Cultural Competence: What’s in a Name?

Some believe that words are mere descriptors of reality, but there is evidence that words also create reality. Scholars such as Benjamin Lee Whorf, and more recently George Lakoff and Lera Boroditsky, (also here) make a compelling case for the power of language to actually shape our experience, thoughts and perception.

As the term “cultural competence” grows as a buzzword in the D&I field, so does discussion about its appropriateness. Since the term is still fairly new, now is the time to consider what reality this word creates, and whether it’s the best expression of our ultimate goal. If our goal is to create commitment, initiatives and behaviors that result in all people receiving equitable, excellent and the most appropriate services, patient care and products possible, then cultural competence is an inadequate term for two reasons.

First, while competence is attractive and familiar in sectors like health care, it implies an end point or a check box. Neither exists when it comes to effective communication across differences. Providing the best, most appropriate services to a variety of people and populations is a moving target — fluid, contextual and evolving. And who gets to decide when this box is checked? Who defines, assesses and grants the competence at the fictional end point? Second, “cultural” is vague. For many, culture is proxy for race just like diverse often means people of color. While we in D&I know culture includes multiple identity groups, the word tricks people into thinking we’re only talking about race and language.

There are other possibilities, but most are also inadequate. Cultural empathy points to an adaptive internal emotional state, but no actions, behaviors or impact. Also, empathy is difficult for certain personalities, thinking types and industries to take seriously. Cultural humility has similar drawbacks. Cultural capacities refers to a finite end state and implies that some folks have it, and some don’t. Sensitivity and awareness are incomplete – an internal state only – and for many, cultural sensitivity elicits the fearful specter of blame-shame-walking-on-eggshells sensitivity training.

My colleague Andrés Tapia suggests we embrace crosscultural dexterity.  Dexterity is a vast improvement, but still implies a way of being instead of a way of behaving that meets a goal. Also, the term cross cultural refers to the comparing and contrasting of one group’s cultural patterns to another. Intercultural is the accurate term to describe what occurs when individuals from different cultures interact with each other. We need people to show behaviors that are effective during the (intercultural) interaction among members of different identity groups; we don’t need people to develop sophisticated (cross cultural) knowledge of different cultural beliefs and practices devoid of context.

Right now my preferred term is “intercultural effectiveness.” Effectiveness focuses on action. It focuses on impact, not intent. Effectiveness is fluid, contextual and constantly evolving. It moves us toward our goal of equity, excellence and appropriateness. To be effective, we need three things — awareness, knowledge and skills. Skills are useful insofar as they are effective, and one’s awareness, knowledge or internal emotional state (empathy, humility, etc.) are irrelevant if one lacks skills. The point of empathy, humility and sensitivity is what we do next in a situation to interact effectively with others and get a better result for everyone.

A close second is cultural responsiveness, used widely in Australia. Their Cultural Responsiveness Framework and Cultural Responsiveness Plans required for health care are excellent examples ahead of what we are doing in the USA.

Words create reality. What is your goal with cultural competence? What is the reality you want to create? Perhaps using a different term will be more effective!