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The L.E.A.R.N. and R.E.S.P.E.C.T. Models of Cross–Cultural Communication

The L.E.A.R.N. Model of Cross–Cultural Communication

• Listen with sympathy and understanding to the patient's perception of the problem
• Explain your perceptions of the problem
• Acknowledge and discuss the differences and similarities
• Recommend treatment
• Negotiate agreement

Source: Berlin, E. & Fowkes, W.A.(1983). A teaching framework for cross-cultural health care. Western Journal of Medicine, 139:934–938. Available from: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1011028&blobtype=pdf

The R.E.S.P.E.C.T Model of Cross–Cultural Communication

• Rapport
  • Connect on a social level
  • Seek the patient's point of view
  • Consciously attempt to suspend judgment
  • Recognize and avoid making assumptions
• Empathy
  • Remember that the patient has come to you for help
  • Seek out and understand the patient's rationale for his or her behaviors or illness
  • Verbally acknowledge and legitimize the patient's feelings
• Support
  • Ask about and try to understand barriers to care and compliance
  • Help the patient overcome barriers
  • Involve family members if appropriate
  • Reassure the patient you are and will be available to help
• Partnership
  • Be flexible with regard to issues of control
  • Negotiate roles when necessary
  • Stress that you will be working together to address medical problems
• Explanations
  • Check often for understanding
  • Use verbal clarification techniques
• Cultural Competence
  • Respect the patient and his or her culture and beliefs
  • Understand that the patient's view of you may be identified by ethnic or cultural stereotypes
  • Be aware of your own biases and preconceptions
  • Know your limitations in addressing medical issues across cultures
  • Understand your personal style and recognize when it may not be working with a given patient
• Trust
  • Self–disclosure may be an issue for some patients who are not accustomed to Western medical approaches
  • Take the necessary time and consciously work to establish trust

Source: Welch, M. (1998). Enhancing awareness and improving cultural competence in health care. A partnership guide for teaching diversity and cross-cultural concepts in heath professional training. San Francisco: University of California at San Francisco.