Intercultural Communication Competence in Healthcare

by Igor Ristić

Earlier this week, I discussed three different areas of communication related foci in the health context. Today I focus specifically on intercultural communication in health contexts between medical staff and their patients.

This issue is close to my heart because I interpreted for some family and friends of family while in high school because I picked up the English language much easier than they did, since I was lucky enough to be young when we moved to this country. I remember a few occasions during which I helped my parents and other members of my family to fill out medical forms, explain symptoms to doctors, and with other tasks related to medical interpreting. I also worked briefly as a medical interpreter for local hospitals with patients who spoke Serbo-Croatinan and did not know English. Most medical staff I’ve had experience with in this context have done fairly well with the language barrier and have focused on the care of the patient, thus staying true to their Hippocratic Oath. However, while the language barrier can be taken care of, and the actual medical skill of the provider is more important than whether or not they can speak a second language (Gibson & Zhong, 2005, p. 630), those who work in healthcare must still work hard on their Intercultural Communication Competence (ICCC). 

I reviewed one study from 2005 in which researchers analyzed communication between medical staff (including doctors) and patients at a non-profit health center in Southern California. They chose a non-profit health center because it was more likely that the staff would interact with patients from other cultures and, in fact, 47% of the patient sample was Hispanic and 15% identified themselves as “other” (p. 625). What the researchers found has significant implications for anyone out there who works in the medical field.

Importance of ICCC

Due to media convergence and the global economy, our world is shrinking faster than ever before and more cultures are being forced to interact with one another. I think this is a beautiful thing, but as with any new development, we have to overcome certain challenges as this process occurs. One of these challenges will be in healthcare. As Gibson and Zhang (2005) state in the study I reviewed:

Communicative misunderstandings between patient and provider can lead to simple dissatisfaction, misdiagnosis, lack of any medical care, or even death. Ineffective intercultural communication can also lead to stress for health care providers, causing anxiety and job dissatisfaction (p. 622).

Our medical staff must be trained to become competent intercultural communicators so that they can provide greater care to our increasingly diverse population (such as my family), and so that they become less stressed about their jobs. I don’t know about you, but I certainly would want my surgeon or the surgeon of a family member to be relaxed and not anxious about their job.

On the same page of their report, the authors define ICCC by using a definition created by other authors:

Previously referred to as ‘‘cross-cultural competence,’’ ‘‘intercultural sensitivity,’’ or ‘‘intercultural effectiveness,’’ intercultural communication competence is commonly known as ‘‘the knowledge, motivation, and skills to interact effectively and appropriately with members of different cultures’’ (Wiseman, 2002, p. 208).

How To Become a Competent Intercultural Communicator

Two specific patterns were found among the medical staff who were perceived as the better intercultural communicators: they were effective empathic communicators and they had previous intercultural experience.

Empathic communicators are skilled at understanding the feelings and emotions of other people, they successfully look at life from other people’s perspectives and understand/appreciate the feelings and worries of others. It came as no surprise to me that empathic communicators were more interculturally competent because it means that, even if they didn’t understand the culture of their patients, they understood how hard and scary the experience of going to a doctor of a different culture was for their patients. The authors of the study state,

The most significant finding of this study is that empathy is positively related to intercultural communication competence based on both providers’ and patients’ perceptions. The results of this study identify empathy as a primary component of intercultural communication competence in the healthcare environment. Medical providers who possess the abilities to listen well and place themselves in the patients place are motivated, knowledgeable, skillful, appropriate and effective when communicating across cultures (p. 629).

The second pattern discovered among effective intercultural communicators was previous intercultural experience, which this study defined as having spent more than three months outside of the United States. Again, the authors of the study:

Participants who lived outside the United States for a period of more than 3 months demonstrated significantly higher levels of intercultural communication competence (p. 630).

Having traveled abroad, I understand why those who spent time abroad were better intercultural communicators; they learned to appreciate other cultures much more by experiencing “the other” and also by realizing how “othered” they felt when in a foreign land. Whenever I see people from the Middle East in Kentucky who look out of their element, I think of myself in Turkey, and can relate to how they must be feeling. Quoting research by Billingmeier and Forman (1975), the authors state:

…extended experience outside of one’s own culture has a lasting effect on the individual’s intercultural knowledge and overall view of diverse cultures (p. 630).

As our world continues to shrink and cultures continue to intertwine, all medical schools, nursing programs, and other medical staff training facilities will have to update their curricula to make sure their students (our future caretakers) become competent intercultural communicators. While not every school will be able to send every student on study abroad tips (although this would be ideal), they can still teach their students about empathic communication and can send them on volunteer trips around the country to teach them about the importance of intercultural competence.

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