IHP 501 Module 6 Cultural Humility Paper Example

Beyond the Two-Hour Workshop: Cultural Competence and Cultural Humility at a Community Health Center

[Student Name]

Southern New Hampshire University

IHP 501: Global Health and Diversity

Module Six Paper

[Instructor Name]

[Date]

Beyond the Two-Hour Workshop: Cultural Competence and Cultural Humility at a Community Health Center

La Esperanza's leadership has scheduled a two-hour workshop for all staff on Latino health beliefs before launching its new diabetes program. The agenda includes slides on familismo, fatalismo and folk remedies. The intention is good, but the approach raises questions. Can a workshop about a group's beliefs prepare staff to care for individuals whose countries, histories and views differ widely? What else must change for care to be culturally and linguistically appropriate? This paper compares cultural competence and cultural humility, reviews what training achieves and recommends a broader approach.

A Framework for Cultural Competence

Betancourt et al. (2003) interviewed experts in government, health plans, academia and community organizations to define cultural competence in a practical way. They described three levels at which barriers arise and must be addressed. Organizational barriers include a lack of diversity in health care leadership and workforce. Structural barriers include the absence of interpreter services, materials that are not adapted to patients' language and literacy and complex processes that are hard for newcomers to navigate. Clinical barriers arise in the encounter, when providers do not recognize how culture, beliefs and social circumstances shape patients' understanding and choices. The framework's strength is that it treats cultural competence as an organizational responsibility, not only an individual skill.

Applying the Framework

Measured against this framework, La Esperanza's workshop addresses only the clinical level, and only partly. Organizationally, the center's leadership team has one Latino member, while most patients are Latino. Structurally, interpreting still relies on family members and untrained staff for many visits, and diabetes materials are translated from English without adaptation to familiar foods. These gaps affect every patient, regardless of how well any clinician understands cultural beliefs.

The Case for Cultural Humility

Competence, one influential critique argued, implies an endpoint (Tervalon & Murray-García, 1998), a body of knowledge one can master, which is neither possible nor desirable when caring for people of many backgrounds. They proposed cultural humility instead: a continuing practice of examining one's own assumptions and biases, noticing the power gap in every clinical encounter and working to narrow it and joining with communities as allies in advocacy. Humility, in this view, means treating each patient as the expert on their own life and culture rather than applying generalizations about a group.

The Risk of Stereotyping

The workshop's slides illustrate the risk humility addresses. Presenting fatalismo, a belief that health outcomes are determined by fate, as a Latino trait may lead staff to interpret a patient's missed appointments as fatalism when the real cause is a supervisor who will not allow time off. Latino immigrants at La Esperanza come from several countries, urban and rural backgrounds and different religious traditions. General descriptions can be useful starting points for questions, but they become harmful when they replace asking the patient.

What Training Achieves

Truong et al. (2014) conducted a review of systematic reviews on interventions to improve cultural competency in health care. They found moderate evidence that training improves health professionals' knowledge, attitudes and skills and some evidence of improved patient satisfaction and access, but limited and inconsistent evidence of effects on health outcomes. Interventions varied widely in content, length and approach, and many studies were of low quality. The authors suggested that training alone is unlikely to reduce disparities without broader organizational change.

Combining the Approaches

The two concepts are complementary. Betancourt's framework tells an organization where to act, and cultural humility tells individuals how to act. A center that invests in interpreters, adapted materials and a diverse workforce creates the structures that make humble, patient-centered encounters possible; clinicians practicing humility identify where structures fail. Neither is sufficient alone.

Recommendations

La Esperanza should replace the one-time workshop with a broader plan. At the organizational level, it should recruit Latino leaders and staff and create a patient advisory council of Latino immigrant patients. At the structural level, it should guarantee trained interpreting at every visit where the patient prefers Spanish and adapt diabetes materials with patients and promotoras to reflect familiar foods, work schedules and literacy. At the clinical level, it should replace lectures on group beliefs with training in asking open questions about patients' own beliefs, circumstances and goals, practiced through role play and reflection, with refreshers each year.

Table 1. Recommendations by Level

Note. Levels follow the framework described by Betancourt and colleagues.

What Humility Looks Like in a Visit

Humility becomes concrete in how a clinician opens and closes a conversation. Instead of assuming that a patient's diet reflects Latino food culture, the clinician might ask what a typical day of meals looks like, who cooks and what foods matter to the family. Instead of attributing missed doses to fatalism, the clinician might ask what makes it hard to take the medicine as prescribed. At the end of the visit, the clinician checks understanding by inviting the patient to describe, in their own phrasing and through a trained interpreter when needed, what they will do when they get home. These habits take little extra time once practiced, and they surface the real barriers, such as cost, work or fear, that group generalizations hide.

Measuring Progress

The center should measure interpreter use for Spanish-preferring patients, patient ratings of respect and understanding broken out by language, workforce diversity at each level and diabetes outcomes by population group. Staff reflection logs and observed communication in simulated visits can show whether humility is being practiced, not just taught.

Conclusion

A two-hour workshop on Latino health beliefs addresses a sliver of what culturally appropriate care requires and risks reinforcing stereotypes. Betancourt's framework points to organizational and structural change, cultural humility offers a better clinical stance and the evidence on training counsels realistic expectations. Together they point La Esperanza toward lasting change rather than a single event.

References

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293-302. https://doi.org/10.1016/S0033-3549(04)50253-4

Tervalon, M., & Murray-García, J. (1998). 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. https://doi.org/10.1353/hpu.2010.0233

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: A systematic review of reviews. BMC Health Services Research, 14, Article 99. https://doi.org/10.1186/1472-6963-14-99