Clearinghouse for Clinical Rotations

Cross cultural communications general


National Center for Cultural Competence
The mission of the National Center for Cultural Competence (NCCC) is to increase the capacity of health and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems. This site includes publications and information for providers and practitioners including assessment tools. Two examples are given below:

Promoting Cultural and Linguistic Competency: Self-Assessment Tools

  • Self Assessment Checklist for Behavioral Health Personnel Providing Services and Supports to Children, Youth and their Family
  • Self Assessment Checklist for Personnel Providing Primary Health Care Services


Working on Common Cross-Cultural Communication Challenges by Marcelle E. DuPraw and Marya Axner (1997)
DuPraw and Axner describe the six fundamental patterns of cultural differences (communication styles, attitudes toward conflict, approaches to completing tasks, decision-making styles, attitudes toward disclosure, and approaches to knowing) and suggest ways for respecting our differences and working together. For the full text, click here.

Cross-Cultural Communication by Michelle LeBaron (July 2003)
LeBaron outlines and demonstrates through examples the ideas, attitudes, and behaviors of four variables of cross-cultural communication: time and space; fate and personal responsibility; face and face-saving; and nonverbal communication. For the full text, click here.


The Spirit Catches You and You Fall Down by Anne Fadiman (1998)
An Amazon review:
Lia Lee was born in 1981 to a family of recent Hmong immigrants and soon developed symptoms of epilepsy. By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: “What the doctors viewed as clinical efficiency, the Hmong viewed as frosty arrogance. “The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling.” Sherwin Nuland said of the account. “There are no villains in Fadiman’s tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty—and their nobility.”

The Dancing Healers: A Doctor’s Journey of Healing with Native Americans by Carl Hammershlag (1998)
A Library Journal review:
The author spent 20 years as a physician working among Native Americans in the Southwest.  He began with a conventional medical outlook but grew to regard the traditional Indian ways of ritual, healing, and dying with awe and admiration. This is a glowing personal account of his experiences, which he claims have enabled him to meld Jewish and Native American spiritual concepts and become a “dancing healer,” one who is able to help others pursue the meaning and wisdom of life and cure their diseases.

Note:You are likely to find the two books listed above in your local bookstore or visit


Health Literacy and Patient Safety
This video is part of a health literacy educational toolkit developed by the American Medical Association Foundation.

A World of Differences: Understanding Cross-Cultural Communication
Produced by University of California, A WORLD OF DIFFERENCES explores 14 different ways—verbal and nonverbal—that two people from different cultures can fail to understand each other. Some of these differences reflect language and translation problems. But many others involve subtle differences in etiquette, gestures, values, norms, rituals, expectations, and other important cross-cultural variations. Cross-Cultural communication can be difficult, inaccurate, and highly stressful. When we are immersed in an environment where the language, attitudes, values and behaviors are alien to our own experience, we may suffer disorientation and frustration—an experience known as “culture shock.” This is because culture affects almost all behaviors. Culture governs how close we stand while talking with another person. Culture governs how we use (or avoid) eye contact. Culture governs how we express (or suppress) powerful emotions such as joy, disapproval, and anger. Culture even governs the expression (if not the actual experience) of love, because culture determines whether we feel free to express love in public settings by holding hands, hugging, or kissing the person we love.
Note:To buy the video, click here.