Measures of cultural competence: Examining hidden assumptions
Measures of cultural competence: Examining hidden assumptions
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DOI：
10.1097/acm.0b013e3180555a2d
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发表时间：
2007-06-01
影响因子：
7.4
通讯作者：
Frank, Blye
中科院分区：
文献类型：
--
作者：
Kumas-Tan, Zofia;Beagan, Brenda;Frank, Blye
目的作者严格审查了医学和卫生专业中最常用的文化能力的定量测量，以确定关于什么构成跨社会和文化多样性的胜任实践的基本假设。方法对PubMed，护理和相关健康文献累积索引，社会服务摘要，和教育资源信息中心确定了最常用的文化能力测量，然后按照结构化分析指南进行主题分析。对10个最广泛使用的指标进行了仔细分析，确定了这些指标中包含的6个主要假设。这些文书将文化等同于族裔和种族，并将文化概念化为族裔或种族化的他者所拥有的属性。文化无能被认为是由于缺乏接触和了解他者，也是由于个人偏见、偏见和歧视行为。许多文书假设，从业者是白色和西方，从业者之间的更大的信心和舒适度意味着增加文化capability.Conclusions现有的措施嵌入高度成问题的假设是什么构成文化能力。他们忽视了社会不平等的权力关系，并假设个人知识和自信足以改变。如果卫生专业的教育工作者和卫生专业人员要在理解、教学、实践和评估文化能力方面取得进展，就需要制定评估文化谦逊和/或评估实际做法的措施。
Purpose The authors critically examined the quantitative measures of cultural competence most commonly used in medicine and in the health professions, to identify underlying assumptions about what constitutes competent practice across social and cultural diversity.Method A systematic review of approximately 20 years of literature listed in PubMed, the Cumulative Index of Nursing and Allied Health Literature, Social Services Abstracts, and the Educational Resources Information Center identified the most frequently used cultural competence measures, which were then thematically analyzed following a structured analytic guide.Results Fifty-four instruments were identified; the 10 most widely used were analyzed closely, identifying six prominent assumptions embedded in the measures In general, these instruments equate culture with ethnicity and race and conceptualize culture as an attribute possessed by the ethnic or racialized Other. Cultural incompetence is presumed to arise from a lack of exposure to and knowledge of the Other, and also from individual biases, prejudices, and acts of discrimination. Many instruments assume that practitioners are white and Western and that greater confidence and comfort among practitioners signify increased cultural competence.Conclusions Existing measures embed highly problematic assumptions about what constitutes cultural competence. They ignore the power relations of social inequality and assume that individual knowledge and self-confidence are sufficient for change. Developing measures that assess cultural humility and/or assess actual practice are needed if educators in the health professions and health professionals are to move forward in efforts to understand, teach, practice, and evaluate cultural competence.