Table 1.

Healthcare Provider Cultural Competence Instrument (HPCCI)

Awareness and sensitivity  1. Race is the most important factor in determining a person’s culture.  2. People with a common cultural background think and act alike.  3. Cultural diversity needs to be considered for each individual and group.  4. If I know about a person’s culture, I do not need to consider their personal preferences for health services.  5. Spirituality and religious beliefs are important aspects of many cultural groups.  6. An individual person may identify with more than one cultural group.

7. Language barriers are the only difficulties for recent immigrants to Australia.  8. I understand that people from different cultures may define the concept of “health care” in different ways.  9. I think that knowing about different cultural groups helps direct my work with individuals and their families.  10. I enjoy working with people who are culturally different from me. Cultural competence behaviours  1. When I identify that cultural heritage and needs of individuals are relevant to my work, I seek information about them.  2. I avoid using generalizations to stereotype groups of people.  3. I am aware of potential barriers to oral health care that might be encountered by people of different cultures.  4. I endeavour to remove obstacles to oral health for people of different cultures when I identify such obstacles.  5. I learn from my peers about people with different cultural heritages.  6. Evaluation from my colleagues about how I interact with people of different cultures is not relevant.  7. I take note of cultural factors during patient interactions, such as during history taking.  8. I ask patients and/or their families about their own understanding of health and illness.  9. I ask patients and/or their families to tell me about their expectations for health services.  10. I seek feedback from patients and/or their families about how I relate to their culture.  11. I find ways to adapt my services to my patient’s preferences. Patient centred communication  1. When there are a variety of treatment options, how often do you give the patient and their family a choice when making a decision?  2. When there are a variety of treatment options, how often do you give the patient and their family control over decisions about their treatment?  3. How often do you explore with patients, their own preventive approaches to oral health?  4. The use of interpreters aids in interacting with patients and families from diverse cultural backgrounds. Practice orientation  1. I understand how to lower communication barriers with patients and their families.  2. I look for nonverbal cues to add to my understanding about my patients and/or their families.  3. I am able to foster a friendly environment with my patients and their families.  4. I attempt to demonstrate a high level of respect for patients and their families.  5. I consistently reflect on my skills as I work with diverse groups of patients and their families.  6. A genuine sense of trust with my patient and their family is important when interacting with my patients.  7. I make every effort to understand the unique circumstances of each patient and their family.  8. I find it hard to ask patients about their cultural backgrounds.  9. I rarely self-assess my abilities when working with patients and their families of diverse backgrounds.  10. I find it difficult to manage cultural issues as well as clinical issues when providing oral health care. Self-assessment of cultural competence  1. The oral health practitioner is the one who should decide what is talked about during a visit.  2. The patient and their family should rely on their oral health practitioners’ knowledge and not try to find out about their condition(s) on their own.  3. When oral health practitioners ask a lot of questions about a patient and their family’s background, they are prying too much into personal matters.  4. If oral health practitioners are truly good at diagnosis and treatment, their interactions with patients and their family are not that important.  5. The patient and their family should be treated as if they are partners with the oral health practitioner, equal in power and status.  6. When the patient and their family disagree with their oral health practitioner, it signifies that they do not respect or trust the health care provider.  7. A treatment plan cannot succeed if it is in conflict with the patient and their family’s lifestyle or values.  8. It is not that important to know a patient and their family’s culture and background to treat the client’s illness.