The challenges of becoming culturally competent

We are all aware of the aspiration for health care services to be both respectful of and responsive to the diverse needs of patients. We are also all aware of how far short we fall of this goal on many occasions. Last week I attended an inspirational meeting of the EACH project (Embedding Community Ambassadors in Community Health), which aims to bring representatives from community groups together with health professionals to improve outcomes for both. A major part of their current work is the delivery of workshops for NHS staff by ‘ambassadors’ from minority ethnic communities, to provide information about health care needs and cultural preferences. This model both enables and empowers community group members who often feel marginalised and unheard, and offers NHS staff a brief glimpse into aspects of intercultural awareness. And it can only be a brief glimpse, which is why cultural competency is often framed as a cyclical process rather than a goal you can tick off as “achieved”.

The meeting I attended enabled workshop leaders to reflect on their experiences in the project to date, and the discussion was both hilarious and wide-ranging. Who knew that the topic of mental health care for Pakistani communities could lead to an explanation of the difficulties for UK residents trying to keep up with fashion trends in India? The take-home message was that there is so much for all of us to learn; to not be afraid of our differences; and the key role of respect for others.

Find out more:

The EACH project

The EACH Project run free workshops on cultural awareness and working with interpreters for NHS staff in the East of England: more details here. Or you can watch their You Tube promo video here.

Model of transcultural competence

There are a variety of models for cultural competency, but a commonly used approach is the Papadopoulos, Tilki and Taylor (1998) model for transcultural competence, with a cycle of four aspects:

  • Cultural awareness, beginning with an examination of our own personal beliefs and values
  • Cultural knowledge, often enhanced through meaningful contact with other communities
  • Cultural sensitivity, achieiving equal partnerships with those in your care
  • Cultural competence, synthesising and applying awareness, knowledge and sensitivity

The full book is: Papadopoulos I, Tilki M and Taylor G (1998): Transcultural Care: A guide for Health Care Professionals. Quay Books. Wilts. (ISBN 1-85642-051 5). Or you can read a brief online guide aimed at nurses.


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