S.E.L.F.: Lessons in institutional cultural humility approach from an academic health center

Cultural Humility is vital for effective healthcare delivery as it fosters trust, open communication, and addresses health disparities. By engaging in ongoing reflection and recognizing patients' cultural identities, providers can create more equitable and inclusive care. Despite its importance, Cultural Humility is rarely taught systematically in healthcare systems, and even when introduced, it is often not assessed, making accountability and consistent practice difficult. These challenges arise from its focus on attitudes and interpersonal dynamics, which are less tangible and harder to evaluate than clinical skills.

To address these gaps, the authors developed a Cultural Humility educational module (S.E.L.F.) for 30,000 employees across a health system. This program provides insights into its development, content, and implementation. The evaluation aimed to demonstrate the effectiveness of the module's delivery, assess participant confidence and comfort, measure commitment to Cultural Humility, and explore scalability across healthcare systems.

The findings indicate positive outcomes, including improved attitudes, knowledge, and satisfaction. Qualitative analysis highlighted the program's utility and impact, emphasizing that ongoing education is essential for professional growth and advancing health equity. Contrary to the belief that a single training is sufficient, this evaluation underscores the importance of continuous learning and dialogue to enact institutional culture change.

The S.E.L.F. model demonstrates how large healthcare systems can implement accessible training to promote Cultural Humility. By adopting these practices, institutions can model equity-driven behaviors and hold themselves accountable for advancing health equity at all organizational levels.