A Genetic Counseling Cultural Competence Toolkit

Cross Cultural Communication
    Health Literacy | Language Access Resources | Multilingual Resources | Interpreters and Translators

Cultural competence is defined as creating a health care system and workforce capable of delivering the highest-quality care to every patient regardless of race, ethnicity, culture, or language proficiency. Linguistic competence includes communicating effectively with people who have limited English proficiency (LEP). LEP pertains not only to people whose native language is not English, but also to the Deaf and individuals with low health literacy. Enhanced cultural competence has been shown to build strong counselor-client alliances, improve knowledge, skills, and attitudes of health professionals, and improve client trust and satisfaction.

To become culturally and linguistically competent, health care providers and professional organizations engage in ongoing education and training in culturally and linguistically appropriate service delivery. Many resources are available. One can easily find handbooks and lists of common practices in particular cultures and religions. This information is useful to acquire general background information, but it cannot provide insight into a specific client’s experiences. These experiences may, or may not, be consistent with what was read and/or expected, in full or in part. More seriously, we create the risk of reinforcing assumptions and stereotypes when we don’t take the time to focus on the individual.

Basic counseling skills such as attentive listening, empathy, and respect form the foundations of successful cross cultural communication. Genetic counselors should also explore the varied worldviews, beliefs and values of each client, as relevant to the situation at hand. Many existing cultural and religious assessment tools can help us open up these topics and quickly obtain critical insights. By letting the client guide, the genetic counselor is best positioned to help in cross cultural communication settings.

Genetics and genetic testing are changing on a daily basis. Therefore, we don’t assume we know the latest research that could prove helpful to a specific client; we check the literature. Similarly, just because we have worked with other clients from the same culture or religion, we may not be adequately informed or prepared for the next client. The genetic counseling literature provides suggestions for working with specific populations, but it is not possible for counselors to be familiar with all the cultures in the U.S. Client-centered culturally competent care requires individualized approaches. The deep respect demonstrated by professionals who fully understand a client, denoted as cultural humility, is a concept that resonates well with the goals of genetic counseling.

The diverse resources in this section of the toolkit expand our horizons about the potentially important role of ethnic, cultural, religion and other differences in the health care setting. These factors may be more important than the genetic basis of a condition in facilitating a client’s decisions, or they may be of limited impact. By taking the culturally humble approach and learning from our clients, we avoid stereotyping and keep the focus on the client’s specific needs.

We suggest beginning your exploration of this section of the toolkit by taking the Quality and Culture Quiz, a self-assessment tool for health care professionals developed and copyrighted by Carteret Communications, 2009. You can access the quiz at: http://www.proprofs.com/quiz-school/story.php?title=crosscultural-healthcare-quality-quiz

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