The authors comment that there is a great deal of uncertainty what
constitutes diversity teaching. We would like to suggest that the aim of
this teaching should be the development of cultural competence.
Cultural competence consists of a set of behaviours and attitudes
that enable professionals to work effectively in cross-cultural
situations. [1] [2] [3] It recognises that each individual has a unique
cultural identity. This identity is a complex mix. Some of the identity is
collective, and similar to other members of the same culture (such as
Asian, Londoner or female), but some of it is specific to that individual.
No two individuals are the same but there is some degree of shared
collective culture.
Awareness of a particular culture, such as Moslem, can provide a
useful “short cut” to understanding the general values, beliefs and
behaviours of an individual but there is a danger that it can stereotype
that individual. The result is that individual needs are not identified
and met. The elucidation of the cultural beliefs of a person requires
specific communication skills.
It is important to be able to identify both the collective and
individual values and beliefs that are held by any person. This should be
the aim of any teaching to develop cultural competence, rather than
continuing with a reductionist approach that can stereotype individuals.
However, there is a greater challenge to undergraduate teaching. Wear
proposes that an important aspect of professional development is a
critical understanding of culture.[4] This understanding requires
learners to look at their biases, challenge their assumptions, know
people beyond labels, confront the effects of power and privilege, and
develop a far greater capacity for compassion and respect. Without this
appreciation, it is unlikely that healthcare will be improved.
[1] Cross TL, Bazron B, Dennis K,Isaacs M. Towards a Culturally
Competent System of Care: A Monograph on Effective Services for Minority
Children Who Are Severely Emotionally Disturbed. Georgetown University
Child Development Center: Washington DC, 1989.
[2]Lavizzo-Mourey R, Mackenzie ER. Cultural competence: essential
measurements of quality for managed care organizations. Annals of Intern
Medicine 1996; 124: 919-921.
[3] Davis K. Exploring the Intersection Between Cultural Competency
and Managed Behavioral Health Care Policy: Implications for State and
County Mental Health Agencies. National Technical Assistance Center for
State Mental Health Planning: Alexandria VA, 1997.
[4] Wear D Insurgent Multiculturalism: Rethinking How and Why We
Teach Culture in Medical Education. Academic Medicine 2003;78: 549-554.
Competing interests:
None declared
Competing interests:
No competing interests
21 February 2005
John E Sandars
Senior Lecturer in Community Based Education
Barry Ewart
Medical Education Unit The Medical School The University of Leeds
Rapid Response:
Cultural competence
The authors comment that there is a great deal of uncertainty what
constitutes diversity teaching. We would like to suggest that the aim of
this teaching should be the development of cultural competence.
Cultural competence consists of a set of behaviours and attitudes
that enable professionals to work effectively in cross-cultural
situations. [1] [2] [3] It recognises that each individual has a unique
cultural identity. This identity is a complex mix. Some of the identity is
collective, and similar to other members of the same culture (such as
Asian, Londoner or female), but some of it is specific to that individual.
No two individuals are the same but there is some degree of shared
collective culture.
Awareness of a particular culture, such as Moslem, can provide a
useful “short cut” to understanding the general values, beliefs and
behaviours of an individual but there is a danger that it can stereotype
that individual. The result is that individual needs are not identified
and met. The elucidation of the cultural beliefs of a person requires
specific communication skills.
It is important to be able to identify both the collective and
individual values and beliefs that are held by any person. This should be
the aim of any teaching to develop cultural competence, rather than
continuing with a reductionist approach that can stereotype individuals.
However, there is a greater challenge to undergraduate teaching. Wear
proposes that an important aspect of professional development is a
critical understanding of culture.[4] This understanding requires
learners to look at their biases, challenge their assumptions, know
people beyond labels, confront the effects of power and privilege, and
develop a far greater capacity for compassion and respect. Without this
appreciation, it is unlikely that healthcare will be improved.
[1] Cross TL, Bazron B, Dennis K,Isaacs M. Towards a Culturally
Competent System of Care: A Monograph on Effective Services for Minority
Children Who Are Severely Emotionally Disturbed. Georgetown University
Child Development Center: Washington DC, 1989.
[2]Lavizzo-Mourey R, Mackenzie ER. Cultural competence: essential
measurements of quality for managed care organizations. Annals of Intern
Medicine 1996; 124: 919-921.
[3] Davis K. Exploring the Intersection Between Cultural Competency
and Managed Behavioral Health Care Policy: Implications for State and
County Mental Health Agencies. National Technical Assistance Center for
State Mental Health Planning: Alexandria VA, 1997.
[4] Wear D Insurgent Multiculturalism: Rethinking How and Why We
Teach Culture in Medical Education. Academic Medicine 2003;78: 549-554.
Competing interests:
None declared
Competing interests: No competing interests