Cultural humility: expert gives 3 practical tips to handle cultural differences during consultations

Sorry, what did you just say? I said last night, I had a lot of fufu with egusi. It's a Nigerian traditional dish. This is what cultural humility can look like. It can initially seem really quite awkward. But actually, cultural humility is crucial for conditions like diabetes just to ensure that we're delivering equitable and excellent care for patients and clients. These are professional actors and I am Shola Oladipo. I'm a registered dietitian with almost 30 years of experience with working in the UK across various cultural communities. Cultural humility starts long before the consultation room. It's about how we address and deal with people. How about the administrative staff? How are they speaking to people? What kind of information are we giving to people pre-appointment? But for now, let's go back to the consultation room. Right, so you have fufu occasionally. What about pasta? Is pasta a food you often eat? Yeah, I love pasta. In fact, I love pasta. I lived in Italy for about 20 years. And while I was there, I met this wonderful Italian man. The first principle of cultural humility is to avoid making assumptions. It's easy, isn't it, for us to just assume that we understand somebody's culture by the way they look, by the colour of their skin, or even by what we feel is the culture that they are immersed in. Now, culture is so complex and nobody is influenced by just a single culture. In life, we're all guilty of making assumptions. Sometimes we get so carried away and we start to believe our own narrative. Can you imagine, just for a minute, what it would sound like if we were totally honest about the assumptions that we are making? I assume this is going to be a straightforward conversation. I don't suppose you fast, do you? Yes, I do. Oh, right. Well, I assume this will be for Ramadan. No, I'm a Christian. I don't do Ramadan. Oh. Oh, I see. In terms of food, I assume as a Christian you're just avoiding red meat. No, I avoid food altogether. Oh, I see. And when you fast, I assume it's just occasional. No, I fast for five days every month. I see. Should I continue to assume? Fasting can seem like a minefield. Often we assume that fasting is totally related to religion. This isn't always the case. So it's important that we ask questions, wait for answers, learn and not make assumptions. Let's start again. Do you fast at any point throughout the year? Yes. OK, why don't you walk me through what that looks like for you? OK. Fasting is something that's observed by people for all sorts of reasons. We often assume it's just religion, but it can be because of culture or just personal choice. The only way to find out is to ask. And this brings me on to our second principle, which is being curious. As busy health care professionals, often we are pressed for time in consultations. By asking that one key question, it can make a huge difference to the quality of care that we're giving to our clients. You said you were religious. Do you have any concerns about the medicine you were prescribed? What did you eat for lunch yesterday? I had beef stew. And what did you eat with your stew? Pounded yam. And how many portions would you say you had? About five or six portions. Now, that's a meal that it may be high in carbohydrates and high in fats. Did you realise that? There are many ways that you can ask questions in a sensitive way. When you say stew, what do you mean exactly? Do you eat your stew on its own? Pounded jam? Could you explain what that is? Cultural humility is really about dismantling the power dynamics. It isn't a one-way conversation. It's not pounded jam. It's pounded yam. It's a bit like mashed potato, but it's not. It's yam. It's not mashed. It's pounded. It's a traditional Nigerian dish. Sounds delicious. By allowing the patient in front of you to be the expert, you will get a lot of needed information. Do you add any sugar to your coffee? No, no, no. It's up a long time ago. And do you have it with anything else? Yeah, I have it with some honey from back home. That is all right, isn't it? Let's discuss that. How often do you exercise? Every single day. In terms of the intensity, would you say that's low, medium, medium-high or high? I would like to believe, in my own mind, that it's high. What exactly does that look like for you? I'm trying to ditch this rucksack and try to get a six-pack. For me, I walk every single day. If I'm honest, Doctor, I really don't enjoy walking. But, however, you know, I do make sure that I keep it up. It's pretty intense. The third principle for cultural humility is showing that you care. Doing your research and just noticing that person in the seat is crucial. Saying something like this might be helpful. So, you're from the Caribbean. Did you know that people from Black African Caribbean heritage have a higher risk towards type 2 diabetes? But don't worry, just by making some changes to lifestyle, we can actually help you to manage that risk. I must confess, I do love a festival. In fact, I love festivals. But, I mean, is that bad? This is a festival. And, actually, there's nothing wrong with festivals, but it's important to discuss balance and moderation. So, perhaps we can burn off some of those calories by dancing at a festival. Well, I'll try anything once. So, you reduce the pasta. Oh, that's great. That's great. What about jollof rice or fufu? I love jollof rice and fufu. I do. They're amazing. A patient of ours brought some into the office. We all tried it. It was great. In many cases, we can look at cultural humility and say, well, surely it's all common sense. But cultural humility is remembering to push beyond your personal preferences and just remembering that person in front of you is not subject to the same mindset, the same culture and the same lifestyle as you. You're fine, but if I was you, I'd watch out for portion sizes, especially complex carbohydrates like white bread, pasta. What about pounded yam? In my experience, having a health care professional that looked like me was very beneficial to me. I'd come across other health care professionals who weren't from the same culture who were equally as good, but that cultural affinity of looking at someone who looked me in the eyes, apart from just being a patient of hers, we would talk about stories of Africa and the Caribbean. So that kind of helped. Practicing cultural humility doesn't necessarily mean that you need to be from the same background as your patient. It can be a bonus, but it's really important that we have an open mind and we're willing to learn. This video has shared a number of principles to help you to practice cultural humility. It's not going to start overnight. It's something that we need to do all of the time. Practicing, practicing and practicing. It's about lifelong learning and changing of a mindset. Thank you.