To provide holistic care that incorporates the individual client’s body, mind and spirit, the health
care provider must seek to understand the various ways culture influences care. To fully prepare
to deliver culturally-competent care, the provider must be self-aware of personal cultural factors
that impact the way others are perceived.
“Self awareness in cultural competence is a deliberate and conscious cognitive and
emotional process of getting to know yourself: your personality, your values, your
beliefs, your professional knowledge standards, your ethics, and the impact of these
factors on the various roles you play when interacting with individuals different from
yourself. The ability to understand oneself sets the stage for integrating new knowledge
related to cultural differences into the professional’s knowledge base and perceptions of
health interventions” (Purnell & Paulanka, 2008, p. 5).
Advance practice nursing students are required to engage in the process of professional
development and diversity competence through self-exploration of a cultural self-assessment.
Directions: Consider each of the following questions carefully and briefly answer based on
personal self-reflection. There are no right or wrong answers, only the student’s personal
answers. Do not hold back in providing an answer. It is fine to state personal feelings about
each question. Only faculty for the course will review this assignment.
Self-Awareness and Health Professionals (10 points)
What attitudes are necessary to deliver quality care to clients whose culture is different than
How might you increase your knowledge about diversity in your community?
Culture and Essential Terminology (20 points)
Who in your family had the most influence in teaching you cultural values and practices? What
cultural practices did you learn in your family that you no longer practice?
Ethnocentrism is the universal tendency of human beings to think that their ways of thinking,
acting and believing are the only right, proper, and natural ways.
If you were to rate yourself on a scale of 1-10 with 1 being less ethnocentric and 10 being very
ethnocentric, what score would you give yourself? What score would your friends give you?
Race is genetic in origin and includes physical characteristics that are similar among members of
the group including skin color, blood type, and hair and eye color.
How do you define race? What other terms do you use to besides race to describe people? In
what category did you classify yourself on the last census? What categories would you add to
the current census classification?
A generalization is the reduction of numerous characteristics of an individual or group of people
to a general form that renders them indistinguishable. Generalizations can lead to stereotyping—
an oversimplified conception, opinion, or belief about some aspect of an individual or group.
Generalizations are a starting point whereas stereotyping is an endpoint.
Everyone engages in stereotypical behavior to some degree. We could not function otherwise.
If someone asked you to think of a nurse, what image do you have? Is the nurse male or female?
How old is the nurse? How is the nurse dressed? Is the nurse wearing a hat? How do you
distinguish a stereotype from a generalization?
Describe a time when you stereotyped a person and another when you made a generalization
about a group of people.
Primary and Secondary Characteristics of Culture (20 points)
Primary characteristics of culture include things that cannot be easily changed, but if change
does occur, a stigma might occur for the person, the family, or the society in which the person
lives. Primary characteristics of culture include nationality, race, color, gender, age, and religious
affiliation. (Examples: A 75 year old devout Islamic female from Saudi Arabia vs. a 19 year old
African American fundamentalist Baptist male from Louisiana.)
What are your primary characteristics of culture? How has each one influenced you and your
worldview? Has your worldview changed as your primary characteristics have changed?
Secondary characteristics include educational status, socioeconomic status, occupation, military
experience, political beliefs, urban versus rural residence, enclave identity, marital status,
parental status, physical characteristics, sexual orientation, gender issues, reason for migration
(sojourner, immigrant or undocumented status), and length of time away from the country of
origin. (Examples: A single, transsexual urban business executive vs. a married heterosexual
rural secretary with two teenagers.)
What are your secondary characteristics of culture? How has each one influenced you and your
worldview? How has your worldview changed as your secondary characteristics have changed?
Ethics Across Cultures (20 points)
How do you perceive truth telling? Do you always tell the truth? Do you always tell the whole
truth? (Example: If a patient asks you how she is doing and if she is going to get better, do you
tell her that everything is okay, even if you know she is not?)
Cultural imperialism, relativism, and imposition are important aspects to be reviewed by health
care practitioners. Cultural imperialism is the practice of extending policies and practices of one
group to disenfranchised and minority groups (example: US government’s forced migration of
Native American tribes to reservations). Cultural relativism is the belief that behaviors and
practices of people should be judged only from the context of their cultural system (example:
proponents believe abortion, euthanasia, female circumcision, and physical punishment of
children should be accepted as cultural values without judgment from outside world vs.
opponents who argue this may undermine condemnation of human rights violations including
family violence which cannot be justified or excused just because someone relates it to their
culture). A cultural imposition is an intrusive application of the majority group’s cultural view
upon individuals and families (example: special diet prescribed without regard for individual
What practices have you seen or exist in your culture that might be considered cultural
imperialism, relativism, or imposition? What have you done to address them when you have seen
Individual Cultural Competence (5 points)
Whose values and beliefs should come first—yours, the organization’s, or the client’s? Why?
The Purnell Model for Cultural Competence
Review The Purnell Model for Cultural Competence provided. Identify how you personally
identify with each area of the model. Briefly describe your personal experience with each of the
Global Society (5 points)
Family (5 points)
Person (3 points)
Overview/Heritage (1 point)
Communication (1 point)
Family Roles and Organization (1 point)
Workforce Issues (1 point)
Biocultural Ecology (1 point)
High-Risk Behaviors (1 point)
Nutrition (1 point)
Pregnancy (1 point)
Death Rituals (1 point)
Spirituality (1 point)
Health care practices (1 point)
Health care practitioners (1 point)
Total = 100 points
The final grade for assignment completion will be assigned using the following grading rubric:
90-100 (A)=Fully defined questions as well as a complete personal identification of The Purnell
Model For Cultural Competence; submitted by assignment due date; reflection of self is evident
80-89 (B)=Partially defined questions/partially complete personal identification of The Purnell
Model For Cultural Competence; submitted by assignment due date; reflection of self not
immediately evident/answers appear formed to meet an unrealistic expectation of another’s
judgment of the response.
70-79 (C)=Answers unclear or limited/limited personal identification of The Purnell Model For
Cultural Competence; submitted by assignment due date; unrealistic responses noted that appear
to promote a perfect response rather than a self-reflection.
As this is a required assignment, no grades lower than a C will be given based on answers
provided. However, a deduction of 10% per day late will be calculated into the final total for
submissions after the assignment due date.
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