Cultural competence in healthcare: building your skills for more inclusive care

Integrating cultural awareness in your healthcare role is an important step toward supporting diverse communities and their unique health needs.

Health disparities within certain groups, such as Aboriginal and Torres Strait Islander peoples, pose ongoing challenges for healthcare professionals and Australia's broader healthcare system. It is vitally important for healthcare organisations and individuals alike to develop cultural competence to help bridge healthcare gaps and provide more effective and inclusive care.

While the broader concept of cultural competence encompasses respect, appreciation and knowledge of all diverse cultural groups, this article’s focus will cover Aboriginal and Torres Strait Islander communities as a primary focus. You’ll also discover how postgraduate courses that include units on Indigenous health can enhance your ability to deliver culturally appropriate and responsive care to these populations.

What is cultural competence?

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Cultural competence allows a service provider, whether an individual or organisation, to better understand, appreciate and interact with people from cultures that are different from their own. It is an ongoing process of reflecting on personal beliefs, biases and assumptions of one’s own and other cultures. It also involves gaining knowledge of the different behaviours, customs and traditions belonging to varying cultural groups. Doing this means providers can respond more effectively to the needs of culturally diverse populations.

It’s important to understand that a person’s culture can influence their worldview and how they make sense of their reality. Culture forms part of how a person behaves, as well as their values and core beliefs. It exists in families and communities, connecting and unifying people in a wider group. Culture is the foundation of who people are as a shared identity.

In Australia, cultural competency should be respectful, aware and dynamic, in an effort to create culturally safe environments for different groups, inclusive of Aboriginal and Torres Strait Islander peoples. Besides these groups, there are many first, second and third-generation Australians who maintain strong connections to their cultural background and heritage. Each group brings their own unique beliefs that require culturally-informed approaches to healthcare delivery.

Aboriginal and Torres Strait Islander health disparities

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The health disparities and outcomes of Aboriginal and Torres Strait Islander peoples represent some of the most significant health inequities in the country. Below is an overview of primary health-related issues experienced by the First Peoples of Australia.

Higher chronic disease prevalence: According to health performance data from the National Indigenous Australians Agency, there are disproportionately higher rates of chronic disease amongst First Nations peoples. These groups are impacted by conditions such as diabetes mellitus, heart disease, cancer and chronic obstructive pulmonary disease, which costs approximately $12,146 per person annually in health expenditure.

Elevated suicide rates: Self-harm and suicide rates are also higher within Aboriginal and Torres Strait Islander peoples, with suicide being one of the leading causes of death. Recent data reveal that suicide rates are more than double that of non-Indigenous Australians. The reasons for this may be multifactorial, however mental health conditions, anxiety, depression and substance use are highly correlated contributors.

Reduced life expectancy: In general, First Nations peoples have a lower life expectancy compared to non-Indigenous Australians. The overall gap is approximately 8.8 years for men and 8.1 years for women. Those living in rural and remote areas are at an even greater disadvantage and tend to live shorter lives compared to those in urban and metropolitan areas.

Rural healthcare access barriers: Approximately 15 per cent of Aboriginal and Torres Strait Islander peoples live in remote or very remote areas. Statistics also show that the more remote an area, the higher proportion of Aboriginal and Torres Strait Islander peoples there are within the local population. Access to healthcare services pose many challenges for these communities as these areas often have fewer health services and significant travel requirements.

Why is cultural competence important in healthcare?

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Cultural competence in healthcare serves an important function as a foundation for delivering effective, ethical and personalised care. Acquiring skills in cultural competency can help ensure positive outcomes for patients, healthcare professionals and the broader healthcare system in Australia.

It improves outcomes and healthcare quality

While there is no standardised, coherent approach to embedding cultural competence in healthcare, developing your awareness is the first step to improving health outcomes within diverse cultural groups. When you begin to develop your cultural competence, you’ll be able to communicate more effectively, build rapport and have a level of understanding of the needs of culturally diverse people.

Many patients and clients from diverse backgrounds may delay or avoid seeking care due to their previous experiences of discrimination, language differences or fear that their beliefs and practices will not be respected. As you focus on understanding the unique health needs of the individual in your healthcare role, you can tailor your approach to provide person-centred care and design interventions that work within their specific cultural framework. You may also be able to educate and empower your client or patient to actively participate in their health.

When people from different cultural backgrounds feel valued and respected, they are more likely to work collaboratively with their healthcare provider and feel as though they are receiving meaningful care. This can have a rippling impact on the individual, the family unit and wider community. As people’s health improves from receiving culturally-appropriate and effective care, this can increase feelings of safety, which can help encourage others to seek out healthcare services more regularly or perhaps preventatively.

It promotes an ethical clinical practice

One important benefit of building cultural competence in healthcare is that it supports the development of an ethical clinical practice. Providing care for people in an inclusive way that promotes autonomy, choice and fairness is woven into the fabric of cultural competence.

Being aware of historical and social contexts, such as the impacts of colonisation, intergenerational trauma and discrimination, can help you deliver more empathetic and ethical care. Be curious, compassionate and wherever possible, consult with Aboriginal and Torres Strait Islander peoples and other cultural groups to implement ways to better support the health of these groups. It’s important to understand that cultural competence is an ongoing commitment to ethical practice development over the course of your healthcare career.

As you develop cultural competency skills, you may also begin to recognise your own biases and assumptions regarding different cultural groups. Without examining your own prejudices or beliefs in your healthcare role, you may be susceptible to misunderstanding your clients or patients and prone to making mistakes in your clinical or professional judgement. Practicing self-awareness is therefore an important step in providing ethical and effective care.

It restores trust in the healthcare system

For many Aboriginal and Torres Strait Islander groups, their experiences of medical abuse or negligence may mean they have a mistrust of mainstream healthcare. Restoring trust in healthcare providers can help pave the way to restoring trust in the healthcare system as a whole.

Showing genuine empathy, respect, compassion, listening without judgement, acknowledging historical experiences and placing value in cultural identity are all important aspects of growing your cultural competency skills.

While the past cannot be changed, showing your awareness can help rebuild a respectful and inclusive approach that frames Australia’s healthcare system as one that has diverse cultural groups’ best interests at heart. Over time, more positive healthcare experiences can contribute to long-term trust restoration, encourage greater engagement, foster better health outcomes and support stronger community interactions with healthcare services.

How to develop cultural competence in your healthcare role

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Developing cultural competence is an evolving process that requires continued learning. This dynamic process asks the individual, sector and healthcare system to review the ingrained attitudes, ideas and knowledge of broad cultural groups, inclusive of Aboriginal and Torres Strait Islander peoples and their health needs.

Here are some strategies that can help develop your cultural competence in your healthcare role.

Support cultural representation in healthcare settings

Promoting the recruitment of skilled Aboriginal and Torres Strait Islander healthcare professionals can help create greater diversity in teams, encourage varied perspectives and support cultural competence. The lived experiences and connection to their culture help bridge the gap between patients or clients, providers and healthcare services. People using a particular service where there are Aboriginal and Torres Strait Islander staff may feel a deeper connection and rapport with them as they have a shared culture, values and beliefs.

Having these professionals play a role in healthcare can help bring valuable insights into how organisations can better develop culturally-appropriate practices and models of care. It highlights that First Nations peoples’ voices are valued and necessary. There could also be career advancement opportunities in leadership and training roles, to become the expert cultural voice and facilitate staff education on how to provide cultural safety and awareness in the workplace.

Greater cultural representation in healthcare also sends a strong message to Aboriginal and Torres Strait Islander peoples that they, too, can pursue a career in this field. Professionals in healthcare can serve as powerful role models for those aspiring to step into this sector and help to dismantle perceptions of certain professions as only being available to specific groups. It demonstrates that with passion, education, hard work and opportunity, a career in healthcare is possible. This visibility can inspire confidence and encourage more culturally diverse people to pursue careers in healthcare, which can lead to a more inclusive and equitable workforce.

Adapt according to your patient’s needs

As there is no one-size-fits all approach to working with culturally diverse communities, you’ll need to be flexible in your practice to support patient or client needs. This means you’ll need to spend time getting to know the individual, ask them questions and find out what works best for their situation. If you’re in a healthcare setting that caters to a specific cultural group, this may mean you need to build your knowledge and skills relevant to that group so you can deliver meaningful care.

In some circumstances, socioeconomic status, language barriers, health literacy and education level can impact how certain cultural groups understand and interact with healthcare providers. Recognising these differences, practicing understanding and making adjustments accordingly can help you deliver a truly person-centred approach that prioritises the individual and their specific care needs.

Nursing coach and educator, Madeline Kessler highlights the importance of working with the individual patient, regardless of their cultural background to best meet their needs. For example, supporting older individuals from various cultural backgrounds who have limited English may require the assistance of a carer or family member who can help translate the information and ensure they fully understand it. “We ensure carers are involved in their care as much as possible and we’ll ask if there are any cultural requirements they need.”

Luke Lawrence from Explore Psychology describes his experience working with culturally diverse clients and the importance of providing individualised care. He mentions that this approach focused on person-centred care applies to all clients, irrespective of their cultural background. “Historically, we would work with any client with a cultural diversity or linguistic diversity with a framework of person-centred care and work to understand how they perceive mental health and psychology through their own perspectives.”

Luke shares that a vital part of practicing cultural competence is to establish safety for the client. “At the heart of a culturally-sensitive practice is building a climate of safety in the room. You can't do that unless you see the client to be the expert on their own life.”

Luke also says that as a psychologist, taking a humanistic counselling approach can sometimes be more effective than endeavouring to strategically manage a client’s mental health, which helps promote effective culturally-appropriate care. “The counselling part is where the magic happens for most clients. This helps them to feel safe, that they’ve got someone in their corner allowing them to feel how they need to feel.”

Reflect on how your personal preconceptions may impact your practice

An important aspect of advancing your cultural competence is in the practice of self-reflection. It’s essential to uncover your personal views on diverse cultures and to acknowledge that unconscious biases may affect how you interact with your patients or clients and could impact your own clinical judgement.

It can also be helpful to acknowledge that your idea of ‘normal’ in terms of healthcare practices can differ to another person’s if they have a different cultural background. You may have established certain expectations of how people should prioritise or treat their own health, which perhaps may not align with those of your patients or clients.

Consider the possibility that your beliefs about different cultures may be a result of your own upbringing or education and ask yourself if they are potentially unfounded, especially if you believe they may be impeding your capacity to perform your healthcare role effectively. Examine your beliefs, look for evidence of their truth or where they need to be reconsidered.

Aside from beliefs about health, Luke says that it’s important in general not to make assumptions about a person’s beliefs, simply because they belong to a particular culture. He says that the more you can understand your client, their story and their personal experiences, the better you are able to help them. “It’s about asking questions, building trust and being open and curious about their experience…Yes, there will be patterns that will emerge but we need to listen to the client at the end of the day.”

Upskill with postgraduate study to develop your cultural competence

Madeline reflects on hers and her colleagues’ clinical nursing experience and how at times they don’t feel they have enough knowledge to provide culturally-appropriate care to their patients. She says that some primary care settings incorporate mandatory cultural awareness training as part of maintaining their accreditation. However, each healthcare setting can vary in terms of patient type and cultural needs, which highlights the importance of upskilling with cultural competence education to support your healthcare role.

Luke highlights the value in seeking additional training, especially if you’ll be working with a particular cultural group. “There are remote communities calling out for mental health practitioners to work amongst the community [to support] predominantly Aboriginal and Torres Strait Islander clients.” He also feels that the specific workplace has some responsibility to ensure they have job-ready skills in this area, especially if they’re hiring provisional psychologists.

Completing cultural competency skills training can help expand your knowledge and appreciation for culturally diverse groups in Australia. You’ll be in a position to deliver more culturally-sensitive healthcare with the readiness to work with various groups, such as Aboriginal and Torres Strait Islander peoples. You’ll also be equipped with the expertise to drive systemic change toward an overall more inclusive society.

Build your expertise through postgraduate courses in Aboriginal and Torres Strait Islander health

Nursing

University of Canberra's Master of Nursing Practice

This face-to-face postgraduate course includes a dedicated Indigenous Health unit to develop important skills relevant to Aboriginal and Torres Strait Islander health issues. You’ll gain the knowledge and confidence to apply culturally-appropriate care using cultural safety principles, while practicing advanced nursing skills in practical settings. You’ll also be positioned to pursue clinical leadership and management roles in a variety of nursing and healthcare environments.

Mental health nursing

Victoria University's Master of Mental Health Nursing

The field of mental health nursing is a rewarding specialisation for nurses interested in caring for people with mental illnesses. This master’s degree equips graduates with a holistic understanding of mental health and its broader impact on families and communities. Units specific to developing cultural competence include Promoting Cultural Competence and Community Health and Biopsychosocial and Cultural Perspectives in Mental Health.

Combined with units on pharmacology, advanced mental health assessment and trauma-informed care, you’ll have the expertise to understand the varying manifestations of mental health conditions within cultural groups and learn how to support people with evidence-based nursing approaches.

Social work

University of Canberra's Master of Social Work (Qualifying)

Social workers value human diversity and respect the broad cultural backgrounds, beliefs and experiences of the individuals and communities they serve. If you’re considering becoming a social worker, this Australian Association of Social Work (AASW)-accredited master’s degree is your ticket to a rewarding career in social care. This postgraduate course is available to people with a background in health, education and other relevant fields who are looking to move into the social work sector.

This master's degree includes the core unit: Working with Diverse Communities. This unit helps students gain comprehensive skills in providing effective cross-cultural care, cultural advocacy and the capacity to promote equitable healthcare access. As part of this course, you’ll also complete practical field placements to consolidate your learning in a range of social work settings. These may include schools, non-government organisations or correctional facilities.

Public health

University of Technology Sydney (UTS) Online's Graduate Diploma in Public Health

Public health careers provide a platform to improve the lives of local and global communities through education, policy development and research. This graduate diploma is designed for professionals interested in developing their expertise on health systems, social health determinants and the interplay of social, economic and technological factors that influence population health outcomes.

Within this course, you’ll undertake the core subject: Foundations in Public Health + Indigenous Public Health. This unit delivers competencies in population health approaches and cultural awareness practices to facilitate the development of culturally-appropriate public health programs and policies.

UTS Online also offers a Graduate Certificate in Public Health. This course is a four-unit postgraduate degree, which includes the cultural competency unit mentioned above and provides graduates with a fundamental understanding of public health principles. This course is nested within the graduate diploma and offers a progressive pathway toward a Master of Public Health. The master’s degree offers comprehensive skills in health data, health promotion, economics and cultural perspectives of health. These courses equip you with cultural competency knowledge and enable you to make a profound local, national or global public health impact.

Counselling

University of Canberra's Master of Counselling

This Australian Counselling Association (ACA)-accredited counselling master’s degree offers a comprehensive curriculum for aspiring counsellors. You’ll be equipped with the skills necessary to provide client-centred and culturally-informed care. The specific unit: Diversity Inclusion Respect serves as an important foundation for cultivating cultural competence and insights into how to support diverse communities with counselling approaches.

In this course, you’ll learn the essential ethical and social underpinnings that apply to counselling theory and practice to support a diverse range of clients in different cultural contexts. You’ll also appreciate the rich histories and traditions of Aboriginal and Torres Strait Islander peoples and learn how to integrate their perspectives, communicate effectively and provide meaningful counselling therapy to these groups.

This master’s degree is open to people with a prior degree in any discipline and is delivered online with an in-person counselling placement component to put your theory into practice. UC Online offers nested qualifications within this course, including the Graduate Certificate in Counselling and the Graduate Diploma in Counselling. Both of these courses have cultural competency units to ensure you gain valuable skills to build a culturally-aware practice.

Mental health

Edith Cowan University’s Graduate Certificate of Mental Wellbeing

This graduate certificate offers a foundational exploration into mental health, making it an ideal choice if you’re passionate about wellbeing, mental health and counselling concepts. The unit: Grounding Self: Cultural Ways of Wellbeing delivers an immersive overview of Aboriginal and Torres Strait Islander models of wellbeing.

Gaining knowledge on wellbeing practices used by these groups can help develop your cultural competency for your own personal interests as well as enhance your current role with additional mental health and wellbeing skills. This course serves as a pathway to ECU Online’s Master of Mental Health, giving you the chance to build comprehensive skills and expertise for a career in the mental health sector.

Advance your healthcare practice today

Cultural competence represents an essential foundation for delivering equitable, effective and inclusive healthcare in Australia's diverse and multicultural society.

The health disparities experienced by Aboriginal and Torres Strait Islander peoples, combined with the complex needs of various communities highlight the critical importance of developing cultural competencies in healthcare. As a professional in this sector, when you build your cultural competence, you help create more inclusive care environments that serve the needs of Australia's increasingly diverse population.

To expand your professional practice with courses that include important cultural competency skills, explore the courses above, select a course and enquire to speak to a Student Enrolment Advisor for support with your application.

At GlobalHealth Education, we partner with respected universities to offer healthcare courses in a range of fields. We also showcase courses from various respected Australian universities. These include nursing, health leadership and management, counselling, psychology, public health, social work and mental health. Transform your career in healthcare and enquire today.