Filling the Cultural Competence Glass (This article appeared in the 2017 Audiology Connections).
Karen L. Beverly-Ducker, MA, CCC-A, CAE, Director, Multicultural Resources, ASHA
Cultural competence involves understanding and appropriately responding to the unique combination of cultural variables-including ability, age, beliefs, ethnicity, experience, gender, gender identity, linguistic background, national origin, race, religion, sexual orientation, and socioeconomic status-that the professional and the client/patient bring to interactions. (http://www.asha.org/Practice-Portal/Professional-Issues/Cultural-Competence/).
"How qualified do you believe you are to address cultural and linguistic influences on service delivery and outcomes?" is a question that has been included on several ASHA member surveys. The question is intended to gauge respondents' self-assessed level of awareness and knowledge of the impact of cultural and linguistic influences on the clinical interaction-from the perspective of both the patient/client and the professional service provider. Here are some examples:
- Is there awareness of and responsiveness to how an audiologic evaluation differs for a client/patient who does not speak English?
- How would the case history form be modified to accommodate a variety of family structures?
- Is there a need for interpreters, translators, and transliterators? Is there also a need to determine which of these services are required?
In 2010, 2012, and 2014, audiologists were asked to use a 5-point scale (from not at all qualified to very qualified) to rate themselves in response to the "cultural competence question."
- 22% of respondents rated themselves as 4 (qualified)-up from 15% in 2010 and 19% in 2012.
- 9 percent rated themselves as 5 (very qualified)-up from 5% in 2010 and 7% in 2012.
- Audiologists in the industry setting were more likely than those in other settings to rate themselves as 1 (not at all qualified) or 2 (not qualified). Percentages for combined 1 and 2 ratings for industry-based audiologists ranged from 42% to 58% in these years.
- Audiologists in colleges/universities were more likely than those in other settings to rate themselves as 4 (qualified) or 5 (very qualified). Percentages for combined 4 and 5 ratings for college/university-based audiologists ranged from 32% to 44% in these years. In 2010 and 2012, 5%–9% of audiologists in private practice rated themselves as very qualified; 8%–18% rated themselves as qualified.
Additional indicators of members' cultural competence revealed the following findings:
- Audiologists used an interpreter or cultural broker (48%) more often than any other approach to address cultural and linguistic influences on communication. This response varied by type of facility, from 67% of audiologists in schools to 36% in colleges and universities.
- Almost 16% of elementary school audiologists-11.1% of those in combined school settings and 12.2% of those in all facility types-indicated a "lack of training in ELLs, technology, low-incidence disorders, or curriculum-based instruction" in response to the question, "What are your greatest challenges as a school-based professional?"
The results of the "cultural competence question" and other indicators are needed to help plan activities, develop programs, and track progress related to ASHA's Strategic Pathway to Excellence-in particular, to Strategic Objective 8 (Increase Members' Cultural Competence). Whether currently considered one third full or two-thirds empty, efforts to fill the cultural competence glass will continue.
References
American Speech-Language-Hearing Association. (2012). Private practice trends, 2006–2012 [Audiology survey report]. Available from http://www.asha.org.
American Speech-Language-Hearing Association. (2013). CCC-A survey summary report: Number and type of responses [Membership survey report]. Available from http://www.asha.org.
American Speech-Language-Hearing Association. (2014). Number and type of responses, educational audiologists [Schools survey summary report]. Available from http://www.asha.org.
American Speech-Language-Hearing Association. (2015). Professional issues in audiology, 2004–2014 [Audiology Survey report]. Available from http://www.asha.org.
Peer Discussion:
- How qualified do you believe you are to address cultural and linguistic influences on service delivery and outcomes?
How would you respond to each of the posed questions?
- Is there awareness of and responsiveness to how an audiologic evaluation differs for a client/patient who does not speak English?
- How would the case history form be modified to accommodate a variety of family structures?
- Is there a need for interpreters, translators, and transliterators? Is there also a need to determine which of these services are required?
Connect! Learn! Empower!
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Melanie Johnson
Membership Program Manager
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