For limited English proficiency (LEP) patients, I attempt to learn and use key words in their language so that I am better able to communicate with them during a medical encounter.

I use trained interpreters during clinical encounters with LEP patients.

When interacting with LEP patients, I always keep in mind that:

a.Limitation in English proficiency is in no way a reflection of their level of intellectual functioning.

b.Their limited ability to speak the language of the dominant culture has no bearing on their ability tocommunicate effectively in their preferred language.

c.They may or may not be literate in their preferred language or English.

When possible, I ensure that all notices and communications to patients are written in their preferred language.

I avoid imposing values that may conflict or be inconsistent with those of cultures or ethnic groups other than my own.

I screen books, movies, and other media resources for negative cultural, ethnic, or racial stereotypes, before sharing them with patients.

I intervene in an appropriate manner when I observe other staff, patients, or families engaging in behaviors that show cultural insensitivity or prejudice.

I understand and accept that family is defined differently by different cultures (e.g., extended family members, fictive kin, godparents).

I recognize and accept that individuals from different culturally diverse backgrounds may desire varying degrees of acculturation into the dominant culture.

I accept and respect that male-female roles in families may vary significantly among different cultures (e.g., who makes major decisions for the family).

I understand that age and life cycle factors must be considered in interactions with individuals and families (e.g., high value placed on the decisions of elders or the role of the eldest male in families).

Even though my professional and moral viewpoints may differ, I accept the family/parents as the ultimate decision makers for services and supports for their children.

I recognize that the meaning or value of medical treatment and health education may vary greatly among cultures.

I accept that religion and other beliefs may influence how families respond to illness, disease, and death.

I recognize and accept that folk and religious beliefs may influence a family's reaction to and approach to disability or special health care needs.

I understand that traditional approaches to health care are influenced by culture.

I understand that families from different cultures have different expectations of their children.

I accept and respect that customs and beliefs about food and its value, preparation, and use are different from culture to culture.

Before visiting or providing services in the home setting, I seek information about acceptable behaviors, courtesies, customs, and expectations that are unique to families or specific cultures and ethnic groups.

I seek information from family members or other key community informants, which will assist in service adaptation to respond to the needs and preferences of culturally and ethnically diverse patients.

I advocate for the review of my organization's mission statement, goals, policies, and procedures, to ensure that they incorporate principles and practices that promote cultural diversity and cultural competence.

Scoring: A B C FOR SELF ANALYSIS ONLY, DO NOT HAND IN