The 5 Rs of Cultural Humility

In the medical realm, cultural humility describes awareness of how people's culture can impact their health behaviors and using this awareness to develop sensitive approaches in treating patients.

By practicing cultural humility, hospitalists can win the hearts and minds of patients, families and care team members they do not know in their everyday practice. It encourages hospitalists to be humble, learn what is important to the patient and leave every encounter having learned something from the interaction.

The Cultural Humility Workgroup of SHM’s Practice Management Committee developed a simple, universal framework to strengthen communication skills and raise awareness of cultural humility:

1. Committing to self-evaluation and self-critique, wanting to learn from every encounter
2. Readdressing power imbalances in the patient-provider dynamic
3. Developing mutually beneficial partnerships between communities

SHM developed the 5 Rs of Cultural Humility as a simple pocket card tool for hospitalists to incorporate into their practice. The first four Rs (Reflection, Respect, Regard and Relevance) are extrinsically focused, while the fifth R (Resiliency) is intrinsic. The theory posits that if you attain the first four Rs in every interaction, it will serve to continue to build on and develop your own personal resiliency.

1. Reflection
   • Hospitalists will approach every encounter with humility and understanding that there is always something to learn from everyone. 
   • What to ask: What did I learn from each person in that encounter?
2. Respect
   • Hospiatlists will treat every person with the utmost respect and strive to preserve dignity at all times.
   • What to ask: Did I treat everyone involved in that encounter respectfully?
3. Regard
   • Hospitalists will hold every person in their highest regard while being aware of and not allowing unconscious biases to interfere in any interactions
   • What to ask: Did unconscious biases drive this interaction? 
4. Relevance
   • Hospitalists will expect cultural humility to be relevant and apply this practice to every encounter.
   • What to ask: How was cultural humility relevant in this interaction?
5. Resiliency
   • Hospitalists will embody the practice of cultural humility to enhance personal resilience and global compassion
   • What to ask: How was my personal resiliency affected by this interaction? 

The 5 Rs of Cultural Humility is available as a downloadable pocket card that can be easily referenced on rounds and shared with colleagues.