Feel The Calm Of The Boat

Paddle with Me
This lesson introduces the concept of cultural competency. In Western medicine, this term has been a buzzword for years. Culturally competency is defined as demonstrating knowledge and sensitivity to a population’s culture. The importance of cultural competency has been acknowledged by the highest levels of health care in the United States (US), as the National Institutes of Health (NIH) recognizes that “cultural competency is critical to reducing health disparities [including chronic diseases] and improving access to high quality health care, health care that is respectful of and responsive to the needs of diverse patients.” (1)

Since the early 1990’s, cultural competency has become a major requirement in quality healthcare. Although cultural competency has evolved to a much more complex concept, it continues to be practitioner-focused; it is the behavior and skills of the practitioner that determines whether the practitioner is competent to work with diverse populations. In the required video, Cultural Competency is shown to be a continuum. The videos describes each stage leading up to “Cultural Proficiency”. Think about what stage you might be at right now.

The Georgetown document gives a summary on the concepts of cultural competency. The US National Center for Cultural Competency is at Georgetown University. I don’t reference this resource very much, frankly, because it does not seem to be relevant to the populations we are studying in the Pacific region. Nonetheless, it offers valuable information and you need to be aware of it as a reference.

The Goody article discusses the Campinha-Bacote model for cultural competency (remember we were introduced to this model earlier, in Module 1, Lesson 2?) Please give this article a good read. It specifically addresses how this model can aid in the understanding of food habits and help you when looking at nutrition-related health problems. It gives good examples of what kinds of questions to ask when trying to assess a nutrition-related problems.

The Purnell model article shares a circular model of cultural competence with 12 domains – one domain is Nutrition. Pay attention to the assumptions made for the Purnell model. What do you think about that?

References:

1. Saha S, Beach MC, Cooper LA. (2008) Patient Centeredness, Cultural Competence and Healthcare Quality. Journal of the National Medical Association. 100(11):1275–1285

A Paddler’s Perspective
The resources in this lesson discuss models of cultural competency. You will hear the term “cultural competency” a lot in Western medicine. It was created as a response to the growing health disparities in minority groups in the United States. What I hope to teach you in this course is to think about the following question..  What seems to be missing in cultural competency? What is lacking in the concepts of cultural competency? How is this competency measured?

I remember working in healthcare when cultural competency became a mandated skill for all healthcare workers. I was working in a local hospital in Hawai‘i, managing 5 dietitians and about 45 other staff in our Nutrition Services Department. We all had to review this “Cultural Competency” binder and take the respective quizzes. Our quiz results were filed into our human resource files as proof that we were “culturally competent” to work. When The Joint Commission or local Department of Health came to review our records, we had to show this proof. I remember thinking how silly this was… there was a chapter on “Caucasian”, and “Japanese”, and “Samoan”, etc. Each chapter had its own quiz. I remember being offended at some of the content in the Caucasian chapter and wondered if any of my colleagues had similar experiences. My nurse friend, Millie, in the telemetry unit is a good example. She spoke Filipino (not sure what dialect) and had the thickest accent ever! She didn’t have an ounce of Filipino blood in her, she was 100% Chinese and raised by a Filipino family. Millie ate Filipino food, married a wonderful Filipino man and had many Filipino friends. What chapter did SHE fit into? How can you put “cultures” into separate chapters? Are we just ONE culture? I hope, by now, you’re seeing my point.