Is cultural competence the right term?

Is cultural competence the right term?

Culturally competent care is when a provider mindfully factors in identity considerations during patient interactions. These skills are essential for delivering the right care—especially for historically underserved communities. For anyone who has experienced discrimination in a health care setting because of their identity, finding a provider who treats them with empathy and respect can lead to better outcomes.

In order to standardize inclusive, identity-centered care delivery in providers, Violet has reimagined cultural competence as a skill that can be measured and improved over time. But it wasn’t always the case that cultural competence was considered a reliable skill and proficiency measurement.

What is the debate surrounding cultural competence?

There’s a debate in the academic community about the term cultural competence. On one hand, cultural competence in health care is an aspirational goal for providers to better understand and consider identities, experiences, and cultures when caring for patients. And on the other hand, a provider can never become “competent” in another culture–some argue that striving for competence is an oversimplification of diverse communities.

In the 1960s and 70s, cultural competence was developed as a framework for clinicians to be more attuned to the needs of culturally diverse patients. Other industries adopted the term to prioritize cultural awareness in order to boost the quality and value of services for diverse people. Cultural competence was critiqued for turning diverse cultures into a monolith that can be learned like a skill.

In the 1990s, a new method was coined to counter these issues: cultural humility. Cultural humility is an approach that involves recognizing one's own limitations and biases while being open to learning from others with different backgrounds and experiences. In contrast, cultural competence is a skill-based approach that focuses on acquiring knowledge and skills to effectively work with people from diverse backgrounds. Cultural humility involves listening and learning from others without assuming superiority, being curious about different cultures, and acknowledging the limitations of one's own knowledge and experiences.

“Cultural competence” has been expanded to include more nuance since its first conception.

The Culturally Competent Community Care (CCCC) Model, developed by Kim-Godwin and colleagues in 2001, is a framework for providing health care services to individuals from diverse cultural backgrounds. The model emphasizes the importance of understanding the cultural beliefs, values, and practices of patients and their communities in order to provide effective care. The CCCC model consists of five key components: cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire. These components are interrelated and must be integrated into health care practices in order to promote cultural competence.

The 3-Dimensional Puzzle Piece Model of Culturally Congruent Care, developed by Schim and colleagues in 2007, is a framework for providing culturally sensitive care to patients. The model emphasizes the importance of three dimensions of care: cultural awareness, cultural knowledge, and cultural skill. The model highlights the need for health care providers to recognize their own biases and attitudes towards patients from diverse cultural backgrounds, and to develop skills that enable them to communicate effectively and respectfully with patients from different cultural groups.

The Process of Cultural Competence in Delivery of Healthcare Services, developed by Campinha-Bacote in 2002, is a five-stage model for achieving cultural competence in health care delivery. The stages are: cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. The model emphasizes the need for health care providers to engage in ongoing self-reflection and learning in order to become culturally competent practitioners. The model highlights the importance of building relationships with patients from diverse cultural backgrounds and of recognizing and respecting the unique cultural practices and beliefs of these patients.

Overall, all three models highlight the importance of understanding and respecting the cultural beliefs and practices of patients in order to provide effective health care services. The models provide useful frameworks for health care providers to develop the skills and knowledge necessary to deliver culturally sensitive care. However, it is important to note that cultural competence is an ongoing process that requires ongoing education, self-reflection, and practice, and that no one model can fully capture the complexity of cultural competence in health care delivery.

However, there needs to be a standard of cultural competence. Because it is an effective intervention to ameliorate discrimination, racism, transphobia, and other biases in health care. With this standardization comes accountability and quality assurance when patients expect culturally competent care from any provider, not just providers with lived experience.

A new standard of culturally competent care.

Violet has reclaimed cultural competence as a clinical skill that merges humility, empathy, nuance, and quality assurance to improve care delivery and outcomes. Violet has created a standardization of cultural competence, called Violet Benchmarks, that powers the first-ever infrastructure for inclusive care. Violet Benchmarks quantify work experience, lived experience, education, and other metrics to assess the cultural competence of clinicians. This data powers interventions, from upskilling via personalized educational pathways to care matching, to make it easier for patients to find the right providers.

Because of Violet, cultural competence is no longer a niche specialty sustained by a small group of BIPOC and LGBTQIA+ doctors serving an outsized population of diverse patients. Now, every provider can receive objective Violet Benchmarks from their employer that indicate cultural competence. Instead of sifting through a small number of diverse providers or clinician profiles that simply claim “gender-affirming” or “interested in BIPOC,” patients can find more providers verified by Violet. For example, a patient who is looking to include non-allopathic healing practices in their treatment can find a provider who respects their cultural traditions, thanks to Violet.

While cultural competence can help bring about positive changes, it shouldn’t be viewed as a single endpoint. Providers must practice cultural humility—ongoing self-reflection, active listening, and a mindset of continuous learning. Violet makes this possible through benchmarks, continuing education, and more.

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