1. 3 Dimensions of Cultural Humility
Commitment to lifelong learning & critical self reflection
Recognize & challenge power imbalances
Advocate for institutional accountability/implement

2. Dimension 1: Lifelong learning & Critical Self Reflection
For the Practitioner:
Understanding your own story
Naming & owning your own identity
Reflecting on and acknowledging cultural & family history, personal biases
Inventorying both privileges & struggles, strengths & vulnerabilities
In what ways do I experience power and privilege? In what ways do I experience discrimination and disenfranchisement? What assumptions do I have about this patient’s culture? What might be my limitations in serving this patient (what I don’t know or think I know)? What might be my strengths in serving this patient?
Commitment to lifelong learning. Asking questions. Discovering cultural & honoring cultural differences.

3. Dimension 2: Recognize & Challenge Power Imbalances
Provider/Patient power imbalance:
Who has control of the medical encounter?
Who should have control over what?
Gender power imbalances:
History of discrimination against women
Minimizing female’s medical complaints (e.g., hysteria)
Lack of respect for the female body
Overtones of abortion/contraceptive debate: Why don’t women get to decide what kind of medical care they receive to control fertility?
Cultural power imbalances
Immigrant, American Indian, African American, Latinx, Religious minorities & ethnic minorities may have beliefs & practices in contradiction to biomedical model
Racial power imbalances—Minority providers are under-represented in medicine:

4. Distribution of U.S. Population by Race/Ethnicity, 2010
Total U.S. Population = million
SOURCE: 2010 U.S. Census

5. Disproportionate Minority Providers in the US
Updated 2014

6. US Medical Students accepted, enrolled and graduated (2010 & 2015)
Total U.S. Enrollees = 18,665 (2010)
2015
SOURCE: AAMC Data Warehouse: Applicant Matriculant File as of October 4, Accessed 1/20/12.

7. Dimension 3: Institutional Accountability
An organizational culture of Reflection
Oakland Children’s Hospital: Creating spaces and policies that allow diverse patient families to heal and recover in culturally relevant ways
Tom Waddell Clinic: Transgender Tuesdays—created designated clinic time for transgender patients.
Trainings
Staff trainings in intercultural communication & health beliefs
Policies & Protocols
How to handle non-traditional requests. How to practice with an ear and heart for cultural differences. How to bridge the patient culture & the clinical culture.
Patient Voice & Community Responsiveness
Patient advocates & patient advisory boards.
Surveying patients with an ear for cultural appropriateness of care.