You're Doing It Wrong: The evolution of cultural competence | Raquel Martin | TEDxRutgersCamden
Summary
TLDRThe speaker passionately critiques the ineffectiveness of current diversity and cultural competency trainings, which they argue often reinforce stereotypes rather than combat biases. They highlight the importance of experiential learning and continuous engagement with diverse communities to truly understand and address racism and prejudice. The speaker shares personal experiences as a black woman and professional in academia and healthcare, emphasizing the need for trainings to address the root causes of discrimination and to promote a more inclusive and understanding society.
Takeaways
- 😔 The speaker expresses frustration with diversity trainings that reinforce stereotypes rather than fostering anti-racism and cultural competency.
- 🌟 Cultural competency is not an achievable goal but a continuous journey that requires experiential learning and engagement with diverse groups.
- 📈 The speaker highlights the negative impacts of poor cultural understanding in various professional roles, including academia, healthcare, and mental health.
- 🔍 The historical context of 'cultural competence' is important, emphasizing the need for ongoing learning and interaction with different cultures, not just academic knowledge.
- 🏥 In healthcare, biases can lead to misdiagnoses and unequal treatment, with black patients experiencing higher mortality rates and less access to standard treatments.
- 👨⚕️ The speaker recounts an incident where a training session for black youths inappropriately used a scene of police brutality, illustrating a lack of cultural sensitivity.
- 📚 Data is shared to humanize the experiences of black individuals, showing how poor cultural confidence can lead to disparities in education and healthcare.
- 🚫 The speaker criticizes the tokenistic approach to diversity trainings, which often occur once a year and lack follow-up or meaningful engagement.
- 🌱 The roots of racism and oppression need to be addressed in trainings, not just the symptoms, to truly improve the human experience.
- 🌈 A comprehensive approach to diversity training should include discussions on intersecting identities and involve a variety of resources and formats to foster understanding.
Q & A
What is the speaker's main concern about the diversity trainings they have attended?
-The speaker is concerned that the diversity trainings they have attended often reinforce stereotypes rather than providing effective ways to address biases and practice anti-racism, cultural competency, and diversity.
Why does the speaker feel that the current approach to diversity training is a waste of time?
-The speaker feels that the current approach is a waste of time because it lacks experiential learning, follow-up, and meaningful engagement, instead focusing on one-time, mandatory trainings that do not lead to tangible improvements in cultural understanding or behavior.
What does the speaker believe is the true meaning of cultural competence as proposed by Dr. Daryl Wing Sue?
-According to the speaker, Dr. Daryl Wing Sue proposed that cultural competence is not about being fully versed in a group of people but rather about engaging in experiential learning and interacting with people from different walks of life as human beings.
How does the speaker describe the impact of poor cultural competence on their various roles?
-The speaker describes the impact of poor cultural competence as significant across their roles as a professor, scientist, licensed clinical psychologist, and a black woman in America, where they witness the effects of racism, bias, and lack of cultural understanding in academia, healthcare, and personal experiences.
What is the significance of the movie 'Crash' scene in the context of the training session mentioned by the speaker?
-The speaker highlights the movie 'Crash' scene as an example of poor cultural competence in a training session aimed at teaching distress tolerance to black youths. The scene's depiction of police brutality reinforces negative stereotypes and is inappropriately used to induce stress.
Why does the speaker argue that cultural competence should not be treated as an achievable goal?
-The speaker argues that treating cultural competence as an achievable goal is misguided because it implies a finish line, whereas it should be an ongoing journey of learning and engagement with diverse cultures and experiences.
What are some of the disparities the speaker mentions in the healthcare system affecting black patients?
-The speaker mentions several disparities in healthcare, including higher mortality rates for black patients with heart disease, cancer, and HIV/AIDS, less likelihood of receiving gold standard treatments, and the ineffectiveness of medical devices like pulse oximeters for individuals with dark skin pigmentation.
How does the speaker connect the patient's experience of imposter syndrome to broader societal issues?
-The speaker connects the patient's experience of imposter syndrome to broader societal issues by suggesting that it could be a result of stereotype threat, which is stress and anxiety that arises from the fear of conforming to negative stereotypes attributed to one's racial or ethnic group.
What does the speaker suggest as a way to improve cultural competence trainings?
-The speaker suggests improving cultural competence trainings by including a variety of information sources, addressing intersecting identities, engaging in meaningful conversations, setting tangible goals, and focusing on the roots of racism and bias rather than just the symptoms.
Why does the speaker emphasize the importance of authenticity and how is it connected to cultural competence?
-The speaker emphasizes the importance of authenticity because it is a privilege that can be perceived as a threat due to racial bias. Authenticity is connected to cultural competence as it involves understanding and respecting individuals' true selves, which includes their racial and cultural identities.
Outlines
📚 The Frustration with Ineffective Trainings
The speaker expresses exhaustion and frustration after attending a training session, which they feel has reinforced stereotypes rather than addressing biases and promoting anti-racism. They lament that such trainings, despite being prevalent, often fail to provide practical ways to improve the human experience. The speaker's personal offense stems from witnessing the negative impact of poor cultural understanding in various roles they hold, including as a professor, scientist, and licensed clinical psychologist. They highlight the importance of experiential learning over academic training and criticize the tokenistic approach to diversity trainings that occur annually, often in February, without any follow-up or meaningful engagement.
🚑 The Consequences of Cultural Incompetence
This paragraph delves into the detrimental effects of cultural incompetence, particularly in the fields of education and healthcare. The speaker shares data showing that black students are more likely to be suspended from school and black patients are at a higher risk of mortality due to disparities in treatment. They also discuss the bias in medical device effectiveness, such as pulse oximeters, and the historical roots of racial disparities in medicine. A therapeutic scenario is presented where a black woman's struggle with imposter syndrome is mishandled due to the clinician's lack of understanding of the patient's cultural context and experiences.
💔 The Impact of Racism and Stereotype Threat
The speaker emphasizes the importance of addressing the root causes of racial stress and difficulties, using the metaphor of a tree to illustrate the concept. They discuss the idea of stereotype threat, which affects the performance of individuals from stereotyped groups, and how it can lead to increased mistakes and stress. The paragraph also touches on the broader implications of racism, including the weaponization of black individuals' appearances and the need for legislation to protect against hair discrimination. The speaker calls for a deeper, more uncomfortable examination of the roots of these issues rather than focusing solely on the symptoms.
🌟 Cultivating Cultural Competence and Tangible Change
In the final paragraph, the speaker calls for a shift in the approach to cultural competence training, advocating for a more engaged and ongoing process rather than a one-time event. They stress the need for varied forms of information and narratives to foster a deeper understanding. The speaker also discusses the importance of addressing discomfort and challenging biases, and the necessity of setting tangible goals and metrics for creating a less oppressive environment. They conclude by emphasizing that cultural competence is not a finish line but a lifelong journey, and that improving the human experience requires understanding and addressing the roots of racism.
Mindmap
Keywords
💡Cultural Competence
💡Stereotypes
💡Bias
💡Racism
💡Oppression
💡Cultural Humility
💡Experiential Learning
💡Diversity Training
💡Stereotype Threat
💡Authenticity
💡Intersectionality
Highlights
Feeling of exhaustion and frustration after diversity trainings that fail to address biases effectively.
The prevalence of trainings that double down on stereotypes rather than fostering anti-racism and cultural competency.
The importance of acknowledging and addressing the impact of power, prejudice, and privilege in society.
Personal offense taken to subpar cultural understanding and its impact on various roles, including professor and scientist.
The role of cultural competence in healthcare and its failure to improve patient outcomes for black patients.
The historical context of cultural competence and its true meaning as coined by Dr. Daryl Wing Sue.
The inadequacy of mandatory trainings that lack follow-up and experiential learning.
The harmful decision-making in mental health practices due to poor cultural competence.
Data on the disproportionate impact of poor cultural confidence on black boys and girls in schools.
The 'unequal treatment' report revealing higher mortality rates for black patients due to racial disparities in healthcare.
The medical device disparity affecting the accuracy of pulse oximeters for black patients.
The dominance of certain communication styles by doctors with black patients, limiting their treatment options.
The historical roots of medical practices, such as J Marion Sims' unethical experiments on enslaved women.
The therapeutic process failure due to not addressing the roots of racism-related stress.
The concept of stereotype threat and its impact on the performance of black individuals.
The need to address the roots of racism in diversity trainings rather than just the symptoms.
The importance of varying the forms of information and narratives in cultural competence trainings.
The necessity of tangible goals and metrics for achieving cultural competence in organizations.
The myth of colorblindness and its implications for addressing racism effectively.
The lifelong journey of cultural competence and the need for continuous improvement in understanding and practice.
Transcripts
last week I walked out of a training
from my colleagues feeling a sense of
exhaustion and frustration
and this is not the first time I have
felt this way
when I leave these trainings I typically
feel like they have doubled down on
stereotypes rather than providing me
with ways to address my biases and
practice anti-racism
cultural competency and diversity
trainings are so prevalent these days
and they should be as we venture to a
space of acknowledging addressing and
understanding the impact that power
Prejudice and privilege has on this
world and all those that reside in it
however the truth is
typically when I attend these trainings
I find them to be a waste of my time
and that is heartbreaking to me because
we are worse off due to these poor
trainings that do not provide us with
ways to improve The Human Experience
I take personal offense to these
lackluster trainings because in the many
roles that I hold I see the impact that
subpar cultural understanding
limited cultural humility
and outdated cultural knowledge has on
the world
I see the impact as a professor
when my students come to me and share
that once again they have been Val
invalidated and the victims of racism by
my colleagues in Academia
I see the impact as a scientist when I
look at statistic after statistic
regarding the number of black patients
and patients of the global majority that
feel seen when they visit their doctors
these patients are significantly more
likely to be misdiagnosed because the
biases that their doctors hold impact
their ability to do an appropriate
assessment and do their job
I see the impact as a licensed clinical
psychologist when I work with patient
after patient after patient
regarding ways to deal with the impact
of Oppression that they experience
in the workplace
in their neighborhoods
and sometimes in their own families
and I see the impact as a black woman in
America who often has to convince others
that I am not a threat simply because of
the color of my skin
or the fact that my hair defies gravity
I see the impact every day
you know so many people attempt to teach
about cultural competence and the role
of cultural competence without
understanding the history behind the
term
did you know that when professor in
psychologist Dr Daryl Wing Sue coined
the phrase cultural competence he stated
that it is not possible to be fully
versed on a group of people in your
lifetime
it's true he actually stated that it is
more important to have experiential
learning to engage with people that
don't look like you who from different
walks of life as human beings than it is
to focus on
the academic trainings the cognitive
understanding that so many of these
diversity trainings seek to embody
but that's not really how we're taught
cultural competence is it
every year we are mandated to go to at
least one mandatory training most of the
time it is in February
we all know why it is typically in
February
and then we see a speaker
we watch a webinar we check off a box we
get the certificate and too often the
education ends there
no afterthought no follow-up no
experiential learning
and that was never how it was meant to
be
when we treat cultural competence like
an achievable goal like a Finish Line to
be crossed we completely missed the mark
and we do Injustice to all those that
will be significantly impacted by our
ignorance
by our insensitivity
and by our inconsideration
I unfortunately have witnessed many
incidents of poor cultural competence
but one that always sticks with me
was during a panel a planning session
between licensed clinical psychologists
the purpose of the session was to
identify ways to teach distress
tolerance to a group of black youths
we typically do this by stimulating some
form of stress that is deemed reasonable
and then allowing the children to
practice their coping skills in a safe
environment this is typically done by
showing a scary movie clip but this year
a psychologist proposed that they
changed the scene to a scene from the
movie Crash
which depicted beliefs police brutality
the offenders were European American
police officers and the victims were a
black couple
I want you to think of how abominable a
decision it was
for licensed mental health professionals
whose job it is to contribute to the
mental healing of youths
to decide that showing
of seeing that depicted police brutality
would create what is deemed as a
reasonable amount of distress
and black youths
I often wonder what contributes to these
poor decision making especially among
licensed mental health professionals
I believe it happens because the way we
seek to understand and learn more about
individuals from diverse backgrounds and
cultures is limited to zoom meetings
and workshops
and webinars
I want to share some data with you so I
can fully help you understand and
humanize the experience
of what poor cultural confidence
contributes to
black boys and girls are respectively
three and six times more likely
to be suspended from school
then their European American peers for
displaying the same behaviors
in 2003 The Institute of medicine
published a 700 page document entitled
unequal treatment
this revealed that
black patients have a higher mortality
rate
when it comes to heart disease
cancer and HIV and AIDS than any other
U.S racial or ethnic group and this
disparity is not due to differences in
access to care in fact at equivalent
levels of access to care Black and
Hispanic patients are significantly less
likely to receive gold standard
treatments
that are known to treat medical
disorders including heart attacks
there's even disparity in the
effectiveness level of medical apparati
pulse oximeters are used every single
day and hospitals to measure the level
of oxygen in the blood
they are used with disorders such as
pneumonia lung cancer and asthma
however a study in 2022 revealed that
they are less effective in individuals
with dark skin pigmentation
like black patients
the inability to appropriately measure
the level of oxygen in the blood
can contribute to a number of medical
difficulties and possibly death
a study of over 4 700 participants
revealed that black patients are more
likely to be subjected to dominant
communication styles from their doctors
less likely to be provided with all the
treatment options and less likely to be
engaged in participatory decision making
for their own Medical Care
and if we go back to the development of
the field of medicine we will come
across J Marion Sims
a man who is lionized as the father of
modern gynecology
and who perfected his technique by
operating on enslaved African women
without anesthesia and certainly without
their consent
I often see these things
therapeutic care as well
I want to put you in the driver's seat
so you can understand how this can
manifest in the therapeutic process
a patient comes to your office a black
woman comes in and she is seeking mental
health care
after you do an assessment you identify
the fact that she is having difficulty
identifying her strengths and abilities
she often feels like a fraud in her
environment
and she is having such difficulty
meeting her goals
so you collaborate together to identify
a plan
you decide to start with assertiveness
training it is an effective treatment
when it comes to anxiety and stress but
it doesn't work
during the next appointment she shares
that she is having difficulty
identifying any positives in her life
when she thinks about goals when she
thinks about what she can achieve she
can't identify one
so you propose the use of a gratitude
Journal
but it doesn't work
during the next session you do more
digging
and she shares that she has never
experienced this form of feeling like an
imposter before typically she thrives in
all her environments and that is when
you decide to empower her you share that
she simply needs to be authentic in her
space and people will welcome her
obvious intellect
in her vivacious personality
and that is where you lost her she goes
you and she does not come back for
another session now as the clinician in
the room you do what anyone does when
they are ghosted personally or
professionally you ask yourself why what
happened you walk yourself through the
steps
you utilize patient-centered care
because your training taught you that so
often black patients aren't even engaged
in treatment options they're just given
to them
you empowered her and used a
strength-based perspective because you
learned in your training so often black
patients are treated from a framework of
deficits which is also harmful
you did everything that you were taught
to do
but what you missed is what wasn't
included in the training and what so
often is not included in the trainings
because they seem to make others
uncomfortable
and that is the fact that
when your skin is weaponized
everything is a privilege authenticity
is a privilege
because everything can be perceived as a
threat
from the tone of your voice
to the way that you wear your hair
did you know that black women were one
and a half times more likely to know
someone
who was sent home for their hairstyle or
to be sent home for their hairstyle
and this isn't limited to the workplace
hair discrimination has been found in
youths as young as five years old
they're creating a respectful and open
world for natural hair is a piece of
legislation that was created by four
phenomenal women who felt that black
individuals should not be held back and
discriminated against in the workplace
and in school because of the way that
they wore their hair
however not even 50 percent of states in
the United States have enacted this
piece of legislation in fact although it
passed the house in March 2022 it was
blocked in the senate in December in
2022.
I want you to think about that for a
second how many times when you think of
privileges do you think about
authenticity
when you take a step to ruminate on that
I want you to ask yourself
has legislation ever had to be passed so
that you were not retaliated against
for the way that you wore your hair the
way that it came out of your head
what's more authentic than that
that stress that anxiety that your
patient felt could likely have been a
result of stereotype threat this is a
form of Stress and Anxiety that presents
itself when you have a fear of
conforming to a stereotype that is
attributed to your group now there are
many egregious stereotypes when it comes
to black people but a very common One
deals with the lack of intellect
if I am working and stereotype threat
presents itself and it often does I will
create so much mental energy combating
that stereotype I'm not stupid I'm smart
I can do this let me check triple check
and double check that I won't even
divert the right amount of energy to
perform the task that is well within my
ability to do
which will contribute to significantly
more mistakes
everyone has stress when it comes to
performing tasks but stereotype threat
gets in the way of you doing things that
you can even have the ability to do
overall
when you think about the integration of
all the symptoms and what contributes to
racism related stress and and
difficulties within the environment I
want you to think about a tree
that stress that hesitance that fear
that imposter syndrome that your patient
was experiencing that was a branch
but the things that are contributing to
those the maintenance of those branches
thriving and whistling in the wind every
day
is racism
those are the roots
if we ever want to improve The Human
Experience of individuals overall
through all of these trainings they must
address the roots
when you walk out of a training with the
same way of thinking the same
information that you walked into the
training with the problem is the
training
we need to vary the forms of information
that we Herald so many times we focus on
peer-reviewed journals and those are a
good start but publication bias also
exists it is easier for a research study
that focuses on European Americans to be
published and one that focuses solely on
black people or black people or people
of the global majority and not in
comparison one that focuses solely on
these individuals and the intricacies of
the experience in the diaspora
we also need to look at the way we do
these trainings are we looking at
intersecting identities
age
ability level
sexual orientation
it seems like a lot to include in one
training and it is and the goal is not
to include it in one training the whole
purpose of this is to be an experience
and understanding that it is a journey
when it comes to cultural competence
we need to focus on engagement
a three-hour talk with 15 minutes of q a
is not enough time
you need to look at books and break them
down you need to listen to podcasts and
break it down we need to really vary the
information that we share the narratives
that are experienced and the way that
people choose to share them
and have a conversation
do you have difficulties having the
conversation are you uncomfortable let's
start there
where is the discomfort coming from
are you afraid of being wrong
that's okay
I would trust someone who admits to
being wrong way before I trust someone
who says that they're right all the time
are you feeling oppressed in the
environment that the the training is
happening let's start there
what form of Oppression are you
experiencing is it internalized
is it institutional is it cultural all
of these have different treatment plants
but they can all be accomplished
we need to come back with tangible goals
and metrics for achieving those goals
it's not enough to say that we want the
environment to be less oppressive we
need to say that we are going to look at
our policies and come back in two months
and three months yes your policy May
state that it is against discrimination
when it comes to skin color but what
about hair
what about hairstyles or hair lengths or
protective styles that are attributed to
certain individuals of racial or ethnic
Origins
how diverse is your company is your
organization really when you go up
different levels of the hierarchy do you
notice that individuals start to look
the same
that's not diversity
and it's just important to look at these
things from day to day it didn't take
one day to build that bias
it's not going to take one day or what
training to break it down
there is no such thing as being
colorblind when you say you don't see my
color you don't see me
and it also places emphasis on the wrong
thing
color is not the issue race is not the
issue
racism is
when we focus on what is really
important
we can work towards improving The Human
Experience overall
and the many roles that I hold
scientists psychologists person
Professor I'm here to tell you therapy
is not going to fix it all
my office should not be the only safe
space that someone holds
I should not have to manage the fear of
individuals who took a Hippocratic oath
to protect me those who decided to Serve
and Protect others the world should feel
like a safe space
and if we are going to address that we
have to look at the roots we have to be
okay with being wrong and we have to
improve The Human Experience overall by
understanding
my cultural competence is not a Finish
Line
we're going to work on this our whole
lives
thank you
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