Awareness of Cultural Humility & Competency in the Clinical Setting
As a second-generation immigrant, I have found that both my parents have had their fair share of challenges with medical literacy. My parents have struggled to communicate their needs at doctor’s appointments, dismissing their concerns due to language barriers. In a country as diverse as this, I know they were not alone in this experience.
Cultural Humility
What is it? In an article by Bostick et al (2021), this concept can be defined in 5 components.
Cultural Awareness: Capacity to reflect on one’s background and recognize biases/assumptions.
Cultural Knowledge: Seeking information about diverse cultural groups.
Cultural Skill: Ability to apply knowledge in a culturally competent manner.
Cultural Encounters: Directly engaging in cross-cultural encounters.
Cultural Desire: Intrinsic motivation to engage in the previous 4 components.
Cultural Competency
Many of us may be more familiar with the concept of cultural competency. The American Physical Therapy Association (APTA) defines this as a journey of understanding and appreciating differences, working toward congruent behaviors, attitudes, and policies to embrace equal access and non-discriminatory practices.
So why do these two things matter, and how do clinicians integrate them into their care? All clinicians should be looking within themselves to question, learn, and examine their current approaches to communicating with individuals who come from linguistically diverse communities. The APTA states that a major principle of a culturally competent system highlights its involvement in determining an individual’s cultural identity and levels of acculturation and assimilation to more effectively apply the concept of “starting where the individual or family is.”
In the Bostick et al article, participants chose to integrate aspects of their personal treatment experiences, creating specific themes that highlight:
1. Cultural and linguistic impediments to communication: There is no universal language for pain. This miscommunication can result in a pain assessment that focuses on the description of pain rather than the impact of pain.
2. Understanding of pain in terms of the extent that it interferes with function and work: Instead of using a pain scale, do you think your patient would better benefit from questions that relate to function?
3. Nurturing of personal attention as a marker of good care: What does good care mean to your patient? What does it look like in a doctor’s office versus a physical therapy clinic?
4. Value attributed to traditional ideas of illness and treatment: What are some remedies that our patient has practiced at home for physical pain and ailment? Do they believe in Western medicine?
Furthermore, having this knowledge not only promotes cultural humility and competency but also trust and empathy between patient and provider. Perhaps it’s having a conversation with a patient advocate who is Spanish-speaking or choosing a physical therapist who is well-versed in Muslim religious practices.
Whatever it may be, we are committed to building therapeutic alliances with our patients from all walks of life here at Hulst Jepsen Physical Therapy. Please call (616) 256-8679 or reach out to any of our clinics to schedule an appointment or if you have any questions about your physical therapy needs!
References:
Achieving Cultural Competence. American Physical Therapy Association. Updated January 15, 2020. https://www.apta.org/patient-care/public-health-population-care/cultural-competence/achieve-cultural-competence
Bostick GP, Norman KE, Sharma A, Toxopeus R, Irwin G, Dhillon R. Improving Cultural Knowledge to Facilitate Cultural Adaptation of Pain Management in a Culturally and Linguistically Diverse Community. Physiother Can. 2021;73(1):19-25. doi:10.3138/ptc-2019-0027
