Culture Bound

Journal of Child and Adolescent Psychiatric Nursing, Feb 2007 by Yearwood, Edilma L

The National Center for Cultural Competence (NCCC) operates out of the Center for Child and Human Development at Georgetown University. The center has long been at the forefront of research, education, policy and standards development, consultation, and creation and dissemination of resource documents related to culture and cultural competence. The stated mission of the NCCC is to "increase the capacity of health and mental health programs to design, implement and evaluate culturally and linguistically competent service delivery systems" (http://www. gucchd.georgetown.edu/nccc).

At the request of the Health Resources and Services Administration (HRSA), the NCCC developed an online Cultural Competence Health Practitioner Assessment (CCHPA). The assessment and self-directed learning recommendations are intended to improve the skills and knowledge base of the practitioner, which would then translate to promotion of quality services for underserved and diverse communities. The self-assessment tool for practitioners is composed of questions assessing cultural knowledge in six categories using a Likert scale format for responses. The test takes less than 30 min and provides immediate feedback as to the knowledge and skills of the individual. Feedback is in the form of a profile of resources (reading materials, videos, web-based materials, and suggested learning experiences) geared to the assessed needs of the test taker. Accessing and using recommended resources assists the individual to develop additional skills and knowledge in movement towards cultural competence. The test assumes that no one ever achieves proficiency or finality in being culturally competent but is always working towards that goal along a personal developmental trajectory. This process engages the individual on one level but also the individual and others within multiple and changing organizational contexts. It acknowledges the dynamic and complex nature that is involved when learning about oneself and others.

The six areas assessed and their descriptors are:

1. Values and belief systems: What do practitioners know about the values and beliefs of the groups they most commonly work with? How do these values and beliefs impact access to care and use of services?

2. Cultural aspects of epidemiology: What are the risk and protective factors that contribute to disease and disease manifestations?

3. Clinical decision making: How can practitioners respect and support cultural values and beliefs of others and how is this manifested in development of treatment plans and healthcare practices?

4. Life cycle events: Refers to knowledge of developmental and life cycle stages within different cultures and practice responsiveness based on this knowledge.

5. Cross-cultural communication: Refers to using of communication skills and accessing resources that foster understanding and adequate sharing of information.

6. Empowerment/Health management: This category refers to working with others to empower them to be active participants in their care and in all aspects of decision making regarding their care (NCCC).

After taking the test, I was impressed with the wide range of resources and was directed to areas that will assist in my ongoing development as a culturally competent healthcare practitioner. Whereas my results indicated strengths in clinical decision making and life cycle events, there were weaknesses in the other areas. The recommended learning resources included materials from a diverse set of disciplines that support use of multiple senses and different learning styles. Behavioral activities were also suggested based on test profile and learning needs. These included more exposure to cultural informants, mentoring others, and more active involvement in policy and community education activities.

I would encourage all practitioners, educators, and researchers to take the online test and use the results as a guide for self-development. As life-long learners, ongoing attention to development of cultural awareness, skills, and knowledge can only enhance all areas of practice with diverse individuals and populations across the lifespan.

Reference

National Center for Cultural Competence. (2005). Cultural competence health practitioner assessment. Available from http:// gucchd.georgetown.edu/nccc

Edilma L. Yearwood, PhD, APRN, BC

Assistant Professor

Georgetown University

School of Nursing & Health Studies

Washington, DC

Author contact: ely2@georgetown.edu, with a copy to the Editor: Poster@uta.edu