Concept Analysis on Cultural Humility

The dramatic and exponential demographic shift in the United States is more apparent in the public schools than anywhere else, further magnifying the importance of addressing and acknowledging racial and ethnic disparities in education. The increase in racial and ethnically diverse learners requires that teachers engage in Cultural Humility; a dynamic and lifelong process focusing on self-reflection and personal critique (Tervalon and Murray-Garcia, 1998), as opposed to Cultural Competence which typically suggests an end to learning or the ability to be fully proficient. Cultural Humility provides strategies and skills required to support racially and ethnically diverse students by affirming their personal identity, dignity, and cultural wealth, through instruction, and culturally responsive classroom management. Thus facilitating an inclusive, engaging, and equitable learning environment, where few behavioral problems and tensions arise (Gay, 2013). Using a pretest-posttest design across two cohorts, this study examined the effects of the Write on Race intervention on cultural competence and humility, school climate, sense of belonging and student-teacher relationship for pre-service teachers when embedded in their teacher preparation curriculum. Findings are discussed, along with implications and future directions for educators and teacher preparation programs regarding training teachers to effectively serve diverse learners.

Purpose This study aims to explore Kuwait University instructors’ perceptions and practices regarding cultural humility, student interaction, professional development and diversity, and the challenges they faced in fostering an inclusive educational environment. Design/methodology/approach Qualitative interview-based data were collected from a diverse group of 11 instructors at Kuwait University. Thematic analysis was conducted to identify key themes and patterns in the participants’ responses, focusing on their experiences and insights related to classroom cultural dynamics. Findings The importance of cultural humility in promoting student engagement and a supportive educational atmosphere was strongly recognised. Respectful dialogue and the integration of diverse perspectives were emphasised. Significant challenges to cultural humility application included societal pressures, a lack of resources and limited professional development opportunities. Instructors showed varying engagement levels with cultural humility. Research limitations/implications The small sample size and self-reported data used may have introduced biases. This study was conducted within a single university, limiting finding generalisability to other educational settings. Practical implications This study recommends Kuwait University to enhance its cultural humility training programme and provide resources to promote inclusive classroom environments. Encouraging cultural exchange and collaboration among faculty members can enrich students’ educational experiences. Originality/value This study contributes to the limited literature on cultural humility in higher education in the Middle East. By highlighting instructors’ perceptions and practices, this study provides valuable insights for policymakers and educational leaders aiming to promote inclusivity and diversity in universities.

Health professions educators often utilize cultural competency and cultural humility constructs in health professions pedagogy. In 2018, Campinha-Bacote introduced the Process of Cultural Competemility in the Delivery of Healthcare Services model an amalgam of both cultural competency and humility to support health professionals' meaningful and impactful relationships with patients and institutions to advance the delivery of quality and equitable care. There is minimal research exploring cultural competemility in educational settings as a relatively new concept. This qualitative hermeneutic, interpretative phenomenological study aims to expand this knowledge by investigating faculty's lived experience facilitating diverse students, who are interested in health professions, using cultural competemility constructs in educational settings. Ten health professions faculty members were interviewed utilizing probing questions to uncover how they engage diverse students in the classroom. Campinha-Bacote's Process of Cultural Competemility in the Delivery of Healthcare Services model served as an interpretative conceptual framework. The study participants reconfirmed the appeal to expand culturally responsive practices beyond cultural competency alone. Additionally, the research study revealed that although the participating faculty may not have priorly known the five components of cultural competency (cultural awareness, cultural knowledge, cultural skill, cultural desire, and cultural encounters), these components were instinctively executed as evidenced by their responses. The study participants reconfirmed how cultural humility pervades cultural competency and its five components. Recommendations derived from study findings entail possible implications to teaching practice and research in relation to faculty and student relations as well as culturally responsive learning environments in health professions education.

Reviewed by: Beginning Medical Spanish: Oral Proficiency and Cultural Humility by Parizad T. Dejbord Sawan Karol Hardin Dejbord Sawan, Parizad T. Beginning Medical Spanish: Oral Proficiency and Cultural Humility. Routledge, 2020. Pp. 207. ISBN 978-0-36732-243-4. The well-documented need for Spanish in healthcare professions has resulted in a variety of textbooks and products; therefore, it would be easy to discount Beginning Medical Spanish: Oral Proficiency and Cultural Humility as just another elementary text. Instead, from seven years of experience teaching Spanish at Akron Children’s Hospital in Ohio, the author presents [End Page 138] conversational Spanish for the substantial niche audience of medical professionals already in the workplace. Created for healthcare personnel with little or no prior Spanish knowledge, the book has two stated foci: oral proficiency and cultural humility. The author promises goals that realistically can be met from a beginning textbook, yet it fills an important gap in existing materials. The text offers content for a specific audience and an orientation to authentic oral communication. The book also includes the commendable goal of cultural humility (cultural sensitivity and awareness of personal bias), rather than cultural competence (“mastering” knowledge about a culture). A significant degree of cultural information is integrated throughout the text, revealing informative and relevant research. Whereas many texts center around terminology, this book emphasizes conversation with patients in order to create rapport. The author has used the text activities and has experience with beginning students in a medical setting. The methodology statement in the introduction is well articulated, and every chapter includes learning outcomes in a logical sequence with a reasonable amount of information for a full-time employee (or even a pre-health undergraduate student). Designed around the format of a two-day per week meeting of 1.5 hours for a three-semester sequence, the book utilizes scaffolding to gradually increase the degree of complexity while also appropriately recycling previously introduced material. Both learners and experienced instructors will find the book’s layout to be simple and easily accessible. Icons are incorporated for a variety of activities, such as audio recordings (available on the textbook website), guided oral practice, role-plays, short conversations, brief grammar explanations, written homework, and cultural material. Activities appear geared toward active communication, and grammar is introduced within a communicative context. For example, subject-adjective order is presented when talking about a favorite season, thereby providing some small talk that can be used with patients. The author also highlights frequent issues for second-language students of Spanish in logical contexts in the book (e.g., specific false cognates, the collective noun familia, and different ways of giving commands). For the most part, vocabulary pertains to US Spanish-speaking patients, even incorporating the occasional US regionalism such as rastrillar las hojas en su yarda (118). The book is divided into twelve chapters (four chapters per semester). The text begins with an emphasis on greetings and leave-takings, something all hospital personnel regularly need to perform in order to establish rapport with patients. Chapter 1 also introduces the verb llamarse, names, titles, and the cultural value of respeto. Chapter 2 includes familial terms, grammatical gender and number, and the role of familismo, contributing to an early emphasis on making connections with patients. Chapter 3 centers on the hospital, including descriptions of people and locations, as well as ser and haber. Chapter 4 introduces estar and numbers in the context of providing directions. The chapter is visually well organized with a useful incorporation of English cognates. Although not included, instructors could augment the chapter, if desired, with additional adjectives relating to a specifically medical context, such as enfermo, mareado, cansado, débil, or decaído. Chapter 5 presents a thorough introduction to dates, time, and the present tense. The role-plays involving making appointments and describing weekly schedules are interactive, controlled, and authentic. At times, last names in activities seem more Peninsular than Latin American, but that is a minor criticism that does not diminish the activities themselves. Chapter 6 offers practice completing hospital forms and requesting patient information, again directed towards establishing rapport. Chapter 7 incorporates stem-changing verbs in the context of describing personal activities and the...

Cancer outcome disparities exist among Black, Indigenous, and people of color despite advancements in screening, detection, and treatment. In addition to racial and ethnic diversity, the U.S. population is experiencing shifts in sociodemographics, including a growing aging population, sex and gender identities, spiritual and religious belief systems, and divides between high- and low-income households. This article provides a foundation for cultural humility as a clinical competency in nursing to improve the quality of cancer care. CINAHL®, PubMed®, Google Scholar, and grey literature were searched using keywords, including cultural humility, cultural competence, nursing, nursing pipeline, nursing workforce, and health. Retraining and retooling the nursing workforce promotes multiculturalism in oncology care and increases opportunities to provide more appropriate, patient-centered care to those living with cancer. Increasing the diversity of nursing faculty and staff, enhancing nursing curricula and education, and creating equitable relationships to support patient-centered care are initiatives to ensure high-quality care.

Background: Cultural competency is becoming an increasingly important concept in evaluation. The developing discussions tend to revolve around how to become culturally competent, why it is important, and how to know when it is attained. More problematically, cultural competency seems bound by dimensions of race, even though culture represents a broader scope of characteristics. Purpose: We review the current usage of cultural competence to point out its limitations and we suggest alternative ideas that can better facilitate communication about this essential topic. We look beyond the evaluation field to learn how cultural competence is handled in other disciplines. Particularly seeking to support communication between evaluation clients and evaluators, we offer strategies to engage in a dialogue about cultural issues. Setting: Not applicable. Intervention: Not applicable. Research Design: Analytic essay. Data Collection and Analysis: Not applicable. Findings: Cultural competence, as a term, is inherently limiting in its connotations, implications, and ability to bring about change. Cultural humility may be a more appropriate term. Regardless of the semantics, the basic need to communicate about the topic remains. Asking for cultural competency, or humility, as we suggest, in Requests for Proposals may be one way to start the conversation. Positioning statements and focused interview questions also may serve to generate discussion between client and evaluator. Keywords: cultural competence, cultural humility, evaluator competence, diversity, client communication

Cultural competency has proven less effective than its proponents had envisioned. Disciplines outside of the law (social work, health and psychology) have turned to the more powerful theory of ‘cultural humility’ – a framework for lifelong learning and self-reflection. Cultural humility contends that one can never really ‘master’ another’s culture, but that we ought to remain respectful and reflective in our approach. In this article I make the case for teaching cultural humility in Australian law schools.

Cultural competence training has been criticized for reinforcing existing stereotypes, ignoring intersectionality and inadvertently marginalizing some individuals and groups. In contrast, cultural humility offers the possibility of transformational learning, requiring individuals to pursue a lifelong course of self-examination. This approach makes authentic engagement with others possible. We review the premises underlying cultural competence and cultural humility, as well as proposed models for the integration of cultural humility into the clinical context. We propose a new model for the integration of cultural humility into clinical research: CARE, signifying Curiosity, Attentiveness, Respect and Responsiveness, and Embodiment. We conclude that the concept of cultural humility can be integrated into the conduct of clinical research.

Cultural competence and cultural humility have been topics in conversations for many years in multiple industries. Indeed, attempts have been made and continue to be made to address cultural ineptness and unawareness. Of particular concern are the attitudes and behaviors exhibited by health care practitioners. More specifically, the author will discuss the importance of cultivating cultural humility among occupational therapy educators, students, and practitioners through modeling and experiential learning strategies. This article is designed to help occupational therapy educators, professionals, and students to increase their awareness about the need for and benefit of cultural humility in education and practice. The discussion centers on the use of cultural humility concepts in occupational therapy along with the incorporation of modeling and experiential learning strategies. The profession of occupational therapy has an ethical responsibility to ensure that diverse individuals and groups are treated without bias.

Cultural humility is a framework developed in the biomedical field to train and guide clinicians to provide equitable and high‐quality care to increasingly diverse patient populations. Cultural humility builds upon the related concept of cultural competency, which has a greater emphasis on obtaining knowledge and skill sets relevant to cross‐cultural care. Instead, cultural humility emphasizes lifelong learning and self‐reflection without a finite end point, patient‐focused interviewing, community‐based care and advocacy, and institutional humility. Since the coining of cultural humility, its application in multiple health fields and with multiple patient populations has been explored. In addition, culturally humble communication strategies have been developed. However, there is still need for further examination of the applications of cultural humility, the impact of cultural humility on clinical practice, and the development of cultural humility training curricula. In addition, cultural humility has been understudied in the field of health communication and more work is needed to examine the relationship between cultural humility and other existing health communication concepts.

Лайсан Музиповна Мухарямова – д.полит.н, профессор, заведующая кафедрой истории, философии и социологии, Казанский государственный медицинский университет. Казань, Россия. Электронная почта: l.mukharyamova@yandex.ru
 Ирина Борисовна Кузнецова– к. с.н., доцент, cтарший научный сотрудник, Школа географии, Земли и наук об окружающей среде, Университет Бирмингема, Бирмингем, Соединенное королевство, доцент кафедры истории, философии и социологии, Казанский государственный медицинский университет. Электронная почта: i.kuznetsova@bham.ac.uk
 DOI: 10.17323/727-0634-2017-15-4-651-659
 Статья представляет собой обзор современных западных подходов к пониманию справедливости в отношении здоровья, обозначая основные дискуссионные моменты. Вслед за Уиллом Кимликой в академических дискуссиях о справедливости выделяются проблемы ответственности и равенства. Вопросы о соотношении между индивидуальной ответственностью и социальными факторами являются фундаментальными для всех современных теорий справедливости в отношении здоровья. Равенство может пониматься как экономическое равенство, как равенство возможностей или как равенство в свободе. Согласно ученым, объясняющим состояние здоровья через призму индивидуальной ответственности, получение неравных медицинских услуг справедливо, если это неравенство является результатом личного выбора и собственных действий. Вместе с тем зависимость количества и качества медицинских услуг от ответственности людей за свое здоровье увеличивает риски для тех, кто уже находится в наихудшем положении. Другая группа ученых анализирует социальные детерминанты здоровья, включающие в себя обстоятельства повседневной жизни, доступность удовлетворения материальных потребностей, окружающую среду, а также социальные, экономические и политические условия, социальные и культурные нормы. Детерминанты формируются вследствие политики и под воздействием распределения финансов, власти и других ресурсов на глобальном, национальном и местном уровне, выступают главными причинами несправедливости. При этом если социальная справедливость понимается как наличие возможностей (в случае с здравоохранением – равный доступ к здоровью), то здоровье тождественно справедливости. Обеспечение справедливости в отношении здоровья является социально-экономической, политической и этической проблемой, решение которой возможно только в таком междисциплинарном поле. Признание на международном уровне социальных факторов здоровья и необходимости преодоления неравенства в отношении доступа к здравоохранению, актуализируют исследование влияния социально-экономических детерминант на индивидуальное поведение людей.

Dental students need to be equipped as clinicians to treat diverse communities and to recognize oral health disparities that are rooted in the social determinants of health. Library instruction is frequently focused on information literacy topics. Within the health sciences this might include critical appraisal or evidence synthesis, and instruction centered on locating and using library resources. This paper details the unique experiences of two liaison librarians to the School of Dental Medicine who taught the topics of cultural competence and cultural humility to first-year dental medicine students. While the authors do not discuss typical information literacy instruction in this paper, they share strategies used to design the instruction sessions, reflections on teaching these themes, lessons learned, and suggestions for other liaison librarians who might have an interest in teaching about cultural competence or cultural humility.

The concept of the social accountability of medical schools has garnered many followers, in response to a broad desire for greater social justice in health care. As its use has spread, the term 'social accountability' has become a meta-narrative for social justice and an inevitable and unquestionable good, while at the same time becoming increasingly ambiguous in its meaning and intent. In this article, we use the lenses of postmodernism and critical reflexivity to unpack the multiple meanings of social accountability. In our view, subjecting the concept of 'social accountability' to critique will enhance the ability to appraise the ways in which it is understood and enacted. We contend that critical reflexivity is necessary for social accountability to achieve its aspirations, and hence we must be prepared to become accountable not only for our actions, but also for the ideologies and discourses underlying them.

Medical doctors should be studying in the future not only about the “alleviation of physical and mental pain and suffering” but also about the “restoration of social functioning of their patients. Medical professionals are urged to carry their culture of helping and caring as contributions to society. They also assume responsibility for the careful use of available resources and their equitable distribution. Central values of medicine are respect for human dignity, respect for self-determination and autonomy, the primacy of patient welfare, the principle of noninjury, and solidarity. Questions of values deal with particularly complex areas of personal identity, because values are causes and reasons for decisions and actions. The potential damage of medical interventions is not automatically justified by the desire to help. The ratio between benefit and risks of medical measures must always be critically appreciated. The professional medical ethic is the basis for the contract between medicine and society with three basic principles: primacy of patient welfare, respect for the rights of self-determination (autonomy) of patients (informed consent), and promoting social justice in health care (solidarity). From these principles, normative values are derived, indispensably connected with medical responsibilities and obligations. Development of these values is discussed in the light of the philosophical background of the dignity of the individual person and the process of decision-making.

Equity in resource allocation is central to the tenet of social justice in health care. The management of surgical waiting lists is of critical importance to clinicians, patients and regulators. In most hospital environments, the basic process has remained unchanged for decades. Patients are assigned to one of three urgency-related categories. Clinicians consequently administer three competing patient pools. The basis by which patients are selected for treatment may be difficult to define. The specific clinical circumstances of each patient are often unreported and may be unknown to those administering the list. Waiting list bias is also recognised. This may reflect clinician advocacy, pressure to meet category timeframe restrictions or perceived training requirements. In this environment, it is difficult to demonstrate propriety in care. We report the implementation of a pilot program to redesign waiting list management within a South Australian public hospital unit. This allows assemblage of patients into a single list. Overall priority is determined by balancing clinical acuity and waiting time. The determination of acuity takes into account both the primary category and the specific characteristics of each patient that are relevant to their intended procedure. Uniquely, the process is applicable to lists containing patients with dissimilar conditions. This paper reviews the limitations of current approaches in meeting reasonable community expectations. The principles and social justification underpinning this reform are introduced. Finally, the benefits offered by the program are discussed and interim results are reported.