Cross-Cultural Sensitivity:Bridging the GapNicholas J. Saller, PT

Did you know...

●A popular brand of golf balls went on sale in Japan in packs of four. Only after sales were nonexistent, did executives find out that the #4 in Japan means death.

Seemingly Trivial

●Little things that are a part of our everyday culture might cause a huge backlash in others.

●It isn’t because we meant to hurt, offend, irritate or anger someone. Rather, what is an everyday thing for one group might be totally foreign or even upsetting to another population.

How about this one...

●Crossing your ankle across your knee with the bottom of your foot toward the person you are speaking with is normal in the USA.

●However, in Arab cultures, it is the worse possible insult.

Culture

To be cultured, you have to know culture...1.Merriam Webster defines culture as, "the

customary beliefs, social forms, and material traits of a racial, religious, or social group; also: the characteristic features of everyday existence (as diversions or a way of life) shared by people in a place or time." (http://www.merriam-webster.com/dictionary/culture)

2.Ironically, culture also means, "expert care and training." (http://www.merriam-webster.com/dictionary/culture)

Integrating the Two Definitions

●If we learn about another’s "culture", we will be able to provide "cultured" patient care.

●The result will make us better clinicians and produce better patient outcomes through demonstrating our "expert care and training"! (http://www.merriam-webster.com/dictionary/culture)

Strategies for Cross-Cultural Sensitivity

●Keep words and phrases simple*(KISS)oNo medical jargon other than the most universal,

basic and absolutely necessary terms.●Speak slower rather than louder*

oChances are a hearing impairment is not what is hampering the communication exchange.

●If you are not sure about their question or an answer to your question then rephrase it*oAlso remember that "yes" doesn't necessarily

indicate affirmation in other cultures; it can also indicate "no and/or maybe.

*Mielke, David. "Effective Global Communication Requires Cross Cultural Sensitivity." AnnArbor.com. 9/20/2009.

Continued● Avoid slang and jargon(1)● Identify your own biases and prejudices.(2)

o They are simple to overcome.o It is fear that drives them and for which education is the

solution.(2)● Perform assessments in a culturally sensitive manner(2)● Patient/Family Misconceptions(2)

o Delivering care across cultures has the potential to create misconceptions and unrealistic expectations.

o This can impair judgement and influence interactions. o It is easy to become frustrated or defensive by the former. o Instead, remain calm and work to help guide good outcomes.

(2)

(1)Mielke, David. "Effective Global Communication Requires Cross Cultural Sensitivity." AnnArbor.com. 9/20/2009.(2) Seibert, PS. "A Checklist to Facilitate Cultural Awareness." J Med Ethics 2002;28:143-146 doi:10.1136/jme.28.3.143

More

●Religious/Spiritual Beliefs(2)oStudies show that these play a role in successful

health recovery.oPatients often attribute successful recovery and

even survival to these beliefs. (2)●Identify language barriers(2)

o Identify the preferred method of communication. Spoken, written, signing, facing, offset, etc. (2)

oTranslator

(2) Seibert, PS. "A Checklist to Facilitate Cultural Awareness." J Med Ethics 2002;28:143-146 doi:10.1136/jme.28.3.143

Interestingly Enough...

●In some cultures, men can be seen holding hands, which in no way indicates that they anything other than good friends.

●In Japan, when exchanging business cards it is considered rude to put your new colleague's business card in your wallet and then back in your back pocket as it is perceived as you are sitting on his face!

So Many Mines in the Field...

●With all of the intricacies of a culture that is different from your own, it is easy to feel like you are walking through a minefield blind and not knowing where to step next.

●While some folks spend weeks, months, or years learning about other cultures in which they will live and/or serve there is a lot of room for error.

Cutural Exercise: Name the Flag and Describe the Cultures...

Which is Texas : Which is Chile

Chile Texas

Mistakes are Inevitable...

●Embarrassment is likely but only temporary.●Don't give up!●On the whole, people from other cultures

cherish those who are trying to show respect and to honor their culture.

Getting More than You Give

●Oftentimes the folks who you are trying to honor by respecting and learning about their culture will in turn honor you with compliments, food, etc...

●Many times you make a lifelong friend!

Additional Hints

●Try to learn a little about the following:oMedical care in the patient’s native country.oFamilial structure.oA few of their native language phrases if they have a

good command of English.oA few general customs of their country.oMaybe a few interesting details about their

hometown in their country.

Everyone Has a Different Story to Tell

A Chilling Lesson in Cross Cultural Sensitivity in Medicine

The Spirit Catches You and You Fall Down

No Is a Powerful Word in All Languages

Take Great Care in What You Say and Do

You never know how someone might respond...

"I've learned that people will forget what you said, people will forget whatyou did, but people will never forget how you made them feel."- Maya Angelou