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The Purnell Model of Cultural Competence in Multidisciplinary Healthcare Teams

Introduction to Cultural Competence and the Purnell Model

The twenty an era of multiculturalisrn and diuersity in health care. Cultural competence, an essential component within the multidisciplinary
healthcare team, has become a major initiative. The Purnell Model of Cultural Competence is proposed as an organizing framework to guide cultural competence among multidiscipinary members of the healthcare team in a variety? of primary, secondary, and tertiary settings. First, essential definitions for understanding culture and cultural concepts are introduced. A brief overview of the Purneil Model for Cultural Competence including purposes, underlying assumptions, and major components of the Model are presented. The primary and secondary} characteristics of culture that determine the degree to which people adhere to their dominant culture are also included. Cultural general knowledge and skills ensures that providers have a process for "becoming" cuituraily competent. This manuscript presents definitions of essential terminology for understanding culture and the Purnell Model for Cultural Competence. 

Healthcare professionals and healthcare organizations are avidly addressing multicultural diversity and racial and ethnic disparities in health. Almost every health journal now has articles addressing "cultural competence." Healthcare professional societies and organizations have some type of standards, initiative, or statement encouraging its members to become culturally sensitive and/or culturally competent. Moreover, one can now find workshops that address culturally sensitive and culturally competent care from a plethora of organizations and individuals. The stress on culture and diversity is good because cultural competence improves the health of the country's citizens.

However, culture is an extremely demanding and complex concept, requiring providers to look at themselves, their patients, their communities, their colleagues, and their Larry Purnell, PhD, RN, FAAN, Professor, University of Delaware, College of Health and Nursing Sciences, Department of Nursing, McDowell Hall, Newark, Delaware. employment settings from multiple perspectives. Increasing one's consciousness of cultural diversity improves the possibilities for healthcare practitioners to provide culturally competent care, and therefore improved care. Cultural competence is a conscious process and not necessarily linear. To add to the complexity of learning culture, no standardization of terminology related to culture and ethnicity exists. The definition of cultural sensitivity presented by one person or group is the same definition that another person or group defines as cultural competence or awareness.

In an attempt to reach consensus and standardize definitions of these and other terms commonly used in health care, the American Academy of Nursing Expert Panel on Cultural Competence has been developing over the last two years a White Paper that addresses this issue. This manuscript presents definitions of essential terminology as a starting point for understanding culture and the Purnell Model for Cultural Competence. 

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