diversity and cultural competency(1 hr)
TRANSCRIPT
© www.AdvFundamentals.com Page 1
Diversity & Cultural Competency
1 CE Hour
Course # 20-451497
Class Objectives
Understand why cultural competency is important
Understand guidelines for achieving cultural competency
Understand techniques for communication with clients from diverse backgrounds
Instructor
Michael Ames, LMT
www.AdvFundamentals.com
407-913-9755
© www.AdvFundamentals.com Page 2
Advanced Fundamentals Education, LLC
Advanced Fundamentals Education, LLC is an approved continuing education provider for
massage therapists. We are approved through the National Certification Board for Therapeutic
Massage & Bodywork (NCBTMB) and the State of Florida to offer continuing education credits
to massage therapists.
NCBTMB Provider #: 451911-12
State of Florida Provider #: 50-13930
Advanced Fundamentals Education, LLC
Phone: 407-913-9755
Email: [email protected]
Website: www.AdvFundamentals.com
Disclaimers:
The information in this course is generally accepted as factual at the time of publication. The
information has been gathered through research or practical experience. Advanced
Fundamentals Education, LLC holds no responsibility for any information later found or claimed
to be inaccurate. It is the responsibility of individual practitioners to determine what is right for
themselves and their clients. It is also the responsibility of individual practitioners to work
within their scope of practice, laws and limitations.
This course is for informational and CEU credit purposes only. There is no certification of any
kind involved. Advanced Fundamentals Education, LLC does not advocate or condone any
illegal, unethical or immoral activity, and no such advocacy or condonation should be implied
from anything herein. Any discussion points throughout this course are merely used as a tool
to facilitate thought and encourage creativity, while still abiding by the laws and ethics of your
location and organization.
The information contained in this course does not necessarily reflect the views of Advanced
Fundamentals Education, LLC. Any similarity to any people or organizations is coincidental. The
original content of this course is copyright protected. You may use the information provided
for your personal use only as it is related to your continuing education or informational needs
as a massage therapist. You may not reproduce this material in any way without written notice
from Advanced Fundamentals Education, LLC.
© www.AdvFundamentals.com Page 3
Directions:
You can download this PDF file to your computer or review the material online while you take
the exam.
The reading material and exam are NOT timed. Read through the material presented
thoroughly.
Once you are ready to take the exam:
1) If you are not on the password protected page, go to it. This is the same page where you downloaded your course material. A password was emailed to you when you purchased your online CEU course(s). The link to the Course Material and quiz can also be found on the “Access Courses” Page.
2) Complete the quiz. A passing grade is 70% or higher. You have unlimited attempts to pass your exam.
3) The quiz is graded automatically and you are shown whether you pass or fail the quiz along with your percentage score. You are not shown what questions you answered incorrectly. However, upon passing, you are shown all the correct answers so you can compare them to your answers (if you have them written down.)
4) Make sure you have saved our email to your contacts to ensure proper delivery of your certificate of completion. [email protected]
5) For Florida Massage Therapists, Course Completions are reported daily to Cebroker.com.
6) If you have any questions not answered here or in the FAQ section of the website, please contact us. We’re here to help any way we can.
* Note: It is highly recommended that you print out any course material you wish to keep, as
well as your certificate of completion. Your certificate of completion is your proof you
completed this course.
* Note: If you are submitting credit for your NCBTMB re-certification, you are responsible for
submission of all your hours along with course information and any certificates needed as proof
of completion.
© www.AdvFundamentals.com Page 4
Diversity and cultural competency for massage therapists
Introduction
Diversity means the condition of having differing elements and qualities. It is the inclusion of
different types of people (as in race, gender, sexual orientation, or culture) in a group or
organization. Lots of things make up a person's culture and world view. Ethnicity, family
heritage, spiritual tradition, beliefs about illness and wellbeing, views about life and death, food
beliefs, family structure, language and non-verbal communication, and attitudes about touch are
a few such examples. In the context of healthcare, cultural competence is simply the ability to relate to and provide
services for people from cultures and traditions other than one's own. What follows are tactics to
become a more culturally competent and sensitive healthcare practitioner in our diverse society.
The population of the United States continues to become more ethnically diverse. As a result, it
is important that you become more familiar with the cultural differences of your clients to
become more sensitive to their perspectives so that you may provide the best care. Additionally,
it is important that you impart sensitivity to other cultures to your support staff, so that each
person you, and any of your support staff are in contact with, is treated with consideration.
This is the essence of the ability to successfully relate with clients or students who come from
cultures other than your own. Because we live in a world rich in texture, sound, color, and
meanings, the study of cultures and the influences of each on the society in which we live and
work can be intriguing, exciting, and an awesome responsibility. In fact, massage therapists and
bodyworkers need personal and interpersonal awareness and sensitivity to develop cultural
knowledge and a set of skills that underlie effective cross-cultural thinking.
With the evolving globalization of society, massage and bodywork professionals require an
understanding of the ethnic and cultural differences and similarities of the varied populations
they serve. Understanding the diversity of your clients' cultures – their beliefs, customs, values
and traditions – is integral to eliminating common cultural biases and providing high-quality,
culturally competent client care. From a social perspective, increased cultural competence is
required for reducing disparities in the health of people of diverse racial, ethnic and cultural
backgrounds.
The Scope of this Course:
This course on diversity and cultural competency for massage therapists defines important
concepts including race, ethnicity, culture, health literacy and health disparities. The course
determines what cultural competence means, how one becomes culturally competent, and
distinguishes between cultural sensitivity and cultural competence.
© www.AdvFundamentals.com Page 5
This massage therapy CEU course looks at diversity and cultural awareness in an employment
and massage therapist setting. The course covers statistics regarding diversity within the massage
industry, definitions of numerous relevant terms, and areas of focus for diversity training within
an organization. It examines ways to avoid pitfalls when working with various clients from
diverse cultures.
© www.AdvFundamentals.com Page 6
Section (1)
What is Cultural Competency?
Cultural competency can be defined as “a set of integrated attitudes, knowledge and skills that
enable a healthcare professional or organization to care effectively for patients from diverse
cultures, groups and communities”. It is a set of congruent behaviors, attitudes and policies that
come together in a system, agency or among professionals that enable working effectively in
cross-cultural situations. Cultural competency for one population may not necessarily translate to
another; it needs to be regarded as an ongoing process developed in a particular intercultural
context.
Cultural competence, a term particularly used in the health field, is the skill to respect and
interact effectively with other cultures. Cultural competence works both ways – some therapists
may be the strangers in a foreign culture. If the culture is very different from their own, they will
inevitably experience “culture shock.” The degree of shock depends upon how willing they are
to accept the new culture. Some of the symptoms of culture shock are confusion, disorientation
and depression. But these pass as one learns to adapt to the new culture.
What is Diversity?
When we talk about diversity, are we simply talking about
tolerance of others, even though they may be different?
Tolerance of other lifestyles is a totally different ball game than
being able to successfully integrate other cultures and their
idiosyncrasies into your working environment.
On the surface, people are very accommodating; they maneuver
easily among people of different cultures and colors. But
underneath that accepting exterior, there may be decades of
prejudice that has either been taught or studied. This is when it is
very important to accurately define the concept of diversity, how
it works, and how beneficial it can be to your business as a
massage therapist.
Discussions about diversity can make many folks feel a bit squeamish and downright
uncomfortable. So, let’s dive in and see what we can do to make things a bit more comfortable
for everyone who comes in contact with you and your business.
Case Study
Her English is slightly broken, but you understand every word she says. She is a native of
Bulgaria. When asked if she would like to take a steam before her treatment, she thinks about it a
second and nods her head “Yes.” You show her to the steam room. She seems surprised. She
turns to give you a confused look. You wonder where the communication broke down.
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You’ve just encountered a cultural difference. In Bulgaria, nodding the head up and down means
“No.”
Before starting the treatment you say to the client “If you feel too cool or need me to adjust the
pressure, just let me know, okay?” The client gently agrees. But 15 minutes into the massage, he
hasn’t relaxed. What’s up?
You’ve just encountered another cultural difference. The tense client is cold. He is from one of
the many cultures where they communicate a problem with more delicacy or subtlety, and you
missed it.
Experts agree that the single most important tactic for working with people of different cultures
is understanding their values. For example:
Americans often feel uncomfortable when someone stands less than three feet
away from them, while most people from the Middle East need to stand almost
nose-to-nose with the person to whom they are speaking.
Although not regularly practiced, some traditional Koreans believe that the soul
rests in the head and may become uncomfortable, even fearful if a provider or
staff member pats their child on the head or ruffles his or her hair.
In Chinese or other Asian cultures, use of the first name could be considered
disrespectful. People from these cultures may not complain about pain, so be
aware of non-verbal clues.
Address Hispanic individuals formally, especially elders. Handshaking is
considered a polite greeting. Hispanics have a holistic understanding of
emotional, spiritual, social and physical factors that affect an illness. Illness is
seen as a crisis for the entire family because Hispanic culture is very family
oriented.
When you encounter cultural differences, you’ll find people saying or doing things which are
different from the way to which you’ve grown accustomed. Knowing those cultural differences
is part of “cultural competence”.
The assessment and management of any patient in pain should always be done in the context of
their cultural, religious and ethnic status. Whilst an understanding of these factors is essential in
all medical care in general, these factors are particularly pertinent to understanding the
following:
pain assessment
incidence of specific pain conditions, and
incidence of co-morbidities and burden of diseases relevant to pain treatment in that
population
possible treatment options and approaches
expected responses and difficulties with implementing treatments
follow-up and attendance
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What does Cultural Competency Teach?
Cultural competency is about the acquisition
of skills to achieve a better understanding of
members of other cultures. It is a commitment
to engage respectfully with people from other
cultures. The focus on cultural competency is
a response to ongoing health inequalities and
related disparities in access to health services
and healthcare experiences for different
communities.
A commitment to cultural competence is the
beginning of an ongoing process that requires
motivation and a willingness to improve cross-cultural communication and practice both in
individuals and organizations. It emphasizes the idea of effectively operating in different cultural
contexts, and fostering constructive interactions between people of different cultures. By doing
so, it encompasses and extends elements of cultural respect, cultural awareness, cultural security
and cultural safety.
Massage therapists’ own biases, stereotypes, values and assumptions about human behavior may
differ from those held by other cultural groups. Cultural competency teaches a set of behaviors
and attitudes that respects and takes into account the person’s cultural background, cultural
beliefs, and values. It incorporates this into the way healthcare is delivered to that individual.
This is important as minorities are usually under-represented in the healthcare workforce.
© www.AdvFundamentals.com Page 9
Section (2)
The Cultural Competency Process
Cultural competency is a dynamic process that is constructed in the context of human relations,
including the process of crossing cultural boundaries. It needs to be considered within a broader,
system-wide social, historical, political and economic context, as well as at the level of
individual professional practice. It should be understood within the context of an individual,
their family and peers, their school and social or sporting clubs, ethnicity, class, race, and gender.
Cultural competency in healthcare describes the ability of systems to provide care to patients
with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social,
cultural, and linguistic needs. It increases access to quality care for all patient populations.
Cultural competency focuses on the capacity of the health worker to improve health status by
integrating culture into the clinical context. Importantly, for individuals, cultural competence
requires more than becoming culturally aware or practicing tolerance. It can be defined as the
ability to identify and challenge one’s own cultural assumptions, one’s values and beliefs that
can impact on people from diverse cultures.
It should create the willingness to move away from using one’s own cultural values as a
benchmark for measuring and judging the behavior of people from other cultural backgrounds. It
is about developing empathy and connected knowledge, the ability to see the world through
another’s eyes, or at the very least to recognize that others may view the world through a
different cultural lens.
Results of Cultural Competency
Socio-cultural differences among patients, healthcare providers, and the healthcare system are
potential causes of disparities in health and healthcare among racial and ethnic groups.
Inadequate cross-cultural communication between providers and patients may lead to patient
dissatisfaction, poor adherence to medications and health promotion strategies, and poorer health
outcomes.
The ultimate goal is a healthcare system and workforce that can deliver the highest quality of
care to every patient, regardless of race, ethnicity, or cultural background. There are links
between cultural competence, quality improvement, and the elimination of racial and ethnic
disparities in care. Cultural competence improves relationships and thereby may improve clinical
results. There remains, however, a need to translate cultural competence into quality indicators or
outcomes that can be measured.
© www.AdvFundamentals.com Page 10
How to implement cultural competence in your practice?
In communicating with clients of diverse backgrounds, it is helpful if you:
Speak a little more slowly (but not more loudly).
Avoid jargon — words you and your co-workers use but which outsiders may not know.
Avoid slang — it might be taken literally or simply confuse the listener.
Avoid giving more information than they need.
Ask them to tell you how they understand what you said — “teach back” or “show me”
techniques.
Create an accepting and respectful environment.
It may be useful to learn a few key phrases in different languages. It will save you time and
clients will interpret your extra effort as professional, respectful and friendly.
Some phrases that would be handy to know in another language are:
“Do you feel comfortable?”
“Are you warm enough?”
“Would you like a drink of water?”
How will being culturally competent help your business?
Improves Service. Being culturally competent helps ensure that you understand what the client
says — and more importantly doesn’t say — and what the client meant to convey.
Builds Trust. The Washington State Department of Health says patients with higher levels of
trust are more satisfied. This is probably true of massage clients as well. Therapists who are
culturally competent build trust in their clients because they appear more professional, more
interested and more experienced.
Competitive Edge. Being culturally competent gives you a business advantage by increasing
your client base.
Cultural competency benefits for clients
Too often, cultural competence is thought of as something that's “nice to achieve.” But it’s more
than that; it’s essential to optimal care. Your ability to deliver culturally competent care can
affect everything from your client’s access to healthcare to whether he or she shows up for
appointments.
“You need to have a broad understanding of how to interact with many different cultures,” says
Erin Shilling, a physical therapist at UCLA Medical Center in Los Angeles. She notes that
connecting with patients promotes a working relationship and makes them more likely to return
for follow-up visits.
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The diversity of the U.S. population continues to grow. Unfortunately, disparity in healthcare
among ethnic groups is growing too. According to the most recent census data, people of color
are less likely to be insured than whites, which can be partly explained by differences in income
and types of employment. Latinos, African-Americans, Asians, and American Indian/Alaska
Natives are less likely to have a regular source of medical care and less likely to have visited a
healthcare provider in the past year than whites.
Shilling’s parents are from different cultures, and she cares for patients with a wide range of
cultures at UCLA. She finds comfort in knowing that “it’s possible for people of many cultures
to interact positively.”
So, how can you deliver culturally competent care that benefits you, your clients, and your
clients’ families? Let’s find out what steps you can take.
1. Experts in the field of trans-cultural nursing, as well as professional chaplains, suggest
exploring your personal cultural identity. The idea here is that your own cultural
influences determine how you think and behave towards others socially and in the
workplace. Identifying your social roles, spiritual self-knowledge, cultural heritage,
personal habits and attitudes, and how you relate to various groups of people in society
expands perspective and self-awareness.
2. Identify the cultural mix in your own community. The cultural tapestry of Miami is
different from that of San Francisco or Des Moines or the Appalachian mountains. What
shapes the tapestry where you live?
3. Generalize, rather than stereotype. Stereotyping is applying a belief or attitude to
everyone in a cultural group. For example, saying that, “all Hispanics do this” or “all
Chinese think that.” We are all individuals. To generalize is to have a basic understanding
about a culture and use that knowledge as a starting point to learn more about a person,
© www.AdvFundamentals.com Page 12
family or group. You don’t have to be an expert about cultures to become more culturally
sensitive and competent, but gathering accurate basic information is a good start.
4. Be curious and ask questions. Suppose you have a client in a hospital or eldercare facility
and you don’t know if there are cultural considerations that would impact your plan of
care or relationship with this client. First ask the client’s social worker to share any
information they may have. The client’s chaplain may be a good resource as well. In
hospice settings, the interdisciplinary team is your best resource. You can also
respectfully ask your client or their family to share relevant information with you. If there
is something you don’t understand, ask!
5. Practice authentic listening. Listen to your client with your ears, eyes, heart and mind.
Authentic listening is paying attention in the moment while gathering information that
can guide right action.
6. Be sensitive to cultural rules regarding touch.
Remember, everyone is unique!
Since massage therapy fosters a holistic approach, factoring in the needs of people from a range
of cultures seems logical. With greater opportunities to serve clients in medical settings, you can
be an example of cultural competence to other healthcare practitioners while at the same time
providing excellent service for your client. Culture can even affect preferences for
complementary therapy. For example, some experts have noticed that Americans use yoga and
massage, while Hispanics may prefer herbal remedies.
It is critical that healthcare providers recognize individual differences and do not participate in
“cultural stereotyping”. Because persons of the same ethnicity can have very different beliefs and
practices, it is important to understand the particular circumstances of the patient or family by
obtaining information on: place of origin; social and economic background; degree of
acculturation; and personal expectations concerning health and medical care.
© www.AdvFundamentals.com Page 13
Section (3)
Cultural Trends and Shifts within the US
Culture includes language, religion, customs, food, codes of manners, behavioral standards,
patterns, and beliefs. Culture may also be defined as values and behaviors shared by a group of
people such as an ethnic, racial, geographic, religious, gender, class, or age group. Everyone
belongs to multiple cultural groups, so that each individual is a blend of many influences.
Cultural values and beliefs are the foundations of behavior, including that related to health. This
integrated pattern of human behavior includes thoughts, communication, beliefs, and customs,
and is learned through exposure to the speech, judgments, and actions of others.
Ethnicity refers to a shared culture and way of life and is socially distinguished by national origin
characteristics. Like ethnicity, race has been described as a socio-cultural concept used to
distinguish groups of people who share history, geography, and physical characteristics.
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The U.S. population has been changing significantly and rapidly, as shown in the Table below.
With this increasing diversity, massage therapists must be aware of the influence of culture on
the manner in which people seek support and help. Census data helps us understand some of
these trends and shifts; however, this data can be skewed by a group’s perception of identity and
often overlook the diversity that exists within groups.
The term Asian American includes people from a variety of nations, such as Afghanistan, China,
India, Pakistan, Syria, and Japan, among others. This group includes families who have
immigrated to and lived in the U.S. for generations. African Americans come from 54 countries,
speak up to 2,000 different languages, and are composed of 33.9 million people who are related
to and share characteristics with the 797 million people living in Africa. Native Americans are
people with unmixed ancestry or who have native lineage as a fraction of their backgrounds —
who may trace roots to any of more than 500 tribes. Native Americans may or may not identify
with their tribal ancestry and culture.
People identified as Hispanic can have Mexican, Puerto Rican, Cuban, Salvadoran, or
Dominican backgrounds. Others within the Hispanic group have Central American, South
American, or other Latino origins.
General Health Behavior and Beliefs
Here are some suggested generalizations about health behavior and beliefs of just a few of the
more common cultures in the U.S.
Hispanic and Latino Patients: Men tend to seek care only when they are unable to perform
their necessary work. If they can continue to work with discomfort, they will often do so for the
© www.AdvFundamentals.com Page 15
sake of their family. Women tend to be the ones who seek care for the family, and often sacrifice
their own health to accomplish this goal. Family is often engaged in decision making for
significant healthcare matters. For Hispanics who seek complementary and alternative medicine
(CAM), providers should consider that holistic healers may be included in self-care and not
disclosed for fear of negative responses by traditional Western physicians.
African American Patients: Patients within this group are reported not to seek preventive
services due to the belief that life is of the present rather than the future. Obesity is common and
accepted as a cultural norm for many. Individuals may also exhibit a great degree of mistrust for
the health system for a variety of reasons, including centuries of mistreatment and abuse. Folk
medicine alternatives may be used to treat certain illnesses, so practitioners should be aware of
this possibility.
American Indian and Alaska Native Patients: Patients within these groups have a common
belief that harmony with nature and traditional healing ceremonies are designed to reestablish
balance. It is common for American Indians to use traditional therapies with the Western
medications they receive. Some American Indians believe that illness is a punishment and is
associated with evil spirits. If the tribal medicine healer cannot heal the disease, he or she will
refer the patient for Western medicinal interventions. It is recommended that Western medical
healthcare practitioners blend traditional cultural health and values with Western medical
strategies.
Every client has a belief about illness, treatment, and expected recovery. This belief regarding
the underlying cause and resolution may have a spiritual basis. Therefore, massage therapists
need to have the skills that allow them to develop a treatment plan that respects the client’s
spiritual health beliefs. Religion also impacts many areas related to medication management.
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As massage therapists become more culturally competent and learn about the cultures of their
clients, they must use care not to stereotype them. Stereotyping involves defining all the
members of a group with the same terms, and is often viewed as an endpoint without variance.
Instead, it is more appropriate to gather information from your interactions and research and use
this to generalize in order to create a starting point from which you can begin to interact with
clients of a particular culture. Generalizations help understand and anticipate client behavior.
The following questions may be useful in assessing culturally diverse clients and families:
So that I might be aware of and respect your cultural beliefs…
1. Can you tell me what languages are spoken in your home and what languages you
understand and speak?
2. Please describe your usual diet. Also, are there times during the year when you change
your diet in celebration of religious or other ethnic holidays?
3. Can you tell me about your beliefs and practices for special events such as birth, marriage
and death that you feel I should know?
4. Can you tell me about your experiences with healthcare providers in your native country?
How often each year did you see a healthcare provider before you arrived in the U.S.?
5. Have you noticed any differences between the type of care you received in your native
country and the type you receive here? If yes, could you tell me about those differences?
6. Do you use any traditional health remedies to improve your health?
7. Is there someone, in addition to yourself, with whom you want us to discuss your medical
condition?
8. Are there certain healthcare procedures and tests which your culture prohibits?
9. Are there any other cultural considerations I should know about to serve your health
needs?
10. Is there anything else you would like to know? Do you have any questions for me?
(Encourage two-way communication.)
Conclusion
Culture is learned; it changes gradually and has different layers. It is immeasurably persuasive
and complex. Some aspects of culture (language, art, clothing and food) are readily apparent
compared with attitudes, values and beliefs. Culture and language are closely linked. Culture is
not static. It is constantly changing as a result of events and contacts with other cultures. The
development of cultural competence is a continuous process, slowly progressing from cultural
incompetence to gaining knowledge, awareness and sensitivity, before becoming competent.
Every person who requires medical or behavioral healthcare is unique both in the way clinical
symptoms are exhibited and in how that individual’s culture impacts his or her health behavior.
As clients journey along the continuum of care, it is critical that the health system prepare to
identify and address both the clinical aspects of care and the patient’s cultural and demographic
differences.
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Cultural issues are now recognized to be important elements in the provision of effective
healthcare. Massage therapists must learn and understand the cultural factors that affect clients’
healthcare decisions. Experts agree that all patients, regardless of race, ethnicity, sex, age,
religion, or physical or mental disability, have the right to high-quality healthcare that reflects
knowledge of and sensitivity to the factors of difference. With the majority of the population
growth within the U.S. expected to be within racial and ethnic minorities and immigrant groups,
our healthcare system must learn how to address the disparities in healthcare that arise from
factors such as race, ethnicity, and cultural and language barriers.
Members of racial minority groups, including Latinos and African Americans, are more likely to
under-utilize mental health services and to delay seeking treatment. Rates of mental illness
among people in most ethnic minorities are similar to those of Caucasians; however, members of
these minorities are more likely to experience confounding factors such as violence, poverty, and
discrimination that may exacerbate the disorder.
We must remember that the delivery of safe and effective care is the priority for all of our
clients. Ethnic and cultural differences must be acknowledged in order for us to apply unbiased
communication skills and the necessary empathy to improve healthcare for clients who have
different physical, spiritual, and language needs.
……………………………………………………………………………………………………………………………………………………….
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Bibliography
Leininger, M. (2005) Culture Care Diversity and Universality, Jones and Bartlett Publishers, Sudbury, MA
Galanti, G., An introduction to cultural differences. Western Journal of Medicine, 2000 May; 172(5).
http://www.nursingcenter.com/lnc/journalarticle?Article_ID=733509
http://www.med.umich.edu/pteducation/cultcomp.htm
http://www.massagetoday.com/mpacms/mt/article.php?id=14603
http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/108684/
http://www.apollo123.com/downloads/cultural_diversity_in_massage_practice_text.pdf
© www.AdvFundamentals.com Page 19
Directions:
You can download this PDF file to your computer or review the material online while you take
the exam.
The reading material and exam are NOT timed. Read through the material presented
thoroughly.
Once you are ready to take the exam:
7) If you are not on the password protected page, go to it. This is the same page where you downloaded your course material. A password was emailed to you when you purchased your online CEU course(s). The link to the Course Material and quiz can also be found on the “Access Courses” Page.
8) Complete the quiz. A passing grade is 70% or higher. You have unlimited attempts to pass your exam.
9) The quiz is graded automatically and you are shown whether you pass or fail the quiz along with your percentage score. You are not shown what questions you answered incorrectly. However, upon passing, you are shown all the correct answers so you can compare them to your answers (if you have them written down.)
10) Make sure you have saved our email to your contacts to ensure proper delivery of your certificate of completion. [email protected]
11) For Florida Massage Therapists, Course Completions are reported daily to Cebroker.com.
12) If you have any questions not answered here or in the FAQ section of the website, please contact us. We’re here to help any way we can.
* Note: It is highly recommended that you print out any course material you wish to keep, as
well as your certificate of completion. Your certificate of completion is your proof you
completed this course.
* Note: If you are submitting credit for your NCBTMB re-certification, you are responsible for
submission of all your hours along with course information and any certificates needed as proof
of completion.
© www.AdvFundamentals.com Page 20
Take your exam online at the password protected page where you
downloaded the material
The 10 questions below are the exact questions in the exact order as the
online quiz.
It is recommended that you prepare your answers here before taking the
online quiz.
1) TRUE or FALSE: Diversity means the condition of having differing elements and qualities.
2) Some of the things that make up a person’s culture and world view are:
a. Ethnicity
b. Family
c. Heritage
d. Spiritual tradition
e. All of the above
3) TRUE or FALSE: Cultural competency can be defined as “a set of integrated attitudes,
knowledge and skills that enable a healthcare professional or organization to care
effectively for patients from diverse cultures, groups and communities.”
4) TRUE or FALSE: The assessment and management of any client in pain should always be
done in the context of their cultural, religious and ethnic status.
5) TRUE or FALSE: Cultural competency, at the very least, is to recognize that others may
view the world through a different cultural lens.
6) Inadequate cross-cultural communication between providers and patients may lead to:
a. Patient dissatisfaction
b. Poor adherence to medications
c. Poor adherence to health promotion strategies
d. Poorer health outcomes
e. All of the above
© www.AdvFundamentals.com Page 21
7) In communicating with clients of diverse backgrounds, it is helpful if you:
a. Speak a little more slowly (but not more loudly)
b. Avoid jargon
c. Avoid slang
d. Have them use the “teach back” or “show me” techniques
e. All of the above
8) TRUE or FALSE: Learning a few key phrases in different languages will save you time,
and clients will interpret your extra effort as professional, respectful and friendly.
9) TRUE or FALSE: According to the most recent census, Latinos, African-Americans, Asians,
and American Indian/Alaska Natives are less likely to have a regular source of medical
care and less likely to have visited a healthcare provider in the past year than whites.
10) How can you deliver culturally competent care that benefits you, your clients, and your
clients' families?
a. Explore your personal cultural identity
b. Generalize, rather than stereotype
c. Be curious and ask questions
d. Practice authentic listening
e. All of the above
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