Moving From Cultural Competency to Cultural Humility in Practice and Education

The concept of cultural humility is a complex phenomenon. It is a step beyond an individual or group being knowledgeable about and gaining cultural competence. Until one is able to intersect with and be accepted within a different culture, a healthcare provider may not achieve humility. A review of the literature can assist the nursing professional to better acquaint themselves with this often elusive and hard to define concept.

Cultural Humility is not developed from ones’ own culture, values, morals, beliefs or experiences, but instead from acknowledgment and acceptance of others for both who they are and the circumstances or situation they live in that may affect their total being including health. Humility is not always expressed in words, nor can formal or informal training alone lead to its mastery. Instead, it is a mindset and internal spirit of accepting and being accepted by others outside ones everyday circle of experience that develops over time. For a healthcare providers it can be attuned to “stepping into and walking within another’s shoes.” Being able to connect both spiritually and psychosocially with those they interact with, serve or provide care to regardless of their race, culture, sexual orientation or socioeconomic status.

It is proposed that cultural humility is both learned and innate. Through verbal and non-verbal communication, relationship building and the provision or receipt of service, common denominators emerge that connect a nurse to the patient/client or population they serve. Denominators such as empathy, compassion, openness, and acceptance of diversity all interplay into the development of a mutually satisfying relationship and sense of empowerment or partnership in healthcare between two or more parties. The importance of self-reflection and self-critique is an ongoing process that a nurse must engage in to achieve cultural humility. Examples encompassing many of the above dimensions that are related to development or display of humility in education and practice will be shared. In addition, evidence-based practices from the literature to promote cultural humility including nursing education, training methods, use of the QIAN Model developed by Chang, Simon & Dong (2010) and cultural immersion healthcare experiences will be discussed.

In conclusion, it is recognized that nursing and other healthcare professions are often challenged when it comes to connecting or intersecting to patients from another culture. The ability to provide multicultural and respectful care is contingent on meeting patients on their level so that the goals set are mutually beneficial and will sustain their health and wellness needs. Through provision of structured evidence-based education and training on the topic of cultural humility, as well as cultivation of the innate positive values and ethical behaviors in its potential and current workforce, nursing will meet the bar for providing globally focused individual, community and population based health outcomes.