Organizational Responsibilities

It is important for health care organizations and professional preparation programs to articulate a commitment to cultural competence and to initiate cultural-competence initiatives. Many organizations are getting social and legal pressures to do this from different segments of the population. In addition to the social impact of diversity, these organizations are beginning to realize that a commitment to diversity makes good business sense.

Professional preparation programs can play a significant role in providing the knowledge and skills for culturally competent health professionals. These programs can provide courses and other formats developed with the sole purpose of addressing cultural competence and/or cultural sensitivity.

Steps to Becoming Culturally Competent

Developing Awareness

• Establishing professional and working rela

• Admitting personal biases, stereotypes, and

tionships with people of different cultures


• Learning another language

• Becoming aware of cultural norms, attitudes,

• Learning verbal and nonverbal cues of other

and beliefs


• Valuing diversity

• Becoming more comfortable in cross-cultural

• Willingness to extend oneself psychologically


and physically to the client population

• Assessing what works and what does not

• Recognizing comfort level in different situations

• Assessing how the beliefs and behaviors of the cultural group affect the client or family

Acquiring Knowledge

• Learning to negotiate between the person's

• Knowing how your culture is viewed by others

beliefs and practices and the culture of your

• Attending classes, workshops, and seminars


about other cultures

• Being more flexible

• Reading about other cultures

• Attending continuing education seminars

• Watching movies and documentaries about

and workshops

other cultures

• Learning to develop culturally relevant and

• Attending cultural events and festivals

appropriate programs, materials, and inter-


• Sharing knowledge and experiences with


• Learning to evaluate culturally relevant and

• Visiting other countries

appropriate programs, materials, and inter-


Developing and Maintaining

• Ongoing evaluation of personal feelings and

Cross-Cultural Skills


• Making friends with people of different cul-

• Overcoming fears, personal biases, stereo


types, and prejudices

They also can provide specific educational components on cultural competence and/or cultural sensitivity within the curricula, internship and residency programs, continuing education programs, and in-service programs. Organizations need to go beyond educating their employees and providing workshops on cultural sensitivity, however. They must also change institutional policies and procedures.

The Office of Minority Health and the Department of Health and Human Services made specific recommendations for culturally effective health care in the document, "Assuring Cultural Competence in Health Care: Recommendations for National Standards and an Outcomes-Focused Research Agenda." Some of these recommendations include:

  • Developing and implementing a strategy to recruit, retain, and promote qualified, diverse, and culturally competent administrative, clinical, and support staff
  • Promoting and supporting the necessary attitudes, behaviors, knowledge, and skills for staff to work respectfully and effectively with patients and each other in a culturally diverse work environment internship: training program clinical: related to hospitals, clinics, and patient care
  • Developing a comprehensive strategy to address culturally and linguistically appropriate services, including strategic goals, plans, policies, and procedures
  • Hiring and training interpreters and bilingual staff
  • Providing a bilingual staff or free interpretation services to clients with limited English skills
  • Translating and making available signage and commonly used educational materials in different languages
  • Developing structures and procedures to address cross-cultural ethical and legal conflicts, complaints, or grievances by patients and staff
  • Preparing and distributing an annual progress report documenting the organizations' progress in implementing these standards, including information on programs, staffing, and resources

While cultural competence has increased significantly, there is still much to be done on the personal, organizational, and societal levels. Education and training to enhance the provision of culturally effective health care must be integrated into lifelong learning. Through these activities, current and future health professionals will be prepared to meet the needs of clients from all segments of the population.

Delores C. S. James


American Academy of Pediatrics (1999). "Culturally Effective Pediatric Care: Education and Training Issues." Pediatrics 103:167-170.

Chin, Jean Lauu (2000). "Culturally Competent Health Care." Public Health Report 115:25-33

Kumanyika, Shiriki, and Morssink, Christian (1999). "Working Effectively in Cross-Cultural and Multicultural Settings." In Nutrition and the Community, 4th edition, ed. Anita Owen, Patricia Splett, and George Owen. Boston: WCB McGraw-Hill.

Internet Resource

Office of Minority Health. "Assuring Cultural Competence in Health Care: Recommendations for National Standards and an Outcomes-Focused Research Agenda." Available from <>

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