Field Epidemiology
 

From Cultural Competency to Structural Competency: A Narrative Humility Approach

Originally presented on March 30, 2015

Speaker:
Sayantani DasGupta, MD MPH
Assistant Clinical Professor of Pediatrics and core faculty member of the Program in Narrative Medicine at Columbia University

This webinar begins within a discussion on how cultural competency has long been the educational mainstay in training health care workers to attend to the needs of diverse populations. This type of training, sometimes called cultural sensitivity or diversity training, usually involves learning about the beliefs and practices of those communities deemed racial and ethnic minorities in the U.S.: African Americans, Latinos/as, Asian and Pacific Islanders and Native Americans.

The framing of a mainstream ‘us’ learning about a racially different ‘them’ – may potentially re- scribe the same power hierarchies and social divisions it seeks to address by reducing people of color communities to a set of homogenous, identifiable and quantifiable ‘teaching points.’ In the late 1980’s, medical educators Tervalon and Murray-Garcia suggested the term ‘cultural humility’ as opposed to ‘cultural competency’ in teaching for the needs of diverse populations. They defined cultural humility as a process of inward looking and self-reflection, such that practitioners were urged to look at their own biases, assumptions and frames of listening as opposed to solely learning about the practices of cultural ‘others.’

This webinar expands the notion of cultural humility to suggest that all stories health care workers encounter have elements of the unknowable – and that all such stories must be approached from a stance of self-examination and narrative humility. This webinar also proposes that while it may not be reasonable or socially just to assume clinicians become ‘competent’ regarding any particular culture or cultures, however we must train ourselves to be competent regarding the structural issues of oppression, injustice and social violence that so deeply impact health care disparities across the spectrum.

This center to margin framing – of a mainstream ‘us’ learning about a racially different ‘them’ – may potentially reinscribe the same power hierarchies and social divisions it seeks to address by reducing people of color communities to a set of homogenous, identifiable and quantifiable ‘teaching points.’ As long ago as the late 1980’s, medical educators Tervalon and Murray-Garcia suggested the term ‘cultural humility’ as opposed to ‘cultural competency’ in teaching for the needs of diverse populations; with cultural humility being understood as a process of inward looking and self-reflection, such that practitioners were urged to look at their own biases, assumptions and frames of listening as opposed to solely learning about the practices of cultural ‘others.’

This webinar will expand the notion of cultural humility to suggest that all stories health care workers encounter have elements of the unknowable – and that all such stories must be approached from a stance of self-examination and narrative humility. Simultaneously, this webinar will suggest that while it may not be reasonable or socially just to assume that clinicians become ‘competent’ regarding any particular culture or cultures, we can and must train ourselves to be competent regarding the structural issues of oppression, injustice and social violence that so deeply impact health care disparities across the spectrum.

After viewing this webinar participants will::

  • Recognize the pitfalls of a traditional cultural competency approach to health care education.
  • Explain the potential benefits of a structural competency approach to health.
  • Apply narrative techniques to identify their own frames of clinical listening.
  • Identify community partners and resources to help connect their own clinical work with broader social justice advocacy.

The planners, moderator, and presenters do not have any financial arrangements or affiliations with any commercial entities whose products, research or services may be discussed in this activity.

No commercial funding has been accepted for this activity.


Continuing Medical Education Credits

The School of Public Health, University at Albany is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians.

The School of Public Health, University at Albany designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Medical Education Credits are offered until March 31, 2018.


Continuing Nurse Education Contact Hours

The University at Albany School of Public Health is an Approved Provider of continuing nurse education by the Northeast Multi-State Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

This offering is approved for 1.0 nursing contact hour(s).

Nursing Contact Hours are offered until March 31, 2018.


Certified Health Education Specialist Contact Hours

Sponsored by the School of Public Health, University and Albany, SUNY, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 1.0 total Category I contact education contact hours. Maximum advanced-level continuing education contact hours available are 0.

Continuing Education Contact Hours are offered until March 31, 2018. 


Social Work

University at Albany, School of Social Welfare, Social Work Continuing Education Program is recognized by the New York State Education Department’s State Board of Social Workers as an approved provider of continuing education for Licensed Social Workers - #0011

This offering is approved for 1.0 social work self-study continuing education hour.

Social Work continuing education hours are offered until December 31, 2017.