11.3 Improving Intercultural Competence

Learning Objectives

  1. Explore strategies to develop intercultural communication competence.
  2. Describe the steps involved in the intercultural development continuum.
  3. Analyze the differences between cultural safety and cultural humility.
  4. Explain how cultural safety and humility can be demonstrated in your practice.

One helpful way to develop intercultural communication competence is to understand intercultural communication issues and best practices. From everything you have learned so far, it may feel complex and overwhelming. The intercultural development continuum is a theory created by Mitchell Hammer (2009) that helps demystify moving from monocultural to intercultural approaches. There are five steps in this transition:

1. Denial: Denial is the problem-denying stage. For example, a well-meaning person might say that they pay no attention to race issues because they are “colour blind” and treat everyone the same, irrespective of race. While this attitude seems fair-minded, it can mean willfully blinding oneself to genuine cultural differences. Little sensitivity or empathy can be present if one denies cultural differences exist. This is a monocultural mindset. When there is denial in organizations, diversity feels ignored.

2. Polarization: Polarization is the stage where one accepts and acknowledges that there is such a thing as cultural difference, but the difference is framed as a negative “us versus them” proposition. This usually means “we” are the good guys, and “they” are the bad guys. Sometimes a person will reverse this approach and say their own culture is wrong or otherwise deficient and see a different culture as superior or very good. Either way, polarization reinforces already-existing biases and stereotypes and misses out on nuanced understanding and empathy. It is thus considered more of a monocultural mindset. When polarization exists in organizations, diversity usually feels uncomfortable.

3. Minimization: Minimization is a hybrid category that is neither monocultural nor intercultural. Minimization recognizes cultural differences, even significant ones, but tends to focus on universal commonalities that can mask or paper over other important cultural distinctions. This is typically characterized by limited cultural self-awareness in the case of a person belonging to a dominant culture or as a strategy by members of nondominant groups to “go along to get along” in an organization. When dominant culture minimization exists in organizations, diversity feels not heard.

4. Acceptance: Acceptance demonstrates a recognition and deeper appreciation of both one’s own and other’s cultural differences and commonalities and is the first dimension that exhibits a more intercultural mindset. People can better detect cultural patterns at this level and see how they make sense in their own and other cultural contexts. There is the capacity to accept others as being different and, simultaneously, fully human. When there is acceptance in organizations, diversity feels understood.

5. Adaptation: Adaptation is characterized by the ability to recognize different cultural patterns in oneself and other cultures and effectively adapt one’s mindset or behaviour to suit the cultural context authentically. When there is an adaptation in organizations, diversity feels valued and involved.

The first two steps out of five reflect monocultural mindsets. According to Hammer (2009), people who belong to dominant cultural groups in a given society or people who have had very little exposure to other cultures may be more likely to have a worldview that is more monocultural. But how does this cause problems in interpersonal communication? For one thing, being blind to the cultural differences of the person you want to communicate with (denial) increases the likelihood that you will encode a message that they will not decode the way you anticipate or vice versa.

For example, culture A considers the head a special and sacred part of the body that others should never touch, certainly not strangers or mere acquaintances. But in your culture, people sometimes pat each other on the head as a sign of respect and caring. So you pat your cultural A colleague on the head, which sets off a vast conflict.

It would take a great deal of careful communication to sort out such a misunderstanding. Still, if each party judges the other by their cultural standards, additional misunderstanding, conflict, and poor communication will likely transpire.

Using this example, polarization can come into play because now there is a basis of experience for the selective perception of the other culture. Culture A might say that your culture is disrespectful and lacks proper morals and values, and it might support these claims with anecdotal evidence of people from your culture patting one another on the sacred head!

Meanwhile, your culture will say that culture A is bad-tempered, unintelligent, and angry by nature and that there would be no point in trying to respect or explain things to them.

According to Hammer (2009), most people who have taken the Intercultural Development Inventory (IDI) inventory, a 50- question questionnaire to determine where they are on the monocultural–intercultural continuum, fall in the category of minimization, which is neither monocultural nor intercultural. It is the middle-of-the-road category that, on the one hand, recognizes cultural difference but, on the other hand, simultaneously downplays it. While not as extreme as the first two stages, interpersonal communication with someone of a different culture can also be difficult in this stage because the same encoding/decoding issues can lead to inaccurate perceptions. On the positive side, recognizing cultural differences provides a foundation for building and a point from which to move toward acceptance, which is an intercultural mindset.

Few people are in the acceptance category than the minimization category, and only a small percentage of people fall into the adaptation category. This means most of you will have your work cut out for you if you recognize the value — considering your increasingly global societies and economies — of developing an intercultural mindset to improve your interpersonal communication skills.

Cultural Safety and Humility

While cultural competence is a step toward effective intercultural communication, all healthcare professionals should embrace a cultural safety and humility framework that recognizes and strives to address power imbalances inherent in healthcare (First Nations, 2021). Cultural safety is an outcome of respectful engagement and is evident when people feel safe receiving care within any healthcare setting (First Nations, 2021, p. 5). Cultural humility is the process of self-reflection to understand one’s personal biases and examine systemic biases that have impacted trust and therapeutic relationships. According to First Nations (2021), “Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience” (p. 7).

Communication is essential within your practice, and it is vital that, as health studies students, you understand your cultural identity and explore your values, attitudes, beliefs, and biases to provide culturally safe practice (Meadus, 2023). Despite the practice setting, students have the opportunity to communicate with culturally diverse clients. While it is not essential to know all cultures, you are expected to adopt a culturally sensitive approach to demonstrate respect, establish trust, and build therapeutic and meaningful relationships (Meadus, 2023).

Watch: Cultural Safety

As you watch the following video, think about how you can demonstrate cultural safety and humility in your professional practice area.

Video Transcript (see Appendix B 11.3)

Key Takeaways

  • When working with culturally diverse clients, it is essential to understand and adopt the principles of cultural competence, safety and humility (Meadus, 2023).
  • Effective intercultural communication is essential in building respectful therapeutic communication interactions.


Complete this Cultural Competence Module and reflect on the following:

  1. What did you learn from the module?
  2. How can you apply what you learned to your professional practice?


First Nations Health Authority, (2021). Creating a Climate For Change. https://www.fnha.ca/wellness/wellness-and-the-first-nations-health-authority/cultural-safety-and-humility

Hammer, M.R. (2009). The Intercultural Development Inventory. In M.A. Moodian (Ed.). Contemporary leadership and intercultural competence. Thousand Oaks, CA: Sage.

Meadus, R. (2023). Communication for nursing and health care professionals. A Canadian perspective. Toronto, ON: Canadian Scholars.

Media Attributions

Northern Health BC (2017, February 17). Cultural Safety: Respect and Dignity in Relationships [Video]. https://www.youtube.com/watch?v=MkxcuhdgIwY

Attribution Statement

Content adapted, with editorial changes, from:​

Ashman, M. (2019). Introduction to Professional Communication [Adapted]. Kwantlen University. https://pressbooks.bccampus.ca/professionalcomms/chapter/8-1-intercultural-communication/

Licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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Professional Communication Skills for Health Studies Copyright © 2023 by Chute, A., Johnston, S., & Pawliuk, B. is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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