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Cultural humility versus cultural competence: What’s the difference?
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Cultural humility versus cultural competence: What’s the difference?
When you hear the term “cultural competence,” it most often refers to healthcare. Providers began emphasizing its importance in the 1960s and 70s, believing that if they could be more culturally knowledgeable, they could be more effective at providing care.
The idea was that clinicians could be more attuned to how their patients or clients talked about and presented symptoms. It was also about understanding cultural factors like diet or preferences that might be contributing factors or might get in the way of following a prescribed treatment plan.
This idea made sense beyond healthcare. In our other organizations — schools, businesses, services — the idea eventually gained traction, too. If people providing help or services are more culturally knowledgeable about their clients or customer base, they can provide better service and more value.
More recently, organizations are also coming to recognize that understanding the culture of their own employees or potential employees might matter. Cultural competence could affect everything from how you think about work flexibility to career paths and organizational culture. But the concept of cultural competence might not be the right solution to the concern.
The idea of cultural competence has a few implications that run counter to the idea of inclusion. Culture — especially one that’s not yours — isn’t something that you can master. Even married couples don’t learn everything there is to know about one another. How then, would someone go about learning generations of lifetimes and experiences?
What providers — and businesses — can strive for instead is cultural humility. But what exactly is that, and how does it differ from cultural competence?
Diversity, inclusion, and belonging have rightfully been given a lot of importance in workplaces over the last few decades — and for good reason. It’s not enough, though, to simply hire people that look different. Read blogs, interviews, and stories by Black authors, and you’ll see that acceptance isn’t the same as inclusion.
Of course, this isn’t limited to the Black experience — or even just to race. People from all backgrounds that aren’t represented by the dominant culture at work can feel left out, ostracized, and unwelcome.
This hit to belonging doesn’t just affect employees from underrepresented backgrounds. BetterUp found that belonging was a top predictor of employees’ intent to stay at their jobs.
Belonging doesn’t just mean diversity. It means that people of all backgrounds feel heard, seen, and recognized for their contributions. Unfortunately, many well-meaning professionals — not just healthcare professionals, but across a variety of fields — strike out in search of cultural competence. And boy, do they strike out.
So why does cultural competence often produce such cringe-worthy results?
Cultural competence is a type of social fluency gained by learning about another culture’s language, set of customs, beliefs, and patterns. It enables service providers to tailor their approach to be culturally responsive and sensitive.
The classic trope of old-school cultural competence are the American businessmen taking “etiquette” lessons before they meet with their wealthy — and sensitive — foreign investors.
The danger is that — while well-intended — the idea of cultural competence implies that people of a certain background are a monolith. It treats them, in essence, as a stereotype. “Follow this set of rules and you won’t offend our foreign guests.”
However, this erases the complexity of human beings. No two people, even from the same background, will have the same perspective or experience. The idea of cultural competence can leave people feeling like they’re being reduced to just one part of their identity. It’s inherently othering and does nothing for belonging.
Cultural humility, a term that was introduced to clinical and academic literature in the late 1990's addresses that concern by being an approach or orientation rather than a fixed set of knowledge or training.
In their article, Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education, public health physician Melanie Tervalon and health educator Jann Murray-Garcia present it as a new idea of relating to people and diversity.
Cultural humility is an approach to sociocultural differences that is “self-first.” It emphasizes intersectionality and understanding one’s own implicit biases. This approach cultivates self-awareness and self-reflection, bringing a respectful willingness to learn to inter-personal interactions.
When a person cultivates cultural humility, they enter their conversations with others in an open, curious manner. This curiosity isn’t directed towards the other person as much as it is at themselves and where their own shortcomings in perception might exist. And they understand that bridging those gaps in awareness is an ongoing process.
In their article, Tervalon and Murray-Garcia outline the following traits of cultural humility:
Intersectionality, diversity, and inclusion are complex topics. In many ways, the only path to making any significant leap from multiculturalism to belonging is through cultural humility. Developing a workplace — as well as a society — that fosters cultural humility and inclusion takes the magnifying glass’ searing heat off of underrepresented employees. It encourages people to lead with the assumption of their own bias first.
Why is this so important? Race, gender, sexuality, and national origin have all become hypersensitized topics in the world. In order to appear culturally competent, people feel the need to assume a defensive stance. After all, the risks of failure are too great. You could be branded a bigot, ostracize your colleagues, and even end your career.
The fact is, though, we all have unconscious biases. They don’t make us evil — they make us human. The idea of cultural competency gives us a false sense of exemption from these human flaws in perception. In one telling example from Cultural humility versus cultural competence, the researchers describe a nurse so convinced of her own expertise that she actually stereotyped a patient. This bias was based on what she’d learned about people of Hispanic descent in a cultural competency class.
What went wrong here? Is cultural competence doing more harm than good?
The problem with this idea is that we ask someone outside of the underrepresented group to state the importance of a different culture in any given scenario. It’s an example of prescribing the problem as the solution. If it was possible for people to do this with any level of accuracy, we wouldn’t have a need for cultural competency in the first place.
Developing cultural humility takes this burden off of the person doing the inquiry and replaces it with one that’s actually possible for them to carry. After all, no one person can become a master of every nuance of every cultural background. What we can do is sweep the porch in front of our own front doors. We can, instead, become masters of ourselves and intimately aware of our own cultural incompetence.
As Tervalon and Murray-Garcia write:
[Cultural humility] eliminates the need for a complete mastery of every group’s health beliefs and other concerns because the patient in the ideal scenario is encouraged to communicate how little or how much culture has to do with that particular clinical encounter.
In other words, instead of relying on our own knowledge to say what the concerns of another community's members are, we could ask.
The idea of cultural competence — and even stereotyping others — gives us “a false sense of security.” Cultural humility, however, requires a paradigm shift. That can be scary, inconvenient, and yield unexpected results. But it’s not more difficult than trying to anticipate the needs of people you don’t understand. And it’s a much more direct path.
If you are developing DEIB programs in your workplace, chances are you already have an excellent foundation of cultural awareness. That’s a critical part of changing your workplace culture.
Cultural humility is for everyone, not just DEIB leaders or advocates. Everyone within the organization can develop their own cultural humility — all it takes is the commitment to try. Remember, cultural humility isn’t a destination. It isn’t mastery of some set of cultural knowledge. Cultural humility is an orientation to the world and people around you.
Tervalon & Murray-Garcia identify three criteria that are necessary to develop cultural humility:
The idea of cultural competence implies that there’s a point at which we’re done learning. We can get a certificate, check a box, and say that we’ve “mastered” our understanding of another culture.
Cultural humility, however, requires comfort with the idea that we are never done learning and growing. We will continue to learn — and unlearn — our understanding of culture and the social dynamics at play in the workplace. And this is a good thing. If we don’t have to keep shifting our understanding, it means that we’re not continuously in contact with diverse people and new experiences.
Medical professionals, managers, and human resources. Existing power structures often have an overrepresentation of the dominant culture in positions of authority. This means that people seeking support from higher levels often have to overcome a lack of representation and solidarity. The idea of cultural competence exacerbates this. As in our example with the nurse, the insistence on one’s own expertise can put other people’s careers and well-being at risk.
The concept of cultural humility may be particularly challenging because it means seeing ourselves as players in an unfair power structure. We may not be the cause of it, but without awareness, we are complicit in these inequities. Working to fix these disparities is an important part of allyship and social justice.
Communities are made up of individuals, and each has an important role to play in creating our workplace culture. As the American Psychological Association (APA) reflects, “Cultural humility, by definition, is larger than our individual selves — we must advocate for it systemically.”
A true understanding of and commitment to cultural humility will naturally lead to this kind of advocacy. But unlike the potential pitfalls of cultural competence, it won’t be performative or devolve into “saviorism.” It will be genuinely motivated by an understanding of one’s own ability to uplift another.
Developing cultural humility in the workplace leads to:
As I mentioned earlier in the article, your existing DEIB strategy is an excellent starting point for building cultural humility. But it doesn’t end there. Think of cultural humility as less training and more of a shift in self-awareness. Collectively, this shift has the power to make a huge difference throughout your organization.
Here are some ways that you can start building cultural humility within your company:
Part of cultural humility is identifying the common ground between individuals. Creating social events is a great way to help your team get to see each other as people. Knowledge helps to reduce stereotype bias. Social events in particular make “diversity” (which can feel like a heavy topic) much more natural and fun.
A core part of developing cultural humility is developing self-awareness. Ironically, self-awareness is particularly difficult to develop by yourself. Working with a coach starts to strengthen reflective skills right away. It can provide a safe sounding board to practice conversations and challenge assumptions.
Cultural competence emphasizes the knowledge of the person in the majority. Cultural humility, however, allows other people to share their own experiences. You may find that culture has no effect on the circumstance — or may affect it in a totally unexpected way.
Here’s an example of how cultural humility and cultural competence can work together:
You’re reading a report on inclusive leadership, and you learn that women of color are still underrepresented in executive positions. Learning this information makes you a little more aware and knowledgeable about the experiences of women of color in the workforce — which is cultural competence.
Rather than filing this knowledge away, you meet with the DEI executive at your workplace. Together with human resources, you find that your company also lacks minority representation in leadership. You set a goal to increase that percentage by 10%.
Now, you meet with the leaders of your employee resource groups. You host a series of conversations to find out what people feel is holding them back from a higher position. You find out that while you could take steps to better support people of color, you’re also not providing enough support for working parents. As a result, many of your senior female leaders (of any ethnic background) are leaving their jobs because they don’t have enough flexibility.
Addressing the needs of the larger workplace helps you increase the number of women of color in your organization, and therefore, the cultural diversity on your leadership team.
The idea of cultural competence implies a finite learning point. The idea is that you can arm yourself with a body of knowledge about a culture. Unfortunately, that doesn’t give people or culture much space to change. It’s a static, reductive approach to diversity, and doesn’t bridge the gap to inclusion.
This thought process has led to a quandary for human resources professionals, leaving them wondering “How do I address belonging when I’m not supposed to talk about our differences?” That way of approaching diversity means that not only do we pretend that these differences don’t exist, but that they don’t contribute anything valuable to who we are in the workplace.
These differences are at the heart of every benefit inclusivity has to offer. Innovation, creativity, collaboration, belonging — they’re all multiplied by diverse, inclusive environments. Erasing our differences doesn’t make for a better environment — just a less interesting one.
The danger of cultural competence is that people may trick themselves out of real knowledge. They may feel like they've “passed the test,” which takes away the need to ask questions or stay open to any other possibilities.
Cultural humility is about curiosity. The pursuit of competence provides the background. But the real discovery is in knowing that there’s something you may not understand about an individual or situation. That humility is the openness to figuring out what that means.
BetterUp Staff Writer
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