All-In: Practicing Cultural Humility in Palliative Care

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Stopwatch icon Time to complete: Approximately 20 minutes

About this Course

This introductory eLearning course explores and reinforces the core tenets of cultural humility, and explores how these tenets apply differently to each member of an interprofessional team. Through the use of interactive scenarios, learners are encouraged to empathize with residents and their caregivers, and to reflect on the implications of “typical” care practices on residents with culturally diverse needs.

The idea of power dynamics and accountability within interprofessional teams is explored. Learners explore how cultural humility transcends personal practice – it is not only about self-reflection and curiosity, but also about organizational accountability and commitment to equity.

Learning Objectives:

  1. Define cultural humility and differentiate it from cultural competence and cultural sensitivity.
  2. Recognize the importance of cultural humility in providing person-centered and family-centered care to residents with culturally diverse needs.
  3. Understand the different roles of interprofessional team members in creating cultural safety, and how cultural humility requires creativity and collaboration.
  4. Empathize with residents and their caregivers from diverse cultural backgrounds and understand the importance of tailoring care to meet their needs.

This eLearning course expands on the concepts of cultural humility introduced in the Ontario CLRI’s All-In Palliative Care training. Learners move from awareness-building in that training to skill development in this course. Highlights include recognizing and respecting cultural differences and demonstrating behaviours that support the delivery of high quality, person- and family-centered palliative care.

Complementary eLearning Available

To enhance or refresh team members’ comfort and confidence in speaking with residents and family members about palliative care and end-of-life care, including supporting grief, we recommend the Communication at End-of-Life eLearning series. Learners are engaged with realistic LTC scenarios and presented with possible options for action. Feedback is provided for each response. Coupled with the Cultural Humility eLearning, these two resources stand to advance the communication skills needed by today’s interprofessional team members working in LTC homes.


This course is for interprofessional team members in long-term care, including personal support workers, registered nurses, registered practical nurses, nurse practitioners, social workers, social service workers, dietitians, recreation therapists, physiotherapists, spiritual care providers and physicians. It is also very relevant for students, volunteers, managers, and anyone with an interest in learning more about cultural humility in long-term care settings.

This Course Can:

  1. Support LTC team members in developing and practicing skills in cultural humility as an approach;
  2. Support LTC teams in understanding that cultural humility requires creativity and collaboration, and can be a helpful approach in building more effective teams;
  3. Serve as a refresher for those that have taken other courses on cultural humility and cultural safety;
  4. Augment any cultural humility and cultural safety training previously taken by LTC team members; 
  5. Support LTC teams in exploring how equitable and culturally humble care requires structural transformation, and the support from people at all levels of the organization.


We would like to thank the people who contributed to the development of content for this course.  

Thank you to the network of contributors whose wisdom and experience are reflected in this course. For their time and insight, we thank:

  • Dr. Amit Arya, Palliative Care Physician, Palliative Care Lead at Kensington Health
  • Tyrone Bernardo, Coordinator, Special Projects and Events, City of Toronto Senior Services and Long-Term Care
  • Dr. Ashley Flanagan, Health Research and Policy Manager, National Institute on Ageing
  • Michelle Fleming, Senior Knowledge Broker, Ontario CLRI at Bruyère
  • Nazira Jaffer, Executive Director, Yee Hong Hospice
  • Andrea Loncaric, Project Coordinator, Ontario CLRI at the RIA
  • Dr. Kimberly Lopez, Assistant Professor of Recreation and Leisure, University of Waterloo
  • Lucianna Mazzone, Social Worker, Owen Hill Care Community
  • Nadia Potoczny, Education Coordinator, Ontario CLRI at Bruyère
  • Pauline Schneider, Interprofessional Educator, Ontario CLRI at Bruyère
  • Peace Serwaah, Program Assistant, Ontario CLRI at Bruyère
  • Natalie Spence, Regional Engagement Liaison, Ontario CLRI at Bruyère
  • Safura Syed, Dietitian & PhD candidate at the Nutrition and Aging Lab, University of Waterloo

We also acknowledge residents in long-term care, their families and support communities, as well as the direct-care providers who serve them daily. Through this course, we aim to acknowledge, to amplify, and to make lighter the work of those who are already providing culturally safe care to others.


Armstrong, P., Armstrong, H., Choiniere, J., Lowndes, R. & Struthers, J. (2020). Re-imagining long-term residential care in the COVID-19 crisis. Canadian Centre for Policy Alternatives. Retrieved from

Austerlic, S. (2009). Cultural Humility and Compassionate Presence at the End of Life. Retrieved from 

Bennett, M. J. (2017). Developmental model of intercultural sensitivity. The International Encyclopedia of Intercultural Communication, 1–10. 

Bradley, S., Owusu, P., Przednowek, A., & Armstrong, P. (2017). We’re told, ‘suck it up’; Long-term care workers’ psychological health and safety. Ageing International,  43(1), 91–109. 

Cheng, C. (2005). Achieving cultural competence: A case study of ethnic Chinese elders in Vancouver long-term residential care. Simon Fraser University. Retrieved from 

Fisher-Borne, M., Montana Cain, J., & Martin, S.L. (2014) From mastery to accountability: Cultural humility as an alternative to cultural competence. Social Work Education, 34(2), 165-181. 

Foronda, C. L., Baptiste, D. L., Pfaff, T., Velez, R., Reinholdt, M., Sanchez, M., & Hudson, K. W. (2018). Cultural competency and cultural humility in simulation-based education: An integrative review. Clinical Simulation in Nursing, 15, 42–60. 

Jovanovic, M. (2008). Cultural Competency in Hospice Care: A Case Study of Hospice Toronto. UWSpace. Retrieved from

Juarez, J. A., Marvel, K., Brezinski, K. L., Glazner, C., Towbin, M. M., & Lawton, S. (2006). Bridging the gap: A curriculum to teach residents cultural humility. Family Medicine 38(2), 97-102. Retrieved from

Kagawa-Singer, M., & Backhall, L. J. (2001). Negotiating cross-cultural issues at the end of life. Journal of American Medical Association, 286(23), 2993.

Lanocha, N. (2021). Lessons in stories: Why narrative medicine has a role in pediatric palliative care training. Children, 8(5), 321. 

Miyagawa, L. A. (2020). Practicing cultural humility when serving immigrant and refugee communities. EthnoMed. Retrieved from 

Patneaude, A., & Kett, J. (2020). Cultural responsiveness and palliative care during the COVID-19 pandemic. Palliative Medicine Reports, 1(1), 171–173. 

Rosa, W. (2017). Interprofessional development in palliative care: Cultural humility and a collaborative future for nursing and medicine. Nursing and Palliative Care, 2(2). 

Sue Cragg Consulting & Ontario CLRI. (2017). Supporting Cultural Diversity in Long-Term Care Needs Assessment and Work Plan for 2017-18. Retrieved from

Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125. 

Yancu, C. N., & Farmer, D. F. (2017). Product or process: Cultural competence or cultural humility? Palliative Medicine and Hospice Care – Open Journal, 3(1). 

Yeager, K. A., & Bauer-Wu, S. (2013). Cultural humility: Essential foundation for clinical researchers. Applied Nursing Research, 26(4), 251–256.