A Concept Analysis of Cultural Competency

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Table of Contents

Introduction
Aims of the Concept
Uses of the Concept
What are the defining Attributes?
Model Case
Other Cases
Antecedents and Consequences
Empirical Referents
Conclusion
References

Introduction

The purpose of this analysis is to expand our understanding of the concept of cultural competency using the Walker and Avant (1995) framework. In line with this analysis, this paper seeks to clarify the defining attributes of cultural competency, identify the antecedents that characterize the concept of cultural competency, and find out the consequences that relate to the concept. A model case demonstrates how cultural competency relates to these attributes. Lastly, this paper shows a borderline case and a contrary case to show the differences between the cultural competency concept and other similar concepts. Empirical referents show people’s perceptions of the concept today.

Aims of the Concept

To distinguish cultural competency from the concept of competence

Uses of the Concept

The main use of the cultural competency concept is to clarify intercultural relationships between nurses and their patients (Jirwe, 2008). It also strives to promote a mutual understanding among colleagues and to provide a precise operational definition that has high construct validity. Collectively, these uses would help in developing a reliable tool for improving nurse-patient relationships and diagnoses (Jirwe, Gerrish, and Emami, 2006).

What are the defining Attributes?

According to Walker and Avant (1995), the concept’s defining attributes are a set of cluster factors commonly associated with the concept. These sets of factors allow an analyst to gain a deeper insight into the concept. Cultural competence has three dimensions – awareness, attitudes, and behaviors. According to Jirwe et al. (2006), ability, openness, and flexibility are the defining attributes of cultural competence. The first concept of awareness refers to a person’s acknowledgment of cultural bias, thoughts, and ideas. Attitude is the second attribute of cultural competence. It refers to a person’s ability to show sensitivity towards other people’s culture. The last attribute (behavior) refers to the actions that characterize a culturally competent person (Jirwe, 2008).

Model Case

Similar to many nurses in her profession, Nancy started her career as a staff nurse. She worked in the medical-surgical nursing unit at her local hospital in Houston, Texas. Unlike most of her colleagues, Nancy loved her job and exercised high levels of self-discipline. Through her commitment and dedication to the practice, she earned a certification in obstetrics and gynecology. Her passion for nursing led her superiors to consider her as the best candidate for filling a flight commander position when it emerged. Two years later, she received a promotion as a deputy commander of her squadron.

Nancy’s case presents a model analysis because her story exemplifies all the attributes of the cultural competency concept. For example, she had the ethical framework needed for building a respectable career. Similarly, she sacrificed some of her freedoms to earn extra certifications needed to progress with her career. She also knew her limitations (awareness) and utilized self-reflection to know which parts of her career she should avoid or indulge in.

Other Cases

Borderline: Brian left college to start a promising career as a nurse in New York. He got a position as a resident nurse in one of his Uncle’s clinics. His employer gave him two weeks to orient himself in his duties. However, when the two weeks lapsed, Brian was unable to undertake his duties effectively. For example, he was unable to communicate patients’ vital recordings (such as low or high blood pressure) to the physician. Although he had respectable ethical standards, Brian suffered from failing to recognize his limitations. In this regard, it is difficult to say he had the competency to undertake his duty. Similarly, his inability to focus on his tasks may have rendered him an incompetent nurse.

Contrary Case: Edith was fresh out of college in 2009. She met a young handsome man in a small military hospital where she worked, fell in love with him, and married him. Since they were both new nurses, the hospital administration did not want to assign them to work in one ward because existing nursing stipulations prohibited married couples from working in the same unit. She got a separate unit at the ICU, but Edith was too timid to ask questions or seek clarifications when unsure about something. This weakness led to several medical errors. It showed her failure to recognize her limitations.

Antecedents and Consequences

Antecedents refer to the things that happen before the development of the concept of cultural competency. Awareness, knowledge, experience, and frameworks of skill behaviors are antecedents of the cultural competency concept (Jirwe, 2008). Awareness is important in this regard because competency begins with the learning process. Experience is equally important because it helps in skill acquisition, thereby enabling nurses to be culturally competent. Lastly, there needs to be a framework to guide the cultural competence model because we cannot use random selection. The consequences of the cultural competence concept are trust, success, job effectiveness, and practice development.

Empirical Referents

Although some authors believe there are inadequate tools for assessing cultural competency, Jirwe (2008) argues that the Dreyfus Skill Acquisition model is the most effective tool for evaluating competency. It has nine different domains. Some researchers have advanced the slater nursing competency scale as an alternative measurement tool for this analysis (Jirwe et al., 2006). These tools work by evaluating the quality of competent care required of first-time nurses. Users recommend that there should be more than one period of observation to fill an entire scale. These tools relate to the critical attributes of ethics and self-reflection.

Conclusion

This analysis demonstrates that the concept of cultural competency distinguishes itself from its synonyms. The concept does not only signify someone’s fitness for a task but also his or her motivation, passion, and commitment to fulfill the given task. It also signifies someone’s willingness to pursue ongoing learning opportunities with the prospect of accomplishing a given task.

References

Jirwe, M. (2008). Cultural Competence in Nursing. Stockholm, SW: Karolinska Institutet.

Jirwe, M., Gerrish, K., & Emami, A. (2006). The Theoretical Framework of Cultural Competence. The Journal of Multicultural Health and Nursing, 12(3), 6-16.

Walker, L.O., & Avant, K. C. (1995). Strategies for Theory Construction in Nursing. Norwalk, C.T: Appleton & Lange.

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