The 5Rs of Cultural Humility

What is cultural humility?

In the medical realm, it is defined as a process of being aware of how people's culture can impact their health behaviors and in turn using this awareness to cultivate sensitive approaches in treating patients.

How do we, as hospitalists, win the hearts and minds of patients, families and care team members that we do not know? What are the obstacles that we face when encountering patients and gaining the trust needed to improve patient care and patient experience?

The Cultural Humility Workgroup of SHM’s Practice Management Committee developed a simple, universal framework to provide a foundation for strengthening communication skills and raising awareness of the basic tenets of cultural humility:

  1. Committing to self-evaluation and self-critique, wanting to learn from every encounter
  2. Readdressing power imbalances in the patient-provider dynamic
  3. Developing mutually beneficial partnerships between communities

Practicing cultural humility is extremely important in this process. It puts everyone on the same platform; there is no “minority,” “majority” or “ethnicity” associated with it. It takes away the need to know everything about a certain culture and encourages us to approach every patient encounter acknowledging that we will humble ourselves, learn what is important to the patient and leave every encounter having learned something from the interaction.

The workgroup developed The 5 Rs of Cultural Humility as a simple tool for hospitalists to incorporate into their practice. The first four Rs (Reflection, Respect, Regard and Relevance) are extrinsically focused, while the 5th R (Resiliency) is intrinsic. Our theory posits that if you attain the first 4 Rs in every interaction, it will serve to continue to build on and develop your own personal resiliency.

1. Reflection

      Hospitalists will approach every encounter with humility and understanding that there is always something to learn from everyone.

2. Respect

      Hospitalists will treat every person with the utmost respect and strive to preserve dignity at all times.

3. Regard

      Hospitalists will hold every person in their highest regard while being aware of and not allowing unconscious biases to interfere in any       interactions.

4. Relevance

      Hospitalists will expect cultural humility to be relevant and apply this practice to every encounter.

5. Resiliency

      Hospitalists will embody the practice of cultural humility to enhance personal resilience and global compassion.

1. Reflection

      What did I learn from each person in that encounter?

2. Respect

      Did I treat everyone involved in that encounter respectfully?

3. Regard

      Did unconscious biases drive this interaction?

4. Relevance

      How was cultural humility relevant in this interaction?

5. Resiliency

      How was my personal resiliency affected by this interaction?

The 5 Rs of Cultural Humility is available as a downloadable pocket card that can be easily referenced on rounds and shared with colleagues, with the hope to achieve heightened awareness of effective communication.

In addition to the definitions of each of the Rs, the card features questions to ask yourself before, during and after every interaction to aid in attaining cultural humility.


Download the PDF

The Hospital Leader Blog will have a series of posts in April providing further context around each of the 5 Rs.

This will be available by May, 10, 2017. Please check back.




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