CULTURAL COMPETENCE TRAINING AND IMPLEMENTATION: PRACTITIONER AND STUDENT PERSPECTIVES

Abstract

Cultural competency training has increased clinician awareness of ethnic disparities in accessing care, however, it has not improved the clinical outcomes of patients (Sequist et al. 2010). Part of the problem for this lies with the models of culture employed in training and clinical practice, which are often simplistic and facilitate stereotyping. This thesis presents a medical anthropological approach to culturally competent care, one that employs a more nuanced and sophisticated understanding of culture. This research explores the extent to which models of “culture” characteristic of cultural competency theorizing, training and implementation are translated into culturally appropriate care in the multicultural community of Thunder Bay, Ontario. Person-centered narratives were collected through interviews with health care administrators, physicians, health care practitioners, nurses, and medical students, concerning their experiences with cultural competency models and their implementation in clinical contexts. This thesis concludes that health care practitioners invoke individualized models of cultural competence, ones that are formed on first-hand experience, and often denounce the generalized “cultural” teachings of educational competency programs. From these narratives, a call for the provision of care services according to individualized and subjective needs emerged. These findings support the need to re-examine educational curricula and the models of cultural competency employed in Canadian care settings.