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Table 1 Stages of Cultural Competence

From: Educating primary care clinicians about health disparities

Cultural Destructiveness Characterized by attitudes, policies, structures, and practices that are destructive to other cultures. They are dehumanizing of other people, and assumptions of superiority are prevalent. This stage occurs consciously.
Cultural Incapacity This stage occurs when there is unintentional cultural destructiveness, bias, paternalism, ignorance, and/or fear.
Cultural Blindness Involves a philosophy of being unbiased, treating all people the same, belief that culture, class or color does not make a difference. People in this stage are well-intentioned; however, it is still ethnocentric.
Cultural Pre-competence Characterized by the realization of weaknesses and gaps that are missing when working with other cultures. There is a desire for inclusion, a commitment to civil rights, and a desire to implement training. However, there may be a danger of false accomplishment.
Cultural Competency Characterized by an acceptance and respect for differences. There is a continual inquiry about other cultures and an expansion of knowledge.
Cultural Proficiency Last stage where all cultures are held in high esteem and there is a responsibility taken for constant development of new knowledge and approaches to interaction. This stage assumes responsibility to transfer skills and advocate cultural competence to others within a system or an organization.
  1. Adapted from Cross et al [25]