CR#2: A Life-Learning Process
Cultural competency and cultural humanity are similar concepts in the sense that they both require critical self-reflection and willingness to be a lifelong learner. However, they have a slightly different point of view towards obtaining cultural skills. According to Melanie Tervalon and Jann Murray-Garcia, co-authors of the journal article “Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education”, being culturally competent requires humility on an individual basis. In other words, it allows for a person to “say when they truly do not know and to search for and access resources that might enhance [knowledge]” (119). Cultural competency encompasses the knowledge, skills, and experience an individual has towards a culture. This competency is dependent on cultural humility to continue that life-long learning process and acquisition of new skills. In other words, only by critically reflecting on what we think we know is how we can identify what we don’t know and would like to know. On the other hand, cultural humility is when someone who feels they have mastered the culture “relinquishes the role of the expert to a [community member] and thereby creates a learning and teaching alliance] (121). In other words, cultural humility is the willingness to learn from others regardless of their social position, education level, political, or professional position.
Also, Tervalon and Murray-Garcia highlight various examples of the power dynamics that exist within the patient-physician care through narrative. For instance, in the article, a nurse dismisses a patient’s postoperative pain by stating how she “knew that Hispanic patients overexpress[ed] the pain [they] feel” (119). In this example, the nurse’s overconfidence, and lack of humility further victimized the patient by not attending to their need. Tervalon and Murray-Garcia also stress how through cultural humility, an induvial can address power imbalances by “engaging in self-reflection and self-critique as lifelong learners and reflective practitioners (118). If the nurse had the humility to acknowledge and validate the pain of the patient instead of stereotyping her, it would have resulted in a better outcome for the patient and a valuable learning lesson for the nurse.
By remaining open to learning from others, we can further enhance our tools and skillsets through a shared experience. A technique that facilitates this learning is ethnography. Ethnography contributes to the learning process by helping a person “develop a rich understanding of how and why people think, behave, and interact as they do in a given community” (Crossman). However, as mentioned before, this level of understanding requires a life-long process of documenting observations through thick descriptions and critically reflecting. Once the individual reaches this level of knowledge, the individual returns to a continuous circular process from cultural humility to cultural competency and back.
In the article, “Close Encounter of Humankind,” Abraham Verghese, a doctor, effectively illustrates the conditions of his patients and in a post-colonial hierarchy by using thick description in his anecdotes and critically reflecting on his reactions. In the article, Verghese explains the order in which the patients arrived, their facial expressions, and the interaction he had with each one. One of his anecdotes, he describes the power imbalance he felt after he apologized for the poor treatment the patient received from the health care system. In return, he explains how “new barriers [were set in place] that neither he nor anyone else would ever cross” (Verghese). The thick descriptions he uses allows the reader to relive this shared experience. As I read the anecdote, I could see the facial expression of the doctor and imagine the gut feeling of being powerless against a situation of a power dynamic.
To help contribute to my life-learning process, I will incorporate three aspects of thick descriptions into my weekly observations at Canal Alliance. The techniques that I found most helpful are reconstructing anecdotes, proving examples, and writing down my reaction to the experience. For my service-learning with Canal Alliance’s ESL program, I want to focus on the dynamic that exists between the community members, the organization, staff members, and volunteers. One of the techniques that I have a hard time implementing, but I hope to incorporate this semester is having direct quotes. Since the ESL program is a fast-paced environment, I always remember the interactions, but I can never reconstruct the full story. Overall, my goal is to maintain a sense of cultural humility to continue my life-long learning.
By Karla Hernandez Navarro
Crossman, Ashley. “Ethnography: What It Is and How To Do It.” ThoughtCo, ThoughtCo, 22 Apr. 2019, www.thoughtco.com/ethnography-definition-3026313.
Tervalon, Melanie and Jann Murray-Garcia. “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.
Verghese, Abraham. “Close Encounter of the Human Kind.” New Yorker Times, Sept 18, 2005
