Clinical ResCUE Model

VO Needs
Lesson 2: Respect Diversity
Slide 1.2 Taking a Person-Centered Approach to
The ResCUE Model cross-cultural care begins with
respecting diversity. The first part of
Revision
the ResCUE Model makes this
actionable through three steps: Avoid
assumptions; Ask to find out; and Build
rapport.
3.1 One of the best ways to avoid
Ask to find out assumptions is by asking to find out
more about a person’s perspective.
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This is especially important when the

patient’s behaviors or decisions seem
to conflict with those of their
providers. Respectfully inquiring about
diverse perspectives conveys key
information necessary to building a
care plan patients are willing and able
to enact.
3.2 The following patient cases will prompt
Looking below the you to think about surface-level
surface assumptions, and what might be
revealed by asking to find out more.
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Click NEXT to begin.
3.3 Mr. Abad is a 57-year-old man from
Mr. Abad Afghanistan with gastric cancer, who
has vehemently refused chemotherapy
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via a continuous infusion pump.

Without understanding more, what

negative assumptions might be made
about Mr. Abad because of his
decision? Type a few words in the box
below, then click NEXT.
3.4 Asking Mr. Abad to explain his decision
Mr. Abad’s decision reveals his concern that a continuous

Revised: 11/13/19 by MLB

Clinical ResCUE Model
VO Needs
Lesson 2: Respect Diversity
New slide infusion pump could come into conflict
with Islamic religious beliefs and
practices. Wudu is the practice of
ritual purification and cleansing of the
body, including the arms, before
prayer. Maintaining wudu is of the
utmost importance to him.

Without understanding more, Mr. Abad

might be labeled as “difficult” or “non-
compliant.”
3.5 Religion and spirituality can be a
Religion and spirituality prominent aspect of a person’s culture
that impacts medical management,
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disease, and illness. Although
providers may feel uncomfortable
exploring religion, studies show that
most patients want to discuss their
belief systems in relation to
healthcare.

Although this desire is shown to

increase in correlation with illness
severity, it can be helpful to discuss
religion and spirituality in the
outpatient setting as preparation for
any major health events that may
occur.
3.6 Asking about spiritual issues and
Asking about religion needs in a carefully worded manner
can help promote trust and
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communication. Read below for some
questions you may consider.
3.7 Mr. Ivanovich is a 69-year-old recent
Mr. Ivanovich Russian immigrant who presents to a
practice with a slight fever and a
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Revised: 11/13/19 by MLB

Clinical ResCUE Model
VO Needs
Lesson 2: Respect Diversity
cough, aggressively demanding a
Chest CT Scan from every employee he
encounters.

Without understanding more, what

negative assumptions might be made
about Mr. Ivanovich because of his
behavior? Type a few words in the box
below, then click NEXT.
3.8 In this case, asking about Mr.
Mr. Ivanovich’s decision Ivanovich’s previous healthcare
experience reveals that he has spent
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most of his adult life in a place where
people were required to be vociferous
advocates for themselves, often
requesting high-end diagnostic tests
knowing full well that they would be
negotiated down to something more
basic like a chest x-ray.

Without understanding more, Mr.

Ivanovich might be seen as “angry” or
“unreasonable.”
3.9 Individuals who come to the U.S. from
Immigration other countries may have a different
understanding of healthcare, and
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expectations for providers, based on
their past experiences.

On another level, adapting to an

entirely new way of life poses an
enormous source of stress.
Understanding one’s unique migration
experience can help to build rapport
and trust, understand behavior, allay
concerns, and focus on interventions.

Revised: 11/13/19 by MLB

Clinical ResCUE Model
VO Needs
Lesson 2: Respect Diversity
3.10 The Person-Centered Approach focuses
Asking about on the individual’s experience, rather
immigration than making assumptions about their
expectations based on nationality. The
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questions below can help you
respectfully find out more.
3.11 Mrs. Cruz is a 48-year-old woman from
Mrs. Cruz Mexico recently diagnosed with
hypertension, who has not been
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adherent to her medications. When a
provider calls to follow up, Mrs. Cruz is
apologetic about “not getting to the
pharmacy.”

Without understanding more, what

negative assumptions might be made
about Mrs. Cruz because of her non-
adherence? Type a few words in the
box below, then click NEXT.
3.12 In this case, asking about Mrs. Cruz’
Mrs. Cruz’ non- ability to obtain her medication reveals
adherence that she has deferred filling her own
prescriptions to ensure her son, who
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has cystic fibrosis, receives the
medical care he needs.

Although her family has health

insurance, it is basic, and the copays
are often too high for them to afford.
On top of financial barriers, she is
having a hard time managing daily
responsibilities in a new country.

Without understanding more, Mrs. Cruz

might be seen as “lazy” or “non-
compliant.”

Revised: 11/13/19 by MLB

Clinical ResCUE Model
VO Needs
Lesson 2: Respect Diversity
3.13 Social stressors, such as work, family
Social stressors responsibilities, housing, and
socioeconomic issues, can easily
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diminish the relative importance of
health and wellness. When faced with
choices that force an individual to
triage their time or resources between
pressing daily issues or health
promotion and disease prevention,
those with a high-level of social stress
may avoid routine health screening,
present late to diagnosis, or fail to
follow-up.

Individuals may not be forthcoming

about these issues, making it is critical
for providers to maintain a heightened
awareness of these issues and the
ability to approach social context in a
respectful manner.
3.14 The questions below can be helpful in
Asking about stressors respectfully learning more about the
stresses one faces, and the supports
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available to manage them.
3.15 Making an effort to understand what
Review of patient cases underlies health behaviors and
decisions is an important part of
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avoiding assumptions and showing
respect for the individual. Take a
moment to review the cases below
before continuing.
4.1 Through the process of respectfully
Building rapport finding out more, we not only receive
important context for clinical care
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giving, but also discover an opportunity
to build rapport and trust.

Revised: 11/13/19 by MLB

Clinical ResCUE Model
VO Needs
Lesson 2: Respect Diversity

Rapport can be fostered through

finding connections and exhibiting
empathy. It also depends on respecting
differences, where they arise.
4.2 Numerous studies have correlated
The power of rapport good communication, empathy, and
rapport with positive health outcomes
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– from reduced diabetes complications
to faster recovery from the common
cold!

In addition, it is well documented that

good rapport between clinician and
patient dramatically decreases the
chance of malpractice claims.
4.3 Consider the following tips for quickly
Tips for building rapport building rapport with patients of all
cultural backgrounds. Click on each
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gray bar to review, then click NEXT.
Open-ended questions Open-ended questions are essential to
4.4 the process of building rapport and
finding out more about the patient’s
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perspective. Open-ended questions:
Require more than a “yes” or “no”
answer;
help you get to the heart of the matter;
and encourage discussion.

Revised: 11/13/19 by MLB