Cultural competence in the multidisciplinary rehabilitation setting: are we falling short of meeting needs?

We present issues relevant to rehabilitation providers who wish to develop or improve their cultural competence in their medical setting and interdisciplinary team. Two case scenarios are presented that illustrate the complexities introduced into the medical rehabilitation setting by the increased numbers of minority patients in the United States in the last 20 years. Professional codes of conduct and practice are discussed for 3 rehabilitation disciplines: physiatry, rehabilitation psychology and neuropsychology, and nursing. The current status of and improvements in professional and continuing medical education are then outlined. Challenges faced by rehabilitation providers seeking to become more culturally competent in their practices are related in the following topic areas: (1) continuing education in language and cultural issues, (2) assessment instruments appropriate for diverse patient populations, (3) majority versus minority population values and beliefs, (4) impact of the immigration and acculturation experiences, (5) health care and insurance coverage issues, (6) attitudes and beliefs about disability, and (7) past experiences with medical professionals and systems. Suggestions for developing and applying enhanced cultural awareness in clinical rehabilitation practice are provided.