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Cultural Competency in Medical Care
Transcript of Cultural Competency in Medical Care
How illness, disease, and their causes are perceived both by the patient/consumer
The behaviors of patients/consumers who are seeking health care and their attitudes toward health care provider
The delivery of services by the provider who looks at the world through his or her own limited set of values, which can compromise access for patients from other cultures. "having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities". Competence implies ... Culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups Competency in Medical Practice Assessing Students in Cross-Cultural Education Models of Effective Cross-Cultural Communication and Negotiation CLAS: Culturally and Linguistically Appropriate Practices
-OMH, 2001 Case Studies A Native American Patient With Diabetes and Amputation Refuses Treatment: She believes that entering the hospital will kill her, and opts for traditional therapies. Her family physician desperately wants to work with the patient to manage her diabetes better. But how? #1 Cultural Fact Some American Indian cultures, the Navajo for example, believe that mentioning an illness will cause the illness. A Hispanic teenage male overdoses on his prescription anti-depressant, which the nurse staff thinks is suicide and the doctor believes was the result of a misunderstanding of dosage instructions because of a language barrier. What implications does this have? Cultural Fact Compared with White or African American students, Hispanic students are more likely to have considered suicide, made a suicide plan, and attempted suicide. #2 Competent Education Models Is this Working? Difference Between Cultural Assumption and Awareness Cultural Humility requires physicians to engage in self-reflection and self critique as lifelong learners and practitioners. It calls for “trainees to identify and examine their own patterns of unintentional and intentional racism, classism, and homophobia…"(120). Culture Vision Cultural Humility U.S. Medicine Focuses on Individual Lifestyle Choices Components of Clinical Culture unhealthy behaviors such as excessive food consumption and lack of exercise, create major risks rather than life conditions such as economic inequality Emphasis in Education on Observable Skills Mastery easily demonstrable mastery of a finite body of knowledge, an endpoint evidenced largely by comparative quantitative assessments Two Relevant "There is...a detectable 'Americanness' in the optimistic belief in medical science and technology, in their limitless progress and promise, their vigorous application, and their power to 'overcome' disease, that pervades our society and is pronounced in medical training"
Renee C. Fox "…it is important to train clinicians to unpack the formative effect that the culture of biomedicine and institutions has on the most routine clinical practices—including bias, inappropriate and excessive use of advanced technology interventions, and…stereotyping".
-Arthur Klienman Critically Examining Clinical Culture Questions and Possible Alternatives?