Chelsea Borsack's Portfolio Page

From KNILT


Navigation links: ETAP 623 Fall 2023 | Mini-Course: An Introduction to Cultural Competence for the Healthcare Provider

About Me

Hello and welcome to my portfolio page! I am a first-year graduate student pursuing a master’s degree in Curriculum Development & Instructional Technology.

I am a practicing dental hygienist (RDH) and have a Bachelor of Science degree in psychology from Wagner College. I previously worked in child welfare as a Child Protective Specialist (CPS) in New York City. My goal is to become a clinical instructor and professor in the program I graduated from at Farmingdale State College.

My Topic and Purpose

This mini course is centered around a concept that I believe is invaluable in healthcare: cultural competence. One of the most concerning topics covered during my dental hygiene program was the widespread nature of health inequities, or "systematic differences in the health status of different population groups" (World Health Organization [WHO], 2018). A major contributing factor to health inequity is cultural incompetence among healthcare providers. A shift is required from a universal approach to a culturally sensitive approach of providing healthcare. It is my hope that my mini-course will help promote this shift.

Scope of Learning Outcomes and Content

Obtained from The University of Kansas, KU Center for Community Health and Development. https://servicelearning.ctb.ku.edu/cultural-competence/

Upon completion of this course, participants will be able to:

  • Define important terms related to cultural competence and the provision of culturally sensitive healthcare
  • Assess their current level of cultural competence, identify their implicit biases, and determine where they lie on the Cultural Competence Continuum
  • Relate cultural competence to their current healthcare practice to reduce health inequities among their patients

The content in this course can also be adapted for use by educators to reduce achievement gaps by providing culturally sustaining instruction to diverse student bodies.

Needs Assessment

Despite innumerable advances in medicine, including research, technology, access, and delivery of patient care, there remain groups of individuals who experience poorer health than others, including poorer prognoses, shorter lifespan, and increased risk of systemic disease.

When healthcare is provided in a one-size-fits-all approach, non-White patients are most likely to experience negative health outcomes. Black people have increased morbidity and increased mortality compared to White people, even when their insurance, income, age, and severity of conditions are comparable (Institute of Medicine, 2003). When extraneous factors and access to care are equal but racial and ethnic minorities are sicker and live shorter lives, the conclusion is that they are receiving lower-quality health care. Considering that health outcomes remain discrepant when socioeconomic factors are similar, it is important to also scrutinize the quality of health care that minority groups receive and identify gaps in the care practitioners provide to patients of various cultures.

There is a clear call for the transformation of how health care providers are trained to interact with racially and ethnically diverse patients. Culturally competent healthcare should not only improve diverse patients’ experience in health care scenarios but improve the ability of health care provider to deliver care to diverse populations and subsequently reduce the incidence of health inequities.

Educational problem: Healthcare providers have not been adequately trained to provide appropriate patient care in cross-cultural situations.

Learners/participants: Students in healthcare training programs.

Existing efforts and remaining gaps: Existing curricula in health care education regarding cultural competence demonstrate efforts to train providers to work with diverse patients, but sometimes focus too much on trying to provide healthcare students with fact-based knowledge about other cultures. The Office of Minority Health (2002) calls for a balance between fact-centered and attitude/skill-centered approaches to teaching cultural competence during health care provider education. Their research suggests that a provider’s knowledge of cultural facts alone is insufficient to improve patient outcomes and that providers additionally need to possess a set of interpersonal skills applicable to all patient interactions. Additionally, some research suggests that some current methods are responsible for “essentializing, commodifying, and appropriating culture, which has resulted in stereotyping and additional disempowerment of patients” (Rukadikar et al., 2022, p. 4326)

Intent: This mini-course will allow participants to become familiar with their role in the prevalence of health inequities and provide them with interpersonal tools to provide appropriate care when working with culturally diverse patients.

Analysis of the Learner and Context

Participants in this mini-course will be students currently enrolled in healthcare training programs or individuals currently working in healthcare who wish to improve their cultural competence. This can range from front desk associates at healthcare practices to dental students to seasoned surgeons. Ideally, participants will complete this course early in their training so as to improve their provision care and identify implicit biases and areas in need of improvement as soon as possible.

Participants will complete this mini-course online. The only required resources are a device with internet connection and an open mind.

Performance-Based Objectives

At the end of this mini-course, participants will be able to

  • Understand their role in the elimination of health inequities through the provision of culturally competent patient care
  • Interact with diverse patients in a way that is culturally sensitive and linguistically appropriate
  • Identify situations where they may hold implicit biases and work to undo these so as to avoid negative patient outcomes

Task and Content Analysis

  1. Defining important terms
    • In this module, participants will learn what cultural competence and will be introduced to the Cultural Competence Continuum
    • Participants will explore the difference between
      • Acceptance and tolerance
      • Health disparities and health inequities
    • Participants will be able to differentiate microaggressions, microinsults, microassaults, and microinvalidations
  2. Assessing cultural competence
    • In this module, participants will determine their level of cultural competence through a series of self-assessments
    • Participants will reflect on biases and stereotypes they hold
    • Participants will identify where they lie on the Cultural Competence Continuum
  3. Relating cultural competence to reducing health inequity
    • Connections will be drawn between cultural factors and differences in health among population groups
    • Participants will practice effective cross-cultural communication and self-assessment

Curriculum Map

References and Resources

  1. Bischof, G., Bischof, A., & Rumpf,  H. (2021). Motivational interviewing: An evidence-based approach for use in medical practice. Deutsches Arzteblatt, 118(7), 109-115. https://doi.org/10.3238/arztebl.m2021.0014
  2. Centers for Disease Control and Prevention. (2021). Cultural competence in health and human services. https://npin.cdc.gov/pages/cultural-competence
  3. Cole, S. A., Sannidhi, D., Jadotte,Y. T., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in Cardiovascular Disease, 77, 86-94. https://doi.org/10.1016/j.pcad.2023.02.003
  4. Conway-Klaassen, J. & Maness, L. (2017). Developing cultural competency in laboratory practice. American Society for Clinical Laboratory Science, 30(1), 43-50. https://doi.org/10.29074/ascls.30.1.43
  5. Cooper, L. A. & Roter, D. L. (2003). Patient-provider communication: The effect of race and ethnicity on process and outcomes of healthcare. In B. D. Smedley, A. Y. Stith, & A. R. Nelson (Eds.), Unequal treatment: Confronting racial and ethnic disparities in health care (pp. 552-593). National Academies Press. https://doi.org/10.17226/1026
  6. Health Policy Institute. (n.d.). Cultural competence in health care: Is it important for people with chronic conditions? Georgetown University. https://hpi.georgetown.edu/cultural/
  7. Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press. https://doi.org/10.17226/10260
  8. Kumagai, A. K. & Lypson, M. L. (2009). Beyond cultural competence: Critical consciousness, social justice, and multicultural education. Academic Medicine, 84(6), 782-787. https://doi.org/10.1097/ACM.0b013e3181a42398
  9. National Academies of Sciences, Engineering, and Medicine. (2016). A framework for educating health professionals to address the social determinants of health. The National Academies Press. https://doi.org/10.17226/21923
  10. National Heart, Lung, and Blood Institute. (n.d.) Health disparities and inequities. National Institute of Health. https://www.nhlbi.nih.gov/science/health-disparities-and-inequities
  11. Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/social-determinants-health
  12. Office of Disease Prevention and Health Promotion. (n.d.). Priority areas. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas
  13. Office of Minority Health. (2002). Teaching cultural competence in health care: A review of current concepts, policies and practices. U.S. Department of Health and Human Services.
  14. Rukadikar, C., Mali, S., Bajpai, R., Rukadikar, A., & Singh, A. K. (2022). A review on cultural competence in medical education. Journal of Family Medicine and Primary Care, 11(8), 4319-4329. https://doi.org.10.4103/jfmpc.jfmpc_2503_21
  15. Saha, S., Arbelaez, J. J., & Cooper, L. A. (2011). Patient-physician relationships and racial disparities in the quality of health care. American Journal of Public Health, 93, 1713-1718. https://doi.org/10.2105/AJPH.93.10.1713
  16. Tervalon, M. & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125. https://doi.org/10.1353/hpu.2010.0233
  17. World Health Organization. (2018). Health inequities and their causes. https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes