1. Cross-Cultural
Sensitivity:
Bridging the Gap
Nicholas J. Saller, PT

2. Did you know...
●A popular brand of golf balls went on sale in
Japan in packs of four. Only after sales
were nonexistent, did executives find out
that the #4 in Japan means death.

3. Seemingly Trivial
●Little things that are a part of our everyday
culture might cause a huge backlash in
others.
●It isn’t because we meant to hurt, offend,
irritate or anger someone. Rather, what is
an everyday thing for one group might be
totally foreign or even upsetting to another
population.

4. How about this one...
●Crossing your ankle across your knee with
the bottom of your foot toward the person
you are speaking with is normal in the USA.
●However, in Arab cultures, it is the worse
possible insult.

5. Culture
To be cultured, you have to know culture...
1.Merriam Webster defines culture as, "the
customary beliefs, social forms, and material
traits of a racial, religious, or social group;
also: the characteristic features of everyday
existence (as diversions or a way of life)
shared by people in a place or time."
(http://www.merriam-webster.com/dictionary/culture)
2.Ironically, culture also means, "expert care
and training."(http://www.merriam-webster.com/dictionary/culture)

6. Integrating the Two Definitions
●If we learn about another’s "culture", we will
be able to provide "cultured" patient care.
●The result will make us better clinicians and
produce better patient outcomes through
demonstrating our "expert care and training"!
(http://www.merriam-webster.com/dictionary/culture)

7. Strategies for Cross-Cultural
Sensitivity
●Keep words and phrases simple*(KISS)
oNo medical jargon other than the most universal,
basic and absolutely necessary terms.
●Speak slower rather than louder*
oChances are a hearing impairment is not what is
hampering the communication exchange.
●If you are not sure about their question or an
answer to your question then rephrase it*
oAlso remember that "yes" doesn't necessarily
indicate affirmation in other cultures; it can also
indicate "no and/or maybe.
*Mielke, David. "Effective Global Communication Requires Cross Cultural Sensitivity." AnnArbor.com. 9/20/2009.

8. Continued
● Avoid slang and jargon(1)
● Identify your own biases and prejudices.(2)
o They are simple to overcome.
o It is fear that drives them and for which education is the
solution.(2)
● Perform assessments in a culturally sensitive manner(2)
● Patient/Family Misconceptions(2)
o Delivering care across cultures has the potential to create
misconceptions and unrealistic expectations.
o This can impair judgement and influence interactions.
o It is easy to become frustrated or defensive by the former.
o Instead, remain calm and work to help guide good outcomes.
(2)
(1)Mielke, David. "Effective Global Communication Requires Cross Cultural Sensitivity." AnnArbor.com. 9/20/2009.
(2) Seibert, PS. "A Checklist to Facilitate Cultural Awareness." J Med Ethics 2002;28:143-146 doi:10.1136/jme.28.3.143

9. More
●Religious/Spiritual Beliefs(2)
oStudies show that these play a role in successful
health recovery.
oPatients often attribute successful recovery and
even survival to these beliefs. (2)
●Identify language barriers(2)
oIdentify the preferred method of communication.
 Spoken, written, signing, facing, offset, etc. (2)
oTranslator

10. Interestingly Enough...
●In some cultures, men can be seen holding
hands, which in no way indicates that they
anything other than good friends.
●In Japan, when exchanging business cards it
is considered rude to put your new
colleague's business card in your wallet and
then back in your back pocket as it is
perceived as you are sitting on his face!

11. So Many Mines in the Field...
●With all of the intricacies of a culture that is
different from your own, it is easy to feel like
you are walking through a minefield blind
and not knowing where to step next.
●While some folks spend weeks, months, or
years learning about other cultures in which
they will live and/or serve there is a lot of
room for error.

12. Cutural Exercise: Name the Flag and
Describe the Cultures...

13. Which is Texas : Which is Chile
Chile Texas

14. Mistakes are Inevitable...
●Embarrassment is likely but only temporary.
●Don't give up!
●On the whole, people from other cultures
cherish those who are trying to show respect
and to honor their culture.

15. Getting More than You Give
●Oftentimes the folks who you are trying to
honor by respecting and learning about their
culture will in turn honor you with
compliments, food, etc...
●Many times you make
a lifelong friend!

16. Additional Hints
●Try to learn a little about the following:
oMedical care in the patient’s native country.
oFamilial structure.
oA few of their native language phrases if they have a
good command of English.
oA few general customs of their country.
oMaybe a few interesting details about their
hometown in their country.

17. Everyone Has a Different Story to
Tell

18. A Chilling Lesson in Cross Cultural
Sensitivity in Medicine
The Spirit Catches You and You Fall Down

19. No Is a Powerful Word in All
Languages

20. Take Great Care in What You Say
and Do
You never know how someone might respond...
"I've learned that people will forget
what you said, people will forget
whatyou did, but people will never
forget how you made them feel."
- Maya Angelou