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Embracing Cultural Humility in Healthcare


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Embrace diversity

As a Queer, Jewish, Black autistic woman with experience as both an RN and patient, I understand the vital importance of cultural humility in healthcare. My life journey has led me to be an advocate for equitable care and that requires acknowledging and respecting the unique cultural backgrounds and beliefs of every individual.

Understanding Cultural Humility

Throughout my career both in nursing and in coaching, I have learned that cultural humility involves recognizing the limits of my cultural knowledge and embracing the diversity of beliefs and values that shape each individual's worldview. As Jaya Aysola, MD, MPH, eloquently puts it, cultural humility entails approaching each encounter as a negotiation between two distinct worldviews. It demands that in healthcare, we understand that every person has a unique culture and background that influences their healthcare needs.

Cultural humility and cultural competence can complement each other, however, cultural humility goes beyond cultural competence. It extends to building connections, understanding individual preferences, and addressing power dynamics between healthcare providers and patients. This approach emphasizes the importance of viewing each person as an individual with their own set of cultural values, rather than succumbing to stereotypes or generalizations.

Impact of Implicit and Known Bias on Healthcare

My own experiences as a patient and healthcare professional have made me acutely aware of how biases (discrimination) both those providers are aware of, known, and implicit or unknown can lead to disparities in treatment and contribute to health inequities. I've witnessed firsthand how biases can affect decision-making and behavior in healthcare settings. I have had healthcare providers dismiss my questions or address a White companion if present when discussing my care plan options.

In addition, the more intersections of diversity you hold the more potential for increased episodes of bias. In a study I came across although racial discrimination was the most commonly reported, statistically the study highlighted how health status, lack of insurance, lower income and being younger compounded the issue. The study found that 21.4% of patients experience some type of bias. (Nong, 2020)



Addressing implicit bias is crucial in providing equitable care. Through cultural humility, healthcare providers can recognize their biases and work towards overcoming them. This ongoing process involves continuously learning, reflecting, and engaging in open dialogue to mitigate the impact of implicit bias on patient care.


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Conflict Resolution and Cultural Humility

In my role as a healthcare provider, I've encountered numerous conflicts that have required effective resolution, especially when working with diverse patient populations. Cultural humility has played a significant role in navigating these conflicts by fostering understanding, empathy, and effective communication. I have found that approaching conflicts with respect and a willingness to listen, while recognizing the influence of cultural values, beliefs, and expectations, has been instrumental in finding mutually beneficial resolutions.

Microexpressions and Healthcare Disparities

As someone who sits in intersecting marginalized spaces, I am acutely aware of how biases and cultural differences can influence the interpretation of microexpressions, leading to disparities in care. Recognizing and interpreting these brief, involuntary facial expressions is crucial for understanding a patient's needs, concerns, and emotions. By embracing cultural humility, healthcare providers can approach microexpressions with an open mind and a willingness to understand the cultural context, thus providing more accurate and culturally sensitive care.

Promoting Health Equity through Cultural Humility

Health equity, which is the goal of providing fair and just healthcare for all individuals, is a cause that is deeply meaningful to me. Cultural humility has proven to be a powerful tool in achieving health equity by promoting inclusivity, addressing implicit biases, and reducing disparities in care. By embracing cultural humility, healthcare providers can create a safe and supportive environment for patients from diverse backgrounds, thereby promoting trust, empowering patients to share their experiences and concerns, and ensuring that healthcare decisions are made collaboratively.

Strategies for Practicing Cultural Humility

Drawing from my own experiences, I believe that practicing cultural humility requires continuous learning and self-reflection. Here are some strategies that I have found to be effective:

  • Raising Awareness of Implicit Bias: I strongly advocate for healthcare providers to undergo training to understand and recognize their own implicit biases, thus enabling conscious decision-making and the ability to challenge biases when they arise.

  • Engaging in Reflective Listening: Actively listening to patients' stories, concerns, and experiences is essential. Reflective listening involves paraphrasing and summarizing patients' statements to ensure accurate understanding and to show empathy.

  • Promoting Open Dialogue: Creating an environment where patients feel comfortable expressing their needs and concerns without fear of judgment is crucial. Encouraging patients to share their cultural beliefs, values, and preferences openly fosters trust and open communication.

  • Educating Yourself: Continuously educating oneself about different cultures, religions, and backgrounds is paramount. Staying informed about cultural practices, traditions, and beliefs is essential to providing culturally sensitive care.

  • Building Trusting Relationships: Establishing trust with patients through respect, empathy, and authenticity is fundamental. Building relationships based on trust allows for open communication and shared decision-making.

The Ongoing Journey Towards Cultural Humility

I know this journey towards cultural humility is ongoing. It requires self-reflection, a commitment to learning, and an openness to challenge biases and assumptions.  But repeat after me, “By prioritizing cultural humility, I aim to foster a more equitable and inclusive healthcare system that leads to better outcomes for all patients.”

We must work towards achieving health equity, using all our available tools to dismantle barriers, address disparities, and promote a patient-centered approach to healthcare. Cultural humility is another tool healthcare providers can wield to ensure patients receive the care they deserve, regardless of their background or cultural identity.

 

Key Reference: Key Reference: Nong, P., Raj, M., Creary, M., Kardia, S. L. R., & Platt, J. E. (2020). Patient-Reported Experiences of Discrimination in the US Health Care System. JAMA network open3(12), e2029650. https://doi.org/10.1001/jamanetworkopen.2020.29650

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