Reconstructing Cultural Competency in Healthcare Settings

Abstract

Racially-stratified health disparities draw attention to issues in cross-cultural healthcare. The concept of cultural competency—behaviors, systems, and policies that together enable adequate treatment in cross-cultural interactions—aims to reduce health disparities. Cultural competency appears in several settings, including health professional training. The theoretical frameworks and educational models for implementing cultural competency provide a foundation for understanding how to improve the content, instruction, and assessment of cultural competence interventions. This review reveals a need for conceptually standardizing cultural competence and including structural knowledge among its criteria. A new method of assessment emphasizes application rather than self-report, integral to ascertaining the effectiveness of interventions. The newly developed cultural competency scale integrates some items used in previous studies, includes structural knowledge, and demonstrates cultural competence through application, rather than self-report. To standardize, an exploratory factor analysis determined underlying factors within competence criteria. To validate, healthcare professionals’ cultural competency scores related to both workplace demographics and hospital performance. A structural equation model determined mediating relationships between cultural competency and hospital performance.