CBIS Cultural Competence and Diversity 3 — Questions and Answers
Question 1: A brain injury survivor from a Indigenous background participates in traditional healing ceremonies alongside Western rehabilitation. The CBIS specialist's best approach is to:
- Discourage traditional practices that cannot be scientifically validated
- Integrate or accommodate traditional practices when they do not conflict with safety (Correct answer)
- Document the practices as non-compliance with the treatment plan
- Consult only with the medical team and disregard non-Western approaches
Correct answer: Integrate or accommodate traditional practices when they do not conflict with safety
Integrating culturally meaningful practices that are safe demonstrates respect and can enhance patient engagement in rehabilitation.
Question 2: Health disparities in TBI outcomes for racial and ethnic minorities are most directly linked to which systemic factor?
- Biological differences in brain structure
- Individual lifestyle choices
- Structural inequities including socioeconomic disadvantage and limited healthcare access (Correct answer)
- Lower educational attainment independent of other factors
Correct answer: Structural inequities including socioeconomic disadvantage and limited healthcare access
Structural inequities such as poverty, insurance gaps, and geographic barriers drive TBI outcome disparities across racial and ethnic groups.
Question 3: A CBIS is reviewing a discharge plan for a patient whose family primarily communicates in Spanish and has expressed distrust of the healthcare system. Which strategy is MOST important?
- Provide discharge instructions in English since the patient speaks some English
- Simplify the plan to reduce overwhelm for the family
- Build trust by engaging a community health worker or promotora familiar with the family's background (Correct answer)
- Refer the family to a social worker and proceed with standard discharge
Correct answer: Build trust by engaging a community health worker or promotora familiar with the family's background
Community health workers or promotoras who share the patient's cultural background can bridge trust gaps and improve follow-through on discharge plans.
Question 4: When a TBI patient's cultural norm involves avoiding direct eye contact with authority figures, a clinician should:
- Interpret avoidance of eye contact as a sign of confusion or decreased arousal
- Note it as a potential neurological symptom in the chart
- Recognize it as a culturally normative behavior and not pathologize it (Correct answer)
- Encourage the patient to maintain eye contact as part of social skills training
Correct answer: Recognize it as a culturally normative behavior and not pathologize it
Eye contact norms vary widely across cultures, and misinterpreting cultural behavior as a neurological symptom can lead to diagnostic errors.
Question 5: Which scenario BEST demonstrates intersectionality as relevant to TBI care?
- A patient who has both a TBI and a spinal cord injury
- A Latina woman who is also low-income and uninsured, facing compounded barriers to TBI rehabilitation (Correct answer)
- A patient who speaks two languages and receives bilingual therapy
- A TBI survivor who belongs to both a veterans' group and a disability advocacy organization
Correct answer: A Latina woman who is also low-income and uninsured, facing compounded barriers to TBI rehabilitation
Intersectionality recognizes that overlapping identities (race, gender, class) create compounded and unique experiences of disadvantage in healthcare.
Question 6: A CBIS working with a predominantly African American community should be aware that historical medical mistrust in this population is largely rooted in:
- Lack of education about medical procedures
- Cultural beliefs that illness is a spiritual failing
- Historical abuses such as the Tuskegee Syphilis Study and systemic racism in healthcare (Correct answer)
- Overuse of alternative medicine as a substitute for professional care
Correct answer: Historical abuses such as the Tuskegee Syphilis Study and systemic racism in healthcare
Historical unethical experiments and ongoing systemic racism in medicine are well-documented sources of mistrust among African Americans.
Question 7: Which of the following tools is specifically designed to assess a clinician's cultural competence in healthcare settings?
- Glasgow Coma Scale
- Cultural Competence Assessment (CCA) (Correct answer)
- Rancho Los Amigos Scale
- Functional Independence Measure (FIM)
Correct answer: Cultural Competence Assessment (CCA)
The Cultural Competence Assessment (CCA) is a validated tool used to evaluate healthcare providers' cultural awareness, knowledge, and skills.
CBIS Cultural Competence and Diversity 3
A brain injury survivor from a Indigenous background participates in traditional healing ceremonies alongside Western rehabilitation.
The CBIS specialist's best approach is to: