. For example, a study from Stanford University found that black men were more likely to talk about their health concerns with a black doctor. Another study found that Hispanics in the United States delay going to the doctor because they do not understand the health care system.

And not all physicians believe they can serve patients of all backgrounds. Previous research shows that doctors from minority backgrounds, and female doctors, as well More likely to serve Minority, financially unstable, and Medicaid eligible residents.

Furthermore, a study from 2015 found that doctors and medical students I felt unprepared When seeing patients who identify as gay, lesbian, bisexual, transgender, or gay. These are some of the reasons why cultural competence plays a huge role in patient care.

A new survey by Healthgrades – an online resource that provides comprehensive information on doctors and hospitals – finds that 31% of responding physicians agreed that their level of cultural proficiency influenced their ability to provide the best possible care to their patients either somewhat or a lot.

Additionally, the survey found a generational difference when it comes to a physician’s willingness to improve their cultural competence. Younger physicians, with a few years of practical experience, seemed more interested in additional cultural competency training when compared to older physicians.

Cultural competence is the ability to understand and respect the beliefs, values, and history of individuals of all cultural backgrounds.

Luz Maria Garcini, associate professor in the Department of Psychological Sciences at Rice University, an associate professor at the United States and Mexico Center, the Baker Institute for Public Policy, and associate faculty at the Research Center for the Advancement of Community Health at UT Health San Antonio.

“Cultural competence improves interpersonal interactions, helps build trust, conveys respect, reduces biases that may lead to inaccurate diagnoses and treatments, and increases the chances that patients will be more compliant with medical recommendations made,” she said. Medical news today.

Dr. Arlette Harry, Assistant Dean for Intercultural Affairs at St. George’s University, agreed that cultural competence is of paramount importance in the health care system.

“We know that it leads to improved patient outcomes, reduced disparities and inefficiencies in care and, ultimately, lower costs,” she explained. “The social determinants of health are not the same for everyone, so health inequality creates a serious challenge for patients and health care workers alike.”

“Cultural competence, along with cultural humility, is a powerful tool in addressing these disparities experienced by people from diverse backgrounds, whether that diversity is culture, race, sexual orientation, socioeconomic status, religion, gender, or disability—invisible or Visible – a little name,” Dr. Harry added.

In addition, Dr. Heri noted that cultural modesty acknowledges historical facts – such as Tuskegee Study and the Stanford Prison Experiment – That led to a lack of trust in the health care system among vulnerable populations.

“It also requires healthcare professionals to develop an awareness of their implicit biases and how they affect patient care as well as interaction with their colleagues,” she continued. “This can only happen through a continuous process of reflection, reflection, and self-evaluation.”

In the Healthgrades survey, 831 US physicians were asked if a person’s personal identity traits — including language, race, gender, sexual orientation and religion — prevented them from providing them the best possible care.

More than half of the responding physicians – 54% – said none of these affected their ability to provide care. Among the individual traits, language was the largest culprit at 31%.

Healthgrades has reportedly conducted a separate survey with the general public. When asked if any of their personal identity traits prevented them from receiving appropriate care from their physician, 10% of participants who identified as people of color answered “yes.”

When clinicians were asked to rate their willingness to care for people from different cultural or ethnic backgrounds, 87% rated themselves as ‘excellent’ or ‘very good’.

However, only 68% of individuals identified as of color rated their physicians’ rate of willingness to care as either “excellent” or “very good” in the parallel survey.

31% of responding physicians agreed that their level of cultural proficiency affects their ability to provide medical treatment either ‘a lot’ or ‘somewhat’.

The answers to this question also showed a generational difference, with younger physicians – in practice less than 10 years ago – making up more than 31% of older doctors who have been in practice for more than 20 years.

And when asked if additional training would help the doctor improve the care he gives to people with different cultural backgrounds, a generational difference emerged again.

55% of younger physicians in practice for 10 years or less said more training would help them care for people of different cultural and ethnic backgrounds, and people of a different gender or sexual orientation.

And 63% of physicians in practice for 20 years or more said they did not need any additional training.

According to Dr. Heri, the process of ensuring that health care workers are culturally knowledgeable has begun when treating patients from different cultural backgrounds, but we are not there yet.

For example, she said medical colleges They have incorporated cultural competence into their curricula, and medical professionals have training options through organizations and platforms such as LinkedIn Learning and the US Department of Health and Human Services, the Office of Minority Health’s “Practical Guide to Culturally Competent Care.”

“But we’re not there yet because cultural competence is a dynamic, lifelong process,” Dr. Heri noted.

“Dimensions of diversity are variable, so providing equitable and comprehensive care means that health care professionals and health organizations and systems must constantly explore relevant content.”

– Dr. Arlette Harry

Dr. added.

In the United States, more than half of active physicians in 2018 were identified as white. However, census projections estimate that so-called minority groups combined will become the dominant population in 2045.

“Cultural competence is not something that can be learned overnight,” Dr. Garcini emphasized.

“[Cultural competency] It requires time, self-awareness and systemic change within our organizations. also, [it] It is an ongoing and ongoing process that we all need to work on constantly. It requires humility and a willingness to listen and learn from diverse perspectives, including learning from patients and members of the community.”

Dr. Luz Maria Garcini

What can medical schools do to help ensure that new doctors enter the medical field with cultural competence?

Dr. Heri said that creating humble and culturally competent medical care workers starts with the recruitment process.

“Universities and medical schools should establish mechanisms to recruit diverse faculty and recruit a diverse student body,” she explained. Students should ‘see’ themselves reflected in their faculty. These practices enhance feeling [belonging] and allowing learning and sharing of ideas in a safe and inclusive setting.”

“Systematic strategies for training cultural competencies must go beyond the lecture method,” Dr. Heri continued. “The use of small group discussions and patient simulations where the nuances of diverse identities, such as disabilities, cruelty, spirituality, end of life, gender, sexual minorities, and age can be explored, is a powerful teaching and learning tool.”

For new and existing clinicians alike, Dr. Garcini said the best way to build cultural competence is through exposure to diverse environments and societies.

“This is why systemic change to diversify our organizations and institutions is essential,” she explained. “We need to learn, listen and consult with each other [in] our daily life “.

Dr. added. “Service providers need to participate in community activities, serve on community boards, talk to people in the community, collaborate with community leaders, and listen to what is important and what matters to the community. Then change may slowly begin.”


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