The American Academy of Family Physicians website defines cultural competence as: "A set of congruent behaviors, attitudes and policies that come together as a system, agency or among professionals and enable that system, agency or those professionals to work effectively in cross-cultural situations. The word 'culture' is used because it implies the integrated pattern of human thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used because it implies having a capacity to function effectively". Campi nha-Ba cote constructed a model that depicts cultural competence into five different areas: cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire.

When working as a healthcare professional, one needs to strive for cultural competence by mastering each of these areas. To begin my journey on mastering each area of cultural competence, I need to first assess my placement in each of the five categories. A very important area is cultural awareness. This involves conducting self-examination of any biases that I may have towards a certain culture. I am guilty of having such biases. While I do not have many biases, it is important that I work through each one and realize that biases are not facts.

I am a Caucasian female who grew up in the suburbs of Detroit. I attended a private school from kindergarten until my sophomore year of college. My school was not very diverse. Once I started working, I was able to meet a few more people of different cultures. All of my professions have been in the suburbs, and the majority of people have been Caucasian.

Eastern Michigan University is very diverse. I am glad that I am finally able to experience such an environment. Cultural knowledge is when a health care professional seeks information regarding different cultures and ethnic groups. They look at the differences that one culture / ethnic group may have regarding treatment of an illness, health conditions, and biological variations. I have yet to do any personal research in this area. I have learned about some of these differences in a few of the nursing classes this past year and a half.

I know that this is a detrimental area of nursing, especially since our country is becoming more diverse. I should eventually become familiarized more in depth of this information. The ability of one to conduct a cultural assessment, and any other relevant cultural data is called cultural skill. Part of cultural skill is also conducting a culturally based physical assessment. Important areas that should be focused on are ethnicity, culture, place of birth, space (degree of comfort), proximity to others, body movement, perception of space, and cultural health practice. I conducted a cultural assessment on one person before, but I did not do a physical assessment.

I was able to discover interesting information about this person's culture. I need to familiarize myself some more with conducting a cultural assessment. I was a bit rusty, but I know that everything comes with practice. The process that encourages the health care professional to interact face to face with people of different cultures to modify any existing beliefs and prevent stereotypes is called cultural encounter. I sometimes have the problem of thinking that someone may be talking about me if they are speaking in another language. An example of this is when I went to an Arabic restaurant.

I decided to go to this restaurant because I wanted to try new foods from a different culture. I was waiting for my carryout and the cashier (who was Arabic), looked at me, turned to an Arabic waiter and then they spoke in Arabic amongst each other. This is not always my mindset. This case I felt uncomfortable because they looked at me first. I need to learn to accept that they may just feel more comfortable speaking in their own language instead of English.

If I ever have a stereotype towards a group of people, I make sure that I push that thought aside and get to know someone that may be in that group. They usually end up being on the total opposite end of what I thought. This is why directly engaging in conversation with people of other cultures is a good idea. Cultural desire is when a health care professional has the mindset of "wanting to" instead of "having to" be involved in the steps of becoming culturally aware, culturally knowledgeable, and culturally skillful and seek cultural encounters. An example of cultural desire would be voluntarily taking a class learning about another culture. I have cultural desire.

I find it interesting to engage in conversation with a person of another culture and learn about the differences between our two cultures. I have had several patients who have been of a different culture and I am willing to care for many more. By reviewing my position in each of the areas in the model, I realize that I do not yet fit into the expectations. I believe that I am on my way to achieving cultural competence.

I still need to work on cultural awareness. I need to conduct a further self-examination to be sure I understand each of my biases. I need to start researching to improve my cultural knowledge. My cultural skill needs to improve in the aspect of becoming more comfortable in conducting a cultural assessment. I engage in conversations, and in friendships with people of other culture (cultural encounter) and enjoy becoming culturally aware and knowledgeable (cultural desire). This guide is very appropriate for the nursing field.

I believe that I am culturally competent enough to work in a health care profession. I will continue to improve in each category. Everyday is a new day. I will be exposed to people of many backgrounds. I need to be ready and willing to adapt so that each person will feel equally comfortable and will receive equivalent healthcare. web October 6, 2004.