Principles Of Cultural Competence Research Articles

Educating health professionals for cultural competence in emergency situations: A study protocol for a randomized controlled trial.

The current study is aimed at developing a culturally informed education program to increase cultural competence in emergencies among healthcare students and to examine its effectiveness using a randomized controlled trial. This is a mixed-methods study, which comprises two phases: (a) Development of educational intervention to increase cultural competence, based on a review of published scientific literature and primary data collection from qualitative semi-structured interviews with key informants; (b) Implementation and assessment of the intervention effectiveness in increasing cultural competence in health students, using a randomized controlled trial. The qualitative phase will include semi-structured interviews with 10 key informants. Data will be analysed using Interpretative Phenomenological Analysis. The assessment of intervention efficacy will be examined by a randomized controlled trial. This phase will include a total of 200 undergraduate health profession students who will be randomized (1:1 ratio) to intervention or non-intervention group. Both study groups will complete pre- and postintervention questionnaires assessing three principles of cultural competence: attitudes, knowledge, and skills. The study is supported by 2-year funding, beginning in September 2018. Although the importance of culturally sensitive health services has long been recognized, there is a lack of cultural competence training in the medical education system, especially in the context of emergencies. Incorporating cultural competence education into the curricula offers an appealing strategy to enhance systematic understanding of cultural diversity at the early stages of professional training. The development of cultural competence training and curricula focusing on situations that may arise during emergencies may play a significant role in minimizing cultural dissonance, improve patient-provider communication, and produce better clinical outcomes.

Reimagining Haj Khalil v. Canada

This paper emphasizes the importance of cultural competence for tort law by analyzing the Federal Court’s decision in Haj Khalil v. Canada. Given that this symposium in honour of Rose Voyvodic’s life and work is entitled “Re-Imagining Access to Justice,” this paper asks “how do the principles of cultural competence allow us to think about the facts of the Haj Khalil differently. In particular, what would a cause in fact analysis look like if it were informed by the principles of cultural competence?” My analysis proceeds by “reading the silences” or focusing on the unstated assumptions and unexplored elements of Haj Khalil’s story to bring into focus factors relevant to factual causation which remain largely unexplored or undervalued by the Federal Court. An examination of the facts that framed Haj Khalil`s claim against immigration officials through a culturally competent lens would open the possibility of a different understanding of causation as it arises on the facts of the case. While Canadian courts have emphasized the importance of social context for fair judgment, they have not fully come to grips with the implications of social context for judicial decision-making. This is particularly the case within negligence law which remains vexed by the need to maintain an objective standard while simultaneously recognizing the importance of context and circumstance to particular claims.

Improving Surgical Residents' Performance on Written Assessments of Cultural Competency

The pressure to implement cultural-competency training at the level of GME is high. The rapidly diversifying American population and the ACGME demand it, and cultural competency is recognized as a core competency under "Professionalism." The objectives for this study were (1) to assess residents' baseline levels of cultural competence, (2) define barriers to skill-acquisition, and (3) examine efficacy of educational programs in improving cultural competence. In all, 43 residents from the University of Connecticut School of Medicine participated in a prospective, Institutional Review Board (IRB)-approved study. During Step 1 (pretest), baseline performance was recorded using 3 assessments: (1) Healthcare Cultural Competency Test (HCCT), (2) Cultural skills acquisition (CSA), and (3) Clinical Scenarios Test (CSE). During Step 2 (Educational Intervention), a 2-part lecture that focused on principles of cultural competency and continued self-learning was presented. Last, for Step 3 (posttest), the post-program evaluation was administered as in Step 1. Answers for Step 1 (pretest) and Step 3 (posttest) were compared using a paired t-test for HCCT and CSE and the chi-square test for CSA. Thirty-five replies were evaluated. Every resident performed better on the posttest than the pretest. Specifically, participants showed 88% improvement in their scores on the HCCT (pretest: 360, posttest: 696; p < 0.01), 2-fold improvement on the CSA (pretest: 6, posttest: 12; p < 0.009), and 40% improvement in CSE (pretest mean score = 23.3, posttest = 34.6; p < 0.01). Commonly identified barriers to learning included inadequate teaching tools and absence of formal training. Surgery residents tested for 3 aspects of cultural competence prior to and after teaching sessions showed marked improvement on all 3 assessment measures after this brief intervention.

Cultural Diversity, Health Care Disparities, and Cultural Competency in American Medicine

A 2003 report by the Institute of Medicine identified several areas of disparity in health care due to discrimination (whether unintentional or intentional), bias, and prejudice. Given that most minority patients are treated by physicians from the majority group, the principles of cultural competency are extremely important. A health care provider is culturally competent when the patient is satisfied that a collaborative partnership has been established that facilitates successful and satisfactory delivery of care. To accomplish this, the physician makes an effort to overcome language barriers and learns to appreciate cultural differences. Taking the step to increase communication and awareness will enhance the quality of medical care delivered to minorities, leading to greater racial and ethnic harmony and understanding in the health care professions.

Weaving a tapestry: Anti‐racism and the pedagogy of clinical social work practice

This paper aims to describe how. the Smith College School for Social Work's commitment to anti‐racism, affirmed in 1994, shapes the teaching of clinical social work practice. The discussion is situated in a review of the School's mission statement, the guiding teaching principles of cultural competence as developed by social work's professional organizations, and current research and clinical findings. A brief review of the literature pertaining to anti‐racism in clinical practice follows. Various assumptions and myths are addressed concerning what constitutes clinical practice grounded in anti‐racism. I then present a case method of teaching clinical practice based on a social constructivist view of valuing multiple theoretical lenses, an “informed not knowing” stance and the intersubjective space. Three central principles inform the teaching of cultural responsiveness. They are: (1) values, ethics and self‐reflection; (2) cross‐cultural knowledge and skills; and (3) empowerment and advocacy. Although a synthesis of social and psychological theories is useful in all psychotherapy, for the sake of brevity, this paper narrows the focus to racial identity development and object relations theories, in particular Winnicottian theory. Both are developmental models. They stress the importance of optimal nurturing environments and of facilitating the emergence of complex racial and psychological identities. Specific questions are posed to promote critical thinking and dialogue in the classroom. Finally, I present a clinical case of couple therapy, lasting seven months, where the clients and clinician self‐identified as white, while the clinical consultant identified as African American. The role of anti‐racism in this therapeutic process is addressed in the context of a case analysis based on the central principles outlined.

Applying Principles of Cultural Competency to Research on Lesbian Health

Applying Principles of Cultural Competency to Research on Lesbian Health

Cultural competence in the care of abused women

This article explains the concept of cultural competence, adding advocacy to models of culturally competent health care already in the literature and demonstrating how it relates to domestic violence. Abuse stages according to Landenburger's model of entrapment and recovery are presented with applicable cultural differences and specificities. Cultural issues related to specific childbearing-stage abuse interventions are also discussed. The principles of cultural competence, abuse- and childbearingstage specificity, and empowerment are used as the basis for this model of clinical intervention with abused women.