Cultural competence as a pedagogical framework
There is no commonly agreed upon pedagogical framework to guide appropriate course and program development. Hopefully such a framework will be developed in coming years. In the meantime, the concept of cultural competence (Sutton, 2000; Tyler, 2002; Westerman, 2004; Nolan and McConnochie 2005; McConnochie and Nolan 2006; Ranzjin, Nolan and McConnochie 2007) provides a useful framework since it encompasses many of the principles that seem important. Other theoretical perspectives that have informed this work include critical psychology, the meaning and impact of 'whiteness', the concept of world-views, and decolonisation.
The following extracts are from a paper by Weaver (1999) concerning social work practice, but it is equally relevant for other disciplines:
"Most models of cultural competence consist of qualities that fall under the general components of knowledge, skills, and values (Matthews, 1996; McPhatter, 1997).
"Knowledge about various cultural groups is essential for cultural competence (Dana, Behn, & Gonwa, 1992; Manoleas, 1994; Mason et al., 1996; Matthews, 1996; Pierce & Pierce, 1996; Ronnau, 1994; Sowers-Hoag & Sandau-Beckler, 1996). It is important to know that diversity exists within ethnic or cultural groups (Mason et al., 1996). [Practitioners] must recognize that relationships between helping professionals and clients may be strained because of historical or contemporary distrust between various groups, in particular, but not limited to, relationships between [oppressed groups] and the dominant society (Mason et al., 1996). The legacies of devastating colonial histories are a constant part of the contemporary reality of [oppressed peoples] (Manoleas, 1994). 'The significance of difference in the helping encounter is compounded by the dynamics of power, for the power inherent in the practitioner role is compounded by the status assignment (power) associated with the cultural/ social group identity of both client and practitioner' (Pinderhughes, 1997, p. 22).
"Awareness of the professional's own values, biases, and beliefs is important for cultural competence (Mason et al., 1996; Ronnau, 1994; Sowers-Hoag & Sandau-Beckler, 1996). A culturally competent helping professional must value diversity and understand the dynamics of difference (Manoleas, 1994; Mason et al., 1996; Ronnau, 1994; Sowers-Hoag & Sandau-Beckler, 1996). Culturally competent practitioners go through a developmental process of shifting from using their own culture as a benchmark for measuring all behavior (Krajewski-Jaime, Brown, Ziefert, & Kaufman, 1996). Knowledge and values must be integrated with [professional] skills for culturally competent practice (Manoleas, 1994; Sowers-Hoag & Sandau-Beckler, 1996; Weaver, 1997). Skills must be adapted to meet the needs of diverse clients (Ronnau, 1994).
"The three components of cultural competence are interactive, and none is sufficient in and of itself to bring about appropriate practice. Striving for cultural competence is a long-term, on-going process of development (McPhatter, 1997)" (p. 218)
The aspects of cultural competence described by Weaver are reflected in the 'Cultural Respect Framework' prepared by the Australian Health Ministers' Advisory Council's Standing Committee on Aboriginal and Torres Strait Islander Health Working Party (Australian Health Ministers' Advisory Council, 2004):
The Cultural Respect Framework recognises that it is important to have strategies and initiatives across the range of dimensions
Knowledge and Awareness
This is the individual cognitive dimension where the focus is on understandings and awareness of the history, experience, culture and rights of Aboriginal and Torres Strait Islander peoples. The goal in this dimension is to change attitudes to facilitate changes in behaviour and ensure that all jurisdictions have relevant programs. It is well recognised, however, that influencing attitudes is a complex proposition and programs are focusing now on building stronger links to the action dimension.
Skilled Practice and Behaviour
This is the action dimension where the focus is on changed behaviour and practice. Strategies include formal education and training as well as strong performance management processes to encourage good practice and culturally appropriate behaviour. Recognising the legitimacy of traditional health practices and developing culturally appropriate protocols are important strategies in this dimension for health organisations.
Strong (Customer and Community) Relationships
This is the organisational dimension where the focus is on an agency or institution's business practices upholding and securing the cultural rights of Aboriginal and Torres Strait Islander peoples. The scope includes management of the workforce to ensure a balance of Aboriginal and Torres Strait Islander and skilled non-Aboriginal and Torres Strait Islander health professionals and workplace management that is sensitive to cultural needs and risk management that reflects cultural differences.
Equity of Outcomes
This is the results dimension where the focus is on the outcomes for individuals and communities. Important strategies include ensuring that there is feedback at the system and organisational levels on relevant key performance indicators and targets, continuous improvement of data and information collection and benchmarking to lift performance.