Embracing diversity: the adequacy and importance of cultural competency education in medical school and residency

What is Cultural Competence?Many definitions of cultural competence have been put forward, but probably the most widely accepted is the following:Cultural and linguistic competence is a set of congruent behaviors, knowledge, attitudes, and policies that come together in a system, organization, or among professionals that enables effective work in cross-cultural situations."Culture" refers to integrated patterns of human behavior that include the language, thoughts, actions, customs, beliefs, and institutions of racial, ethnic, social, or religious groups."Competence" implies having the capacity to function effectively as an individual or an organization within the context of the cultural beliefs, practices, and needs presented by patients and their communities. 1 Cultural competence in health care combines the tenets of patient/family-centered care with an understanding of the social and cultural influences that affect the quality of medical services and treatment.With the ever-increasing diversity of the population of the United States and strong evidence of racial and ethnic disparities in health care, it is critically important that health care professionals are educated specifically to address issues of culture in an effective manner.Bodies such as the National Academies of Sciences' Institute of Medicine 2 and the American Medical Association have recognized this.In 2000, the Liaison Committee on Medical Education (LCME) introduced the following standard for cultural competence: "The faculty and students must demonstrate an understanding of the manner in which people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments.Medical students should learn to recognize and appropriately address gender and cultural biases in health care delivery, while considering first the health of the patient."This standard has given added impetus and emphasis to medical schools to introduce education in cultural competence into the undergraduate medical curriculum (or, in some cases, specifically identify it).