Talk:Cultural humility

Peer Review from Jenn & Natalie:

Cultural humility is conceptualized as the “ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the [person].[1] ” Cultural humility is different from other culturally-based training ideals because it focuses on being humble rather than on achieving a state of knowledge or awareness (possible rephrasing). Cultural humility was formed in the physical healthcare field and adapted for therapists and social workers to increase the quality of their interactions with clients and community members. Background To understand cultural humility, it is important to think about the importance of culture. The authors of the Culturally and Linguistically Appropriate Standards (CLAS) explain the importance [Another word may help?] of culture in that “culture defines how health care information is received, how rights and protections are exercised, what is considered to be a health problem, how symptoms and concerns about the problem are expressed, who should provide treatment for the problem, and what type of treatment should be given. In sum, because health care is a cultural construct, arising from beliefs about the nature of disease and the human body, cultural issues are actually central in the delivery of health services treatment and preventative interventions. By understanding, valuing, and incorporating the cultural differences of America’s diverse population and examining one’s own health-related values and beliefs, health care about the nature of disease and the human body, cultural issues are actually central in the delivery of health services treatment and preventative interventions.”[2] [This quote is great, and really provides a great background for your topic. I would just be careful about using very long quotes in Wikipedia articles. I think we’ve been warned away from that and encouraged to describe more rather than quote.] Cultural Humility was born out of the medical field for medical educators looking for a new way to frame multicultural understanding for new health care professionals. It was introduced as an alternative to Cultural Competence, which has many negative connotations. Competence assumes that one can learn or know enough, that cultures are monolithic, and that one can actually reach a full understanding of a culture to which they do not belong. Cultural humility can also be associated with cultural sensitivity, which encourages individuals to be thoughtful when considering culture. However, sensitivity does not touch on the necessity of learning, reflection, or growth[3] . Cultural humility incorporates a consistent commitment to learning and reflection, but also an understanding of power dynamics and one’s own role in society. It is based on the idea of mutually beneficial relationships rather than one person educating or aiding another in attempt to minimize the power imbalances in client-professional relationships. There are three main components to cultural humility; [Should be a colon (:) rather than a semicolon (;)] lifelong commitment to self-evaluation and self-critique, fix power imbalances, and develop partnerships with people and groups who advocate for others.[4] History Cultural Humility is a term coined by Melanie Tervalon and Jann Murray-Garcia in 1998 to describe a way of infiltrating multiculturalism into their work as healthcare professionals. Replacing the idea of cultural competency, cultural humility was based on the idea of focusing on self-reflection and life-long learning. Tervalon and Murray-Garcia believed that health care professionals were not receiving appropriate education or training in terms of multiculturalism, and developed a new method of approaching the topic.[5] . Cultural Competence was an idea first promoted in the healthcare profession. Competence educational programs are aimed at preventing medical misdiagnoses and errors due to lack of cultural understanding. However, with the increasing diversity in the United States combined with an added cultural awareness, competence was not serving the needs of all medical professionals.[6] [Perhaps it would help to switch these two paragraphs so that they follow a more chronological timeline (first cultural competence, then cultural humility). As it stands now, it sounds a little redundant to start with the solution and then describe why cultural humility was necessary in the first place.] [-Great idea for a table! Makes things very clear. -I would try to reword the “goals” section of cultural humility to make the sentence flow a little better. -Also, maybe consider using a list format instead of a paragraph format? Instead of: “Challenging for professionals to grasp the idea of learning with and from clients. No end result, which those in academia and medical fields can struggle with” maybe try: “Challenging for professionals to grasp the idea of learning with and from clients. No end result, which those in academia and medical fields can struggle with.”] Cultural Humility in Social Work Recently, the social work profession has begun adopting cultural humility into frameworks for service delivery and practice. Most cultural humility rhetoric focuses on micro practice social work (maybe explaing what micro practice is)[7] [8] in terms of worker/client relationships and culturally appropriate intervention procedures. However, in its core, social work posits cultural humility as a strong self-reflection tool for the worker. Most importantly, It [Capitalization error.] encourages us to realize our power, privilege and prejudices, and be willing to accept that acquired education and credentials alone are insufficient to address social inequality.[9] As such, this reflective practice[10], enables social workers to understand that the client is an expert in their own lives and that it is not the role of the worker to lean on their own understanding. In short, clients are the experts on their lives, not their service providers [Very good point, but the wording is a little redundant.].[11] Those who practice cultural humility view their clients as capable and work to understand their worldview and any oppression or discrimination that they may have experienced as well[12]. In terms of the workplace of a social worker, supervisors should try to help workers to: Normalize not knowing • Supervisors and managers, we need to instill in our staff the understanding that it is not only okay to not know—it is a necessary condition for growth, central to the practice of cultural humility and good social work practice. [You make some excellent suggestions in this section, but I’m not sure about your use of the first person. Removing “we” may be more appropriate for a Wiki article format.] Create a culture-based client self-assessment tool • We need to offer them [Specify who you mean; “clients”] a mechanism by which they can be seen and heard—an instrument such as this affords that opportunity. While our clients have the right to refuse to complete it, we as practitioners can nonetheless remain vigilant and true in our practice of cultural humility. In-service: A cultural self-identification workshop • As a supervisor or program manager you can lead an in-service style conversation where staff members self-report how they differ from the cultural stereotypes others may believe about them.[13] -This looks great! You both did an excellent job. -Don’t forget to embed link to other articles (such as cultural competence, etc.) -As it stands now, there is inconsistent capitalization of “cultural competence” and “cultural humility” especially. I don’t think they necessarily need to be capitalized, but make sure you use one form throughout. -I know this is the hardest part, but don’t forget to include your reference list! — Preceding unsigned comment added by Swjennls (talk • contribs) 21:01, 10 March 2014 (UTC) — Preceding unsigned comment added by Aschwedt (talk • contribs) 17:31, March 19, 2014 (UTC)

Cultural humility in the medical field

The emergence of cultural competency in the medical field has helped improve patient care to accommodate growing diverse communities, however, disparities still remain in the care being provided.

In 2014 a study was conducted by Mary Isaacson where she asked nurses to assess their cultural competency. She noticed that majority of the nurses scored themselves high however, after being immersed into the Native American culture at an Indian reservation, they scored themselves much lower. Isaacson also noticed that although majority of the nurses had claimed to be culturally competent, they in fact reported many negative stereotypes in their journal. The study goes on to say that culturally competency needs to have ethics to keep nurses accountable.

So, to further assist healthcare professionals in providing quality care for a diverse population, medical fields, such as nursing, have begun to incorporate cultural humility into their curriculum. This shifts the individual's mindset to realizing that cultural competency is an ongoing process, not a destination. An individual cultivates cultural humility by understanding that one can never be fully competent in a culture. They must constantly examine their own beliefs, cultures, and biases so that they can avoid imposing such onto their patients. They must also engage the patient with respect and in a curious manner in hopes to better understand the patient's culture and beliefs. This challenges the individuals assumption and stereotypes to better assist the patient. It has helped reduce the amount of microaggression and misdiagnosis taken place in healthcare and has better equipped medical care professions with the ability to repair ruptures in the provider-patient relationship.

References