Introduction

If you are interested in cultural inclusiveness, cultural competence, cultural humility, and cultural diversity, I encourage you to continue reading. Using various activities such as journaling, word games, and scenarios, this guidebook asks you to use critical and reflective thinking skills to explore the process of cultural sensibility. What is cultural sensibility? In short, cultural sensibility refers to deliberate behaviors that proactively provide an enriched provider–consumer/patient interaction, where the healthcare provider acknowledges cultural issues and situations through thoughtful reasoning, responsiveness, and discreet (attentive, considerate, and observant) interactions.

I was searching for a term that implied practical, applied behaviors, attitudes, and approaches to equip healthcare workers in what is currently discussed as cultural competence, cultural sensitivity, cultural humility, cultural diversity, and various other terms that highlight differences and the grouping of individuals according to their lack of similarity with healthcare workers. These terms are not wrong, negative, or bad, and they have a critical place in the evolving continuum addressing cultural implications in the delivery of healthcare. However, these terms do not equip healthcare workers with skills to address personal issues of bias and stereotypes that can lead to provider-biased healthcare and contribute to healthcare disparities. Drawing from definitions, synonyms, and antonyms in thesauruses and dictionaries, I examined existing cultural terms in search of a word that would emphasize behaviors and attitudes when combined with the word culture. The best term was sensibility, which describes a responsiveness of both the conscious and emotional senses. From this review, the definition of cultural sensibility was envisioned.

A review of the literature identified an earlier grappling by Dogra (2003) with concepts surrounding cultural diversity. Her work compared two models for teaching cultural diversity: cultural expertise and her term cultural sensibility. Later she used her comparisons to explore medical students’ learning about cultural diversity beyond the expertise (categorical) approach of teaching cultural group differences and utilized her concept of cultural sensibility (Dogra & Karnik, 2003). The authors drew clear distinctions between:

• Cultural expertise: Proficiency in applying facts

• Cultural sensitivity: The degree of compassion and understanding

• Cultural sensibility: A broader perspective that implies an action toward openness

Cultural sensibility offers healthcare providers a process that encourages them to first consider their own attitudes, biases, beliefs, and prejudices through self-reflection. The process of self-reflection allows us the opportunity to accept or change our biases, beliefs, and prejudices. Most important, however, it allows us to recognize that these areas have the potential to interfere with effective healthcare interactions.

In each chapter of this guidebook, you have an opportunity to reflect on the actions described in various scenarios and perhaps identify similar experiences from your professional practice. As you do so, you can start to leverage historical experiences to enhance in-the-moment clinical experiences using reflection-in-action (Albanese, 2006) and thus create culturally sensible healthcare encounters.

This guidebook is primarily designed for nurses and pre-licensed nurses who are interested in cultural diversity, inclusivity, and culturally appropriate healthcare. Throughout this guidebook, you are challenged to examine cultural issues beyond just theory and to instead explore culture as it affects your professional role.

Educators might find this guidebook useful as a companion text, one that encourages students to consider practical effects of cultural sensibility in courses where cultural content in healthcare is covered. In addition, schools of nursing with low-diversity faculty/student populations might find this guidebook enlightening, as it prompts readers to consider the healthcare experience from a wider perspective. Likewise, organizations experiencing rapid shifts in their consumer population may find this guidebook an invaluable resource.

Although this guidebook derives from my nursing experience and perspective, most healthcare workers will find the comprehensive examples helpful. Because this guidebook encourages reflection on your life and behaviors, do not hesitate to seek help from your professional support services as you read and participate in the activities if you are dealing with unresolved emotional experiences.

Maya Angelou is credited with saying, “When you know better, you do better.” It is my hope that after learning cultural sensibility skills, we will know better, but more important, we will do better.