Learning Objective #1: Discuss the concept of clinical cultural competence from the perspective of the clinician

Learning Objective #2: Examine how organizational factors influence clinician behavior in the provision of culturally competent care

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Globalization of society and the increasing evidence on health disparities has shifted the need for culturally competent clinical care from important to urgent. Considerable literature exists on frameworks and guidelines for developing cultural competence at the individual as well as the organizational level. However, despite good intentions and multiple initiatives to support cultural competence in clinical care, there is little evidence as to which initiatives are successful. Even less is known about how the organizational initiatives influence practices at the level of clinical care. Understanding the critical processes that link organizational initiative to clinical care practices is critical to developing evidence based foundation for promoting cultural competence.

This paper will present findings from a qualitative research study examining the influence of organizational factors on clinical cultural competence. The purpose of this study was twofold: (a) to identify the salient features of cultural competence at the clinical level and (b) examine the processes through which organizational factors impact on the clinician's ability to provide culturally competent care. The study utilized a qualitative, case study method, which allows for an examination of the context, processes, salient elements, and lessons learned with respect to the influence of organizational factors on clinical cultural competence. Data were collected at two clinical programs within a hospital engaged in a major diversity initiative. Findings indicate a critical need to develop a common understanding of cultural competence, differentiate clinical cultural competence from clinical competence and to make cultural competence visible to practitioners. The study also revealed mediating processes that are necessary to ensure that critical resources such as policy and education are effective. These will be further discussed in the presentation.