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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 healthcare, 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 word “cross cultural” refers to the comparing and contrasting of one group’s cultural patterns to another group’s.  “Intercultural” is the accurate term to describe what occurs when individuals from different cultures interact with each other.  We need people to do 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 towards 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 healthcare are excellent examples ahead 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!



  • Carlos Cortes says:

    Very thoughtful and well argued column, Susana. For me, your proposed “solutions” don’t work much better than the linguistic “problems” that you so well identified, but you’ve certainly done a fine job of analysis. Maybe there isn’t a “solution.” I certainly don’t have one. Possibly the recognizing of the limitations of any single word is the most important aspect of this discussion.

    By the way, I mentioned this column in another chat room, because I think lots of people should read it. Keep up the fine work.


    • Susana Rinderle says:

      Gracias Don Carlos. I appreciate you reading, your comments, and your sharing the piece. Yes, as you well know, this conversation is a complex, convoluted, and neverending one! Since ultimately we humans have to pick words to use, even if they are imperfect, what term do you recommend or prefer, and why?

      • Carlos Cortes says:

        Susana, I’m not sure if I ever answered your letter. As for words I prefer instead of cultural competence, I don’t have any strong feelings. My pragmatic side says let’s go along with cultural competence, since it is so well established, but continue to point out its limitations and keep up the pressure to make that competence really meaningful. Regardless of what term emerges victorious, my fear is that it’s substance will get dumbed down so that people start qualifying just because they can breathe.

  • Susana Rinderle says:

    An excellent piece by Paul Gorski arguing for cultural proficiency (not cultural competence) and equity literacy!

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