The need for cultural competency pertains to both individual clinicians and staff as well as to the health care organization as a whole. This need is not new, but it has received greater emphasis recently as a result of several factors. The latest US Census data shows that America is becoming more culturally diverse. Rural areas as well as urban areas are increasingly composed of people for whom English is not their first language, and who hold to behaviors, practices, and beliefs that differ from the majority. Disparities in health have been documented along racial and ethnic lines, underscoring the urgent need to develop care that competently reaches all people. Legally, the health care community is expected to communicate with patients in their preferred language (Title VI, Civil Rights Act). Accrediting bodies such as JCAHCO have added cultural competency to review criteria. Finally, there is an increasing recognition that compliance on the part of the patient is related to cultural competence on the part of the clinician.

Cultural competency in practice requires that one be a continual learner. Cultural humility and a desire to better understand your patients are essential. Models for improvement suggest that we often make the greatest progress by taking a series of small steps and pausing frequently to assess if that step is a step in the right direction. The focus of this article is clinical practice, but the organization as a whole must also work towards incorporating cultural competency; the resources that follow address this need. To start with, consider adapting history taking to include cultural issues, understand your patients' perceptions of health and illness, their dependence on family systems, and their use of faith and tradition in healing. Recognize that stressful circumstances may alter your patient's ability to cope, resulting in a preference for the ways of her native culture.

MCN recognizes that the migrant population has unique needs and
characteristics that must be addressed in order to optimize health outcomes. Central to this understanding is the role of cultural factors in determining wellness, illness, adherence, and health
status improvement. While clinicians are trained in many skill sets, most have not received formal education in the area that may profoundly impact their success in all other areas: cultural competency. Accordingly, MCN has developed a expert set of resources and trainings in cultural competency geared for clinical practice.