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Cultural Competence can enhance mutual respect in the classroom, improve communication, provide a more supportive learning environment, and increase critical thinking and innovation. Teaching cultural competence can help make institutions and classrooms more welcoming and accessible to all types of students.

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What Is Cultural Competence In Education? Why It’s Important

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Explore the importance of cultural competence in education, its benefits, and practical strategies to create inclusive classes.

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This is so important, especially in the U.S., we are a country build by people from all around the world with so many different cultures. Some people have issues when interacting with another person from a different background. Maybe if more people were educated about cultural competence, this problem would be reduced. ExtendaTouch is taking a good initiative by creating a space where people can connect, speak and learn about cultural competence.

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15 year old Pablo, already involved in the juvenile justice system, is now also struggling with mental health issues. Pablo has behavioral problems which worsened after his father's death. He experienced with drugs and alcohol at a young age due to being in a gang. His mother worked long hours so she was always hard to contact. Until a counselor met with Pablo and his mother, explaining the circumstances. The counselor believer Pablos desire for independence from his family was influenced. She didn't know how to handle this cultural competently. I think she should involve the family more actively, and have mutual respect for both of them. Encourage Pablo to express his feelings and provide community resources and information for him to get better.

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A case study illustrates the problems in providing culturally competent mental health care.

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Dr. Martin shares the history of cultural competence, how we have lost the original vision of the concept, and methods to remedy this issue. Because therapy can't be the only safe space, we must improve the human experience. Dr. Martin specializes in racism related stress, racial identity development, and anti-racist and anti-oppressive care. Dr. Martin is passionate about mental health education, activism, and critical consciousness.

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You're Doing It Wrong: The evolution of cultural competence | Raquel Martin | TEDxRutgersCamden

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This website explains how to create a practice that welcomes the LGBTQ community, explains their challenges, and how to understand the terms.

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Continuing Education Activity

The lesbian, gay, bisexual, transgender or queer/questioning (LGBTQ) community consists of a cross cultural broad range of community members and includes all races, ethnic and religious backgrounds, and a range of socioeconomic status. The healthcare needs of the lesbian, gay, bisexual, transgender or queer community should be considered to provide the best care and avoid inequalities of care. This activity reviews the evaluation and treatment of members of the LGBTQ community and highlights the role of the interprofessional team in caring for patients that are members of this community in a professional, ethical, and caring manner.

Objectives:

Describe acceptable terms for gender and sexual identity in the lesbian, gay, bisexual, transgender, or queer community.

Summarize challenges in the care of the lesbian, gay, bisexual, transgender, or queer community.

Outline communication strategies to provide culturally correct evaluation and treatment of the lesbian, gay, bisexual, transgender, or queer community.

Explain the cultural competence in the care for LGBTQ community patients.

Access free multiple choice questions on this topic.
Issues of Concern

Learning to take care of members of the lesbian, gay, bisexual, transgender, or queer community involves understanding and being open to multiple special considerations and avoiding unconscious and perceived biases. Members of the LGBTQ community have unfortunately experienced a challenging history, but health professionals can learn to provide compassionate, comprehensive, and high-quality care with education. The following will assist the provider in caring for LGBTQ patients.[4]

Patient Versus Provider Use of Slang Terms

Members of the LGBTQ community, in describing their sexual orientation or partners, may use terms such as fag, dyke, gay, homo, or queer. While patients may use these terms, they are considered derogatory when describing a patient by a health care provider. The provider and staff should listen to the LGBTQ patient and follow their lead, and when in doubt, ask the patient how they or their partner should be described. Once the terms are established, a note should be made in the record to follow the pattern of description for future visits. Electronic medical records may require modification to provide appropriate terminology.[7]

Challenges To Caring for LGBTQ Community[4]

Healthcare providers without training and education often face challenges in the care of patients in the LGBTQ community such as:[8]

How to Create A Practice That Welcomes Members of the LGBTQ Community[5]

There are several ways providers can welcome members of the LGBTQ community, such as:

False Assumptions

Healthcare professionals may falsely make assumptions about LGBTQ community members, such as females do not have children or are at low risk of sexually transmitted infections.

The LGBTQ community is often harassed and may be subject to violence. Transgender patients are particularly at risk. They may also experience domestic violence. As such, ask all patients screening questions such as:

Are you now or have you ever been physically, mentally, or sexually abused by someone close to you?

Are you currently abused in any way?

Have you ever been sexually assaulted?

Are you afraid of anyone?

Patients should be informed confidentiality will be maintained as much as state reporting levels allow.

Special Needs of Bisexual and Lesbian Women[4][11]

A woman that identify themselves as bisexual or lesbian may range from feminine to masculine. Their needs are similar to all women, but they may have the following additional needs. Healthcare providers need to make sure these patients feel comfortable in making disclosures regarding their sexual practices. In general, these patients have similar healthcare needs to heterosexual patients. If they have challenges, they usually stem from lifelong discrimination and harassment, resulting in anxiety, depression, and stress. Bisexual and lesbian women may face additional challenges, such as:

Special Needs for Bisexual and Gay Men[11]

The healthcare needs of bisexual and gay men are similar to the general male population. However, they have higher rates of domestic violence, substance abuse, and depression. Due to a higher rate of homophobia in certain cultures, such as African Americans, Asians, Latino, and Pacific Island, males may have even higher rates of mental health challenges. Bisexual and gay men may face additional challenges, such as:

The health care provider should ensure that the staff is trained to appropriately care and speak to LGBTQ patients appropriately and ethically, further understanding that discrimination is illegal and morally unacceptable. Religious beliefs or negative feelings must be put aside.[8] Address such issues as:

Avoid discriminatory beliefs

Basic knowledge of issues in the LGBTQ community including depression, discrimination, domestic violence, harassment, HIV, homophobia, safe sex, sexually transmitted diseases, substance abuse

Use of appropriate language

LGBTQ Is Not A Disease

Regrettably, at one point in medical history, being LGBTQ meant having a psychiatric disease. Fortunately, after years of lobbying, in 1973, the American Psychiatric Association members voted to determine if homosexuality was a disease. The ensuing vote led to a compromise, and homosexuality as a diagnosis was removed from DSM-II. It was replaced with "sexual orientation disturbance" for patients "in conflict with" their sexual practice and orientation. Later, in 1987, homosexuality was completely removed from the DSM.

LGBTQ Features, Medical, and Surgical Therapy[12][13]

LGBTQ has two distinct features, gender identity and sexual orientation. When obtaining a history, providers should ask about gender identity and sexual orientation and gender identity to better understand patients' health risks.

Sexual orientation for gay and lesbian individuals usually involves being attracted to people of the same sex, whereas heterosexuals are mostly attracted to individuals of the opposite sex. Sexual orientation is an identity label and sometimes does not correspond to a person's sexual behavior.

Gender identity for transgender patients identifies sex other than the one they were assigned at birth, whereas cisgender patients identify with the sex they were given at birth. The term transgender also includes patients who identify gender as non-binary, meaning that their gender identity is not exclusive to males or females.

When evaluating a patient, use non-gendered words and evaluate how the patient describes the person they are in a relationship. Listen to how the patient describes the relationship. For example, a transgender couple may prefer to be described as a same-gender couple and not a straight couple. People in a relationship who have non-binary genders may prefer the term partner.

Providers should not assume gender or sexuality. While sex may be documented, it is important to be culturally sensitive and use the name they wish to be called.

Transgender transitional care

Transgender individuals may seek medical and surgical gender-affirming interventions. This includes hormone therapy, facial hair removal, surgery, speech modification, genital tucking, and chest binding. Some consider these procedures medically necessary. The current standard of care allows transgender patients to determine what interventions they need to affirm their own gender identity.

Surgery

Surgeries available to the transgender populations include feminizing vaginoplasty, masculinizing phalloplasty, scrotoplasty, masculinizing chest surgery, facial feminization procedures, reduction thyrochondroplasty, and orchiectomy. These procedures are considered cosmetic; however, some patients believe these procedures help their gender identity.

Gender-affirming hormone therapy is a common medical intervention used by transgender individuals. Such treatment allows secondary sex characteristics aligned with an individual's gender identity. Hormones are used to suppress male secondary sex characteristics in favor of developing female secondary sex characteristics. The approach of therapy is to combine an androgen and estrogen and sometimes add progestogen.

Estrogen

The estrogen 17-beta estradiol, which is chemically identical to that produced by the ovary, is commonly used for feminizing therapy. The drug is given via cream, oral, sublingual, or transdermal. Conjugated equine estrogens have been used but are no longer prescribed due to blood clots' potential, increased cardiovascular risk, and ethical considerations.

Androgen Blockers

Androgen blockers (antiandrogens) are often used to suppress testosterone production and male secondary sexual characteristics. The effect is less reliable because the sexual characteristics that are established by puberty are typically not reversible. Spironolactone, a potassium-sparing diuretic, has an anti-androgen effect on testosterone production at high doses of 200 to 400 mg/day. Hyperkalemia is a serious side effect. Patients may develop polydipsia, polyuria, and orthostasis. If the patient is also taking an ARB or Ace inhibitor, monitoring should be frequent. Androgen blockers may be used as single agents to decrease masculinization and in patients with contraindications to estrogen therapy. Side effects may include decreased energy, mood depression, and hot flashes.

Testosterone

Testosterone identical to testosterone secreted from the human testicle is injected or used topically for non-transgender men with low androgen levels. Higher dosing may be needed in transgender men than in non-transgender men.

Hormonal Therapy Effects[14]

Bisexual women, lesbian, and transgender men face pregnancy challenges. For cisgender, female, same-sex couples, who lack a sperm-carrying partner, child-bearing requires fertility support. Transgender men are challenged by a male-presenting pregnant.

Gynecologic Risks

Risk factors include:

Bisexual women, lesbians, and transgender men are less likely to receive pap tests

Cisgender women who have sex with women, who have both male and female partners, may be at increased risk of sexually transmitted infections and HIV

Lesbians may be at increased risk of polycystic ovary syndrome

Transgender men who have sex with men may be at increased risk for HIV infection

Promoting LGBTQ Privacy and Confidentiality[16]

Some members of the LGBTQ community may not make their gender or sexual orientation public. Further, they may not be used to discussing their relationships with others. The health provider needs to assure the patient that their communication and medical records, including tests and results, are confidential.

While there are no laws that specifically address the LGBTQ community, the following laws address privacy.

HIPAA Privacy Rule - The law respects the patient's wishes on privacy matters. Hospitals and providers may only disclose a patient's PHI to a family member, relative, close friend, or any other person the patient identifies.

Patient Protection and Affordable Care Act - The law prohibits sex discrimination in any institution that receives federal funds. The law prohibits discrimination based on gender identity; requires that all gender identities be treated equally; prohibits the denial of health coverage based on gender identity, pregnancy, and sex stereotyping; and requires individuals to be treated consistent with their gender identity.

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Cultural Competence in the Care of LGBTQ Patients

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The lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) community consists of a cross-cultural broad range of community members and includes all races, ethnic and religious backgrounds, and socioeconomic status.

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Implicit Biases is our automatic attitudes and stereotypes that affect our understanding, actions, and decisions. They are hidden preferences or prejudices we have without even realizing it.

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Implicit Bias | Cultural Competence | Wild Iris Medical Education

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Define cultural competency. Learn about stereotypes and strategies to reduce implicit bias in patient care regarding race, gender, sexual orientation, etc.

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Example: While a teacher might not realize they are favoring a group, this behavior can send the message that boys are better at math, then the girls. This discourages the girls from participating.

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Implicit Bias: Definition & Examples (4 Minute Explanation)

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“Implicit biases may affect the behavior even of those individuals who have nothing but the best intentions.”

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'Best intentions' won't solve implicit bias in health care

Texas Medical Center institutions are creating arenas of awareness and understanding to address bias

When you encounter a new person and start to write a story in your mind about them based on nothing more than your own experiences, that is called implicit or unconscious bias. Implicit bias encompasses attitudes and assumptions about race and ethnicity, but also gender, weight, age, social stratum and other classifications.

In some ways, making snap judgments is how we order our world-slotting people quickly into our own predetermined categories.

But in medicine, implicit bias creates blind spots that can have real consequences for health outcomes.

Physical therapy students, for example, who tend to be young, athletic and fit, have confessed to biases against heavier patients or those with sedentary lifestyles, said Jeffrey S. Farroni, Ph.D., J.D., an associate professor of clinical ethics with the Institute for the Medical Humanities at The University of Texas Medical Branch at Galveston (UTMB). After learning about their unconscious attitudes, those same students aimed to transcend those thoughts to ensure that they provided all of their patients the same level of care.

"It's compassionate honesty that puts us in a position to do our jobs better and take care of folks," Farroni said. "How can we get better if we don't challenge ourselves?"

For the past two decades, the implicit association test, or IAT, has helped people recognize their personal biases. Created in 1995 and first published in scientific literature in 1998, the IAT has become the foundation for equity, diversity and inclusion training across institutions in the Texas Medical Center and beyond. The test helps to educate medical students, edify employees and hire leaders.

The IAT quizzes different associations between photos, other images and words to determine whether someone has slight, moderate, strong or no preferences. For instance, to measure leanings toward Republicans or Democrats, quick-fire images of Ronald Reagan, Barack Obama, an elephant or a donkey appear. If you are faster responding to associations that pair "good" and "Republican" than associations that pair "good" and "Democrat," then you likely have some preference for Republicans over Democrats.

Baylor College of Medicine professor Anne Gill, DrPH, started working with bias after reading a 2007 medical journal article about how blood clot treatment for black and white patients could be predicted by the results of physicians' IATs. The groundbreaking study was the first to analyze whether unconscious racial bias predicted the clinical decisions of doctors.

"It was a very moving and compelling article that really began to show that our unconscious bias or our implicit biases do impact the way care is rendered," Gill said. "What was remarkable in this particular article was that the physicians that were included in the study were residents and so they were much younger and much more progressive and really felt that they did not have any biases."

The best intentions

One phrase in the article captured Gill's attention: "Implicit biases may affect the behavior even of those individuals who have nothing but the best intentions."
The best intentions.
Around the same time, Baylor received a National Institutes of Health grant to increase behavioral and social sciences training in medical education. Gill used the funding to develop a workshop to determine whether or not the course was a useful strategy to identify bias.

It was. And not long after, Baylor added the unconscious bias workshop-taught by Gill until recently-to its third-year medical school curriculum.

"When we first began, it was so new and novel," Gill said. "Now, the students seem to be much more accepting of the process and more willing to admit that they have biases and they are concerned. They want to know how to deal with them."

But initiating conversations about sensitive topics isn't easy.

"The challenge from an educational point of view is how you make these topics resonate for people," Farroni said. "The great example is white privilege. I'll bring that up in some sessions and you see white students' eyes bulge out like: What are you talking about? or like it doesn't apply to them. When you open up that space, it's tricky. These tend to be very delicate topics that we tend to not talk about, which is why we need to. If you can create a space where students can explore these things and look into themselves, it's pretty amazing how it opens their eyes."

Students at McGovern Medical School sit for mandatory unconscious bias lectures and "are encouraged to take the IAT," said LaTanya J. Love, M.D., vice president for diversity and leadership development at The University of Texas Health Science Center at Houston (UTHealth), which includes schools of nursing, dentistry and public health. She also serves as associate dean for admissions and student affairs, associate dean for diversity and inclusion and associate professor of pediatrics at the medical school.

"We're trying to bring a lot more awareness to what unconscious bias is and how it can affect health care delivery, how there can be unconscious bias against a health care provider and-once we recognize our own biases as health care providers-ways that we can overcome them," she said. "It's our responsibility to bring awareness in this diverse city."

In her role at UTHealth, Love has helped develop unconscious bias training for members of search committees, which are usually formed to fill leadership positions, such as dean, department chair or division director, "so we don't potentially overlook a wonderful leader," she said.

UTHealth also has worked with its partner, Memorial Hermann Health System, to address bias against health care workers.

"For instance, a patient says I don't want a doctor of a particular ethnicity, religion or gender. How do we handle that?" Love said. "We formed a committee to come up with policies about handling these types of situations."

Unconscious bias classes have been offered for the last eight years at The University of Texas MD Anderson Cancer Center, but are now a mandatory part of annual training, said Larry Perkins, Ph.D., associate vice president of talent and diversity. Weekly courses are offered for the center's 21,000 employees and 3,000 leaders.

The commitment stems from Houston's status as a majority-minority city.

"Over 50 percent of our employees come from an underrepresented group. Our patient population is diverse. We have a global patient population. On any given day, 54 different languages can be heard in this institution," Perkins said. "Awareness is our priority. In our new employee orientation, we talk about diversity and inclusion."

In an era of mass shootings that sometimes target specific racial, religious and ethnic groups, medical personnel serve on the front lines, delivering trauma care to victims in emergency departments, psychiatric support to survivors and comfort to the families of the deceased. In such a high-stakes environment, medical workers who are trained to confront and push against their own biases have taken a significant step toward healing a troubled nation.

The implicit revolution

The "implicit revolution" is still evolving, said Janice Sabin, Ph.D., research associate professor at the University of Washington School of Medicine who works with IAT co-creator Tony Greenwald, Ph.D.

"It's a whole new way to understand why extremely well-meaning people can potentially behave in a biased way. In health care, people are altruistic and very well intentioned, so why are there still disparities in care?" she asked. Then she answered: "Bias in medical decision-making has been studied for 30 years. It's basically how our minds work. We make snap judgments. We assess things quickly so that we actually function in our world."

Sabin, who also is affiliated faculty of the University of Washington medical school's Center for Health Equity, Diversity and Inclusion, commends organizations that use the IAT, bias training and ongoing discussions, but cautions that the test itself should remain voluntary.

"We never force anyone as homework or as part of a program to take an IAT because to go into that cold and not know what that really means can be damaging," she said. "Giving people context on what an IAT result means is super important. You can come away demoralized or defensive. ... Understanding what it means-that you make associations really quickly and that this could impact patient care-that's the crux of what people need to know."

Baylor, UTHealth and UTMB are among the TMC institutions that spread awareness of unconscious bias to admissions, faculty hiring and health care delivery.

"One of the key things about implicit biases is that people generally don't know that they have them," said social psychologist Kate Ratliff, Ph.D., an associate professor of psychology at the University of Florida. "We have these associations that can influence our judgment and the way we behave, but people typically aren't very aware of them. The IAT and measures like the IAT allow us to assess them."

Ratliff is the executive director of Project Implicit, an international collaboration of researchers including IAT co-creator Greenwald who are interested in implicit social cognition. The nonprofit advises universities, medical schools, corporations and other organizations about ways to reduce bias.

The test is not designed as a diagnostic tool, but as an educational first step that "can be really eye-opening for people who generally think that they're unbiased," Ratliff said.

Test results can bring people to new realizations about themselves.

"After that, the question is developing practices that help prevent those biases from influencing behavior," Ratliff said. "You have to actively work to figure out how you're going to stop those biases from influencing how you actually treat patients."

'Off Label'

That's been the goal of a constellation of efforts at UTMB, where bias training has challenged health care provider assumptions about patient immigration status or disposition.

Farroni cites the frustration of physicians who complain about "non-compliant" patients-those who don't follow the prescribed treatment regimen.

"Maybe what's happening medically right now is not the most important thing in their life and it's just not a priority based on these other things," he said, reflecting on how he counsels doctors. "Now, to a medical person, they say: What do you mean? But, people have complicated lives."

Another arena of reckoning at UTMB is an employee gathering called "Off Label," where participants meet without wearing their identification badges.

"We get rid of hierarchies and there's no agenda-it's just whatever is on your mind. The only rules are to be respectful and attentive," Farroni said. "The experience has been awesome."

In one instance, some nurses were upset about the gravely ill patients selected for care on a floor.

"In that session, there was a senior faculty physician who got to listen to the experiences of the nurses who were faced with the consequences of decisions he was making as a physician. He had never gotten to hear that before," Farroni said. "He never had to be with the patients for long periods of time. What he also got to do was to provide an explanation about the decisions he made and the nurses understood. They were able to break down communication barriers and they all came away with new understanding."

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'Best intentions' won't solve implicit bias in health care - TMC News

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Texas Medical Center institutions are creating arenas of awareness and understanding to address bias When you encounter a new person and start to write a story in your mind about them based on nothing more than your own experiences, that is called implicit or unconscious bias.

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If you want to see how you score on implicit bias this website has a test!

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My thoughts on Implicit Bias is that yes we may think these nasty things, but that just makes us human. It's all about how you say them, we should never put one another down as we all are living in the same universe. We should come together and be kind because it is that easy. Implicit bias should not be present in the classroom because it can lead to unfair treatment of students. When teachers have implicit biases, they might favor some students over others. This can affect how they grade, discipline, or interact with students. All students deserve to be treated fairly and have equal opportunities to succeed.

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 Why a Framework for Developing Cultural Competence Should Include Valuing Diversity

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 Why a Framework for Developing Cultural Competence Should Include Valuing Diversity

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Cultural diversity is crucial because it enriches societies by bringing together a variety of perspectives, traditions, and experiences. It fosters tolerance, understanding, and empathy among people of different backgrounds, leading to more innovative solutions, social cohesion, and a richer tapestry of human heritage.

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M ost would argue that cultural competence is just another way of focusing on diversity and inclusion. Oftentimes, people will make the mistake of confusing cultural diversity and cultural competency. Cultural diversity is the existence of a variety of cultural or ethnic groups in an organization, but does not equate to competency in serving those groups. However, cultural competency is when organizations have a set of principles, beliefs and attitudes about cultural differences and experiences, and apply those principles, beliefs and attitudes to operations as policy.

In order for nonprofit organizations to address the current discontent of today's environment and be responsive to the needs of a changing population, nonprofits should focus on addressing cultural incapacity, cultural blindness and gaps in multicultural representation in organizational leadership and program design. In essence, create a clear understanding of cultural competence in your organization.

In recent months, many nonprofits have been working to establish and share ways to contribute to the cultural competence conversation. Some actions have included creating equity within their workplace, identifying and dismantling white-dominant values and amplifying the voices of BIPOC (Black, Indigenous and People of Color). Why should this matter to nonprofits? If your nonprofit services a diverse community, then cultural competence has a direct impact on the success of your programs and service delivery. A lack of cultural competence marginalizes people, creating the loss of potential resources to those communities that need it most, and in some cases, creates tangible harm to individuals and certain
populations.

Cultural destructiveness has resulted in dangerous studies like the "U.S. Public Health Service Syphilis Study at Tuskegee," which intentionally and systematically misled Black men consenting to be research subjects where they were observed with untreated syphilis rather than provided treatments to improve the disease.

Even though a treatment for syphilis was identified in 1945, the study continued until 1972 when journalists condemned the research as explicitly racist and culturally destructive. Meanwhile in 2020, the denial of COVID-19 testing early on for certain groups of people can be described as cultural incapacity. This lack of testing often resulted in delayed care, increased spread of the virus within the BIPOC community and worse health outcomes. Outside of the health care setting, similar examples can be seen in the way police issue citations at a higher rate to BIPOC than white people for the same offenses.

With this framework in mind, alongside our current circumstances, the urgency for incorporating cultural competence into all aspects of our society becomes a literal life and death issue that many organizations have to address throughout their work, so how can you start to create a culturally competent environment in your nonprofit? There are three fundamental steps nonprofits can consider:

1. A culturally competent organization integrates knowledge about individuals and groups of people into specific standards, practices and attitudes to increase the quality of services provided and ultimately yield better outcomes by reducing disparities.

2. Organizations cannot be culturally competent without employing culturally competent individuals, and individuals cannot thrive in their journey toward becoming culturally competent without an organization that fosters continued self-assessment, cultural learning and growth.

3. Principles of cultural competence include valuing diversity, having the capacity for self-assessment, being conscious of the inherent dynamics when different cultures interact, institutionalizing cultural knowledge and developing adaptations to service delivery that reflect an understanding of cultural diversity and new cultural knowledge.

According to the Mission Box, a lack of cultural competence can lead to ineffective programs, loss of funding and conflicts among staff members. The culturally competent nonprofit is aware and deliberate in its inclusiveness in hiring, training, day-to-day operations, program outreach, design and delivery, and regularly assesses its responsiveness to the cultural needs of its employees, the people and communities it serves.
Editor's Note: This Fundraising Connection column was originally published in the September/October 2020 print edition of NonProfit PRO. Click here to subscribe.

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Most would argue that cultural competence is just another way of focusing on diversity and inclusion. Oftentimes, people will make the mistake of confusing cultural diversity and cultural competency.

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This resource emphasizes that ongoing self assessment is crucial because it helps individuals recognize their own biases, understand their cultural influences, and identify areas for improvement.

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By actively seeking to learn about different cultures, individuals can better understand values, beliefs, and practices of others. This knowledge helps in building respectful and effective relationships.

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Managing Differences and Ability to Adapt to the Cultural Needs of the Community 

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Managing Differences and Ability to Adapt to the Cultural Needs of the Community 

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By recognizing and valuing the diverse cultural backgrounds of students, teachers foster a sense of respect and inclusion. Adapting to the cultural needs of the community allows teachers to use teaching strategies that are more effective for students. This helps build trust and support from students.

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cultural competence ability to adapt to the community

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To be effective in diverse classrooms, teachers must connect teaching materials to student's cultural backgrounds. Ignoring student norms causes resistance, while responsive teaching encourages involvement.

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To be effective in multicultural classrooms, teachers must relate teaching content to the cultural backgrounds of their students. According to the research, teaching that ignores student norms of behavior and communication provokes student resistance, while teaching that is responsive prompts student involvement (Olneck 1995). There is growing evidence that strong, continual engagement among diverse students requires a holistic approach-that is, an approach where the how, what, and why of teaching are unified and meaningful (Ogbu 1995).

To that end, we have developed a comprehensive model of culturally responsive teaching: a pedagogy that crosses disciplines and cultures to engage learners while respecting their cultural integrity. It accommodates the dynamic mix of race, ethnicity, class, gender, region, religion, and family that contributes to every student's cultural identity. The foundation for this approach lies in theories of intrinsic motivation.

Before we outline our framework for culturally responsive teaching, we will address the bond of motivation and culture, and analyze some of the social and institutional resistance to teaching based on principles of intrinsic motivation. Understanding these relationships provides a clearer view of the challenges we must overcome if we are to genuinely transform teaching and successfully engage all students.

Motivation Is Inseparable from Culture

Engagement is the visible outcome of motivation, the natural capacity to direct energy in the pursuit of a goal. Our emotions influence our motivation. In turn, our emotions are socialized through culture-the deeply learned confluence of language, beliefs, values, and behaviors that pervades every aspect of our lives. For example, one person working at a task feels frustrated and stops, while another person working at the task feels joy and continues. Yet another person, with an even different set of cultural beliefs, feels frustrated at the task but continues with increased determination. What may elicit that frustration, joy, or determination may differ across cultures, because cultures differ in their definitions of novelty, hazard, opportunity, and gratification, and in their definitions of appropriate responses. Thus, the response a student has to a learning activity reflects his or her culture.

While the internal logic as to why a student does something may not coincide with that of the teacher, it is, nonetheless, present. And, to be effective, the teacher must understand that perspective. Rather than trying to know what to do to students, we must work with students to interpret and deepen their existing knowledge and enthusiasm for learning. From this viewpoint, motivationally effective teaching is culturally responsive teaching.

Locked in Mid-Century

Most educators with whom we have worked would agree that there is a strong relationship between culture and motivation, and that it only makes sense to understand a student's perspective. Why, then, do we have such difficulty acting this way in the classroom?

One major reason is that we feel very little social pressure to act otherwise. The popular media and structural systems of education remain locked in a deterministic, mechanistic, and behavioristic orientation toward human motivation.

If one were to do a content analysis of national news broadcasts and news magazines for the last 40 years to identify the most widely used metaphor for motivation, "the carrot and the stick"-reward and punish, manipulate and control-would prevail. As a result, our national consciousness assumes there are many people who need to be motivated by other people.

The prevailing question, "How do I motivate them?" implies that "they" are somehow dependent, incapable of self-motivation, and in need of help from a more powerful "other." In this sense, the "at-risk" label acts to heighten our perception of students as motivationally dysfunctional, and increases our tendency not to trust their perspective. The fact that an inordinately high number of "at-risk" students are poor and people of color should cause us to reflect on how well we understand motivation. Thoughtful scholars have suggested that this label now serves as a euphemism for "culturally deprived" (Banks 1993).

Secondary education is influenced a great deal by the practices of higher education, and both levels tend to follow the precepts of extrinsic reinforcement. Teaching and testing practices, competitive assessment procedures, grades, grade point averages, and eligibility for select vocations and colleges form an interrelated system. This system is based on the assumption that human beings will strive to learn when they are externally rewarded for a specific behavior or punished for lack of it.

Schools and colleges successfully educate a disproportionately low number of low-income and ethnic minority students (Wlodkowski and Ginsberg 1995). Because the importance of grades and grade point averages increases as a student advances in school, it is legitimate to question whether extrinsic motivation systems are effective for significant numbers of students across cultures. We can only conclude that, as long as the educational system continues to relate motivation to learn with external rewards and punishments, culturally different students will, in large part, be excluded from engagement and success in school.

Changing Consciousness About Motivation

It is part of human nature to be curious, to be active, to initiate thought and behavior, to make meaning from experience, and to be effective at what we value. These primary sources of motivation reside in all of us, across all cultures. When students can see that what they are learning makes sense and is important, their intrinsic motivation emerges.

We can begin to replace the carrot and stick metaphor with the words "understand" and "elicit"; to change the concept of motivation from reward and punishment to communication and respect. We can influence the motivation of students by coming to know their perspective, by drawing forth who they naturally and culturally are, and by seeing them as unique and active. Sharing our resources with theirs, working together, we can create greater energy for learning.

Intrinsic systems of motivation can accommodate cultural differences. Theories of intrinsic motivation have been successfully applied and researched in areas such as cross-cultural studies (Csikszentmihalyi and Csikszentmihalyi 1988); bilingual education (Cummins 1986); and education, work, and sports (Deci and Ryan 1985). Ample documentation across a variety of student and regional settings suggests that noncompetitive, informational evaluation processes are more effective than competitive, controlling evaluation procedures (Deci et al. 1991, Deci and Ryan 1991).

A growing number of educational models, including constructivism and multiple intelligences theory, are based on intrinsic motivation. They see student perspective as central to teaching. Unfortunately, educators must often apply these theories within educational systems dominated by extrinsic reinforcement, where grades and class rank are emphasized. And, when extrinsic rewards continue to be the primary motivators, intrinsic motivation is dampened. Those students whose socialization accommodates the extrinsic approach surge ahead, while those students-often the culturally different-whose socialization does not, fall behind. A holistic, culturally responsive pedagogy based on intrinsic motivation is needed to correct this imbalance.

An Intrinsic Motivational Framework

We propose a model of culturally responsive teaching based on theories of intrinsic motivation. This model is respectful of different cultures and is capable of creating a common culture that all students can accept. Within this framework, pedagogical alignment-the coordination of approaches to teaching that ensure maximum consistent effect-is critical. The more harmonious the elements of teaching are, the more likely they are to evoke, encourage, and sustain intrinsic motivation.

1. Establishing inclusion -creating a learning atmosphere in which students and teachers feel respected by and connected to one another.

2. Developing attitude -creating a favorable disposition toward the learning experience through personal relevance and choice.

3. Enhancing meaning -creating challenging, thoughtful learning experiences that include student perspectives and values.

4. Engendering competence -creating an understanding that students are effective in learning something they value.

These conditions are essential to developing intrinsic motivation. They are sensitive to cultural differences. They work in concert as they influence students and teachers, and they happen in a moment as well as over a period of time.

Culturally Responsive Teaching

Let us look at an actual episode of culturally responsive teaching based on this motivational framework. It occurs in an urban high school social science class with a diverse group of students and an experienced teacher.

At the start of a new term, the teacher wants to familiarize students with active research methods. She will use such methods throughout the semester, and she knows from previous experience that many students view research as abstract, irrelevant, and oppressive work.

After reflecting on the framework, her teaching goal, and her repertoire of methods, she randomly assigns students to small groups. She encourages them to discuss any previous experiences they may have had in doing research as well as their expectations and concerns for the course. Each group then shares its experiences, expectations, and concerns as she records them on the chalkboard. In this manner, she is able to understand her students' perspectives and to increase their connection to one another and herself (motivational condition: establishing inclusion).

The teacher explains that most people are researchers much of the time, and she asks the students what they would like to research among themselves. After a lively discussion, the class decides to investigate and predict the amount of sleep some members of the class had the previous night. This experience engages student choice, increases the relevance of the activity, and contributes to the favorable disposition emerging in the class (motivational condition: developing attitude). The students are learning in a way that includes their experiences and perspectives.

Five students volunteer to serve as subjects, and the other students form research teams. Each team must develop a set of observations and questions to ask the volunteers. (They cannot ask them how many hours of sleep they had the night before.) After they ask their questions, the teams rank the five volunteers from the most to the least amount of sleep. When the volunteers reveal the amount of time they slept, the students discover that no research team was correct in ranking more than three students.

Students discuss why this outcome may have occurred, and consider questions that might have increased their accuracy, such as, "How many hours of sleep do you need to feel rested?" Collaborative learning, hypothesis testing, critical questioning, and predicting heighten the engagement, challenge, and complexity of this process for the students (motivational condition: enhancing meaning).

These procedures encourage and model equitable participation for all students.

After the discussion, the teacher asks the students to write a series of statements about what this activity has taught them about research. Students then break into small groups to exchange their insights. Self-assessment helps the students to gain, from an authentic experience, an understanding of something they may value (motivational condition: engendering competence).

This snapshot of culturally responsive teaching illustrates how the four motivational conditions constantly influence and interact with one another. Without establishing inclusion (small groups to discuss experiences) and developing attitude (students choosing a relevant research), the enhancement of meaning (research teams devising hypotheses) may not have occurred with equal ease and energy; and the self-assessment to engender competence (what students learned from their perspective) may have had a dismal outcome. According to this model of teaching, all the motivational conditions contribute to student engagement.

Norms, Procedures, and Structures

Although the above event actually occurred, it may sound like a fairy tale because everything worked smoothly. In reality, teaching situations often become fragmented by the competing needs and interests of a diverse student body. All too often, we use educational norms and procedures that are contradictory. The result is that we confuse students and decrease their intrinsic motivation. For example, consider the teacher who uses cooperative learning yet gives pop quizzes; or who espouses constructivist learning yet grades for participation; or who abhors discrimination yet calls mainly on boys during class discussions.

In an effort to help educators avoid such errors of incoherence, we have compiled educational norms, procedures, and structures that are effective from a motivational as well as multicultural perspective (see fig. 1). Together, they provide an integrated system of teaching practices for our model of culturally responsive teaching. They are categorized according to the motivational conditions of the framework:

Norms are the explicit values espoused by the teacher and students. Procedures are learning processes that carry out the norms. Structures are the rules or binding expectations that support the norms and procedures.

Figure 1. Four Conditions Necessary for Culturally Responsive Teaching

Emphasize the human purpose of what is being learned and its relationship to the students' experience.

Share the ownership of knowing with all students.

Collaborate and cooperate. The class assumes a hopeful view of people and their capacity to change.

Treat all students equitably. Invite them to point out behaviors or practices that discriminate.

Procedures: Collaborative learning approaches; cooperative learning; writing groups; peer teaching; multi-dimensional sharing; focus groups; and reframing.

Structures: Ground rules, learning communities; and cooperative base groups.
2. Develop Positive Attitude

Relate teaching and learning activities to students' experience or previous knowledge.

Encourage students to make choices in content and assessment methods based on their experiences, values, needs, and strengths.

Procedures: Clear learning goals; problem solving goals; fair and clear criteria of evaluation; relevant learning models; learning contracts; approaches based on multiple intelligences theory, pedagogical flexibility based on style, and experiential learning.

Structure: Culturally responsive teacher/student/parent conferences.

Provide challenging learning experiences involving higher order thinking and critical inquiry. Address relevant, real-world issues in an action-oriented manner.

Encourage discussion of relevant experiences. Incorporate student dialect into classroom dialogue.

Procedures: Critical questioning; guided reciprocal peer questioning; posing problems; decision making; investigation of definitions; historical investigations; experimental inquiry; invention; art; simulations; and case study methods.

Structures: Projects and the problem-posing model.

Connect the assessment process to the students' world, frames of reference, and values.

Include multiple ways to represent knowledge and skills and allow for attainment of outcomes at different points in time.

Encourage self-assessment.

Procedures: Feedback; contextualized assessment; authentic assessment tasks; portfolios and process-folios; tests and testing formats critiqued for bias; and self-assessment.

Structures: Narrative evaluations; credit/no credit systems; and contracts for grades.

Based on Wlodkowski, R. J., and M. B. Ginsberg. (1995). Diversity and Motivation: Culturally Responsive Teaching. San Francisco: Jossey-Bass.

Teaching in a way that respects diversity is challenging, of course. Consider the following case example. The norm that Mr. Clark, a U.S. history teacher, is aiming for is "sharing the ownership of knowing." The topic is the notion of cultural pluralism, and, later, the roles that our socioeconomic backgrounds play in our lives. Clark uses the procedures of collaborative learning and critical questioning to facilitate student comprehension of the concepts of "melting pot," "social class," and other terms.

Clark asks the class to first brainstorm words that are associated with culture. Students volunteer "language," "ethnicity," "gender," "religion," "food preference," and so forth. In pairs, students then talk to their partner about ways in which they believe they are culturally similar and distinct from each other.

After 15 minutes, the teacher asks students to note three observations about the concept of culture. The most prevalent response is that "we were surprised at how much we have in common." Clark indicates that he sees this as well. He asks the class, "If we have such commonality, why do some groups of people in the United States have such difficulty becoming economically secure?" Note what happen as students struggle over whose perceptions are the most accurate. First student: Some have more difficulty because of discrimination, because people have prejudices against people whose skin is a different color from theirs. Second student: I don't think it's that simple. Look how many people of color are doing well. We've got generals, mayors, and corporation executives. There's a black middle class and they are economically secure. Third student: Yeah, that might be so, but it isn't as many people as you think. The newspapers just make a big deal about minorities succeeding.

1. Which ethnic groups are most economically successful? Least successful?

2. What proportion of each ethnic group is lower income, middle income, upper income?

3. Are more people of color economically successful today than 20 years ago? 100 years ago?

4. What is the relationship of educational opportunity to income status?

5. Do middle- and upper-class African Americans and Latinos encounter more discrimination than do European Americans?

6. Is there a difference in the quality of family and community support among middle- and upper-income African Americans, European Americans, and Latinos?

As a result of the discussion, students begin to see how the viewpoints about race and socioeconomic backgrounds are part of a broad and complex picture. The difference of opinion has become a stimulus for deeper learning. Students then divide into three groups: one to conduct library research of relevant documents and studies; one to read and analyze relevant biographies and autobiographies; and one to interview community members who represent different cultures.

A Holistic Approach

For culturally different students, engagement in learning is most likely to occur when they are intrinsically motivated to learn. This motivational framework provides a holistic and culturally responsive way to create, plan, and refine teaching activities, lessons, and assessment practices.

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A Framework for Culturally Responsive Teaching

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Research has shown that no one teaching strategy will consistently engage all learners. The key is helping students relate lesson content to their own backgrounds.

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When I was in sixth grade, I was going through alot. My mother was not at her best. I would go to school and get judged by not only the students, but the teacher too. I felt hopeless and started lacking on my assignments due to not feeling welcome in the class anymore. I would spend most of my time indoors at recess, for "acting out" or for "not being nice." The teacher knew what I was going through at home and still did not listen to me when I tried explaining to her that I was tired and just wanted to be happy. Instead, she criticized me and made me feel like I was a menace to the classroom. This is my personal reflection of implicit bias because before everything went down at my home, I was a great student and friend. But when she found out what was going on, she told the class and I got made fun of.

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When Implicit Bias is not taken care of in schools students can preform poorly, start a hostile school environment for those students, reduce opportunities, and lower their self esteem.

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A new study finds evidence that teachers’ implicit bias may lead to unequal student outcomes.

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Discussion how bias can affect the way certain learners are treated in the classroom.

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Unconscious Bias, visible difference and teaching

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Ways Teachers can Reduce Bias in the Classroom 

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Ways Teachers can Reduce Bias in the Classroom 

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1. Cultivate awareness of their biases

2. Work to increase empathy and empathic communication

3. Practice mindfulness and loving-kindness

4. Develop cross-group friendships in their own lives

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A friend of mine recently told me about an incident involving students at Berkeley High School. On the first day of classes, African-American juniors and seniors were being asked by their honors course teacher to show him their schedule when they entered the classroom. The teacher, who was white, apparently assumed the black students were lost and in the wrong room, and his gesture made them feel unwelcome and humiliated.

This is an example of implicit bias-a behavior that arises from subconscious associations, which may even contradict someone's explicit values. Implicit racial bias plays a role in many classrooms and schools with potentially devastating effects. In one recent experiment with preschool teachers, researchers found that when teachers were primed to look for behavioral problems while watching a classroom video with black and white children (none of whom were misbehaving), teachers gazed much longer at black children than white children, as if anticipating the behavioral problems would come from the black children.

In another experiment from the same study, teachers read a vignette about a behavioral problem with a preschooler randomly identified as a black boy, black girl, white boy, or white girl, and then were given details about the child's background or not. Providing the background information on the child increased the severity of suggested disciplinary actions when the race of the teacher didn't match that of the child, supporting the idea that we are more inclined to punish those who look different from us.

In fact, disciplinary actions are more likely to be perpetuated against African Americans-boys and girls alike-than any other group of students, regardless of the infraction. And while it's understandable that teachers would want to prevent disruptions in the classrooms and take actions to avoid them, some seem to have little idea of how to do that without turning to ingrained biases.

Of course, teachers are not alone in having racial biases. Their behavior reflects how social messages are hard to escape, even for people of color. But studies like these show how racial disparities can be perpetuated in classrooms, too. If left unchecked, this kind of biased treatment can haunt a student well into elementary school and beyond, making the promise of "schools as the great social equalizers" a false one.

The good news is that teachers can learn to combat their prejudice, even the implicit kind, if they become more aware of it and take steps to actively fight it in themselves. Here are some of the ways that might help educators treat all of their students with dignity and care.

1. Cultivate awareness of their biases

Teachers are human and therefore influenced by psychological biases, like the fundamental attribution error, when we assume that others who behave in a certain way do so because of their character (a fixed trait) rather than in response to environmental circumstances. In-group bias leads us to assign positive characteristics and motivations to people who are similar to us.

Biases like these are natural, used as cognitive shorthand for making quick social judgments in ambiguous situations, especially those involving people from unfamiliar ethnic or social groups. They become a problem when we're not aware of their impact on other people. And if we're part of a majority group with more social, economic, or political power than a minority one, then accumulated unconscious bias can be extremely destructive, limiting the life opportunities and hurting the well-being of the minority group.

Many researchers believe that becoming more aware of our biases can help us improve our interactions with others, decrease our sense of unease in interracial contexts, and make better decisions. Though most of this research has been done with other professional groups or the general public, the same lessons are likely to apply to teachers.

However, many teachers feel pressures not to cop to those biases, perhaps out of fear they will be accused of racism. This leaves them blind to the ways that biases work at an unconscious level. Pretending to be colorblind is not helpful and in fact adhering to a color-blind philosophy has been shown to increase implicit bias, at least in college students. Admitting that we are all subject to biases creates a safer space to examine them more carefully and to take steps to fight them.

2. Work to increase empathy and empathic communication

Empathy -the ability to understand another's perspective and emotions-is important in all human social encounters, including teaching. Yet, often teachers have little understanding of the communities where their students live and have trouble understanding their perspectives, leading them to treat these students more harshly.

One solution: learning about the lives of students and showing that you care. At least one study has found that actively trying to take the perspective of another person-as opposed to trying to be "objective"-increased one's ability to not fall prey to stereotypical views of others. Actively inducing empathy for another person has been tied to a willingness to consider environmental circumstances more closely when handing out punishments for misbehavior. And, one recent study has found that training teachers in empathy cut down student suspension rates in half.

Though perhaps more research has been done on empathy in other professionals (such as physicians and police officers), teachers may want to take note of the ways that they have learned to increase their empathy through a combination of stress reduction, learning how to manage difficult emotions, and practicing empathic communication. Treating students with kindness and consideration is a sure way to bring out kindness in them, too.

3. Practice mindfulness and loving-kindness

Mindfulness practices-such as paying attention in a nonjudgmental way to one's breath or other sensations-has been shown to decrease stress in teachers, which can indirectly have an effect on reducing bias. But according to some research, mindfulness may also have a direct effect on bias reduction as well.

In one study, young white participants who listened to a 10-minute audiotape with instructions in mindfulness showed less implicit bias towards blacks and older people than those who listened to a 10-minute discussion of nature. This suggests that nonjudgmental awareness, even when not specifically focused on reducing prejudice, can help reduce unconscious biases.

Loving-kindness meditation-a practice that involves consciously sending out compassionate thoughts toward others-may also help. In a recent study, the random assignment of a short-term loving-kindness meditation reduced implicit bias toward a targeted group, though it didn't decrease implicit bias for other groups not targeted by the meditation.

4. Develop cross-group friendships in their own lives

While it's important to take steps in the classroom, the relationships we form outside of the classroom can also have an impact on bias.

Cross-group friendships have been shown in several studies to decrease stress in intergroup situations, to decrease prejudice toward outgroup members, and to decrease one's preference for social hierarchy or domination over lower-status groups. These findings alone might encourage teachers to seek out cross-group friendships in their lives so that they can be more receptive to the diverse students they find in their classrooms.

Another reason for teachers to consider developing cross-group friendships is that they may influence their students to do the same. When people see cross-group friendships working out in positive ways, they tend to be more willing to engage in cross-group friendships themselves.

In addition, positive cross-group friendships can have contagion effects in other people within social groups, turning whole communities into warmer, more receptive spaces for cross-group interactions. All of this bodes well for teachers role-modeling the kind of behavior they want to see in their students.

Of course, this doesn't necessarily mean teachers should indiscriminately approach someone just because they are from a different racial group. Instead, teachers can reach out to colleagues at work, or get involved in activities or perhaps attend events where people with different backgrounds and perspectives come together for a common cause. Developing friendships can be one of the best ways to break down barriers of prejudice, and it's more easily done when people have some common interests.

Is this a lot to ask, given all the burdens our society heaps on teachers? Perhaps. Teachers should get more support than they do, and, ideally, school districts should make reducing implicit bias a priority backed up with money, policy, and training. Individual teachers can only do so much.

Luckily, the teaching profession tends to attract altruists who want to teach in a way that helps their students. By working at countering implicit bias in themselves, they can truly make a difference in the lives of their students, making them feel safe, cared for, and welcome in the classroom.

Greater Good wants to know: Do you think this article will influence your opinions or behavior?

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Four Ways Teachers Can Reduce Implicit Bias

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We're all subject to bias. Here are tips to help teachers treat all of their students with dignity and care.

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As you begin to consider the presence of teacher bias in your classroom, start by taking account of where bias may exist and determine how everything from teaching materials to classroom decor can be updated to align with anti-bias teaching strategies and culturally responsive teaching strategies.