MGH Guides: Culturally Competent and Effective Healthcare: Cross-Cultural Communication

Communicating Across Cultures

All of the principles on this page apply to working with clients/patients who have cultural backgrounds different from your own, but here are some additional tips for working with these populations.

Observe and Listen carefully - you may need to pick up on subtle cues to help you determine whether your patient/client understands and is communicating openly.
Be aware of your own non-verbal tendencies (eye contact, personal space, touch, etc) and whether those tendencies make your patient/client uncomfortable.
Deference and reserve do not automatically indicate agreement. Provide your clients/patients extra opportunities and prompts for questions.
Explore your patient/client's perspective, being particularly sensitive to belief systems and customs.

"How has your condition impacted your daily life?"

"What do you know about your condition and how it works?"

Respect family dynamics. If a client/patient is accompanied by one or more family members, include them in introductions, but ask your client/patient how she or he would like them included in decision making.
Be sensitive to differing views on sexuality and gender roles. Be up front about the typical questions and examinations that might occur, but ask permission before proceeding.

(Based on Betancourt, J.R., Green, A. R., & Carrillo, J. E. (2021). The patient's culture and effective communication. UpToDate. Retrieved February 17, 2023 from https://www.uptodate.com/contents/the-patients-culture-and-effective-communication)

Communicating with Language Differences

Aspects of culture such as norms and attitudes may impact provider-client communication, both verbal and non-verbal. In addition to the the resources on this page, the information sources on the Cultural Knowledge tab can help you learn more about such cultural factors.

Culturally effective providers are able to communicate with Limited English Proficiency (LEP) clients in culturally and linguistically appropriate ways. This means using an interpreter whenever possible and providing translated health information. The following resources have information on using interpreters, sources of translated health information handouts, and additional tools for communicating with LEP clients.

Please visit our Health Literacy and Communication guide for more resources and best practices for communicating with clients.

Language Apps

Medibabble
A free iOS mobile app that assists with language differences between practitioners and patients.

Resources for Patients

Ask Me 3
Ask Me 3® is an educational program that encourages patients and families to ask three specific questions of their providers to better understand their health conditions and what they need to do to stay healthy.
WASCLA Tools for Health Resources
The Tools for Health project offers a collection of materials about consumer rights and how to obtain language services in the 31 most-commonly spoken languages in Washington. The toolkit includes an “ISpeak” card for consumers to bring with them when seeking care which identifies the language they speak, and a “Know Your Rights” flyer to inform both consumers and providers regarding the use of interpreter services in healthcare settings.

Health Information in Different Languages

Deaf Doc
Health education videos presented in American Sign Language for the deaf community.
Health Information Translations
Health Information Translations provides education resources in multiple languages for health care professionals and others to use in their communities. Resources are easy to read and culturally appropriate.
SPIRAL: Selected Patient Information in Asian Languages
SPIRAL aims to increase access to Asian-language health information for consumers and health care providers. The SPIRAL web site is a collection of links to Asian-language patient care documents that have been created by authoritative sources and are freely available on the World Wide Web. Links are organized by topic and language.
MedlinePlus Health Information in Multiple Languages
Consumer health information from MedlinePlus, a trusted source, in 60+ languages. Browse by language or health topic.
EthnoMed Multilingual Patient Education
Patient Education handouts in multiple languages. Browse by language or health topic. Even includes materials for low vision clients.
ECHO Multilingual Programming
Handouts and video clips on various health topics in several different languages.

An Introduction to Spanish for Health Care Workers by Robert O. Chase; Clarisa B. Medina de Chase
ISBN: 9780300124262
Publication Date: 2009-03-10
e-Book. Click title for access.
Now in its third edition, this widely used textbook is designed for students with little or no formal background in Spanish. It provides the necessary language and vocabulary to facilitate better communication between health care providers and the growing Spanish-speaking community. This classroom text uses readings, exercises, and interactive activities such as challenging and enjoyable improvisation to integrate structure, Spanish medical vocabulary, and colloquial terms that nurses, doctors, dentists, and allied health professionals need most. Rich cultural notes explain Latino customs and communication styles.

Working with Interpreters

Bilingual Health Communication by Elaine Hsieh
Call Number: DIV CULHU BILINGUAL
ISBN: 9781138999459
Publication Date: 2016
The electronic version of this book allows unlimited user access. A physical copy of the book is also available for borrowing from Bellack Library.

Address Language Differences: Tool #9
Strategies for addressing language differences from the Agency for Healthcare Research and Quality's Universal Precautions Toolkit.
Working with Medical Interpreters
Sindhu, K. (2020, May 13). Wolters Kluwer Expert Insights.

Evidence

Functions of small talk in healthcare interpreting: an exploratory study in medical encounters facilitated by healthcare interpreters.
Álvaro Aranda, C., & Lázaro Gutiérrez, R. (2022). Functions of small talk in healthcare interpreting: an exploratory study in medical encounters facilitated by healthcare interpreters. Language & Intercultural Communication, 22(1), 21–34. https://doi-org.treadwell.idm.oclc.org/10.1080/14708477.2021.2024842
The impact of a health introduction course for medical interpreters in the healthcare sector.
Abdulkadir, L. S., Sodemann, M., Gudex, C., Möller, S., & Nielsen, D. S. (2021). The impact of a health introduction course for medical interpreters in the healthcare sector. Nordic Journal of Nursing Research, 41(2), 109–116. https://doi-org.treadwell.idm.oclc.org/10.1177/2057158520975188
Healthcare Provider Perspectives Regarding Use of Medical Interpreters During End-of-Life Conversations With Limited English Proficient Patients.
Silva, M. D., Adelman, R. D., Singh, V., Gupta, R., Moxley, J., Sobota, R. M., Tsai, S., Abel, B. T., & Reid, M. C. (2022). Healthcare Provider Perspectives Regarding Use of Medical Interpreters During End-of-Life Conversations With Limited English Proficient Patients. American Journal of Hospice & Palliative Medicine, 39(2), 220–227. https://doi-org.treadwell.idm.oclc.org/10.1177/10499091211015916
Prevalent practices amongst healthcare professionals in paediatric settings in using medical interpreters for families with limited national language proficiency: A narrative scoping review
Ogunnaike, Y., Hyde, A., & Somanadhan, S. (2022). Prevalent practices amongst healthcare professionals in paediatric settings in using medical interpreters for families with limited national language proficiency: A narrative scoping review. International Journal of Nursing Studies Advances, 4. https://doi-org.treadwell.idm.oclc.org/10.1016/j.ijnsa.2022.100109

Culturally Competent and Effective Healthcare

Communicating Across Cultures

Communicating Across Cultures

All of the principles on this page apply to working with clients/patients who have cultural backgrounds different from your own, but here are some additional tips for working with these populations.

Further Reading

Communicating with Language Differences

Aspects of culture such as norms and attitudes may impact provider-client communication, both verbal and non-verbal. In addition to the the resources on this page, the information sources on the Cultural Knowledge tab can help you learn more about such cultural factors.

Language Apps

Resources for Patients

Health Information in Different Languages