The Dangers of Cultural Competency
This book excerpt is from Chapter 6 of my new book, A Case of Culture, now available on Amazon, Barnes & Noble, and Kobo. Learn more about the book here.
Being familiar and competent with the practices of a certain culture can often help to counter external biases and judgments. However, cultural competency isn’t always enough. In fact, when used on its own, cultural competency can lead to dire consequences.
The term “competency” exudes a sense of being all-knowing and all-powerful, which can create an unhealthy power dynamic. More importantly, the term implies that one has learned everything they need to learn about a certain culture or group of people, when in fact learning is a never-ending process. It is this false security of knowledge that can lead to the formation of biases and stereotypes, where one makes a judgment about someone by virtue of the cultural group to which they belong.
We see examples of cultural stereotyping and implicit bias all too often in healthcare. A nurse who has taken a course in cross-cultural training fails to treat a Hispanic patient’s postoperative pain because “[she] ‘knows’ that Hispanic patients over-express the pain they are feeling.” (Tervalon & Murray-Garcia, 1998) A doctor fails to acknowledge a Jewish patient’s request for a follow-up appointment because she remembers reading that “Jews can be extra vocal and demanding of assistance.” A Muslim provider dismisses a Muslim patient’s symptoms as due to Ramadan fasting, when the patient has actually refrained from fasting due to her preexisting symptoms.
When providers make clinical decisions based solely on their “self-proclaimed cultural expertise” rather than the individual circumstances of their patients, the health of their patients can be compromised. In fact, a 2017 nursing textbook was pulled by its publisher due to its inclusion of such dangerously presumptive and overly simplistic portrayals and stereotypes of various cultures (Sini, 2017).
This is why cultural humility is a far more desirable goal for cultural brokers and healthcare providers (for anyone in fact) than is cultural competency. While cultural competency is a topic or subject that people feel must be learned and mastered, cultural humility is a philosophy, a mindset that one uses to handle different situations in unique ways. When one looks beyond culture and race and ethnicity, each of us is a complicated multidimensional human being with our own histories & stories.
Cultural humility recognizes this uniqueness and understands that no individual can learn and know everything there is to know about any given culture or group of people. This humility is what enables us to be open to learning new things and shifting our existing knowledge base. As Melanie Tervalon, one of the first researchers to coin this term, explains it: “Cultural humility challenges us to think more deeply about what culture is and how it doesn’t mean thinking about a list of traits that you can ascribe to people.” This focus on lifelong learning and self-improvement is the key to dispelling stereotypes and biases.
In this article series, I share excerpts and stories from my book, A Case of Culture. If you would like to learn more about what happens next, you can find the rest of the story in Chapter 6 of my book, out now on Amazon, Barnes & Noble, and Kobo. If you enjoyed this book excerpt, please consider subscribing to this weekly excerpt series and sharing it with your network. Join our virtual Book Launch Celebration with Dr. Hasan Gokal of Code Blue Radio on Sunday February 20. RSVP here. To learn more about the book, visit my website. If you would like to connect with me, you can reach me here via email at snigdha.nandipati@gmail.com or @snigdhanandiauthor on Instagram and Facebook.
