Three zones of cultural competency: surface competency, bias twilight, and the confronting midnight zone.

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dc.contributor.author Jowsey, Tanisha en
dc.date.accessioned 2019-10-29T00:26:44Z en
dc.date.issued 2019-08-13 en
dc.identifier.citation BMC medical education 19(1):306 13 Aug 2019 en
dc.identifier.issn 1472-6920 en
dc.identifier.uri http://hdl.handle.net/2292/48672 en
dc.description.abstract BACKGROUND:Regulatory authorities in healthcare are authorised to develop and assess the cultural competence of their professionals. There remains significant diversity on approaches to cultural competency training and assessment. Little evidence exists about whether existing cultural competency training leads to improved patient health outcomes and reductions in health disparity. DISCUSSION:In this paper I frame cultural competency as analogous to the ocean and consisting of three zones: surface competency zone, bias twilight zone, and the confronting midnight zone. The surface competency zone focuses on deployment of culturally-specific knowledge: what people see, say, and do. The bias twilight zone is where people engage in critical reflection on their inherent/unconscious biases, and how such biases inform their thoughts and practices. The confronting midnight zone is where people engage in critical consciousness and self-awareness. Here they look beyond their biases to interrogate their power and positionality in society (their own privileges and centralisation). This attention is coupled with a commitment to social justice and to working within their means to reduce health disparities. CONCLUSIONS:I suggest surface cultural competency is somewhat easier to see, teach and reach than the bias twilight or confronting midnight zones. But it is these deeper zones that cultural competency training needs to attend to if we are to see systemic cultural changes in healthcare provision. Research assessing the extent by which cultural competency training within each zone informs improved patient outcomes and reductions in health disparity is called for. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries BMC medical education en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title Three zones of cultural competency: surface competency, bias twilight, and the confronting midnight zone. en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12909-019-1746-0 en
pubs.issue 1 en
pubs.begin-page 306 en
pubs.volume 19 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 779313 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Cent Medical & Hlth Sci Educat en
dc.identifier.eissn 1472-6920 en
pubs.record-created-at-source-date 2019-08-15 en
pubs.dimensions-id 31409358 en


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