Michigan: Implicit (Unconscious) BiasPage 5 of 11

4. Cultural Sensitivity and Cultural Competence

We each serve as a unique link in a chain of knowledge that reaches back into the past through the millennia and pushes forward into future. Each person is responsible to their community for the knowledge that they receive as learners and eventually pass on as knowledge keepers. The survival of our communities is predicated on the integrity of this interconnected knowledge cycle.

Keeta Gladue
Indigenous Academic Integrity, 2020

Health and well-being are fundamentally influenced by culture. Developing this self-awareness means recognizing that all forms of knowledge and practice are influenced by culture (Napier et al., 2017).

Cultural Sensitivity

Cultural sensitivity is a respect for another person’s strengths, culture, and knowledge. It means a person understands that cultural differences exist and can affect values, learning, and behavior. People who are culturally sensitive have a set of skills that allows them to understand and learn about people whose cultural background is not the same as their own.

Cultural Competence

Cultural competence occurs when knowledge, attitudes, and skills are integrated into a person’s daily actions. Cultural competence requires a self-examination of one’s own cultural and professional background and encourages healthcare providers to manage prejudices and stereotypes that may affect their behavior when interacting with someone from a different culture (Gradellini et al., 2021).

Cultural competence is a critical component of health equity and importantly, can offer new models of care that account for more than just biology and medicine. An awareness of culture helps us understand the relative nature of values we often assume to be universal. It allows us to understand the influences of diverse but interrelated issues, such as socioeconomic status, environmental conditions, age, gender, religion, sexual orientation, and level of education (Napier et al., 2017).

In recent years, the quality of cultural competence training has improved, although problems remain:

  • Lack of consensus on what should be taught
  • Timing of training
  • Lack of standard references
  • Limited and inconsistent formal evaluation of interventions (Gradellini et al., 2021)

A commonly used tool for analyzing and improving intercultural sensitivity is Bennett’s Developmental Model of Intercultural Sensitivity. It suggests that individuals move from "ethnocentrism" meaning that an individual’s own culture is experienced as central to reality to "ethnorelativism" meaning that an individual’s culture is experienced in the context of other cultures. This involves six stages, starting with denial and moving on to defense, minimization, acceptance, adaptation, and finally, integration.

Bennett’s Developmental Model of Intercultural Sensitivity (DMIS) [9:51]