Respecting Client & Staff Diversity
Healthcare Core Curriculum
Dede Carr, BS, CDA, LDA
Pat Reinhart, RN
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Respecting Client & Staff Diversity
Module Description
This module provides a framework for dealing with diverse clients/individuals
and staff.
Belief systems, cultural practices, respect and sensitivity to cultural issues,
gender issues and sexuality issues are included.
Awareness and use of effective strategies to appropriately deal with client and
staff diversity are emphasized.
Review on the D2L site the
Course Outline
Competency Modules and Instructor Notes
Module Outline and Instructor Resources
This module consists of 5 competencies for students to master.
These competencies are listed on the following slide and will be addressed
throughout the remainder of the power point.
Each competency is taught through a series of units which include suggested
assignments for students to complete to learn the competency. Feel free to use
the assignments or develop your own.
(see next slide)
Module Outline and Instructor Resources
Find these learning activities and resources on the website or create your own.
The Course Outline also has documents that the instructor can use in teaching
the lesson.
These competencies are listed on the following slide and will then be
addressed throughout the remainder of the power point.
Module Competencies
1. Describe one’s personal belief system.
2. Explain the belief systems and practices of diverse cultures.
3. Explore personal responsibility as a healthcare employee to treat each person
as an individual (customer service).
4. Discuss the appropriate workplace expectations to interact with team
members and care for clients/individuals from diverse cultures, genders, age
groups and/or sexual orientations.
5. Using a problem solving process applied to healthcare situations, describe
how healthcare employees can respect client and staff diversity.
Describe one’s personal belief system.
COMPETENCY #1
Competency #1:
Describe one’s own personal belief system.
Units included in this competency are:
A. Discuss the role of culture in developing a belief system.
B. Explain what is meant by a belief system.
C. Identify the learner’s personal belief system.
D. Identify extrinsic factors that may influence personal belief systems.
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
Recommended Content
From the moment we are born, we begin developing a belief system. We all live our
lives under a belief system, but not many of us are aware of our belief system. We tend
to take things for granted and may just assume everything will work out for the good.
It is critical to understand how a person’s belief system develops for success within this
module.
On the following slide, some highlights of a person’s belief system that author R. T.
Kelly addresses in the book Cultural and Ethnic Considerations, are noted for
background information for you.
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
A persons’ belief system is heavily influenced by their culture and values passed from
generation to generation.
Culture is learned from significant people in one’s life and as a one grows up, one
internalizes the values and beliefs of one’s culture.
So…. one’s culture plays a significant role as one is developing a belief system.
It is our beliefs that guide our behaviors, communication, and lifestyle.
Some of the things included in a person’s belief system are one’s religious beliefs,
political beliefs and ethical beliefs.
Beliefs guide the choices that a person makes and the how a person lives with those
choices.
(Kelly, p. 125)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
The curriculum states that culture is composed of common aspects such as:





lifestyle
language
tradition
rules
values
This is all true and yet culture is also what is taught to us and passed down from one
generation to the next.
The following slides will address the role of language within a culture and lifestyle as it
pertains to the family.
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system.
Language
 One of the most apparent communication variation is language. Language variations
might involve no understanding of each other’s language, to situations where one can
understand the other’s language, but has limited skills in speaking the language.
Although both parties may speak English, there may be different meanings for words
in the English language.
 Communication patterns reflect core cultural values of a society. Some cultures value
individualism while others value group harmony.
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
Differences in status and position, age, gender and outsider versus insider determine
the content and process of communication.
For example, among Asian cultures, face-saving communication promotes harmony
by indirect communication and avoidance of conflict. In this culture, messages
spoken often have little to do with their meanings. Saying “no” to a superior or older
adult is not permissible, hence an affirmative response will only mean “I heard you”
rather than full agreement. This has important implications in in the healthcare
setting because the healthcare provider can be perceived as a person of authority to
some Asian, African, or Hispanic clients. Observing a client’s behavior and clarifying
messages heard from a trusted insider will prevent misinterpretation.
(Potter and Perry, pp. 117-118)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
Lifestyle within the Family
◦ The description of family (types/structure) may vary among cultures: nuclear,
extended, single-parent, blended, etc.
◦ Some of the family structures are based on biological relationships. Others are based
on meeting basic needs of the family by forming a group of unrelated individuals.
◦ Intergenerational support and patterns of living arrangements are related to cultural
background. For example, traditional Chinese, African-American, Japanese, and
Hispanic persons are more likely to live in extended family households than are their
white counterparts. (Potter and Perry, p. 131)
◦ A common mistake for healthcare workers is to assume that every family is a
traditional nuclear family.
◦ It’s more important to know whom the patient depends on for comfort and decisionmaking and how the patient describes family.
(Kelly, p. 130)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
Value placed on children and elders within society are culturally derived.
In some cultures children are not disciplined by spanking or other forms of physical
punishment. Rather, children are allowed to interact with their environment while caregivers
provide subtle directions to prevent harm or injury.
In other cultures, elders are considered the holders of the culture’s wisdom and therefore are
highly respected.
Responsibility for care of older relatives is determined by cultural practices. In many cultures,
older relative who cannot live independently live with a married son or daughter and family.
(Berman et al., pp. 318-319)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1A: Discuss the role of culture in developing
a belief system
Tips for presenting the material
Students may proudly share some their family make-ups. This can be a sensitive issue
for some, especially those students who have no family -- perhaps because of growing
up in the foster care system or having cut all ties with their family members.
Students may also share forms of discipline that have been passed down from one
generation to the next. Such conversations can be hard to monitor and hard to keep
judgment out of the conversation.
◦
◦
(see next slide)
Module Competency #1B and 1C: Personal Belief System
At this point, both Unit #1B: (Explain what is meant by a belief system) and
Unit #1C: (Identify the learner’s personal belief system) will be discussed as one
unit.
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Recommended Content
A person’s belief system is comprised of their cultural values.
A person does not have control over their gender, race, age or which family they were
born into, however, these attributes play a critical part in a person’s belief system.
 For example, a man may believe that he should get paid more than a woman because
he is the head of the household.
 Another example: The youngest child in the family may have a more lenient curfew
because mom and dad have eased up over the years. Their belief system has shifted.
One’s belief system does, however, determine one’s political affiliation,
religious/spiritual practices, and profession, just to name a few.
(New World Encyclopedia)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Cultural Values
 Values which support the belief and behaviors that are accepted within each
culture pertain to:







Age
Gender
Family
Religion/spirituality
Time orientation
Politics
Behavior and practices
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
The 7 cultural values listed on the previous slide all play an important role in a person
developing their own belief system.
These values influence and guide a person’s behavior and communication.
Many of the values are set such as gender, age, traditional practices.
One value that is so critical in healthcare and throughout life is timeliness.
Time can be culturally learned -- some students understand the value of timeliness
and being on time, while others struggle with it daily. Having a better understanding of
time within various cultures can help us to better understand our students.
The next 3 slides will introduce to you some ideas that can be discussed with students.
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Let’s review the concept of time, and how it can impact the healthcare culture.
Timeliness among healthcare workers varies and conflicts can arise when a healthcare
worker is always late for work. It is important to discuss reasons for this, rather than to
assume the person does not care about the job. If it is due to a cultural belief, the health care
staff involved needs to develop a strategy to solve the problem.
Perception of time (time orientation) can be future-oriented or present-oriented.
Many people in the United States are future-oriented; African American, Hispanic, and
American Indian tend to be present-oriented.
 If a pregnant woman is a member of the present-oriented culture, she may miss an appointment
because of a current family need. For example, if an older child needs a ride home from school, the
mother may skip a doctor’s appointment to take care of the older child. She sees the present need as
much more urgent than keeping an appointment related to an event that is several months away.
(Kelly, p. 129)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
The measurement of time can have different meanings in various cultures.
The United States and Northern European cultures regard being on time for appointments as
a high priority. Expectations that all individuals will follow this pattern. Japanese Americans
are generally prompt and adhere to fixed schedules, especially when meeting someone of
high regard.
Many other cultures may feel that other concerns are more important.
 For example, Eastern cultures including Chinese, East Indian
Hindu, Filipino, and Korean view schedules and time
as being much more flexible. (Kelly, p. 129)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1B and 1C: Belief System
Some Asians spend time getting to know someone and may view abrupt endings to
conversations as rude.
Mexican-Americans may be late for an appointment because they are more
concerned with a current activity than going to a previously planned meeting.
 This is known as “elasticity” and implies that future-oriented activities can be
recovered but present-orientated activities cannot.
When a patient is late for an appointment, fails to come at all, or does not follow a
therapeutic schedule, the healthcare worker who does not understand these cultural
differences may be angry. (Kelly, p. 129)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Family may significantly influence one’s personal belief system
Family was previously described in Unit #1A
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Value placed on children and elders within society are culturally derived.
In some cultures children are not disciplined by spanking or other forms of physical
punishment. Rather, children are allowed to interact with their environment while
caregivers provide subtle directions to prevent harm or injury.
In other cultures, elders are considered the holders of the culture’s wisdom and are
highly respected.
(Berman et al., pp. 318-319)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
With the continued appearance of American society changing and traditional cultures
blending and assimilating with each generation, all cultures bring to the healthcare
arena their own views of what needs to happen to remain healthy or seek healthcare.
As healthcare educators, it is critical to be aware of the three types beliefs hypothesized
by Berman:
1. Magico-Religious health belief view
2. Scientific or biomedical health belief view
3. Holistic health belief view
(Berman et al., p. 318)
The following slides will introduce you to this health belief framework.
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
In the Magico-religious health belief view, health and illness are controlled by supernatural
forces.
The client may believe that illness is the result of “being bad” or opposing God’s will.
Getting well is also viewed as dependent on God’s will. The client may use statements such as,
“If it is God’s will, I will recover” or “What did I do wrong to be punished with cancer?”
Some cultures believe that magic can cause illness or that a sorcerer or witch may put a spell or
hex on the client.
Some people view illness as possession by an evil spirit.
 Although these beliefs are not supported by research, clients who believe that such things can cause illness
may in fact become ill as a result.
 Such illnesses may require magical treatments in addition to scientific treatment.
(Berman et al., pp. 317-318)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Scientific or biomedical health belief is based on the belief that life and life processes
are controlled by physical and biochemical processes that can be manipulated by
humans.
The client with this view will believe that illness is caused by germs, viruses, bacteria, or
a breakdown of the human body. The client will expect a pill, or treatment, or surgery.
(Berman et al., p. 318)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Holistic health belief holds that forces of nature must be maintained in balance or harmony. Human
life is one aspect that must be in harmony with the rest of nature and when the natural balance or
harmony is disturbed, illness results.
The North and South America Native Americans use the medicine wheel as an ancient symbol to
express many concepts for health and wellness, it teaches four aspects of the individual’s nature:
physical, mental, emotional and spiritual. The four dimensions must be in balance to be healthy. The
medicine wheel can also be used to express the individual’s relationship with the environment as
dimension of wellness.
Examples of the holistic health belief view include: the concept of yin and yang in Chinese culture
and the hot-cold theory of illness in many Spanish cultures.
In the hot-cold theory, people believe that certain conditions are “cold,” such as a new mother who
delivered a baby. To treat the new mother, warm or hot foods and a blanket are provided.
Many cultures believe that the best way to treat a fever is increase an elimination of toxins through
sweat baths.
(Berman et al., p. 318)
(see next slide)
Module Competency #1: Personal Belief System
Units #1B and 1C: Belief System
Remember that the 3 various health belief views provides the educator a brief
understanding of the where our students are coming from and who our students will
be caring for:
1. Magico-Religious health belief view
2. Scientific or biomedical health belief view
3. Holistic health belief view
Tips for presenting the material:
Many of the students who have had the opportunity to explore these views find that
patients do not fall under one specific view, but rather a combination of 2 views or all
3 views.
(see next slide)
Module Competency #1: Personal Belief System
Unit #1D: Identify extrinsic factors that may
influence personal belief systems.
Recommended Content
The curriculum addresses the issue of identifying extrinsic factors and how these factors
shape a person’s belief system.
The following slides will be discussed:
Culture shock
Assimilation
Acculturation
As America continues to be a melting pot for many different cultures and as our
classrooms represent that melting pot, it is important to address culture shock, talk
about what it really is, and how our own cultural shock and that of our patients can
influence the therapeutic process.
(see next slide)
Module Competency #1: Personal Belief System
Unit #1D: Identify extrinsic factors that may
influence personal belief systems
What is culture shock?
Culture shock is a disorder that occurs in response to transition from one cultural
setting to another so a person’s previous behavior patterns are ineffective in such a
setting, and basic cues for social behavior are absent.
Expressions of culture shock may range from confusion and anxiety to silence and
immobility, to agitation, rage or fury. (Berman et al., p. 315)
Culture shock is used to describe the anxiety and nervousness that occurs when a
person leaves some place that is comfortable and familiar. Many changes occur and the
person needs to adapt to those changes. Even though the changes can be full of
excitement, it can still be overwhelming.
(Nemours Foundation)
The important thing to remember is that culture shock is temporary.
(Juliar, p. 305)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1D: Identify extrinsic factors that may
influence personal belief systems
Everyone entering into a new culture will adjust to it differently. For some people, it may
mean they are/were excited about their new move. Others may have been forced to
move, making the adjustment that much more difficult.
Even though everyone experiences culture shock in a different way, the most common
feelings are:
◦ Not wanting to be around people who are different
◦ Loneliness
◦ Anxiety
◦ Sadness
◦ Feeling left out
◦ Extreme homesickness
(Nemours Foundation)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1D: Identify extrinsic factors that may
influence personal belief systems
The involuntary process of acculturation occurs when people adapt to or borrow traits
from another culture. The members from the non-dominant cultural group is often
forced to learn the new culture to survive.
Acculturation can also be defined as the changes of one’ cultural patterns to those of
the host society.
(Spector, as cited in Berman et al., p. 314)
While becoming participants in the dominant culture, members of the non-dominant
cultural group are always identified as members of the culture from which they
originated.
People immigrating to the United States from any country will be associated with their
native countries for many years, if not all their lives.
(Berman et al., p. 314)
(see next slide)
Module Competency #1: Personal Belief System
Unit #1D: Identify extrinsic factors that may
influence personal belief systems
Assimilation: the process by which an individual develops a new cultural identity.
Assimilation means becoming like the members of the dominant culture.
Assimilation can be described as a collection of sub-processes: a process of inclusion
through which a person gradually ceases to conform to any standard of life that differs
from the dominant group standards and at the same time, a process through which the
person learns to conform to all of the dominant cultural group.
The process of assimilation is when the foreigner is fully merged into the dominant
cultural group. (McLemore and Romo, as cited in Berman et al., p. 314)
(see next slide)
Module Competency #1: Personal Belief System
Recommended Learning Activities
Assignment
Location
Notes
Review Vocabulary List
On Website and in Module Outline
and Instructor Resources Document
Review Vocabulary List with students
Examples of Cultural
Misunderstandings in Healthcare
On Website and in Module Outline
and Instructor Resources Document
Discuss in Class
RCS Competency 1: Self Assessment:
Assignment on website
This assignment allows students to
assess their cultural competency and
reflect on their subcultures.
RCS Competency 1: Cultural
Diversity Journal
Assignment on website
Students journal on personal beliefs
and values.
RCS Competency 1: Family and
Cultural Influences:
Assignment on website
Students reflect on their parents
values and culture and how they
relate to those.
Explain the belief systems and practices of diverse
cultures.
COMPETENCY #2
Competency #2:
Explain the belief systems and practices of diverse cultures.
Units included in this competency are:
A. List cultures found within a healthcare setting.
B. Describe the belief systems (cultural values, behavior practices, communication
patterns, and methods of perceiving, judging, and organizing daily life) of ethnic
cultures and subcultures.
C. Describe the “-isms.”
D. Describe the belief systems pertaining to age.
Module Competency #2: Explain the belief systems and
practices of diverse cultures
At this point, both Unit #2A (List cultures found within a healthcare setting) and
Unit #2B: (Describe the belief systems (cultural values, behavior practices,
communication patterns, and methods of perceiving, judging, and organizing
daily life) of ethnic cultures and subcultures) will be discussed as one unit.
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Units #2A and 2B: Belief System of Various
Cultures
Recommended Content
During this part of the curriculum of Respecting Client and Staff Diversity, students will
be exploring and discussing belief systems of various cultures.
The curriculum asks the instructor to address 3 of the following cultures with the
students. However, cultures do not need to be limited to this list:
1.
African American
2.
Native American
3.
Asian
4.
Hispanic
5.
Latino
6.
Caucasian
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Units #2A and 2B: Belief System of Various
Cultures
The following 3 slides will briefly introduce the instructor to 3 different cultures:
1. African American
2. Asian
3. Hispanic
Tips for presenting the materials
These slides provide a taste of each culture and yet in class, discussions provide for lively
debates. Remind students to be respectful and share from their own experiences. Each
experience is valid and unique, as some of us are recent immigrants, and some are
several generations removed. Some of us have several ethnic experiences from different
sides of the family to draw from.
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Units #2A and 2B: Belief System of Various
Cultures
African Americans tend to be focused more on people rather than on objects, making
family bonding a primary core value.
Within in the African American culture, children are the center of the family and family
extends beyond mom, dad and the children.
Family includes aunts, uncles, grandparents, cousins, etc.
African Americans have a deep sense of spirituality.
Christianity and Islam are 2 of the primary religions along
with a host of others.
Men and women within the African American culture tend to have equal relationships.
(Cultural Diversity Organization)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Units #2A and 2B: Belief System of Various
Cultures
Religion is valued greatly within the Asian culture. The primary religions of the culture
are Buddhism, Confucianism, Hinduism, Islam and Christianity. (Juliar, 2003, p. 308)
Other values of the Asian people are: “group orientation (collectivity); family cohesion
and responsibility; self-control and personal discipline; emphasis on educational
achievement; respect for authority; reverence for the elderly (filial piety); the use of
shame for behavioral control; and interdependence of families and individuals.”
(Juliar, p. 310).
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Units #2A and 2B: Belief System of Various
Cultures
The Hispanic culture like many others, value family as the most important social unit.
In most Hispanic families, the father is the head of the household and the mother cares
for the home.
The Catholic religion is the primary religion for more than 90% of the Spanish-speaking
world.
Elders hold a high place within the family structure and are often consulted for advice.
When someone is ill within the Hispanic culture, they expect to be taken well care of.
The Hispanic people tend to live in the present and as a result do not typically seek
preventive health care. (Juliar, pp. 310-311)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2C: Describe the “-isms”
Recommended Content
Students live with –isms everyday and yet may not understand the meaning behind
them.
 An -ism is a suffix, or something placed at the end of a word.
 An -ism can be defined as a “theory, a system or a practice” or “an action, a
characteristic or a behavior.” (answers.com,)
Words that end in -ism may portray an “attitude of prejudice against a certain group.”
(answers.com)
 The –ism suffix tends to be an oppressive and especially discriminatory attitude or
belief (Merrian-Webster INC.,)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2C: Describe the“-isms”
Classism is prejudice, discrimination, mistreatment, neglect of or lack of respect for
any human and their rational needs (food, clothing, shelter, education, respect
communication, etc.) based on people’s socioeconomic class. (Freire, n.d.)
Criteria for measuring class is usually education, income, occupation and wealth.
Classism is extremely complex. It involves economic exploitation, beliefs, attitudes and
prejudices, terrorization, violence, invalidation, etc.
Classism is the belief that people from certain social or economic classes are superior
to others. (Freire, n.d.)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2C: Describe the“-isms”
Racism is a belief that race is the primary determinant of human traits and capacities
and that racial differences produce an inherent superiority of a particular race.
Racism is a belief or doctrine that inherent differences among the various human
races determine cultural or individual achievement, usually involving the idea that
one's own race is superior and has the right to rule others.
Racism is a policy, system of government, etc., based upon or fostering such a
doctrine; discrimination.
(Random House Dictionary)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2C: Describe the“-isms”
Ageism is prejudice or discrimination against a particular age-group, especially
the elderly (Merriam Webster on-line)
Ageism may also apply to young adults or children
Sexism is prejudice or discrimination based on sex, usually against women.
(Merriam Webster on-line)
Sexism may also be defined as behavior, conditions, or attitudes that foster
stereotypes of social roles based on sex. (Merriam Webster on-line)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2C: Describe the“-isms”
Recommended Learning Activities
Assignment
Topic
Resources
Notes
Ageism
YouTube video “When Do You Think
Someone is Old”
Ableism
Movie: “My Left Foot”
Assignment on website can
be used as a class
discussion.
Class Discussion
Racism
A Class Divided
RCS Competency 3 Movie a Class
Divided:
Students watch the movie
and answer reflected
questions.
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2D: Describe the belief systems
pertaining to gender
Recommended Content
There are more males entering the previously predominant female occupations of nursing and
healthcare. This brings another subculture and possibilities for stereotyping, biases, and
prejudices.
Even though women and men are more similar than different, some communication patterns
are identifiably different.
The key to working effectively with the opposite gender is to recognize communication
differences and realize enormous contributions each style brings to the workplace.
While men can be more direct and get right to the point, women often bring valuable
interpersonal skills to the workplace. Both men and women are effective problem-solvers. Men
usually think of one thing at a time and women tend to consider several things at once. (Juliar, p. 390)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2D: Describe the belief systems
pertaining to age
Recommended Content
In healthcare, it is important to have some understanding of what different eras were
like so that we can better understand our patients/clients.
Many of our students fall into the Generation Y category and are unaware of various
eras and/or characteristics of them. It is critical for students to have a brief
understanding of the various eras because someday they will be caring for
patients/clients whose ages span over several decades and generational thinking.
The following slides briefly introduce a couple of highlights from each era:




WWII era
Baby Boomers era
Generation X era
Generation Y era
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2D: Describe the belief systems
pertaining to age
World War II Era
People born during this era valued very highly the work that they did. Men went off to their jobs and
the women stayed home to raise the children.
During this time, people had a great respect for leadership. They also had a strong work ethic. A
man would tend to “give his life” for the company where he worked. That same man had a drive to
reach the top of the corporate ladder, no matter what the cost. As men climbed the corporate ladder,
their respect for leadership was constant. (Bosenberg)
Baby Boomer Era
In the work world, the Baby Boomers favor a team approach, however they are driven to be the star
of the team. The Boomers are impressed with authority, but tend to have friendly relationships with
their bosses.
As Boomers grew into young adulthood, a strong emphasis on personal development came to life.
(Bosenberg, 2011)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2D: Describe the belief systems
pertaining to age
The 51 million members of Generation X were born between 1965 and 1976.
Divorce and working moms created "latchkey" kids out of many in this generation. As
a result, Gen Xers grew up with independence, resilience and adaptability. Generation
X feels strongly that "I don't need someone looking over my shoulder."
At the same time, this generation expects immediate and ongoing feedback, and is
equally comfortable giving feedback to others. Other traits include working well in
multicultural settings, desire for fun in the workplace and a realistic approach to getting
things done.
(Thielfoldt and Scheef)
(see next slide)
Module Competency #2: Belief System and Practices of Diverse Cultures
Unit #2D: Describe the belief systems
pertaining to age
Generation Y make up for 70 million of the world’s population and were born in the mid-1980's
and later.
Generation Y is the most diverse generation in history. This population of people has been
born to teenage mothers as well as mothers in their 40s.
They are tech-savvy, family-centric and achievement-oriented.
(Kane, n.d.)
Generation Y grew up with technology and rely on it to perform their jobs better.
Armed with BlackBerrys, laptops, cell phones and other gadgets, Generation Y is plugged-in 24
hours a day, 7 days a week.
This generation prefers to communicate through e-mail and text messaging rather than face-toface contact and prefers webinars and online technology to traditional lecture-based
presentations. (Kane, n.d.)
Module Competency #2: Belief System and Practices of
Diverse Cultures
Recommended Learning Activities
Assignment
Resources
Notes
RCS Competency 2-3
Cultural Interaction
Interview
Assignment on website
Students interview two
persons from another
culture and reflect on the
experience.
Explore personal responsibility as a healthcare
employee to treat each person as an individual
(customer service).
COMPETENCY #3
Competency #3: Explore personal responsibility as a
healthcare employee to treat each person as an individual
(customer service).
Units included in this competency are:
A. Discuss cultural stereotyping.
B. Identify personal cultural prejudices.
C. Identify cultural interactions with team members and clients.
Module Competency #3: Explore personal responsibility as a
healthcare worker to treat each person as an individual
(customer service)
At this point, both Unit #3A (Discuss cultural stereotyping) and Unit #3B:
(Identify personal cultural prejudices) will be discussed as one unit.
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Recommended Content
The ancients first formed cultural stereotypes when they came upon a new race or
tribe. They quickly had to decide if the people were safe to encounter. Since there
wasn’t much time to determine if the group was safe or not, judgments where made
towards the race or tribe as a whole, and not on an individual basis.
These assumptions, or stereotypes, were then passed down from generation to
generation and still impact our lives today. Books and films have supported the aspect
of cultural stereotype.
For example, they may depict the black man as a great basketball player or the black woman who is a
servant for a white woman.
(Eagle Feather Research Institute)
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Cultural blind spot syndrome is a belief that “just because the client looks and behaves
much the way you do, you assume that there are no cultural differences or potential
barriers to care.” (Buchwald as cited in Juliar, p. 350)
For example, white American nurses may assume that white American patients believe
in the same cultural values as they do. This assumption is false.
◦ White Americans come from many different ethnocultural backgrounds—Irish,
Russian, German, Jewish, and English to name but a few. In addition, white nurses
and patients may also belong to different subcultures that have different values.
◦ For example, a white male patient of Italian descent who is gay will probably have
somewhat different values than a white Irish-American nurse who is married with 3
children.
(Juliar, p. 350)
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Cultural Stereotyping and
Prejudices
Through the discussion of this portion of the module, assumptions of stereotyping will
be discussed with the students. This is an area in which many students will have
personal experience to share. The discussion can be lively and needs to be controlled
with respect and sensitivity.
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Communication barriers can lead to a great number of misunderstandings. In the
module entitled “Communications in Health Care Settings”, communication is taught at
length.
However, as communication relates to stereotyping and prejudices, let’s look at just 2
barriers to communication.
1. Foreign languages and dialects
2. Street talk, slang and idioms.
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Foreign Languages and Dialects
Some facts:
 Over 6,000 different languages and dialects are spoken today.
 The number of people in America who speak a language other than English is
growing.
 10% of the population speak more than just English.
 The English language has more than 25,000 different words.
 The most widely spoken language is Mandarin Chinese. (Juliar, p. 351)
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Definitions of Dialect
 “A distinctive way a language is spoken or written in a given locality or by a group of
individuals.”
(Webster’s Dictionary as cited in Juliar, p. 352)
“A regional or social variety of a language distinguished by pronunciation, grammar, or
vocabulary, especially a variety of speech differing from the standard literary language
or speech pattern of the culture in which it exists.” (Dictionary .com)
“The language peculiar to the members of a group, especially in an occupation;
jargon” (thefreedictionary.com)
(see next slide)
Module Competency #3: Personal Responsibility and Customer Service
Units #3A and 3B: Stereotyping and Prejudices
Street Talk, Slang, Idioms and Medical Terminology
Street talk, slang, and idioms are expressions that may be used by people that can
sometimes create a language barrier.
For example, if you are from a white middle class family, you may not understand
that when an African-American person uses the word “hood” they are referring to
their neighborhood or that the “Amen Corner” refers to the corner in the church
where the older women of the church sit. (Juliar, p. 353)
Module Competency #3: Personal Responsibility and Customer Service
Unit #3C: Identify cultural interactions with team
members and clients
Recommended Content
The curriculum breaks down cultural interactions with team members into 4 parts.
They are:
1.
Conversations – verbal and non-verbal
2.
Thoughts regarding interactions
3.
Feelings evoked by the interactions
4.
Physical interactions – touch related to the physical care of a client
Tips on presenting the material
These 4 areas of interaction with team members can provide for some interesting stories
from the students.
Module Competency #3: Personal Responsibility and
Customer Service
Recommended Learning Activities
Assignment
Resources
Notes
RCS Competency 3 Cultural
Prejudice
Assignment on website
Reflection on cultural
prejudice and how it feels.
RCS Competency 3 Unique
Potato Exercise
Assignment on website
Bring a bag of potatoes
Students choose a potato and
describe the uniqueness of it.
RCS Competency 3 Website –
Keirsey Temperament Sorter II
The Keirsey Inventory Sorter:
http://www.keirsey.com/sorter/re
gister.aspx
This is a 70 question
personality inventory. Students
reflect on how to
communicate with others
according to their results.
Discuss the appropriate workplace expectations
to interact with team members and care for
clients/individuals from diverse cultures, genders,
age groups and/or sexual orientations.
COMPETENCY #4
Competency #4:
Discuss the appropriate workplace expectations to interact with team
members and care for clients/individuals from diverse cultures,
genders, age groups and/or sexual orientations.
Unit included in this competency is:
A. Discuss workplace expectations for team members and clients of divers cultures,
genders, ages and sexual orientations.
Module Competency #4: Workplace Expectations
Unit #4A: Discuss workplace expectations for team members
and clients of diverse cultures, genders, ages and sexual
orientations.
Recommended Content
This competency addresses respect in the workplace, from respect with team members
to respect with patients/clients of diversity.
Diversity as defined by how the patient/client differs from the healthcare provider.
Different age, skin color, class, religion, education level, language, sexuality, etc. can be
differing factors.
The curriculum also addresses respectful communication with team members and
patients/clients from various cultures.
◦
(see next slide)
Module Competency #4: Workplace Expectations
Unit #4A: Discuss workplace expectations for team members
and clients of diverse cultures, genders, ages and sexual
orientations.
Respectful communication includes, but not limited to:
 Verbal and nonverbal communication
 Written communication
 Age appropriate and gender appropriate communication
 Requesting clarification, if needed
 Validating the feelings of a patient/client
(see next slide)
Module Competency #4: Workplace Expectations
Recommended Learning Activities
RCS Competency 4
Transcultural Interaction
Diary
Assignment on website
Students journal after each
encounter with someone
who is culturally diverse
and reflect on the positive
and the negative in the
encounter.
RCS Competency 4 5
Scenario Cultural Diversity
Ethics
Assignment on website
Student reflects on a child
having marks from
“coining” on their skin and
whether to report it.
Using a problem solving process, applied to
healthcare situations, describe how healthcare
employees can respect client and staff diversity.
COMPETENCY #5
Competency #5:
Using a problem solving process, applied to healthcare
situations, describe how healthcare employees can respect
client and staff diversity.
Unit included in this competency is:
A. Discuss the problem solving process as applied to respecting client and staff
diversity.
Module Competency #5: Problem Solving
Unit #5A: Problem Solving as Applied to
Diverse Cultures
Recommended Content
The problem solving process can be broken down into the following 5 steps:
1. Identify the problem
2. Gather information
3. Create alternative solutions
4. Select and act on solution
5. Evaluate and revise as needed
Module Competency #5: Problem Solving
Recommended Learning Activities
Assignment
Resources
Notes
RCS Competency 2, 3, 4, 5. The
Spirit Catches You and You Fall
Down Learning Activity
Book by: Fadiman, Anne (1997) Students read the book “The
Spirit Catches you and you fall
down” and answer questions
regarding the Hmong people
and the cultural problems they
had with the healthcare system
and doctors in the United
States
RCS Competency 5 Scenario
Diversity Case Study
Assignment on website
An interesting case study of a
Moslem woman picking up a
Prescription from a pharmacy.
This completes the
curriculum for
Respecting Client & Staff Diversity.
(see next slide)
What to do now?
You’ve now been introduced to Respecting Client & Staff Diversity.
Presented were key points found on the instructor resource outline and several possible
learning activities to use.
You received tips on teaching the material, along with areas to be sensitive to with students.
Now, click on the “Assessments” tab and complete the Respecting Client & Staff Diversity Self
Assessment.
You are invited to go to the website to preview additional learning activities, PowerPoints,
assessments, etc.
You are encouraged to use the instructor learning resource module outline to make notes on
which online resources would benefit you and your teaching style.
Accessing HealthForce Minnesota
To access the HCCC curriculum go to:
1.www.healthforceminnesota.org/Curriculum.htm
2.Click on the Health Care Core Curriculum
3.Choose Curriculum (Password Required)
A. Password: HCCC
4.Select desired module to view
“This workforce solution was funded by a grant awarded by the
U.S. Department of Labor’s Employment and Training
Administration. The solution was created by the grantee and
does not necessarily reflect the official position of the U.S.
Department of Labor. The Department of Labor makes no
guarantees, warranties, or assurances of any kind, express or
implied, with respect to such information, including any
information on linked sites and including, but not limited to,
accuracy of the information or its completeness, timeliness,
usefulness, adequacy, continued availability, or ownership.”
This work by the Health Professions Pathways (H2P)
Consortium, a Department of Labor, TAACCCT funded project is
licensed under a Creative Commons Attribution 3.0 Unported
License.
This power point created by:
Dede Carr, BS, CDA, LDA
Pat Reinhart, RN
References
Berman, A., Snyder, S.J., Kozier, B., and Erb, G. (2008).Culture and heritage. In A. Berman, S.J.
Snyder, B. Kozier, and G. Erb (Eds.). Kozier and Erb’s Fundamentals of nursing: Concepts, process,
and practice (8th ed.) (pp. 311-329). Upper Saddle River, NJ: Prentice Hall
Bosenberg. M.(2011, March 2). The Population Baby Boom of 1946-1964 in the United States
Retrieved from http://geography.about.com/od/populationgeography/a/babyboom.htm
Culture Diversity Organization. (1997-2008).Transcultural nursing: Basic concepts and case
studies. Retrieved from http://www.culturediversity.org/index.html
Eagle Feather Research Institute http://eaglefeather.org/pages/about.php
Freire,P. (n.d.). The Politics of Education. Retrieved from
http://renew.education.ucsb.edu/downloads/overheads_handouts/class.pdf
References
Juliar, K. (2003) Minnesota Healthcare Core Curriculum (2nd ed.). Clifton Park, NY: Delmar
Publishers
Kane, S. (n.d.). Generation Y. Retrieved from
http://legalcareers.about.com/od/practicetips/a/GenerationY.htm
Kelly, R.T. (2006). Cultural and ethnic considerations. In B.L. Christensen and E. O. Kockrow (Eds.).
Foundations and adult health nursing (5th ed.) (pp. 124-148). St. Louis, MO: Elsevier, Mosby
References
Nemours Foundation. (1995-2011). Culture shock. Retrieved from
http://kidshealth.org/teen/your_mind/emotions/culture_shock.html#
New World Encyclopedia. (2007). Culture. Retrieved from
http://www.newworldencyclopedia.org/entry/Culture
Potter, P.A. and Perry, A.G. (2009). Culture and ethnicity. In P.A. Potter and A.G. Perry (Eds.).
Fundamentals of nursing (7th ed.) (pp. 106-120). St. Louis, MO: Elsevier, Mosby
Thielfoldt, D. and Scheef, D. (2004, August). Generation X and the millennial: What you need to
know about mentoring the new generations. Retrieved from
http://apps.americanbar.org/lpm/lpt/articles/mgt08044.html
You have completed
Heath Care Core Curriculum
Respecting Client and Staff Diversity
Congratulations!!!
Complete the “Self Assessment” tab found
under “Assessments”.