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Canyon College
COURSE SYLLABUS: Cultural Diversity & Cultural Competence
| Course Title: | HS552 - Cultural Diversity & Cultural Competence |
| Department: | Health Sciences |
| Instructor: | Anna Prest, MSN, RN, CNOR E-Mail - Vitae |
With the evolving globalization of our society, health care professionals, administrators, and supporting members of the team require an understanding of the ethnic and cultural differences and similarities of the varied populations they serve. This course is designed to acquaint the student with health care delivery implications of globalization in the context of cultural competence resulting from migrating peoples, rapid transportation, and increasing facility of telecommunications and computer technology.I. Course Welcome:
In this course, "health care" includes health promotion, prevention efforts, and intervention or treatment for disease, injury, or mental/emotional problems.
Students will explore the data emerging that supports the premise of health care disparity in the US by using online resources, texts, and journal articles. The issues of health insurance and access to care, health status and health habits, patient-physician interaction, patient attitudes, and quality of clinical care of three major minority populations of the U.S.-Hispanics, Asian-Americans, and African Americans-will be studied with reference to barriers within the cultures and potential biases of providers of care.
Introduction of similar issues among Native Americans and newly immigrating cultures will be addressed as will the newly-recognized problem of disparity of care for woman, particularly of certain minority populations. Substance for proposal of solutions beneficial to the care recipient, the provider, and institutions will be focused on theory and concept of cultural diversity enhanced by cultural competence and proficiency.
Although the focus of discussion is on US health care, this class will be of value for health professionals of any nation.
Because we live in a world rich in texture, sound, color, and meanings, the study of culture and the influences of each on the society in which we live and work can be intriguing, exciting, and an awesome responsibility. I welcome you to this course and wish for you the benefit you seek.II. Course Objectives:
At the close of this course the student will:
The course is intended to sensitize the student to the issues and concerns of cultural context and resulting potentials for unequal, or disparate, health care among minority and vulnerable populations. Texts and articles present information for enhancing the practice of health and human services professionals through assessment, effective communication, and design and implementation of personal and organizational strategies and action plans in developing culturally proficient health care.
Course assignments are designed so that they are individually tailored within an area of focus as selected by the student, thus supporting the specific health care or role interest of each student. The course begins by examining the problem of health disparity: through data and reviewing related theory and progresses through problem-solving skills to remediate selected cultural barriers to quality health care.
This course has homework assignments or activities which will draw upon numerous and varied resources online and in text. These activities and assignments include information from the textbook and contemporary healthcare journals, as well as prior coursework and professional experiences.
Required Texts: Online Bookstore
Two books are required for this course. They may be ordered from any book store or online book vendor.
1. Intercultural competence: Interpersonal communication across cultures, by Lustig, M.W. and Koester, J. Allyn and Bacon, 2002/2003. ISBN: 0321081773IV. Grading
2. Special populations in the community, by Sebastian, J.G. and Bushy, A. Aspen Publ., 1999. ISBN: 0834213648
Assignments will be graded based on completeness, correctness and timeliness of submissions. They will be viewed for word content (number of words required per the syllabus), spelling and grammar excellence, APA format; plagiarism, and quality of content using the following rubric:
Written submissions are to be in APA format where indicated; Editions 4 and 5 are acceptable.
Midterm and Final Weeks
The Midterm grade is determined by aggregate point performance of work submitted in weeks 1-4. The Final point allocation is determined through aggregate points submitted for all weeks of the course. Final Letter Grade Letter grades will be assigned at the conclusion of the eight weeks based on cumulative points achieved over the entire eight-week course.
Grading StandardLetter grades are based on the following criteria:
The grading scale based on 235 possible points is as follows:
A = 222 - 235 points A - = 209 - 221.5 points B + = 202 - 208.5 points B = 195 - 201.5 points B - = 186 - 194.5 points C + = 178 - 185.5 points C = 162 - 177.5 points C - = 156 - 161.5 points D = 141 - 155.5 points F = below 140 points
Fractional point values will be rounded up to the nearest whole number.
A Clearly demonstrates excellent performance in meeting the requirements of the course. Uses unusually sharp insight and is able to view and evaluate issues from more than one perspective. Integrates knowledge from previous experience or study and can anticipate the next steps in the progression of ideas or concepts. Applies knowledge to academic written work with proficiency and very little guidance. Offers new, unsolicited information to the content of the class.
B Grasps knowledge of subject matter at a level considered to be good to very good. Accomplishes more than the minimum requirements of the course. Academic performance is of high quality. Shows initiative and is an active participant.
C Demonstrates a satisfactory comprehension of the subject matter. Accomplishes only minimal requirements and displays limited or no initiative. Written work is at an acceptable level, but considerable guidance is required to meet academic standards.
D Below average work; barely acceptable.
F Quality of work unacceptable.The course facilitator's standard for continually-progressing critical thinking in communication and writing is based on Bloom's Taxonomy of:
Course Week and Due Dates:Submitting Assignments - Instructions
Generally, Monday is the first of the course week, and Sunday is the last day of the course week. Assignments scheduled for completion during a class week should be sent as an attachment to the instructor via email by end of the day Sunday, determined by your own time zone. If a student is sending assignments through the postal service, please make prior arrangements with instructor, as there is no postal delivery on Sunday or federal holidays.
Students may submit work as attachments in MSWord (any version) or WordPerfect (any version) or HTML and send as an email note or file attachment, except as the requested MSWord table in assignment #1. If you use another word processing program (such as Works), please save as an .rtf file.
Formats for files received other than those specified here that your instructor cannot open using MSWord will be returned to you for reprocessing, and will be considered late. Any questions on formatting of your file attachment documents, please e-mail your instructor with any questions now so that we can find a format that will work for your particular needs. Thanks in advance on this matter.Please include:
Weekly assignments must be received by the instructor not later than Sunday midnight (your time zone) of the week assigned. Students who anticipate that their schedule may cause assignments to be out of compliance are advised to contact instructor at least one week in advance, as an extension may be permitted with prior mutual agreement. Three percent (3%) will be deducted from the assignment for late unexcused submissions. Instructor discretion regarding point penalties for any late work will be considered final.Absentee Policy
While this course is designed to be completed through independent study, "attendance" is recorded through assignment submissions in a timely manner to the instructor's email address (or via post). However, please note that any student who has not participated (completed assignments) for 14 consecutive days without prior discussion with the instructor regarding such absence shall be recommended for administrative withdrawal. The school shall make recommendations to the instructor as to what action will be taken.Academic Honesty
Canyon College policies are in effect. All work must be your own. Presenting as one's own the words, ideas, or expression of another in any form is cheating through plagiarism, and will not be tolerated. The Course Facilitator retains the right to engage academic search services for Internet Plagiarism at any time on any student papers submitted for credit in this course. You area not share your work with any other current or potential students.VI. Pre-Course Assignment and Communication
Prior to the beginning of your study for this course (within 2 days) you must post to your course facilitator a pre-course assignment-your introduction of yourself. This should include you name, address, phone number (day and evening), email address, fax number if you have one, and any specific directions for contacting you if your course facilitator needs to. Normally all communication will take place via email, but in the case of an emergency I may need to contact you. When you contact me by email, your subject line must always be CANYON COLLEGE followed by your first and last name. I check my email daily and will respond to your messages within 48 hours. If you do not understand an assignment, please contact me right away. Do not jeopardize your time in delay.
In addition to your vital information (which is held in confidentiality) you are expected to include a brief biography of yourself such as: the cultural and/or ethnic group you belong to, your present occupational position, the career you pursue, reason for enrolling in this class, and any other personal information you wish to share that will enhance my perception of who you are.VII. Assignments That Generate Creativity
These assignments are major projects that reflect your comprehension and application of the content of the course.
Week 2
1. A self-inventory of cultural beliefs will be performed and summary report of 300 words. Use the two self-inventory tools your course facilitator will email you as you begin class. They are "Ethnic Self-Awareness Inventory" and Self-Assessment Checklist of Culturally competent Practice." (20 points)
Week 3
2. A need-based assessment of the organization the student works or volunteers for using the Cultural Comptenecy tool of #1 above and resources at the "Manager's electronic Resource Center: at Management Services for Health. Write a summary in 600-800 words reporting on the results of assessment in APA format. It is to be submitted using at least 5 professional references, 3 of which should come you're your assigned readings and/or websites. One reference may be a culturally-sensitive interview with a managing employee or co-worker; protect confidentiality of person and company. (30 points)
Week 4
3. From a self-selected special population (cultural and linguistic), form a topic outline for a proposed remediation plan to intervene in a specific health disparity of concern to that group. Necessary elements: Introduction of special population and assessment of health disparity concerns, consequences if no intervention is performed, projection of potential results/benefits of an intervention, brief outline of proposed remdiation plan, evaluation method. The outline will be submitted in Week 4 and the proposal will be completed in Week 6. (25 points: 15=content, 5=supporting sources, 5=structure &mechanical quality)
Week 6
4. Complete proposed remediation plan for a self-selected special population with a specific health disparity concern (# 3 above). Must reflect utilization of theory and conceptual development of cultural comptenecy and proficiency, applying standards and recommendations of governmental, academic, and professional organizations and leaders. Adjustments of your topic outline may be necessary; give rationale for that. APA format. Use the MSG website as a major source of reference. (45 points: development of remediation plan=20, utilization of resources=10, quality and appropriateness of proposal=10, professional writing quality=5).
Week 7
5. Propose a culturally proficient communication or education event for your assessed employiee organization of #2. (35 points: utilization of resources in content writing=15, quality and appropriateness of event=10, utilization of assessment results=5, professional writing quality=5). Examples: health fair, radio/TV programming, workshop, play, music or food festival. Be creative!
Week 8VIII. Course Bi-Weekly Assignments Required and Recommended Readings and Related Assignments
6. Using the National Center for Cultural Competence Assessment and Planner's Guide, (see web link below) the student will propose a detailed plan for a culturally competent health promotion event in one's own community (church, parent teacher's organization, workplace, neighborhood, etc.) Pretend you are the Coordinator who will identify all resources and delegate duties as necessary. Describe the steps you will take in a time schedule and the contacts you will make. Link: www.georgetown.edu/research/gucdc/nccc. The mission of the National Center for Cultural Competence (NCCC) is to increase the capacity of health and mental health programs to design implement, and evaluate culturally and linguistically competent service delivery systems. (40 points)
WEEKS 1 and 2
Sebastian J.G. and Bushy A. (1999). Special populations in the community. Foreword Preface Introduction to Part I - "Definitions and Theory Underlying Vulnerability."
1. Disparity in health care in America is a long-standing issue. Visit www.osophs.dhhs.gov/phs200/exhibits.htm click on "If you knew the conditions . . ." to learn of the plight of Native Americans through history. In 250 word, summarize the trend of society's response to their health care needs. (5 points)
2. The Surgeon General published a report on Mental Health: Culture, Race, and Ethnicity found at www.surgeongeneral.gov/library/mentalhealth/cre/default.asp. From it report the significance of effective communication to the delivery of mental health services in 450-500 words. (10 points) Introduction to Part II - "the Need for Cultural-Linguistic Competent Care for Families with Special Health Problems."
3. Discussion Question #4 on page 66 of Sebastian and Bushy. (Minimum of 250 words, non APA format.). Due Week 2. (10 points) "Using epidemiologic reports from the Centers for Disease Control and Prevention www.cdc.gov or from the state Department of Health www.statelocalgov.net/index.cfm identify the most prevalent health conditions in your catchment area that could be attributed to racial or ethnic genetic predisposition. Describe treatment protocols for these conditions and identify strategies to integrate the ethnocultural belief into client care plans.
4. Draw on the principles set out in Sebastian & Bushy's Introduction chapter to Part II, choose either one of the 8 chapters (5-12) in that section about special populations with health problems or a population group from the MSH website and summarize in 400 words the distinctness of the cultural group, the significance of their problem or health risk, suggested interventions that are culturally competent. (15 points)
5. From Lustig M.W. & Koester J. (2003). Intercultural competence: Interpersonal communication across cultures. (3 points each) Chapter 1 - "Introduction to Intercultural Competence" DQ #2, page 23 Chapter 2 - "Culture and Intercultural Communication" Example 3 Question, page 46; DQ #5, page 54________________________________________________________________________
Chapter 3 - "Intercultural Communication Competence" DQ #3, page 81
Creative Assignment #1- Due Week 2.
WEEKS 3 and 4
Sebastian J.G and Bushy A. (1999). Special populations in the community 1. Introduction to Part III - "Resiliency and Social Support." Discussion Question # 1 on page 194. (Minimum of 250 words, non-APA format.) Due Week 4. (5 points) "Reflect on resiliency and healthiness. Describe individuals that you have encountered or cared for who exhibited these features. Describe their attitudes and behaviors. How do these fit with hardiness theory? How do they describe their support systems?
The following chapters are chosen at your discretion for application to creative assignment #3 in addition to those found at http://www.cmwf.org below. (Remediation plan for special population.) Chapter 6 - "Cardiovascular Disease Risk Factors in Anglo and Mexican American Children and Their Mothers"
Chapter 9 - "Access to Health Care: Perspectives of African American Families with Chronically Ill Children"
Chapter 12 - "Themes of Stressors for Childbearing Women on the Island of Hawaii"
Chapter 15 - "A Comparative Analysis of Chronic Disease Prevalence among Older Koreans and Non-Hispanic Whites"
Chapter 17 - "A Multidisciplinary Health Care Outreach Team to the Homeless: The 10-Year Experience of the Montefiore Care for the Homeless Team"
Chapter 19 - "An Ethnonursing Study of Muscogee (Creek) Indians and Effective health Care Practices for Treating Alcohol Abuse"
2. From Lustig M.W. & Koester J. (2003). Intercultural competence: Interpersonal communication across cultures.
Chapter 4 - "Cultural Patterns and Communications: Foundations" Activity, social relations, self, world, time. DQ #4, page 108, in at least 250 words. (5 points) Chapter 6 - "Cultural Identity, Cultural Biases, and Intercultural Contact" DQ #3, page 173 (3 points) Creative Assignment #3 Due in Week 4.
Data on the quality of health care perceived by minority populations in the U.S. are found at http://www.cmwf.org "Quality of Health Care for Hispanic Populations" "Quality of Health Care for Asian-American Populations" "Quality of Health Care for African American Populations"
http://www.iom.edu/search_results.asp?qs=unequal+treatment The Institute of Medicine Report "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care." [If you have difficulty via this link, cut off the digits back to "edu" and conduct a search with keywords of "unequal treatment", the article will appear at the top of the list. It is a pdf file, so you will need Acrobat reader.]
http://www.AHRQ.gov Student selects articles pertinent to this course. Just above "Research Findings" you will find "Minority Health" and below it you will find the Online Newsletter--good sources. http://www.bphc.hrsa.gov/campaign/ Health Resources and Services Administration campaign for "0" disparities in health care http://www.wiche.edu/MentalHealth/Cultural_Comp/index.htm Cultural Competence in Managed Mental Health Care for diverse racial and ethnic populations. Recommended Reading Montes JH, Eng E, Braithwaite RL. "A Commentary on Minority Health as a Paradigm Shift in the United States," American Journal of Health Promotion Vol. 9 (4), March/April 1995; 247-250. McKenna M. "A Call for Advocates for Cultural Awareness," Journal of Transcultural Nursing Vol 12 (1), January 2001; 5 [Issues of this are rich with theory and practice in cultural diversity and competent health care.] Their website is www.tcns.org . (You won't find their journal in electronic form.) http://www.cdc.gov/mmwr Diabetes in Women Associated with Low Income, in the Feb. 22, 2002 issue________________________________________________________________________
WEEKS 5 and 6
Sebastian J.G. and Bushy A. (1999). Special populations in the community Chapter 11 - "Coping with the Cost of Care: An Exploratory Study of Lower Income Minorities in the Rural South"
Lustig M.W. & Koester J. (2003). Intercultural competence: Interpersonal communication across cultures. Chapter 10 - "Intercultural Competence in Interpersonal Relationships" Chapter 11 - "Episodes, Contexts, and Intercultural Interactions" Creative Assignment #4 Due in Week 6.
http://www.omhrc.gov/clas The Office on Minority Health website where recommended Standards for Culturally and Linguistically Appropriate Health Care Services are found. http://www.diversityrx.org Articles, news, and resource list of organizations focused on diversity and competent health care. Recommended Readings Davidhizar R, Dowd S, Newman J, & Giger. "Managing Diversity in the Health Care Workplace," The Health Care Supervisor, Mar. 1999. Aspen Publ. Rauch JB. "A Model for Learning Cultural Competency," Continuum [a social work periodical], November/December 1999; 9-14. http://www.nmha.org National Mental Health Association position papers. In search box type in "position statement, culture." Kumanyika, SK, Morssink CB, & Nestle M. "Minority Women and Advocacy for Women's Health," American Journal of Public Health, Vol. 91 (9); 1383-87.________________________________________________________________________
WEEKS 7 and 8
Sebastian J.G. and Bushy A. (1999). Special populations in the community Chapter 25 - "Partnership Building with Special Populations" Lustig M.W. & Koester J. (2003). Intercultural competence: Interpersonal communication across cultures. Chapter 12 -"The Potential for Intercultural Competence"
Creative Assignment #5, Due Week 7, #6 Due Week 8.