Culturally Competent Practices

BC2002: Cultural Competence: Apply culturally competent practices when working with patients and other healthcare professionals.

Instructions

Write your responses where it reads “Enter your response here.” Write as much as needed to satisfy the requirements indicated. Each item contains the Rubric, which will be used to evaluate your responses.

At the end of the template, you will list the references you used to support your responses.

Item 1

Go to the Office of Health and Human Service’s “Think Cultural Health” website: https://www.thinkculturalhealth.hhs.gov/education/

1. Choose the program that most applies to you or that most interests you. (Disaster and Emergency Personnel; Nurses and Social Workers; Oral Health Professionals; or Physicians Nurse Practitioners and Physician Assistants)
   Note: There is also a link to a guide for Health Care Administrators and Providers, but this is not a program, only a helpful resource.
2. Register for that program. When entering your “Profile” and asked for “Certificate Type,” choose “Statement of Participation.” (*Note: Keep your username and password handy).
3. Complete all three courses for your chosen program. You must get a score of at least 70% to complete the certification. Submit your completion certificate.
4. Once you have completed your program, answer the following questions:

• Describe your results from the program and how this knowledge can further your skills as a healthcare provider.
• In your own words, define cultural competence and explain how cultural competence can impact the workplace, health outcomes, and healthcare.

Your Response; Culturally Competent Practices

The results from my program are listed below. I averaged about 87% overall. I need to be more knowledgeable in the linguistic portion but overall, I am confident that I can contribute to a culturally competent environment. I am now aware of the various trainings that can be implemented in my current workplace. Having a better understanding of the population that I serve and analyzing my current knowledge and potential biases will allow me to improve the care I provide to my patients.

Cultural competence encompasses skills, values, and principles that acknowledge, respect” and work towards optimal interactions between an individual and the various cultural and ethnic groups that an individual might come in contact with. The term is not exclusive to race and ethnicity. A key factor of Cultural competency is effective communication. Cultural competency springs from the increase in diversity in surrounding areas. By having an in-depth understanding of how to effectively and respectfully interact with people from a wide range of cultures, the individual maximizes optimal interactions in the workplace, thereby creating healthier outcomes and better healthcare.

Cultural Competence in the workplace first requires the organization to assess itself and the employees on their understanding of cultural differences and ideals from the surrounding community that they serve. If there is no competence, the patient-provider interaction becomes strained, leading to miscommunications. Miscommunications can be intentional or unintentional, but both are negative impacts. Miscommunication increases the risk of medical errors and non-compliance from the patient concerning their care and treatment, resulting in poor health outcomes. Positive communication involving culturally competent healthcare personnel leads to better patient satisfaction. A satisfied patient reflects an understanding in their care in treatment which leads to healthy outcomes. Access to care improves when patients understand and are comfortable with the care, and the provider providing the care understands the patients’ diverse backgrounds. Explain how you would handle patient complaints about a transgender bathroom arrangement like the one described

In conclusion, an organization that has been trained and continuously improves its cultural competence can better serve the diverse population that surrounds them by providing respectful quality care that is assessable and applicable to them. Training is continuous and always requires the organization to assess itself.

 

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations
Module 1: What is Cultural Competence?
Submit your Cultural Competence Certification completion certificate.   Learning Objective 1.1: Complete cultural competence certification program.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Describe your results from the program and how this knowledge can further your skills as a healthcare provider.   Learning Objective 1.2: Analyze the results of your cultural competence certification program.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
In your own words, define cultural competence.   Learning Objective 1.3: Define cultural competence.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Module 2: Addressing Cultural Competence in Healthcare
Explain how cultural competence can impact the workplace, health outcomes, and healthcare.   Learning Objective 2.1: Analyze the impact cultural competence has on the workplace, health outcomes, and healthcare.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.

Item 2

Consider the following case study: A 25-year-old woman enters the clinic as a ­first-time patient. She tells the receptionist that she has not seen a physician for over 6 years and she would like a checkup. She is given an intake form to fi­ll out on which she reports that her current gender identity is female, and her assigned gender at birth was male. Her fi­rst name is Justina, but her identi­fication lists a masculine ­first name, Justin. While she is waiting to see a physician, she enters the women’s restroom. A short time later, another patient comes out of the women’s restroom and reports to the receptionist that she thinks a man is using the women’s restroom. The receptionist immediately sends a medical assistant into the women’s restroom to see if there is a problem. The medical assistant returns and says everything is fine. Justina exits the restroom and sits in the waiting area unaware that any of this has occurred. After a short wait, a nurse appears with a chart and calls for Justin. Justina looks around sheepishly. The nurse calls again for Justin. The patient who had reported a man in the women’s room laughs derisively. Justina, feeling awkward, gets up and goes to the nurse, who takes her to an exam room. In the exam room, Justina waits nervously for the physician. Culturally Competent Practices

• Explain how you would handle patient complaints about a transgender bathroom arrangement like the one described.
• Explain what you think is the best way to address a patient whose preferred name does not match the name on their identification card.
• Recommend at least two strategies that you could use to prevent and address patients who criticize or harass transgender patients in your clinic waiting room.

Your Response

Enter your response here.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations
Module 2: Addressing Cultural Competence in Healthcare
Explain how you would handle patient complaints about a transgender bathroom arrangement like the one described.   Explain what you think is the best way to address a patient whose preferred name does not match the name on their identification card.   Learning Objective 2.2: Apply culturally competent practices to LGBTQ patients.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Recommend at least two strategies that you could use to prevent and address patients who criticize or harass transgender patients in your clinic waiting room.   Learning Objective 2.3: Recommend strategies to prevent criticism or harassment of LGBTQ patients.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.

Item 3

Consider the following case study: Santiago is a 41-year-old man who has been living with HIV for 7 years. Santiago has been living in the United States for the past 14 years, although his family still lives in Guatemala. When Santiago comes into the clinic for his treatment, his provider recognizes that Santiago has not been following his treatment plan, and his viral load is increasing rapidly. In order for his health to be maintained, Santiago should be given immediate care and medication. When asked about his adherence to the treatment plan, Santiago says that he is afraid of the side effects of the medications and that he has been supplementing his treatment plan with practicing daily prayer, undergoing spiritual cleansings, and visiting a folk healer. Culturally Competent Practices

• Explain how you would find out additional information about the spiritual cleansings and practices of the folk healer that Santiago has been visiting while being sensitive to Santiago’s beliefs.
• Recommend at least two culturally competent approaches that the provider could use to address Santiago’s fears about the side effects of the antiviral medications that were prescribed to him.
• Explain the ethically and culturally appropriate action you should take in this circumstance. Should you “strongly recommend” that Santiago take the medication despite his fears? Explain.
• Identify at least two additional considerations that should be taken into account when analyzing Santiago’s case. Explain. Culturally Competent Practices

Your Response

Enter your response here.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations
Module 2: Addressing Cultural Competence in Healthcare
Explain how you would find out additional information about the spiritual cleansings and practices of the folk healer that Santiago has been visiting while being sensitive to Santiago’s beliefs.   Learning Objective 2.4: Apply culturally sensitive interview techniques.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Recommend at least two culturally competent approaches that the provider could use to address Santiago’s fears about the side effects of the antiviral medications that were prescribed to him.   Learning Objective 2.5: Recommend culturally competent strategies to explain the effects of biomedical treatments.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Explain the ethically and culturally appropriate actions you should take in this circumstance. Should you “strongly recommend” that Santiago take the medication despite his fears?   Learning Objective 2.6: Recommend ethical and culturally appropriate actions for medically critical situations.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Identify and explain at least two additional considerations that should be taken into account when addressing Santiago’s case.   Learning Objective 2.7: Analyze cultural considerations in challenging medical, patient care, or clinical situations.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.

Item 4

Consider the following case study: Shaylee is a 24-year-old female. She is a member of the millennial generation who relies heavily on technology for many things, including healthcare. She comes into the clinic complaining of gastrointestinal distress. She also says that she is often constipated, gets diarrhea easily, and has noticed blood in her stool on several occasions. Shaylee has visited several websites and is certain that she has inflammatory bowel disease (IBS). Her mother also suffers from IBS, and WebMD stated that IBS runs in the family. You explain to Shaylee that to officially diagnose her with IBS and to ensure she gets the appropriate treatment, she must undergo several diagnostic tests. Shaylee refuses the tests explaining that she does not have good health insurance and cannot afford them. She insists that she has done her research on IBS and becomes agitated when you state that you cannot confirm the diagnosis without testing. Shaylee emphatically states that she knows she has IBS. She will not leave the office until you give her a prescription for Linzess, a medication that she also researched and found that it is highly recommended for the treatment of IBS. Culturally Competent Practices

• Recommend at least two strategies that you could use to explain the importance of testing to Shaylee while being sensitive to her millennial culture. Culturally Competent Practices
• Explain at least two of the barriers faced by you as a healthcare provider to aid in Shaylee’s care.
• Identify at least two additional considerations that should be taken into account when analyzing Shaylee’s case. Explain.

Your Response

Enter your response here.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations
Module 2: Addressing Cultural Competence in Healthcare
Recommend at least two strategies you could use to explain the importance of testing to Shaylee while being sensitive to her millennial culture.   Learning Objective 2.8: Recommend culturally competent strategies used to explain medical care options.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Explain at least two of the barriers faced by you as a healthcare provider to aid in Shaylee’s care.   Learning Objective 2.9: Evaluate barriers to providing healthcare faced by providers.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Identify and explain at least two additional considerations that should be taken into account when analyzing Shaylee’s case.   Learning Objective 2.10: Analyze cultural considerations in challenging situations.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.

Item 5

Consider the following case study: You have been working at the county health department for about 8 months. You work with a core team of health professionals with a rotating schedule of specialists and additional providers. One of your colleagues, Aika, grew up in Japan and has only been living and working in the United States for 7 years. Japan is predominantly a patriarchal culture where men are obeyed and deferred to, and women are expected to anticipate needs proactively. Although Aika has embraced her life in the United States, she has maintained many of her traditional Japanese beliefs and customs. She often uses her different perspective to bridge cultural gaps with patients giving her a wonderful reputation with her departmental colleagues. However, on Thursdays, Dr. Boelter, an OB/GYN, works in the clinic and is often curt, sharp, and disrespectful with the staff who do not follow his specific protocols. Aika consistently avoids this doctor, refuses to give her opinion in his presence, and has cried on several occasions because of his abrupt commands. Culturally Competent Practices

• Recommend at least two strategies you can use to address the situation with Aika to try to make her feel more comfortable.
• Recommend at least two strategies you could use to develop Dr. Boelter’s respect for Aika’s culture.
• Recommend at least two strategies you can use to enhance diversity awareness, prevent multicultural conflict, and promote cultural competence in this workplace setting.
• Explain any other considerations that should be taken into account when addressing Aika’s situation. Culturally Competent Practices

Your Response

Enter your response here.

Rubric

	0 Not Present	1 Needs Improvement	2 Meets Expectations
Module 2: Addressing Cultural Competence in Healthcare
Recommend at least two strategies you can use to address the situation with Aika to try and make her feel more comfortable.   Recommend at least two strategies that you could use to develop Dr. Boelter’s respect for Aika’s culture.   Recommend at least two strategies you can use to enhance diversity awareness, prevent multicultural conflict, and promote cultural competence in this workplace setting.   Learning Objective 2.11: Recommend strategies to create a culturally inclusive environment.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.
Identify at least two other consideration that should be taken into account when addressing Aika’s situation. Explain   Learning Objective 2.12: Analyze cultural considerations in challenging patient care situations.	Response is missing.	Response is vague, inaccurate, or incomplete.	Response is clear, accurate, and complete.

References

Provide a citation for each resource you used to write your response to this Assessment. A sample citation is provided below:

• Abolfotouh, M. A., BaniMustafa, A. A., Mahfouz, A. A., Al-Assiri, M. H., Al-Juhani, A. F., & Alaskar, A. S. (2015). Using the health belief model to predict breast self examination among Saudi women. BMC Public Health, 15(1163). doi:10.1186/s12889-015-2510-y

Mastery Rubric

In order to achieve mastery of this Competency, you must achieve a “2” on every rubric row, in addition to meeting the additional expectation indicated in the Mastery Rubric. Culturally Competent Practices

 

Mastery Rubric	No	Yes
Exceeds Expectations: In-Depth Analysis
Learning Objective: Analyze cultural considerations in challenging medical, clinical, or patient care situations.	Responses do not indicate an in-depth understanding of strategies and considerations that should be made to provide culturally competent care in challenging medical, clinical, or patient care situations.	Responses indicate an in-depth understanding of strategies and considerations that should be made to provide culturally competent care in challenging medical, clinical, or patient care situations.

Professional Skill Building

 

The faculty Assessor will provide feedback based on the following Professional Skill(s): Written Communication, Engaging Multiple Social and Cultural Perspectives, and Inquiry & Analysis.  Although the feedback is here to inform the development of your skills, it is not a barrier to achieving the Competency, unless the writing is too poor to be able to score the content of the Assessment. Review the rubric and check your work based on the Learning Objectives listed. If you are concerned that you will not meet these expectations yet, reach out to your Coach so he or she can work with you to further develop these important professional skills.

 

It is highly recommended that you use this opportunity to practice these important skills in the context of this Competency Assessment in order to receive feedback about your current level of proficiency.

 

Written Communication: Write with clarity, coherence, and purpose.
	0 Not Present	1 Needs Improvement	2 Meets Expectations
Written Communication WC 1.1: Construct complete and correct sentences (AWE 2; Sentence Level Skills)	Sentences are incoherent and impede reader’s access to ideas.	Sentences are incomplete and/or include fragments and run-on sentences, limiting reader’s access to ideas.	Sentence structure effectively conveys meaning to the reader.
Written Communication WC 1.2: Demonstrate the effective use of grammar and mechanics. (AWE 2; Sentence Level Skills)	Multiple inaccuracies in grammar and mechanics impede reader’s access to ideas.	Some inaccuracies in grammar and mechanics limit reader’s access to ideas.	Use of grammar and mechanics is straightforward and effectively conveys meaning to reader.
Written Communication WC 1.4: Use supporting material to support a claim. (AWE 2; Use of Evidence)	Supporting materials are not present.	Supporting material is used inconsistently or inappropriately.	Supporting material is used to enhance meaning. Writing is appropriately paraphrased and uses direct quotes, as applicable.
Written Communication WC 1.6: Identify sources (AWE 2; Credit to Source)	Sources are missing.	Writing inconsistently identifies or misrepresents sources.	Writing clearly identifies the source of nonoriginal material and/or ideas.

Engaging Multiple Social and Cultural Perspectives: Apply strategies to develop intellectual flexibility and broad knowledge that enables perception of the world through the perspectives of diverse social and cultural perspectives.
	0 Not Present	1 Needs Improvement	2 Meets Expectations
Engaging Multiple Social and Cultural Perspectives 1.1: Recognize the value of one’s own and others’ social and cultural perspectives.	Recognition is not present.	Response demonstrates a vague understanding of the value of one’s own and others’ social and cultural perspectives.	Response demonstrates a clear understanding of the value of one’s own and others’ social and cultural perspectives.
Engaging Multiple Social and Cultural Perspectives 1.2: Recognize how knowledge from different cultural and social perspectives might affect interpretations of issues in society.	Recognition is not present.	Response demonstrates a vague understanding of how different cultural and social perspectives might affect interpretations of issues.	Response demonstrates a clear understanding of how different cultural and social perspectives might affect interpretations of issues.
Engaging Multiple Social and Cultural Perspectives 1.3: Evaluate the source of one’s own perspectives on selected issues in culture and society.	Evaluation is not present.	Response provides an incomplete evaluation of the source of one’s own perspectives on selected issues in culture and society.	Response provides a thorough evaluation of the source of one’s own perspectives on selected issues in culture and society.
Engaging Multiple Social and Cultural Perspectives 1.4: Evaluate competing social and cultural perspectives on specific problems in order to arrive at a solution.	Evaluation is not present.	Response provides an incomplete evaluation of perspectives and/or does not offer a viable solution.	Response provides a thorough evaluation of differing perspectives and is able to make a judgment regarding viable solutions.

Inquiry and Analysis: Apply strategies to identify, frame, and evaluate issues and problems.
	0 Not Present	1 Needs Improvement	2 Meets Expectations
Inquiry and Analysis IA 1.1: Identify a problem or question in a selected area of study.	No problem or question is presented.	The problem or question is vague or inappropriate to the selected field of study.	The problem or question is clearly stated in a form appropriate to the selected field of study.
Inquiry and Analysis IA 1.2: Use a logical organizing principle to identify the key parts or elements of a problem or question in a selected field of study.	Elements or parts of the problem or question are not presented.	Elements or parts of the problem or question are presented in a disorganized manner.	Elements or parts of the problem or question are presented in an organized manner.
Inquiry and Analysis IA 1.3: Evaluate theories and approaches to explain complex problems within a chosen field of study.	No theoretical approach is presented.	A theoretical approach is vaguely presented.	A theoretical approach to the problem or question is presented and justified.
Inquiry and Analysis IA 1.4: Apply organizing principles and theoretical approaches to identify solutions to a problem.	No attempt is made to connect theories or organizing principles to solutions to the problem.	Connections between theories or organizing principles solutions to the problem are vague.	Theories and organizing principles are used to make connections, identify gaps, and/or provide evidence for showing solutions to the problem or questions.