Objectives:
After you complete this course, you will be able to:

1. Define "culture" and "ethnic group."

2. Compare specific cultural practices of various patient populations.

3. List at least five strategies to promote effective cross-cultural communication in the multi-cultural workplace.

4. Appraise barriers to adequate healthcare related to cultural practices and beliefs.

5. Describe methods to assist the healthcare worker in assessing the cultural practices of patients.

6. Identify specific components to a cultural assessment.

Introduction
America has been called the "Great American Melting Pot" for its reputation of assimilating various cultures. However, population demographics are reshaping the "melting pot" ideal, and healthcare has demonstrated the need for cultural diversity training. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) now requires evidence that healthcare workers have knowledge of the impact of cultural backgrounds on the delivery of healthcare. The Healthy People 2000 initiative, developed by the U.S. Department of Health and Human Services, specifically targeted improving the health status of racial and ethnic minorities, particularly low income groups.

Early on the National League of Nursing, the American Nurses Association, and the American Academy of Nursing recognized the importance and relevance of cultural diversity competence. Knowledge of cultural diversity in patients has been discussed and theorized about in nursing since Leininger suggested that culture-care diversity should guide nursing practice. However, all healthcare workers must become more proficient in recognizing and responding to the cultural identity of patients. It is impossible to assume one can learn all there is to learn about every culture, but completing a thorough assessment (which includes a cultural assessment) is imperative.

The goal for healthcare workers is to bridge the accent and language barriers, understand variations in pain response, identify alternative medical treatment beliefs, and grasp various cultural attitudes about healthcare and healthcare providers. In addition, a thorough cultural assessment would include assessment of time, touch, and dietary practices.