Cross-cultural communication is one of the more critical communication issues in healthcare today.
And for good reason. Cross-cultural communication training is helpful to numerous outcomes. And when it’s missing, outcomes suffer.
Here are some common pitfalls when it comes to communicating across difference – and what you can do to avoid them.
Mistake #1: Forgetting yourself.
Also known as forgetting that your own position is culturally mediated and created.
We’re all reading situations from a certain perspective, but our perspectives can become invisible to us. This is an important starting point, and that’s why I’m sharing it with you first.
We all can fall into the trap of thinking that our ways of seeing things are normal, or natural, or common sense. It’s easy to forget they are culturally influenced and socially situated. For instance, your ideas about how the human body works are built on millennia of research, supported by your education, enriched by your years of experience, and reinforced by your social groups.
Instead: Remember where you stand, how you’re seeing, and how you got there. Acknowledge your own position and what you take for granted. Then you can spend some energy on your patient’s position.
Mistake #2: Gazing at the gap.
Otherwise known as emphasizing differences between these cultures. Or focusing on disadvantages, and gaps.
You’re in trouble if you assume your patients can meet you where you are, in your ‘culture.’ Or even in the middle. You will do more of building of the bridge and the crossing between cultures.
For example, I’ve written before about an OB-GYN who regularly encounters patients who believe they urinate and menstruate from the same place. Is this frustrating to her? Sure. But she doesn’t let that get in the way of her patient relationship.
Instead: Don’t fall into the abyss. Yes, there are differences between you and your patient. Go ahead and be frustrated, or exasperated. Then get to work talking across them. Remember, cross cultural communication is crossing work. This is bridging work.
Mistake #3: Essentializing.
Aka generalizing, stereotyping, lumping folks together.
It might be easier to recognize essentializing when it happens to you: it’s been suggested that medicine is a kind of a “culture.” If it is, you know it’s not a monolithic culture. For example, use of the hashtag #whatadrlookslike could be seen as drawing awareness to assumptions of a universal norm of male whiteness in medicine.
Instead: One-size-fits-all solutions are seductive but misleading when it comes to human communication. Don’t put pressure on yourself to have it all figured out about a group. Ask some good questions.
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Mistake #4: Feeling pressured to get it right.
Otherwise known as: feeling you need to be extremely clever; ignoring your audience; designing at the white board.
Don’t put pressure on yourself to hypothesize or guess about your patient’s ‘culture,’ life, and thoughts so you can ‘say it right.’
Instead: Stay curious. When it comes to communicating across cultures, we don’t get it right, or arrive, or know it all. It’s a process. Involve patients and patient representatives in developing communication guidelines, as this study team did. If you’re on a large scale project, reach out to your patient advisory board.
In your own practice, ask patients about their language use. (It’s a good idea not to assume that your guesses about the patient’s life and thoughts are correct.) Go ahead and ask for clarification. Ask some follow-up questions. Check for your own understanding of their perspective: “If I hear you right, what you’re saying is this…”
Mistake #5 Closing the door.
Otherwise known as: leaving out your colleagues.
One sure-fire way to lose your groove is to talk to exactly no one about how difficult this work can be.
Instead: Reach out to some colleagues who are also interested in cross-cultural communication, as did the team in this “Ethics Rounds.” Consider joining (or starting) a community of practice with some like-minded colleagues, maybe even some smart people outside your institution.
Mistake #6: Being a lone ranger.
Aka doing this alone.
Cross-cultural communication is no joke, and it merits support. If you’re an educator, you’re preparing and supporting others to do some delicate and difficult bridge-building. This means you have to do everything I’ve already been talking about…and then teach others to do it. Yikes!
Instead: Get some institutional support, as this study recommends. Take advantage of the resources on this site. And contact me. I’d love to help.
