From Competence to Connection: Cultivating Cultural Humility in Interprofessional Teams

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Have you ever finished a patient encounter feeling like something is missing? Sometimes, a patient may appear hesitant, refuse a recommendation, or approach their health differently than we expect. Pause. This is where cultural humility begins.

Cultural Humility: A Way of Life

Cultural humility was first introduced by Tervalon and Murray-Garcia (1998), who argued that cultural competency training alone failed to address the underlying causes of health disparities in the United States. Power imbalances, systemic bias, and structural inequity required something deeper: an ongoing commitment to self-examination, openness, and willingness to share power at every level of care.

Rather than asking healthcare professionals to become experts on every culture, cultural humility asks them to look inward, examining their own assumptions and blind spots, while approaching each patient as the expert on their own life. When every team member, regardless of role, brings this same humility to both patients and colleagues, care becomes a truly collaborative act rather than a series of parallel interventions (Liamputtong, 2022). Hierarchies become less rigid, and overlooked perspectives are recognized as valuable clinical insights. 

Competemility: Why Interprofessional Teams Need Both

Cultural competence and cultural humility are not opposites. Healthcare professionals need both for effective care. This blend is called "competemility" (Campinha-Bacote, 2018). Competence without humility risks reducing patients to cultural stereotypes, while humility without competence leaves healthcare professionals without the knowledge needed to act. “Providers require both the product (cultural competence: knowledge of health beliefs, disparities, and practices) and the process (cultural humility: self-awareness, openness, and recognition of biases)” (Yancu & Farmer, 2017). Applied to the interprofessional team, competemility means that each discipline contributes its knowledge base, while simultaneously practicing the humility to listen, defer when appropriate, and resist letting professional identity become professional hierarchy. 

How Can You Cultivate Cultural Humility?

Intentional practice is key. The "4 C's" offer a useful framework (InsideTrack, 2022).

  • Curiosity: Shift from the Golden Rule to the Platinum Rule: instead of treating others how you want to be treated, treat them the way they want to be treated.
  • Comfort: Get comfortable with discomfort. You will make mistakes, so create a safe space for people to give you feedback, and be willing to apologize and change.
  • Clarity: Understand yourself, the social dynamics in the room, and how your own identity shapes your interactions.
  • Confidence: Notice your internal growth. Look for increased comfort with differences and a greater openness to discussing fairness.

Additional daily practices include learning more about the community you serve and the broader systemic barriers, listening with intention, and normalizing different definitions of quality of life (Stubbe, 2020). 

Beyond the Patient: Cultural Humility in Teamwork

Cultural humility is equally vital for interprofessional teamwork and institutional culture. Racism, sexism, ableism, and other forms of bias are embedded in our broader world and often trickle down into healthcare systems and policies. A major barrier to truly collaborative teams is that healthcare members avoid authentic conversations about systemic bias because those conversations are uncomfortable (Khan, 2021). Cultural humility provides the framework for having them. 

Why it Matters

When patients feel seen, respected, and genuinely heard, trust follows. Clinicians who commit to ongoing self-reflection and remain open to patients' beliefs, values, and lived experiences are better equipped to make decisions collaboratively and deliver care that best fits the individual in front of them. Across teams and communities, that ripple effect is what begins to close the gaps that have long defined healthcare inequity. This is what moves healthcare from transactional to meaningful. 

References

  1. Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Healthcare for the Poor and Underserved, 9(2), 117–125.
  2. Liamputtong, P. (Ed.). (2022). Handbook of Social Inclusion: Research and practices in Health and Social Sciences. Springer. 
  3. Stubbe DE. Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. Focus (Am Psychiatr Publ). 2020 Jan;18(1):49-51. doi: 10.1176/appi.focus.20190041. Epub 2020 Jan 24. PMID: 32047398; PMCID: PMC7011228.
  4. Lekas HM, Pahl K, Fuller Lewis C. Rethinking Cultural Competence: Shifting to Cultural Humility. Health Serv Insights. 2020 Dec 20;13:1178632920970580. doi: 10.1177/1178632920970580. PMID: 33424230; PMCID: PMC7756036.
  5. InsideTrack. (2022, March 10). Understanding cultural competence and humility. InsideTrack.
  6. Campinha-Bacote, J. (December 4, 2018) "Cultural Competemility: A Paradigm Shift in the Cultural Competence versus Cultural Humility Debate – Part I" OJIN: The Online Journal of Issues in Nursing Vol. 24, No. 1.
  7. Yancu CN, Farmer DF. Product or process: Cultural competence or cultural humility? Palliat Med Hosp Care Open J. 2017; 3(1): e1-e4. doi:10.17140/PMHCOJ-3-e005
  8. Khan, S. (2021, January 13). Cultural Humility vs. Cultural Competence — and Why Providers Need Both. HealthCity.