Cultural Competence: The Ultimate Guide to Cultural Proficiency

How do cultural knowledge, cultural proficiency, and cultural competence training improve Diversity and inclusion?

In the world, there are thousands of different cultures that encompass how different people from all around the planet live and view life. It is important to be culturally competent, but what does that mean? How can it help us to improve cultural diversity in the workplace and improve social cohesion?

What Is Cultural Competence?

Before knowing what cultural competence really is all about, it is best if you fully know and grasp the concept of culture. To briefly describe the word culture, it is the distinct set of values, principles, norms, beliefs, and traditions that influence how individuals from a specific region or place think, perceive, behave, interpret, and decide on their judgments regarding their world.

In a nutshell, cultural competence is one’s ability to fully understand, converse with, and efficiently interact with different people with all sorts of cultural backgrounds. Cultural competence is more than just being respectful of other cultures, nor does it mean that a person is just aware of the customs and traditions of specific cultures.

Cultural competence has four aspects that correlate with each other, namely: awareness of one’s own view of the cultural world, attitude on differences between cultures, cultural knowledge acquired on various cultural beliefs, views, and practices, and lastly, the skills between different cultures and their interrelationships.

Being culturally competent requires not only becoming culturally aware and knowledged. It also requires the ability to identify, challenge specifically, and accept a person’s cultural beliefs, assumptions, and principles, as well as to commit in communicating at the expense of their cultural interface.

Cultural Competence Continuum

The cultural competence continuum is composed of 6 stages that an individual undergoes to reach cultural proficiency. This model helps an individual to understand further the phases that are normally milestones for someone to be culturally competent. 

Cultural Destructiveness

This phase defined by the policies, attitudes, practices, and structures that are parts of a system, an organization, or an indigenous group of people, otherwise known as tribe or community, that are particularly destructive and harmful to a certain cultural group. This is actually the most negative portion of the cultural competence continuum.

For example, forced assimilation is a type of involuntary procedure of cultural assimilation of ethnic or religious minority groups. During this process, the people are forced to learn, understand, and adopt specific languages, norms, beliefs, values, traditions, identity, customs, perceptions, and most of the time, religion and ideology of an already existing community.

Forced assimilation takes place whenever a state places extreme measures for the emphasis of a homogenous identity as a whole nation. This will result in the harsh measures of exterminating an already existing minority group with their own set of values, norms, practices. Basically, they have a different culture from the whole nation.

But because of the strict implementation of the government, they are forced to abandon their beliefs, customs, values, principles, practices, way of thinking, and norms. The worst ending for these minority groups is physical elimination – they are expelled, and sometimes genocide takes place to get rid of the whole minority.

Cultural Incapacity

This phase is where the system or the people in a regional culture are very biased. They do not have the capacity to effectively respond to the needs, preferences, interests, and traditions of a large group with different cultural beliefs.

In this category, there is a stereotype – they believe in the superiority of a culture with a larger scope, which leads to the disempowerment of other smaller ethnic groups with their very own set of cultural attributes.

For example, racism is still rampant in the 21st Century. It is a particular belief or ideology that instils the thought of a specific racial group being superior to another race. Racism is when a specific group of people with similar race are marginalized and oppressed based on their racial culture.

In the 21st century, this is exemplified by stereotyping a specific race, an unfair process of hiring based on a person’s ethical race, and other discriminatory acts that stop a person from having equal opportunities as a person who belongs to a dominant race.

Cultural Blindness

Cultural blindness is the phase where the system, the organization, or the government treats all cultures as if they are one. They start treating and viewing people equally, when, in fact, these people have different sets of beliefs and traditions that might contradict each other.

Usually, the dominant culture has an advantage because their culture is considered as the basis for how all cultures will be treated. The “lesser” ethnical groups are forced to follow the culture of the dominant group.

Cultural blindness is a system that is often classified by the ignorance as well as the unrealistic fear and worry of people who do not belong to the dominant group. This is because the only needs that are met by the system are the needs of the dominant culture.

For example, when it comes to religion, if you serve different people from different religions with pork, a lot would not be able to eat it. But because Christianity is used as the basis by the system, the needs of people from other religions such as Islam and Judaism are not met.

Cultural Pre-Competence

This phase is where the system, the organization, or the government starts to realize what their strengths are. This phase also allows them to see the areas where they need to improve on so that they can effectively respond and accommodate the needs of a diverse group of people coming from different cultural backgrounds.

During this, the government becomes more committed to providing the needs and support that all minority groups ought to seek. However, there is still a lack of information about maximizing the capacities that the government has to provide the best experience for all cultures within the nation.

The downside of this stage is that it has the capacity to lead to tokenism. Tokenism is when a group only makes a symbolic or perfunctory effort to say that they have already done their part. For example, tokenism is when a company only hires some people of color to look as if they are diverse in their hiring process.

Cultural Competence

During this phase is where the whole system accepts and respects the different cultures within their group. With this, they continue to assess themselves and further improve their services for all the people within their sector who are from various cultural ethnicities.

They start to provide a more satisfactory programs and events that can cater to different cultures, and this is because they finally understand these groups on a deeper and more effective level.

Cultural Proficiency

Finally, cultural proficiency has been reached. During this phase, the different cultures within a group or a nation are held with high esteem, and they are effectively taken good care of by the system, the organization, or the government.

Cultural Competency in Practice

There are a lot of places where cultural competence takes place. Here are some examples where this is practised.

For example, the workplace is an environment filled with people from different cultural backgrounds. So a company needs to have leaders and employees who can respect each others’ traditions, beliefs, values, and norms.

A detailed example of cultural competence within the workplace is when colleagues understand how each others’ tradition is important for one another. Like when a particular workmate is very punctual, the people within the workplace will provide them with a nice attendance during meetings.

In school, there are a lot of kids who have different upbringing. Because of their different cultures, the school cafeteria often provides more than just one type of meat or fish for their lunch.

The Purnell Model Focusing On Cultural Competence

The Purnell Model assumes that different individuals from various families are part of several cultural tribes or groups, commonly referred to as subcultures. It states that every single individual has their own right to be understood and respected for his or her distinct and unique difference and cultural heritage.

Usually, caregivers such as nurses and doctors can assess, curate a plan, and intervene using a culturally competent way of technique can improve and enhance the care given to clients and patients within their scope of care.

In this model, people are more inclined to understand any culture – study and examine it using a conceptual framework that will aid in a better understanding of these cultures. Purnell Model contains 12 aspects, otherwise known as domains of all cultures that most health care providers must take into consideration.

But before diving into the 12 domains, it is important to understand the following:

All cultures share some special similarities.

There are also differences within, among, and between these cultures.

Cultures have the capacity of changing as time passes by, but this occurs slowly.

Culture has the power to influence an individual’s interpretations, judgments, and response to healthcare.

Here are Purnell’s 12 Domains that encompass how cultural competence affects a caregiver’s professional performance.

Overview and Heritage

These are the cultural traits that are passed down from one generation to another. These are inherited beliefs, customs, norms, principles, traditions, and attributes that encompass a specific group. It consists of a group’s culture that gives them their own sense of identity and individuality.

Communication

This concept is related to a group’s dominant dialect and languages. These help a group become more understanding of each other. Other than languages, gestures are also a huge part of a group’s culture. For example, Filipinos often use their mouth when they point to something.

Family Roles and Organization

A culture has its own family dynamic with the appropriate distribution of power. Most cultures consider men to be the head of the household while women are considered to be the ones who are responsible for maintaining a lovely and livable home.

Workforce Issues

This domain is related to the assimilation, acculturation, autonomy, gender roles, way of communication, ethnic style of communication, as well as health care practices from where the group originates from.

Bicultural Ecology

This part contains the variations between people with different racial and ethnic origins in the likes of skin coloration as well as physical differences in the way that their bodies are built.

High-Risk Behaviors

High-risk behaviors are the use of tobacco, the intake of alcohol, and the use of recreational drugs. Others include an individual’s lack of physical exercise and a relatively high-risk practice of sexual activities.

Nutrition

Inclusions are adequate food intake, appropriate and healthy food choices, rituals before, during, and after a meal, as well as how food and its substances are used whenever medical interventions are done.

Pregnancy, Childbearing, and Birth-Giving

This portion contains the practices of each culture to induce fertility, their specific birth control methods, views and judgment on pregnancy, as well as other practices related to having a child.

Death Rituals

These rituals are done when a member of the group passes away.

Spirituality

Religious practices, behaviors, and prayers that take part and give meaning to the group’s life and the people’s sources of strength and will to live are all parts of this domain.

Healthcare Practices

This is the group’s focus on healthcare practices. This is classified into two: prevention and cure. The barriers in healthcare, together with the person’s response to noxious stimuli, pain, are both encompassed within this domain.

Healthcare Practitioner

This concept pertains to the usage, status, and the point of view of the traditional and allopathic medical healthcare practitioners within the area. In some cultures, the gender of the medical physician might also have a significant effect on the manner of healthcare that is provided.

Cultural Competence Training

This is a specific set of instructions given to healthcare providers who need to achieve a level of cultural competence. On top of that, the ability to have a deeper understanding, appreciation, and interpretation of other cultures in the most accurate manner possible are also key points of the training.

Because of a world that is continuously becoming more globalized as time passes by, medical healthcare professionals need to have a decent competence when it comes to various cultural backgrounds. This will help them identify and curate the most accurate treatment plan for their patients, especially those with a more demanding and detailed set of beliefs.

For example, a certain culture from Jehovah’s Witnesses denotes that they cannot accept any form of blood transfusion because it is against the will of God to receive blood from other people and even their own blood.

This has to be known by the doctors and nurses assigned to that specific patient’s case because if they miss this, the patient can be expelled and ostracized from their religion.

Fortunately, most state legislation requires medical practitioners to undergo cultural and linguistic competence training before being given a chance to perform their duties.

Cultural Competence In Different Fields

Various fields need to be culturally competent because nowadays, there are a lot of different places and professional institutions that contain more than just one cultural background. With the rapid takeover of globalization in the economy, we are now, more than ever, required to be culturally competent in our fields.

Cultural Competence In Education

Cultural competence is best taught during a child’s growing years. The best venue for this is through school, where children learn different things that will be beneficial for their future. This has to start with how their professors treat everybody in the class as well as their workmates because children only mimic what they see adults do.

They can also incorporate the following guide:

R – Recognize your very own ideas, biases, stereotypes, and appreciation of different cultures that are not your own

A – Acknowledge or admit the fact that there are solid differences in how people are treated based on their appearance and their cultural background

C – Commitment is a huge part of the necessary change that we seek. It is important to commit to spreading the news that cultural competence is in and discrimination is out.

E – Educate yourself and the people around you regarding the cultural differences and similarities between yours and other people’s so that you can have a deeper understanding.

Because a lot of classrooms host a diverse variety of students, children will have an easier time accepting each other, especially when they are taught at a very young age.

Cultural Competence In Social Work

Cultural competence is greatly required when it comes to social work. It requires social workers to personally examine and study their very own cultural backgrounds, individualities, and identities. This is done because it increases the awareness of personal values, stereotypes, assumptions, and biases.

By being culturally competent, it allows them to have and develop a deeper and more meaningful relationship with their clients. This is important in their field because they deal with a lot of people from different cultural backgrounds. It will greatly help and make their jobs easier if they are competent in terms of the culture and upbringing of their client.

Cultural Competence In Healthcare

In healthcare, cultural competence mainly refers to a medical professional’s ability to provide the appropriate care to patients with different cultures that require a special mode of treatment. These values, behaviors, principles, beliefs, and traditions have huge impacts on how the course of treatment will push through and take place.

Someone who is culturally competent in the healthcare industry means that he or she is capable of interacting and associating themselves with behaviors, policies, and attitudes in cross-cultural situations.

Some of the things that a healthcare system may improve upon are the following:

  • Collect data regarding race, ethnicity, and language preference (REAL)
  • Identify, report, and study the disparities within the system.
  • Provide and explore culturally, linguistically, and medically competent care for patients.
  • Develop and innovate some culturally competent programs for the management of diseases.
  • Increase and generate better diversity and minority within the workforce of the healthcare system
  • Make your community more involved by encouraging them.
  • Prioritize cultural competency within the institution.

Cultural Competence In Nursing

By being a culturally competent nurse helps in aiding an improvement, development, and growth of the institution as well as the connection that you have with your patient. Because nursing is a profession that often requires a person to be versatile, it is a requirement to become competent culturally.

Culturally competent care provision in nursing centers around the following aspects:

  • A better understanding and knowledge about the relationship between patients and nurses
  • Gaining knowledge and fascination of different cultural traditions, practices, and world views
  • To develop great communication skills that will enable the promotion and achievement of a solid interaction among different sets of cultures.
  • Encouraging a positive attitude that is often displayed and centered on differences and different cultures

In nursing, it is important that a nurse is culturally aware, knowledgeable, skilled, encountered, and desired. These five building blocks will yield a culturally competent nurse in a short period of time.

Lastly, cultural competency is extremely essential in the nursing profession because it helps nurses in providing a better quality of service for their patients. This will ultimately lead to a high satisfaction rate, as well as better care for the patient.

Difference Between Cultural Competence and Cultural Humility

Basically, cultural humility is a person’s capability of having a civil and interpersonal stance with the culture of other people. On the other hand, cultural competence aids in the effective interaction of a person with people who have different cultures.

Cultural Humility vs Cultural Comptency

Cultural Humility is the lifelong process of reflection within the self as well as self-critiquing. During these, the individual starts to learn about the cultural heritage and traditions of other groups as well as starting an examination about his or her personal set of beliefs and identities as a culture.

Cultural Competency can be referred to as a tool that can level the extremely imbalanced dynamic between a patient and a healthcare provider. It encompasses all the things that are needed to effectively communicate and provide the needs of the patient without compromising their cultural beliefs and traditions.

Cultural Competence References and Resources

  • De Guzman, M. R., et al. 2016. Cultural Competence: An Important Skill Set for the 21st Century.
  • 2017. What Does It Mean To Be Culturally Competent? www.makeitourbusiness.ca
  • Purnell, L. 2002. The Purnell Model For Cultural Competence. Journal of Transcultural Nursing. 13(3), 193-197.
  • Murphy, K. 2011. The Importance of Cultural Competence. www.journals.lww.com
  • The Chicago School. 2020. The Importance of Cultural Competence In Nursing. www.thechicagoschool.edu
  • Farmer, G. 2020. How Schools and Teachers Can Get Better at Cultural Competence. www.educationnext.org
  • Surfin, Julia. 2019. 3 Things to Know: Cultural Humility
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About the author

Jess Man

Jessica is the Editor-in-Chief and Senior Diversity Advisor at Diversity Social. Jessica has over 10 years of working with and advising employers to be more diverse and create an inclusive working environment.
Jessica's experience spans private and non-profit sectors in multiple industries.
Jessica's expertise experience is beyond Diversity & Inclusion, she is also a certified professional IT recruiter in Data & Analytics, Database administration, Artificial Intelligence area.

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