THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



Understanding cultural humility can help patients

The ACR/ARHP Annual Meeting, like many activities for health professionals, focuses on learning from experts. But this year’s ARHP keynote speaker asked the audience to take a different approach during her presentation.

“Cultural humility does the opposite of what we learn when we study. When we learn, we want to become an expert. Cultural humility invites one to question expertise in something,” said Vivian Chávez, DrPH, Associate Professor in the Department of Health Education at San Francisco State University, who spoke at the ARHP Keynote Address: Cultural Humility for Rheumatology Health Professionals on Sunday.

Dr. Chávez, who early in her presentation talked about her family members who have dealt with rheumatic disease, explained cultural humanity and how to apply the concept within a rheumatology practice.

Cultural humility is an ongoing process to rectify power imbalances in relationships and develop partnerships based on mutual trust.

“If you Google it, you can see so many different fields apply the lessons learned about cultural humility to their practices, whether it’s research, whether it’s education, whether it’s psychology, or grieving and hospice care, they adapt it to what they need,” she said.

Understanding cultural humility can help create safe spaces for patients so they can be who they truly are and create those relationships of respect and trust that can lead to more positive outcomes.

Culture is like an iceberg, Dr. Chávez said. Behaviors — the things visible on the surface — make up a small percentage of a person’s culture. The question is how to engage and discover what lies below the cultural waterline.

The brain has an urge to take shortcuts, Dr. Chávez said. That natural tendency leads to stereotyping.

“You might see somebody who looks of a certain ethnicity, race, size, color, whatever, but they also have other layers of identity that unless we spend a little bit of quality time, we might miss,” she said.

Everybody has a culture, and it’s about more than ethnicity. A professional association such as the ARHP is a culture that forms and represents its members.

Creating and maintaining cultural humility toward others requires stepping back and learning more about your own cultures and value systems.

“I think it’s so important for you to give yourself time for self-reflection and awareness. It’s not an extra ‘feel-good,’ but it’s related to your interaction with the people that you meet,” she said.

Dr. Chávez also emphasized the concept of resilience, something many rheumatology patients practice every day. She cited research that showed three important things people in difficult circumstances do to thrive despite their challenges. They:

  • Form caring relationships, both caring about and being cared for by others.
  • Have high expectations, which gives people the belief that they can accomplish something.
  • Actively participate in life events and receive support from others for participating.

A video Dr. Chávez created looks deeper into the concept of cultural humility. “Cultural Humility: People, Principles and Practices” is available on YouTube.