CR 2: Developing Cultural Humility
Cultural competence is a lifelong aspiration rather than an achievement someone can check off their list or add to a resume. It is critical to understand the term’s true definition, for a false understanding of cultural competence can be detrimental to the individuals and communities with which we interact. In their article “Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education,” Melanie Tervalon and Jann Murray-GarcÍa enlighten an unjust assumption made by a nurse. They explain that an African American nurse once ignored the obvious pain of a hispanic patient, even disregarding the concern of a colleague, stating she “took a course in nursing school in cross-cultural medicine and ‘knew’ that Hispanic patients over express ‘the pain they are feeling’” (119). The nurse perhaps had succumb to the post-colonial mentality that she, the educated upper class member, could block all members of another culture into a preconceived stereotype. The fact that the nurse ignored the input of her colleague, who perhaps could have shared some wisdom in this situation, is proof enough that the nurse lacked true cultural competence. Tervalon and Murray-GarcÍa define cultural competence as follows:
“Cultural competence in clinical practice is best defined not by a discrete endpoint but as a commitment and active engagement in a lifelong process that individuals enter into on an ongoing basis with patients, communities, colleagues, and with themselves” (118).
The nurse in Tervalon and Murray-García’s story failed to enact the perhaps most critical component of cultural competence — cultural humility. In order to embark on the endeavor of cultivating cultural competence one must first recognize that their perspective is quite limited and be open to further developing their awareness. Tervalon and Murray-García argue the ideal trainee is both “flexible and humble” but most importantly not afraid to “say that they do not know when they truly do not know and to search for and access resources that might enhance immeasurably the care of the patient” (119). This process involves recognizing one’s own multidimensional cultural identity, reflecting on one’s position in the power structures surrounding them and the communities with which they interact, and actively remedying power imbalances when they are identified. Through humility and self reflection, knowledge can be integrated into behavior and our interaction with others. Cultural competence requires an ongoing effort to maintain humility as one’s knowledge and the surrounding world simultaneously.
I plan to practice cultural humility as I begin to work with the Marin Chinese Cultural Association and make no claim to cultural competence. To be transparent, I have had little to no immersive experience with the Chinese and Chinese American community. I presently feel as if I’m coming to the task with a blank slate; however, I’m sure my perspective has been tainted by years of behavioral and social shaping. I’d like to first begin by attempting some of the social, political, and economic structures that surround my life and the communities I’m most familiar with. I would then plan to begin doing some research first into the history of the Marin Chinese Cultural Association which I hope will spark much further research into the Chinese and Chinese American culture in the Bay Area, taichi, and mahjong.
During my actual time on site, I think it would be beneficial to track the attendance of the taichi and mahjong classes and hopefully determine what portion of the attendees identify as Chinese or Chinese American. I think it would also be useful to attempt to speak one-on-one with at least one attendee per session, even if just for a minute of two, so I can get a sense of who these individuals are and what has led them to the MCCA. However, there is much to be learned through pure observation.
I feel perhaps the most challenging task will be to describe the tai chi movement itself and will be challenged to practice my thick description skills throughout the semester. As Dr. Wu explained, performance is often the most challenging event to capture in words. In his article, “Close Encounter of the Human Kind,” Abraham Verghese effortlessly captures not only the actions of his subject, but he captures the atmosphere that surrounds him. Verghese writes, “My first patient sat before me, haggard, pointing to what ailed her, as if speech no longer served her. I peeled her shoes from her swollen feet, trying not to remove skin in the process” (Verghese). While the mood of Verghese’s writing is quite different from mood surrounding tai chi, I believe I can utilize his talent for selecting words that convey an intentional energy such as “haggard” and “peeled.” Shaping language will be of utmost importance as I attempt to make sense of my observations.Perhaps even a few times throughout the semester I can even ask some of the members to describe how they feel when performing tai chi to see what sort of language they utilize.
