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From Cultural to Intercultural Competence
By Mari González
When I read the quote, “Intercultural Competence is a continuous cycle of learning, reflecting, and improving,” at the IDA Institute website, I was reminded of a similar definition I wrote before:
“Intercultural communication is a continuous cycle of individual awareness, dialogue, and practice that reduces confusion, frustration, and misunderstandings resulting in more efficient teamwork leading to higher morale, smoother operations, and increased work productivity.”
While being culturally competent can be a never ending process of professional development and self-improvement, intercultural competence is not achieved by learning, reflecting, and improving alone. Intercultural communication requires practice through actual interactions across cultural boundaries and the ability to adapt and shift perspectives in order to create an initial connection and a two-way beneficial communication process between medical providers and their culturally diverse patients.
For many years, the focus in healthcare has been in cultural competence as the knowledge and understanding of diverse cultural values in the form of conceptual training. We cannot continue to narrow down the increasingly diverse “two-way interactions” as one-way competency. Betancourt’s (2002) definition for cultural competence as a responsibility and “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” leaves the essence of healthcare ambiguous and undefined. Patients do not interact with systems. They interact with providers.
Care is provided by, with, and for people through human interaction not through systems. We need to move from cultural into intercultural competence. We need an updated and expanded definition for intercultural communication in healthcare as “the interaction between healthcare professionals and patients from different cultural backgrounds in order to reach understanding, build a shared reality and establish a satisfactory relationship” (Ramos-Raure, 2021). The delivery of care has to be continuously tailored. Each interaction will be different and healthcare and service providers need intercultural communication skills not the usual required cultural competence training.
* Image by the National Cancer Institute
Understanding Geert Hofstede’s Four Manifestations of Culture
By Mari D. González
As an cross-cultural consultant, I was trained to analyze communication across cultures and to interpret the differences and similarities among various ethnic groups. One model that is useful when examining culture across nationalities for international marketing or across ethnicities within a country is Geert Hofstede’s Four Manifestations of Culture.
Hofstede categorizes the expression of culture from what is most obvious to what is most difficult to perceive and understand. This can be compared to an iceberg in which the symbols, heroes, and rituals are at the tip–the smaller visible area–and the values are hidden and invisible, yet they form the larger area. Below are examples of the Four Manifestations of Culture:
1. SYMBOLS: Colors, food, words, flags, dress, jargon, commodities, and so on.
2. HEROES: Real or unreal characters that personify what is highly prized within a group or nation and who serve as role models or leaders.
3. RITUALS: Collective activities that are essential to maintain cultural groups’ cohesion. For instance, U.S.-born Latino youth watching a soccer game in Spanish with their parents and grandparents is considered a ritual.
4. VALUES: The most subjective and less visible expressions of culture that influence concepts, notions, expectations, perceptions, worldview, and so on.
Most people in general are familiar with the first three of Hofstede’s manifestations because those are learned at home or school while growing up during a process called “enculturation.” To analyze the not so obvious aspects of culture, which are the in-culture shared values, academic training in cross-cultural communication theory and an inherent curiosity are necessary. To be effective in intercultural communication, we need to see beyond our own ethnocentric tendencies by observing differences with total openness. It takes acknowledging and analyzing our own personal biases and stepping out of our comfort zones.
I have heard from many people who say they love learning about other cultures and that is the reason they travel the world and have friends of different ethnicities and nationalities. Traveling exposes people to symbols, the first manifestation of culture, and mingling outside one’s cultural group exposes people to both heroes and rituals. Yet, we can only learn about culture—the stuff that groups share—through socializing, and from close socializing or through acquiring training in cross-cultural communication plus observation and self-inquiry.
To include diverse participants whether your students, your clients, patients, or even your own employees, it is essential to have a basic understanding of cross-cultural communication in order to attain a broader perspective and a deeper understanding of our culturally differences. Finally, only the analysis is cross-cultural. The participants are increasingly diverse because our societies are becoming more multicultural.
* The image by James Penstone is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 2.0 UK: England & Wales License.
Accents and Cultural Identity Formation
By Mari D. González
“I have traveled more than anyone else, and I have noticed that even the angels speak English with an accent” ~Mark Twain
I love accents. I find them intriguing. They tell me that the speaker is bilingual. Accents define people socioculturally and correlate to their upbringing and ethnic, national, or group identity. Some accents are difficult to understand, some are melodious, and some take time to get used to. Our evaluations are subjective and relative to our personal opinions.
I am accustomed to accents. In California, there are immigrants in different professions including medical. I have interpreted for doctors from China and India who are not understood by patients with good second-language English fluency. Such difficulty is due to the patients’ lack of familiarity with people from those countries or perhaps they simply are not as intrigued as I am.
I came across an article written by a Peruvian author who spoke about the need to diminish one’s accent because “having a Spanish accent is seen as a minus.” None of my non-English-dominant colleagues have ever discussed accent reduction. This isolated “accent” perspective does not reflect the overall Latino/Hispanic concern.
Some immigrants demonstrate a greater desire to assimilate than Mexicans. It indicates a desire to fitting in instead of integrating. Mexican-American have a different perception of assimilation and actually oppose it. This opposition might be in response to U.S.-Mexican-specific historical factors.
The background of the current state of Latinos/Hispanics in the U.S. is the Chicano Movement. Whether we agree with it or not, the Chicano Movement is a point in history that precedes where we are now as a cultural group. It defines the second developmental stage of group identity formation called “Conflict.”
The first developmental stage of group identity formation is called “Identification with the dominant culture.” It is a desire to eliminate what makes one different from members of the dominant culture or assimilation. The author’s desire to reduce his accent implies being at this first developmental stage described as having a preference for an Anglo Orientation according to the research by Vasti Torres.
Reading Latino writers such as Rodolfo Acuña, Gloria Anzaldua, Hayes-Bautista, researcher, professor Amado Padilla, and journalist, Gregory Rodriguez help us understand the past and present context of Latino identity in the U.S. and why some people have a desire to assimilate and others to integrate.
How Does Intercultural Competence in the Workplace Looks Like?
By Mari D. González
I conducted a series of training sessions last year for a company whose employees are close to 50 percent Latinos of which about 30 percent are not fully bilingual. The communication across cultures is as challenging for English-dominants as it is for Spanish-dominants.
Several Asian-American employees also work for this company. Their communication style is different from Americans as well as from Latinos which enriched our training activities and discussions.
At the end of the mixed-group training sessions, I asked participants to brainstorm on what they had learned and what has worked for them in the past that they can apply when communicating with someone outside their primary culture and language.
My question was, based on what you have learned during training and from your own personal experience, what do you recommend when working with people from different cultures?
I wanted the “takeaways” to come from them instead of me. This is what they came up with:
- Have a positive attitude.
- Do not be afraid to ask questions.
- Use “yes or no” questions.
- When unclear, ask again, paraphrase and repeat.
- When something is critical, communicate face-to-face.
- Use non-verbal communication such as hand gestures.
- Ask for help when needed; simply say “I need help.”
- Talk slowly, not necessarily louder.
- Avoid the use of slang.
- Show it instead of telling it.
- Use pictures and visual aids if possible.
- Give a warning upfront if your second language skills are limited.
Low-Context, High-Context, and Losing Face?
By Mari D. González
According to anthropologist and intercultural communication pioneer, Edward T. Hall, North European and North American macro-cultures would be defined as “Low-context.” Their communication preference is characterized by explicit verbal messages. Hall explains that in Low-context, “Effective verbal communication is expected to be direct and unambiguous.” Low-context communication is related to an individualistic identity in which people are “I” conscious and express private opinions publicly.
Societies from the rest of the world including Latin America, Asia, and Arab countries utilize High-context communication in which, “most of the information is part of the context or internalized in the person; very little is made explicit (Hall, as cited by de Mooij, 2014). In these countries, people are programmed to read context and meaning between words.
In High-context or collectivist societies expressing personal opinions and disregarding the group of reference’s perceptions is not the norm. The personal identity is related to the group of reference and a shared “we” identity. There is a risk of making them feel uncomfortable. An offense to a person of that cultural group is an offense to all the in-group members to which Asians call “losing face.”
* Image by Icons8 Team on Unsplash
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