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An increasing number of residency programs in the United States now offer global health experiences for trainees, yet many participating residents lack the behaviors and skills needed to engage effectively with local partners and colleagues. In the experience of the authors, trainees working in global settings fall into 1 of 4 learner categories determined by their degree of cultural humility and their willingness to engage with their hosts. This viewpoint proses the concept of \"re-orientation,\" or ongoing structured mentorship, as a way to provide key opportunities for residents to mature in these two important areas during their global experiences. We propose that residencies should incorporate \"re-orientation\" as a component of their global health rotations in order to provide their trainees with the skills and behaviors to engage successfully with their local colleagues and partners.

Healthcare and social services providers are deemed culturally competent when they offer culturally appropriate care to the populations they serve. While a review of the literature highlights the limited effectiveness of cultural competence training, its value remains largely unchallenged and it is institutionally mandated as a means of decreasing health disparities and improving quality of care. A plethora of trainings are designed to expose providers to different cultures and expand their understanding of the beliefs, values and behavior thus, achieving competence. Although this intention is commendable, training providers in becoming competent in various cultures presents the risk of stereotyping, stigmatizing, and othering patients and can foster implicit racist attitudes and behaviors. Further, by disregarding intersectionality, cultural competence trainings tend to undermine provider recognition that patients inhabit multiple social statuses that potentially shape their beliefs, values and behavior. To address these risks, we propose training providers in cultural humility, that is, an orientation to care that is based on self-reflexivity, appreciation of patients’ lay expertise, openness to sharing power with patients, and to continue learning from one’s patients. We also briefly discuss our own cultural humility training. Training providers in cultural humility and abandoning the term cultural competence is a long-awaited paradigm shift that must be advanced.

Background Cross-cultural educational initiatives for professionals are now commonplace across a variety of sectors including health care. A growing number of studies have attempted to explore the utility of such initiatives on workplace behaviors and client outcomes. Yet few studies have explored how professionals perceive cross-cultural educational models (e.g., cultural awareness, cultural competence) and the extent to which they (and their organizations) execute the principles in practice. In response, this study aimed to explore the general perspectives of health care professionals on culturally competent care, their experiences working with multi-cultural patients, their own levels of cultural competence and the extent to which they believe their workplaces address cross-cultural challenges. Methods The perspectives and experiences of a sample of 56 health care professionals across several health care systems from a Mid-Western state in the United States were sourced via a 19-item questionnaire. The questionnaire comprised both open-ended questions and multiple choice items. Percentages across participant responses were calculated for multiple choice items. A thematic analysis of open-ended responses was undertaken to identify dominant themes. Results Participants largely expressed confidence in their ability to meet the needs of multi-cultural clientele despite almost half the sample not having undergone formal cross-cultural training. The majority of the sample appeared to view cross-cultural education from a ‘cultural awareness’ perspective - effective cross-cultural care was often defined in terms of possessing useful cultural knowledge (e.g., norms and customs) and facilitating communication (the use of interpreters); in other words, from an immediate practical standpoint. The principles of systemic cross-cultural approaches (e.g., cultural competence, cultural safety) such as a recognition of racism, power imbalances, entrenched majority culture biases and the need for self-reflexivity (awareness of one’s own prejudices) were scarcely acknowledged by study participants. Conclusions Findings indicate a need for interventions that acknowledge the value of cultural awareness-based approaches, while also exploring the utility of more comprehensive cultural competence and safety approaches.

Cultural awareness training for health professionals is now commonplace across a variety of sectors. Its popularity has spawned several alternatives (i.e., cultural competence, cultural safety, cultural humility, cultural intelligence) and overlapping derivatives (diversity training, anti-racism training, micro-aggression training). The ever-increasing reach of cultural awareness initiatives in health settings has generally been well intentioned - to improve cross-cultural clinical encounters and patient outcomes with the broader expectation of reducing health disparities. Yet the capacity of cultural awareness training to accomplish or even impact such outcomes is seldom comprehensively scrutinized. In response, this paper applies a much needed critical lens to cultural awareness training and its derivatives by examining their underpinning philosophies, assumptions and most importantly, verification of their effectiveness. The paper finds cultural awareness approaches to be over-generalizing, simplistic and impractical. They may even induce unintended negative consequences. Decades of research point to their failure to realize meaningful outcomes in health care settings and beyond. Broader expectations of their capacity to reduce health disparities are almost certainly unachievable. Alternative suggestions for improving cross-cultural health care interactions and research are discussed within.

Background Racial concordance between patients and clinician has been linked to improved satisfaction and patient outcomes. Objectives (1) To examine the likelihood of clinician-patient racial concordance in non-Hispanic White, non-Hispanic Black, Asian, and Hispanic patients and (2) to evaluate the impact of patient-clinician race concordance on healthcare use and expenditures within each racial ethnic group. Methods We analyzed data from the 2010–2016 Medical Expenditure Panel Survey (MEPS). We used bivariate and multivariate models to assess the association between patient-clinician race concordance and emergency department (ED) use, hospitalizations, and total healthcare expenses, controlling for patient socio-demographic factors, insurance coverage, health status, and survey year fixed effects. Results Of the 50,626 adults in the analysis sample, 32,350 had racial concordance with their clinician. Among Asian and Hispanic patients, low income, less education, and non-private insurance were associated with an increased likelihood of patient-clinician racial concordance. Emergency department use was lower among Whites and Hispanics with concordant clinicians compared to those without a discordant clinician (15.6% vs. 17.3%, p  = 0.02 and 12.9% vs. 16.2%, p  = 0.01 respectively). Total healthcare expenditures were lower among Black, Asian, and Hispanic patients with race-concordant clinicians than those with discordant clinicians (14%, 34%, and 20%, p  < 0.001 respectively). Conclusions These results add to the body of evidence supporting the hypothesis that racial concordance contributes to a more effective therapeutic relationship and improved healthcare. These results emphasize the need for medical education surrounding cultural humility and the importance of diversifying the healthcare workforce.

Many medical accreditation bodies agree that medical students should be trained to care for diverse patient populations. However, the teaching methods that medical schools employ to accomplish this goal vary widely. The purpose of this work is to summarize current cultural competency teaching for medical students and their evaluation methods. A scoping review was completed by searching the databases PubMed, Scopus, MedEdPORTAL, and MEDLINE for the search terms “medical education” and “cultural competency” or “cultural competence.” Results were summarized using a narrative synthesis technique. One hundred fifty-four articles on cultural competency interventions for medical students were systematically identified from the literature and categorized by teaching methods, length of intervention, and content. Fifty-six articles had a general focus, and ninety-eight articles were focused on specific populations including race/ethnicity, global health, socioeconomic status, language, immigration status, disability, spirituality at the end of life, rurality, and lesbian, gay, bisexual, transgender, and queer. About 54% of interventions used lectures as a teaching modality, 45% of the interventions described were mandatory, and 9.7% of interventions were not formally evaluated. The authors advocate for expansion and more rigorous analysis of teaching methods, teaching philosophies, and outcome evaluations with randomized controlled trials that compare the relative effectiveness of general and population-specific cultural competency interventions.

The link between miscommunication and poor patient outcomes has been well documented. To understand the current state of knowledge regarding interprofessional communication, an integrative review was performed. The review suggested that nurses and physicians are trained differently and they exhibit differences in communication styles. The distinct frustrations that nurses and physicians expressed with each other were discussed. Egos, lack of confidence, lack of organization and structural hierarchies hindered relationships and communications. Research suggested that training programs with the use of standardized tools and simulation are effective in improving interprofessional communication skills. Recommendations include education beyond communication techniques to address the broader related constructs of patient safety, valuing diversity, team science, and cultural humility. Future directions in education are to add courses in patient safety to the curriculum, use handover tools that are interprofessional in nature, practice in simulation hospitals for training, and use virtual simulation to unite the professions.

Despite recent advancements in integrating racial issues into clinical mental health practices, racial disparities persist in mental health care for racialized communities in Western countries. Mental health professionals often lack adequate training to address the impact of racial discrimination, and racialized clients frequently receive racially unadapted services. This study critiques the traditional focus on cultural competence and advocates for cultural humility, a continuous, self-reflective practice that challenges power imbalances and fosters mutual respect. It evaluates the “Providing Antiracist Mental Health Care” training, which includes five modules (racial awareness, racially adapted assessments, humanistic approach to medication, antiracist therapeutic treatments, and tailored care for youth and families). Implemented among mental health care providers ( N = 25) in schools in Ontario (Canada), the training demonstrated improvements in cultural humility scores from pretest to posttest and follow-up. Post hoc analyses confirmed increases from pretest to posttest and from posttest to follow-up. Results in subscales for openness, self-awareness, and ego-lessness showed improvements, while supportive interaction and self-reflection did not. Sociodemographic factors revealed interaction effects for age, gender, race, language spoken at home, and place of birth. Older, women, White, Canadian-born, and unilingual mental health providers showed the most improvements, while racialized, bilingual, and foreign-born participants showed marginal differences over time. These findings underscore the importance of ongoing supervision and tailored interventions in training programs to enhance cultural humility and improve therapeutic outcomes for racialized individuals. (PsycInfo Database Record (c) 2025 APA, all rights reserved) (Source: journal abstract)

School psychology has faced longstanding challenges in advancing equity and parity due to persistent oppression, racism, and colonialism in the field. These challenges have contributed to critical shortages of faculty and practitioners who are Black, Indigenous, and People of Color (BIPOC), racial disparities in educational and mental health services for children, and White hegemony in school psychology research and scholarship. The purpose of this commentary is to outline and advocate for a cultural humility framework as the foundation of social justice to improve discourse, practices, and service delivery by engaging in ongoing self-awareness (e.g., critical reflexivity, understanding of power and privilege), and sustained actions (e.g., social justice advocacy, alliances with communities) to improve outcomes of the individual and community (e.g., relational empowerment). Implications of incorporating cultural humility for trainers, researchers, and practitioners are discussed as continuing efforts to improve institutional and professional accountability are needed to facilitate systemic change. Impact Statement The field of school psychology continues to face challenges advancing equity in research, practice, and policy. We present a cultural humility framework as a foundation for antiracism and anticolonialism. School psychologists engage in critical reflexivity, acknowledge their power and privilege, act to remove structural barriers, and use relational empowerment to partner with communities.