C. c) Cultural competence                 Next

Cultural competence

Tthe development of cultural competence is a continuous process, not a single event. The journey inlcudes:

Cultural incompetence: lack of knowledge of the cultural implications of health behaviour

Cultural knowledge: learning the elements of culture and their role in shaping and defining health behaviour !II

Cultural awareness: recognising and understanding the cultural implications of behaviour

Cultural sensitivity: the integration of cultural knowledge and awareness into individual and institutional behaviour

Cultural competence: the routine application of culturally appropriate health care interventions and practices

Cultural proficiency: the integration of cultural competence into one's reper¬toire for scholarship (e.g. practice, teaching and research).

Did you know cultural competence:

TICK the items you know.
Find out more about what you don't know.

Choice 1Incldues knowledge, behaviour and attitudes-not simply knowledge.
Choice 1Incldues skills which needs to be expressed in behaviour as the capacity to function effectively in intercultural contexts-not simply knowledge and awareness.
Choice 2Extends beyond individual professional behaviours and includes organisations and systems-a culturally incompetent system can under¬mine the work of culturally competent practitioners.

 

Thinking about your own cultural competence with Indigenous Australians
where do you think you are on the cultural competence journey?

Choice 1Cultural incompetence: lack of knowledge of the cultural implications of health behaviour
Choice 1Cultural knowledge: learning the elements of culture and their role in shaping and defining health behaviour
Choice 1Cultural awareness: recognising and understanding the cultural implications of behaviour
Choice 2Cultural sensitivity: the integration of cultural knowledge and awareness into individual and institutional behaviour
Choice 3Cultural competence: the routine application of culturally appropriate health care interventions and practices
Choice 4Cultural proficiency: the integration of cultural competence into one's repertoire for scholarship (e.g. practice, teaching and research).

 

 

 

 

Cultural competence

There are many possible definitions of cultural competence.

Tracy Westerman (2004, p. 2) comments that 'cultural competence is about the ability of practitioners to identify, intervene and treat mental health complaints in ways that recognise the central role that culture plays in mental illness.' .

The model of cultural competence we describe in this chapter is based on the definition derived from Cross et al. (1989, p. 1): Cultural and linguistic competence is a set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations. "Culture" refers to integrated patterns of human behavior that include the language, thoughts, actions, customs, beliefs, and institutions of racial, ethnic, social, or religious groups. "Competence" implies having the capacity to function effectively as an individual or an organization within the context of the cultural beliefs, practices, and needs presented by patients and their communities. eality.

Cross et al.'s (1989) definition of cultural competence emphasises three crucial issues for practitioners who want to become culturally competent:

  • Cultural competence includes knowledge, behaviour and attitudes-not simply knowledge.
  • Cultural competence is a skill which needs to be expressed in behaviour as the capacity to function effectively in intercultural contexts-not simply knowledge and awareness.
  • Cultural competence extends beyond individual professional behaviours and includes organisations and systems-a culturally incompetent system can under¬mine the work of culturally competent practitioners.

 

The Process of Cultural Competence

There is widespread agreement within the literature that the development of cultural competence is a continuous process, not a single event.

As Campinha-Bacote (2005, p. 1) notes, 'Competence is a process, not an event; a journey, not a destination; dynamic, not static; and involves the paradox of knowing'.

Marcia Wells (2000, p. 192) has developed a model based on Cross et al.'s (1989) conception of cultural competence as a continuum. Her model places the elements of cultural competence (knowledge, attitudes and skills) in a developmental framework with the following sequence of stages along a continuum from cultural incompetence to cultural proficiency:

Cultural incompetence: lack of knowledge of the cultural implications of health behaviour

Cultural knowledge: learning the elements of culture and their role in shaping and defining health behaviour !II Cultural awareness: recognising and understanding the cultural implications of behaviour

Cultural sensitivity: the integration of cultural knowledge and awareness into individual and institutional behaviour

Cultural competence: the routine application of culturally appropriate health care interventions and practices

Cultural proficiency: the integration of cultural competence into one's reper¬toire for scholarship (e.g. practice, teaching and research).

Definitions

Cultural Knowledge

Cultural Knowledge is familiarization with selected cultural characteristics, history, values, belief systems, and behaviours of the members of another ethnic group (Adams, 1995)

Cultural Awareness

Cultural Awareness is developing sensitivity and understanding of another ethnic group. Awareness extends to special foods, manners of dress, language, religious preferences and observances, and differences in communication styles. As an example, in some cultures it is impolite to make eye contact, especially with someone you do not know well. Cultural Awareness also involves changes in attitudes and values and reflects an openness and flexibility in working with others of another culture.

Cultural Sensitivity

Cultural Sensitivity is recognizing and knowing that both cultural differences as well as similarities exist, and not making value judgments of good or bad, better or worse, right or wrong (Texas Department of Health, National Maternal and Child Health Resource Center on Cultural Competency, 1997). It is important to be familiar with and sensitive to special events, activities, meaning of holidays, and other ethnic celebrations and the special foods that are served at these times.

Cultural Competence

Cultural Competence is a set of congruent behaviours, attitudes, and policies that come together in a system, agency, or among professionals that enables that system, agency, or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, and Isaacs, 1989). Cultural competence also refers to a set of academic and interpersonal skills that allow individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups. This requires a willingness and ability to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing targeted interventions, communications, and other supports.