Standards of Cultural Competence

Cultural competence refers to the acquisition of skills to better understand members of other cultures in order to achieve the best possible health outcome (Durie M 2001)

The concept of cultural competence is applicable to all ethnic and social groups however in the context of the Treaty of Waitangi in which Maori are acknowledged as the tangata whenua of New Zealand there is a requirement that Maori health needs are catered for equitably.

Culture includes but is not restricted to age, gender, sexual orientation, occupation, socio-economic status, ethnic origin or migrant experience, religious or spiritual belief and disability.

Cultural competence involves the ability to perceive and identify cultural risk and to respond in ways that promote cultural safety. Cultural competence is based on the ability of services to demonstrate that they can identify areas of cultural risk in the services provided and establish management practices to eliminate those risks and to put policies and procedures in place that act to monitor risk reduction and evaluate cultural competence.

Principle	Elements	Indicators
1. Demonstrates the ability to apply the principles of the Treaty of Waitangi	Understand the Treaty of Waitangi and its relevance to the health of Māori in Aotearoa / New Zealand. Demonstrates knowledge of differing health status of Maori and non-Māori.	Incorporates a Treaty Workshop or some form of Treaty learning as part of CPD during career.
2. Demonstrates safe cultural practice	Demonstrates willingness to communicate effectively cross culturally. Practises in a manner that acknowledges beliefs and attitudes may vary across cultures. Applies the principles of being culturally safe in own practice. Encourages safe cultural practice within the workplace. Does not assume all patients share the same world view. Assists the patient in obtaining cultural support or representation as appropriate.	Recognises that the verbal and non verbal communication styles of patients may differ and adapt as required. Language barriers are addressed; use of interpreter is encouraged where appropriate. Asks if all information has been understood. Considers cultural information volunteered by the patient when completing assessment, diagnosis and formulation of management plan. Seeks assistance when necessary to better understand the patients cultural needs. Acknowledges that own beliefs and practises may differ from others but should not impact on the provision of competent optometric care. Communicates with patient advocate regarding care planning where appropriate. Care and treatment plan are negotiated by optometrist, patient, and family or advocate where appropriate.
3. Reflects on own practice and values that impact on patients cultural safety	Recognises own beliefs, values and prejudices that may arise in relation to patients ethnicity, age, culture, beliefs, gender, sexual orientation or disability. Acknowledges when ability to provide care is inhibited by own personal attributes and seeks alternative means of attaining patients cultural safety. Validates own processes are culturally safe especially when advising trainees/colleagues.	Does not impose own values on patients. There is evidence of appropriate use of referral to an alternative practitioner.
4. Continues professional development in terms of cultural competency	Understands the need for ongoing cultural competence education and training for both clinical and support staff.	Incorporates cultural competence training as part of CPD programme.
5. Works towards being culturally competent in a broad sense, for improved health outcomes for all New Zealanders	Develops and maintains an awareness of the cultural composition within the local community.	Develops strategies to improve access to optometry services for those groups.

Reference

Durie M. (2001). Cultural Competency and Medical Practice in New Zealand. Australian and New Zealand Boards and Council Conference. Wellington NZ.