How can i become culturally competent

Methods A. Table 2. Studies specifically addressing treatment harms may also include retrospective and case series designs. Systematic reviews must include risk of bias assessment with validated tools.

Time of Publication Search all literature forward. Cultural competence as a concept and concerned gained traction in the published literature during the early s. Publication type Published in peer reviewed journals, grey literature sourced from governmental or research organizations Language of Publication English B.

Data Abstraction and Data Management Studies meeting inclusion criteria will be distributed among investigators for data extraction. Assessment of Methodological Risk of Bias of Individual Studies Risk of bias of eligible studies will be assessed using instruments specific to study design. Data Synthesis We will summarize the results into evidence tables and synthesize evidence for each unique population, comparison, and outcome combination.

Table 3. Intermediate Provider Outcomes Intermediate Patient Outcomes Intermediate organizational outcomes- structural changes and availability of culturally competent healthcare across system Final Patient-Centered Outcomes- improved medical and mental health We will explore second order interactions if literature is identified allowing such examination.

Grading the Strength of Evidence SOE for Major Comparisons and Outcomes The overall strength of evidence for primary outcomes of KQ within each comparison will be evaluated based on four required domains: 1 study limitations risk of bias ; 2 directness single, direct link between intervention and outcome ; 3 consistency similarity of effect direction and size ; and 4 precision degree of certainty around an estimate.

Based on these factors, the overall strength of evidence for each outcome will be rated as: 12 High : Very confident that estimate of effect lies close to true effect. Few or no deficiencies in body of evidence, findings believed to be stable. Moderate : Moderately confidence that estimate of effect lies close to true effect. Some deficiencies in body of evidence; findings likely to be stable, but some doubt. Low : Limited confidence that estimate of effect lies close to true effect; major or numerous deficiencies in body of evidence.

Additional evidence necessary before concluding that findings are stable or that estimate of effect is close to true effect.

Insufficient : No evidence, unable to estimate an effect, or no confidence in estimate of effect. No evidence is available or the body of evidence precludes judgment.

Assessing Applicability Cultural competence intervention research by definition generally draws on defined priority populations, and very possibly specific subgroups of those priority populations.

Last Accessed May 29, Gregg J, Saha S. Losing culture on the way to competence; the use and misuse of culture in medical education. Academic Medicine. MD, MPH. Prevalence of secondary conditions among people with disabilities. American Journal of Public Health. Chapter 8: Assessing risk of bias in included studies. The Cochrane Collaboration; Viswanathan M, Berkman ND. Development of the RTI item bank on risk of bias and precision of observational studies.

Journal of Clinical Epidemiology. Using existing systematic reviews to replace de novo processes in conducting Comparative Effectiveness Reviews Agency for Healthcare Research and Quality. Rockville, MD: Review Manager RevMan [Computer program]. Version 5. PMID Methods Guide for Comparative Effectiveness Reviews. Definition of Terms Not applicable. Summary of Protocol Amendments If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale in this section.

Key Informants Key informants are the end users of research, including patients and caregivers, practicing clinicians, relevant professional and consumer organizations, purchasers of health care, and others with experience in making health care decisions. Technical Experts Technical experts constitute a multi-disciplinary group of clinical, content, and methodological experts who provide input in defining populations, interventions, comparisons, or outcomes and identify particular studies or databases to search.

Peer Reviewers Peer reviewers are invited to provide written comments on the draft report based on their clinical, content, or methodological expertise. Role of the Funder This project was funded under Contract No. Appendixes Appendix A. Prospective Outcome has not occurred at the time the study is initiated and information is collected over time to assess relationships with the outcome. Mixed Studies in which one group is studied prospectively and the other retrospectively.

Retrospective Analyzes data from past records. Yes Partially Some, but not all, criteria stated or some not clearly stated. No 3 Are baseline characteristics measured using valid and reliable measures and equivalent in both groups?

Yes No Uncertain Could not be ascertained. Yes Intervention described included adequate service details Partially Some of the above features. No None of the above features. Yes Considering patient characteristics 6 Did researchers isolate the impact from a concurrent intervention or an unintended exposure that might bias results?

Yes Accounted for concurrent informal care Partially No 7 Any attempt to balance the allocation between the groups e. Yes if yes, what was used?

No Uncertain Could not be ascertained. Who were outcome assessors? Yes Measure valid and reliable i. Partially Some of the above features partially validated scale No None of the above features self-report, scales with lower validity, reliability ; not equivalent across groups Uncertain Could not be ascertained. Yes measurement period of interest if repeated measures No Uncertain Could not be ascertained i.

Yes No Uncertain Could not be ascertained i. Yes Partially Some variables taken into account or adjustment achieved to some extent. These biases may cause us to inadvertently act in ways that are discriminatory towards others. However, if we are aware of our biases, we can work to diminish our own prejudices and the implications they may have in our interactions with others. Acknowledging that we all have biases and that we all hold stereotypes is the first step in cultural competence.

Tolerating different cultural backgrounds is a step in the right direction. However, tolerance is not always optimal. In fact, tolerance usually means that you are simply putting up with something that is undesirable. Overall, cultural competence has three important components: active listening, demonstrating empathy, and effective engagement. Each is detailed in the next section.

When was the last time you engaged in an active listening conversation with someone who has vastly different experiences and beliefs than you? You should listen for total meaning by focusing on the content that is being given and concentrating on what is being said. Active listening entails thinking about the feeling behind the content or the emotion involved.

The emotion gives evidence of the real intent of the conversation, which will help you identify if the person is upset, inquisitive, or acting on another emotion and allow you to respond appropriately. In addition to listening for total meaning, you should also avoid mental distractions when building cultural competency through active listening. This means listening with focus and not becoming involved in mental chitchat about how you are going to respond to a person or question.

For example, if you believe that homosexuality is immoral and a choice and you are in a debate with a friend on the legalization of same sex marriage, instead of engaging in mental chitchat about what scientific or biblical facts you can recite to prove your perspective, the key is focusing on what is being said and how it is being said. Lastly, once you have listened for true meaning, the other person feels understood, and you both have limited mental distractions, you will want to make sure you ask more questions of the other person than offer solutions.

Do not jump directly to giving people advice or offering solutions about what you perceive to be the problem or their problem. The response that is effective, especially if you are in a situation in which you are responsible for resolving a conflict between two people, requires seeking more information and multiple perspectives first.

The second component of cultural competency is demonstrating empathy. Take the previous example related to sexual orientation. A privilege of being heterosexual in our society is having multiple media, print images, and entertainment that portray heterosexual love and relationships and indicate it is not taboo to hug or give a peck to your girlfriend or husband while in public.

These images are not as prevalent for same-sex couples. To be effective, you must engage in appropriate inquiry and dialog. It also involves building relationships with an individual or particular cultural group. The third component of cultural competency is effective engagement. Engagement should be mutually beneficial and a reciprocal learning experience in which you learn from one another. Focus on the behaviors and the situation, not the person. Value-laden statements making the individual the target should be avoided.

If the focus of the conversation or interaction is about a tradition or belief, keep the feedback within the context of that tradition or belief. Activities may include: Reviewing how the organization's programs, policies, and practices incorporate and accommodate local values and customs. Modifying current programs or interventions to better reflect the local customs and values of those affected by the organization's actions. Redesigning proposed activities with the assistance of people from multiple cultures in order to assure their relevance and increase their effectiveness.

For each activity aimed at reaching goals at the organizational and program level, indicate: Who will complete the activity What will they do By when With what resources In communication with whom Review your organization's progress in meeting your goals for becoming culturally competent.

Evaluate the organization's level of cultural competence and make needed adjustments. Are you satisfied with the organization's progress? What adjustments might improve your success? Depending on your situation, success might look like: All citizens are engaged in decision that affect their lives. People take a stand when groups are targeted with unjust treatment.

Public policies correct inequalities in the system e. There are bridges and social ties among people from different cultures, backgrounds, and communities. What would success look like for cultural inclusiveness in your community? Assess the cultural inclusiveness of the community as a whole, if you have not already done so in your cultural audit.

What cultural groups exist in the community? How do these groups function? Consider the interaction of their leaders, their social structure, where they live, what languages they speak, their cultural "rules", their methods of decision-making, and their social, political, and religious gathering places How are particular groups seen by the rest of the community?

Is there, or has there ever been, discrimination? What's the community's history, including the history of different cultural groups in the community, their relationship with greater community, and their history with each other? Invite opinion leaders and others from all groups to join in creating a vision of inclusiveness for the whole community Purposely seek out and invite representatives of many cultural groups to join your efforts to create an inclusive community.

Many people from different cultural groups should be involved from the very beginning in order to promote equal partnership and ownership in the process. Once the group has formed, choose leaders and methods of functioning that build consensus among the members.

Who should be at the table or represented? Identify a substantive issue from which to build inclusiveness What is the most important issue in your community that affects people of all cultural backgrounds? Identify a common issue that can help bring people of different cultures together to work towards a common purpose What substantive issues may help bring people from different cultural groups together in your community? Develop a strategic plan for using that issue to build inclusiveness within a participatory process Describe long-range goals related to the creation of an inclusive community e.

Describe short-range goals e. Describe how you will assess or evaluate progress reaching those goals. Encourage group members to establish relationships outside the group. Indicate how you will do so including by: Arranging for culturally diverse groups of people to carry out specific projects together.

Regular discussions of common ground and similar concerns at public meetings. Participation in events and celebrations of different cultures. Rotating groups meetings among communities of the cultures represented in the broader community.

Establishing regular social occasions outside the group. Actively create a welcoming atmosphere for those outside the group. Describe ways your organization might encourage individual relationships among members.

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Follow the instructions in it to access your account. Relationships are a powerful part of who we are. They can help make us feel like we belong, like we have something to contribute to this world. What Is Cultural Competence? To have multicultural competence, you need: A basic understanding of your own culture. A willingness to learn about the cultural practices and worldview of others. A positive attitude toward cultural differences and a readiness to accept and respect those differences.

Why Is Cultural Competence Important? Cultural Competence Examples Cultural competence is necessary in every aspect of life—personal or professional. Here are a few examples that demonstrate its importance: Cultural Competency in Medicine Cultural competency is incredibly important in the field of medicine. The medical team was, unsurprisingly, troubled by this behavior, so they sought the advice of a nurse familiar with Vietnamese culture… Then they understood.

What appeared to be the absence of care for their child was, in fact, a difficult act of love.