In Search of Cultural Competence

Abstract

We have failed to understand that teachers are first and foremost cultural workers, not neutral professionals exercising pedagogical or psychological skills on a culturally-detached playing field.1(p306) The winter issue of the Journal of Physical Therapy Education provides several articles that give us an opportunity to reflect on some of the more difficult and complex issues that face physical therapy education. First is an innovative position paper by Wehbe-Alamah and Fry, which describes a model for developing and maintaining a culturally sensitive and welcoming academic environment for students, faculty, and staff of culturally diverse backgrounds. Physical therapy faculty often address the importance of assuring culturally competent behavior in the clinical setting. Wehbe-Alamah and Fry have provided a position paper that shifts the focus to the educational setting, challenging academic educators to evaluate the cultural competence of their own behaviors and environment. Providing a welcoming and culturally sensitive environment to an ethnically and religiously diverse community of learners and staff is becoming an increasingly complex task, as our learners become— slowly but surely—more diverse in their race, ethnicity, religious affiliations, socioeconomic background, and learning abilities. For some physical therapy faculty, this may mean a wealth of new experiences; while, for many of our students, diversity is representative of their high school and college experiences. Educators across primary, secondary, and higher education have long focused on developing educational institutions and programs designed to provide appropriate educational environments for students of diverse backgrounds. This May 2014 marks the 60th anniversary of the landmark Brown versus the Board of Education Supreme Court decision, which made racial segregation illegal in the United States. Thus, there is potential that our students arrive to physical therapy education with more tolerance for and interest in cultural differences than ever before. Is the diversity gap between our faculty and students a barrier to modeling cultural competence in our academic settings? Wehbe-Alamah and Fry present a model that can assist our generation of teachers to continue this decades-long pursuit of cultural competence in our own clinical and educational practices. If all members of the educational community model a commitment to creating a culturally sensitive learning environment, our students may have more success carrying these values and practices into the clinical setting. Also in this issue, Hinman, Peel, and Price, members and staff of the Commission on Accreditation in Physical Therapy Education, contribute the results of a study of leadership retention in physical therapist (PT) and physical therapist assistant (PTA) programs The findings may not surprise our readership. An invited commentary on this research, by Gordon, provides a suggested position description for the academic leader of a PT program. The findings of this study and the recommended role responsibilities by Gordon will provide those hiring academic leaders and those considering such opportunities with important perspectives to consider. Finally, Grignon et al provide a research report that summarizes the expected outcomes of physical therapist graduates from 75 PT programs, with an eye to the possibilities of developing a uniform set of expected graduate outcomes. These researchers found 10 common expected outcomes for graduates of PT programs. They also contrasted these expected outcomes for physical therapists to those found in the literature for physicians, nurses, dentists, social workers, psychologists, and others—finding some overlap in expected outcomes. So what expected outcomes make physical therapists unique? The editors were struck with the absence in these data of any specific reference to movement: the graduate’s movement and his or her ability to analyze and correct a patient’s movement. The terms “skills” and “psychomotor skills” do appear in several of the 10 common expected outcomes reported in this paper. It is interesting, however, that we have yet to incorporate the foundational and conceptual term of “movement” into our language for our graduates’ expected outcomes. Do we focus on improving our students’ movement throughout the curriculum? Perhaps an expected outcome defining a level of movement proficiency sets physical therapists apart from other health care professionals. The newly adopted APTA Vision statement also points educators towards the importance in our profession of enhancing movement: “Transforming society by optimizing movement to improve the human experience.” We hope that you also find these articles worthy of reflection and comment. Let us know what you think. Letters to the editor can be addressed to either editor. We look forward to a vibrant correspondence!