© 2016 N. Chernyak
2016 – №1 (11)
Summary: The article compares the terms intercultural competence and cultural humility that are currently used to formulate the objective of medical students training. The author suggests a variant of translation from English into Russian for the term cultural humility. It is concluded that researchers oftentimes underestimate the dynamic nature of intercultural competence and ignore the evidence of its development through life.
Keywords: intercultural competence, cultural humility, medical students
Medical ethnocentrism is recognized as one of the obstacles to high-quality health care. It is manifested in the physician’s conviction that provided medical services are universal. In reality, physicians encounter patients from various cultural backgrounds (Khukhlaev, Chibisova 2010: 172) who need to be approached differently. In the modern multicultural society, doctors are expected to demonstrate not only effective (in terms of achieving an objective), but also appropriate (in terms of meeting patients’ expectations) behavior based on the existing knowledge, skills, attitudes, and experience of intercultural communication in the context of a health care institution.
Patient-doctor communication is being studied by scientists from different fields. Linguists highlight the importance of the doctors’ ability to cope with language and culture barriers that exist in intercultural communication with patients (Champaneria, Axtell 2004: 2142). Psychologists recognize the necessity of physicians’ readiness to adapt to another culture (Davis, Finney 2006: 318). Medical anthropologists emphasize the role of medical pluralism for medical students training (Betancourt 2004: 954; Echeverri, Brookover et al. 2010: 7). Medical pluralism in defined as the “coexistence of various medical paradigms: ethnic/folk medicine, New Age movement medicine, biomedical/official, great traditional medical systems such as Tibetan or Chinese” (Dobkin de Rios, Rakovski 2012: 3).
Such interdisciplinarity led to terminological inconsistency in publications on this subject (Gibson, Zhong 2005: 622; Chun, Young et al. 2009: 368). Several related terms are used interchangeably in academic journals: cross-cultural competency (Greer, Park et al. 2007: 1112), intercultural communicative competence (Gibson, Zhong 2005: 621), transnational competence, cultural awareness (Majumdar, Browne 2004: 162, Griswold, Zayas et al. 2007: 55, Hamilton, Woodward-Kron 2010: 560), cultural competency (Hobgood, Sawning et al. 2006: 1288; Ho, Yao et al. 2008: 719; Chun, Young et al. 2009: 368; Murray-Garcia, Tervalon 2017: 19), and cultural competence (Campinha-Bacote 1997: 260; Betancourt 2004: 953; Champaneria, Axtell 2004: 2142; Brathwaite, Majumdar 2006: 470; Davis, Smith 2009: 503; Hudelson, Perron et al. 2011: 1; Castiglioni 2013: 26).
The most frequently used term is cultural competence (Murray-Garcia, Tervalon 2017: 19). However, a number of recent studies devoted to different aspects of medical students training criticize the term intercultural competence for being static (Murray-Garcia, Tervalon 2017: 19). Thus, researchers doubt that it is rational to adopt competency-based approach to intercultural training. It is believed that competency-based training describes culture as static and stable (Kleinman, Benson 2006: 1673).
The term cultural humility was introduced as an attempt to overcome the static nature of the term intercultural competence of health care providers (Tervalon, Murray-García 1998: 117; Loue 2012: 1). Cultural humilty could be translated from English into Russian differently. Currently, there is no generally accepted variant of translation. The term kulturnaja bespristrastnost is suggested as the most appropriate.
In general, cultural humilty is understood as a lifelong commitment to self-evaluation in situations of intercultural communication with patients (Campinha-Bacote 2007: 26). Components of cultural humilty are self-reflection, the ability to learn from patients through active listening, the ability to develop mutually respectful partnerships, and the orientation towards lifelong learning (Tervalon, Murray-García 1998: 123; Cheng 2007: 36; Griswold , Zayas et al. 2007: 59; Murray-Garcia, Tervalon 2017: 22).
The central role in the development of cultural humilty in future doctors is assigned to faculty of medical schools, namely the ability to recognize their own communicative mistakes in the presence of medical students, as well as the ability to discuss their own prejudices that can unconsciously emerge in discourse or actions (Murray-Garcia, Tervalon 2017: 26). Thus, teachers become for medical students a model of behavior in situations of professional intercultural communication.
Some authors define cultural humilty as a structural component of intercultural competence of health care professionals (Campinha-Bacote 2007: 25). In this case, cultural humility facilitates lifelong learning aimed at intercultural competence development (Cheng 2007: 41).
Other authors understand these terms as independent and argue that unlike intercultural competence cultural humilty does not imply the achievement of the moment of full mastery (Butler, Swift et al. 2011: 223). The acquisition of cultural humilty is not a final goal, but an active process and a style of interaction with others. Thus, this term is perceived as more dynamic in comparison with intercultural competence (Tervalon, Murray-García 1998: 120; Lipponen 2005: 1).
Nowadays, cultural humility is oftentimes viewed as a more appropriate term for designating the objective of training in comparison to intercultural competence (Lipponen 2005: 120; Anand, Lahiri 2009: 390; Loue 2012: 1). However, in our opinion, in such cases authors underestimate the dynamic nature of intercultural competence and ignore numerous studies that advocate for the development of intercultural competence throughout life.
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