Book Review: "Reflections From Common Ground"

"Reflections From Common Ground: Cultural Awareness in Healthcare" by Beth Lincoln, MSN, RN, is a timely and important guide to developing and strengthening cultural competence in the arena of healthcare.

Published by PESI Healthcare in 2010, this thoughtful book explores the importance of cultural sensitivity and cultural competence while putting such ideas in a meaningful historical context.

Statistics and information presented in "Reflections From Common Ground" are supported in the substantial lists of resources appended to each individual chapter, and Ms. Lincoln's prose itself reflects significant study and accumulated knowledge regarding this topic that holds such relevance in an increasingly diverse 21st-century world.

Beyond mere descriptions of various cultures with whom we may come in contact in the course of our clinical interactions, the author offers individual chapters devoted to significant cultural groups who commonly access the American healthcare system (including Mexican, Filipino, Jewish Orthodox, Bosnian, Native American, Hmong, African American, Vietnamese, Arab Muslim, Chinese and Anglo). Within those chapters, Lincoln uses the magic of stories to more fully illustrate the norms and beliefs of the culture in question. These stories were written by Lincoln's colleague Cody Gillette Kirkham based on true patient stories from Lincoln's rich clinical career, and they serve to further contextualize patients' experiences using the tool of historical perspective. 

Meanwhile, healthcare disparities receive significant attention from the author, with statistics on cancer, cardiovascular disease, HIV/AIDS, infant mortality and obesity further supporting the notion that certain groups suffer disproportionately in terms of particular healthcare outcomes. 

"Research is vital to reducing and ultimately eliminating poor health outcomes found in minority groups and other vulnerable populations. The elimination of barriers, along with the implementation of a trusting and respectful relationship with the patient and community, helps to ensure a reduction in health disparities."

One concept put forth by the author that was entirely new to me is the notion of "cultural humility". Lincoln quotes Tervalon and Murrary-Garcia who coined the phrase as meaning "an ongoing process of self-reflection and self critique, a way of being aware of our relationship with others and ourselves". The authors adds:

"Cultural humility encourages us not only to recognize and acknowledge our biased assumptions, but to take responsibility for our actions and interactions with others. It calls us to identify power inequities that may exist between us and our patients. Once recognized, how do we deal with the inequity?"

Cultural sensitivity and competence are increasingly salient issues when it comes to the delivery of healthcare in an increasingly diverse nation, and Ms. Lincoln clearly delivers a thorough and well-written guide for those of us willing to accompany her on this ongoing journey of self-discovery. Please visit the author's website at Celemonde.com.

(Note: Beth Lincoln will appear as our guest on RN.FM Radio on Monday, February 4th. Feel free to listen to the live broadcast or tune in for the archived recording.)