Cultural Competency: Why It Matters to Nursing Training

Health care providers owe something more to their patients than sound, quantitative advice about diseases and their appropriate treatments. But what this additional duty is, exactly, can be difficult to articulate. The American Nurses Association (ANA) emphasizes that nurses ought to offer care “with respect for human dignity” and keep in mind “the uniqueness of the individual client”— adding that “unrealized or unacknowledged biases may prevent nurses from proving optimal quality care.”  What the ANA is emphasizing, in other words, is the need for cultural competency in the health care setting — which the U.S. Department of Health and Human Services defines as “a set of attitudes, perspectives, behaviors and policies … that promote positive and effective interactions with diverse cultures.”

But can the soft skill of cultural competency be taught to nurses and physicians in training, alongside lessons about human anatomy and cellular biology? More and more, experts in the health care field agree that, yes, not only can cultural competency be taught — but it must be taught to future health care providers, and more effectively than it often is today.

Given today’s disparities in health outcomes across economic, ethnic and racial lines, it’s imperative that health care providers reach for every tool they can to close those gaps — and cultural competency is one of those crucial tools. There is evidence that patients heal more effectively when they perceive a health care provider is listening to them, and not prejudging them or pre-diagnosing them based on stereotypes and unconscious bias. Health care providers should realize that strong cultural competency skills can even be a matter of life and death.

Considering those stakes, another question arises: Is it possible for health care providers to be culturally competent from day one on the job? Experts say that for the good of patients, the goal should be nothing less. But how can nursing and physician training programs achieve this ambitious goal?

One method used in some training settings today is cultural simulation. A simulation involves people paid to act as standardized patients who offer specific complaints and predetermined cues so the health care-provider-in-training can work to strengthen her cultural competence muscles — listening carefully, keeping an open mind, noticing harmful pre-judgments as they come up, and doing away with them. After a simulation session, trainers explain any cultural insensitivities the trainee displayed.

One problem is that there is a limit to how ill or mentally disturbed an actor can pretend to be. That’s where cutting-edge medical training technology can help.

“Patient simulators that are better than what most people work with today can really give people the opportunity to interact with patients who exhibit the subtle cues that real humans do,” says Gregory Welch, the Florida Hospital Endowed Chair in Health Care Simulation at the University of Central Florida. “The cues these simulators help train health care providers to notice might be emotional, they might be pathological, they might be cultural.” Students learn about these through the UCF Online Nursing, B.S. program

More believable and more technologically nuanced patient simulators are a particularly promising trend when it comes to the development of cultural competency for the health care setting. With the help of tools like these, there is reason to hope that the newest generation of health care providers can continue a trend everyone wants to see: being better and more effective than the generation of professionals that came before.