22 Cases and Articles to Help Bring Diversity Issues into Class Discussions

Explore more.

  • Course Materials
  • Diversity, Equity, and Inclusion

T he recent civic unrest in the United States following the death of George Floyd has elevated the urgency to recognize and study issues of diversity and the needs of underrepresented groups in all aspects of public life.

Business schools—and educational institutions across the spectrum—are no exception. It’s vital that educators facilitate safe and productive dialogue with students about issues of inclusion and diversity. To help, we’ve gathered a collection of case studies (all with teaching notes) and articles that can encourage and support these critical discussions.

These materials are listed across three broad topic areas: leadership and inclusion, cases featuring protagonists from historically underrepresented groups, and women and leadership around the world. This list is hardly exhaustive, but we hope it provides ways to think creatively and constructively about how educators can integrate these important topics in their classes. HBP will continue to curate and share content that addresses these equity issues and that features diverse protagonists.

Editors’ note: To access the full text of these articles, cases, and accompanying teaching notes, you must be registered with HBP Education. We invite you to sign up for a free educator account here . Verification may take a day; in the meantime, you can read all of our Inspiring Minds content .

Leadership and Inclusion

John Rogers, Jr.—Ariel Investments Co.

—by Steven S. Rogers and Greg White

Gender and Free Speech at Google (A)

—by Nien-hê Hsieh, Martha J. Crawford, and Sarah Mehta

The Massport Model: Integrating Diversity and Inclusion into Public-Private Partnerships

—by Laura Winig and Robert Livingston

“Numbers Take Us Only So Far”

—by Maxine Williams

For Women and Minorities to Get Ahead, Managers Must Assign Work Fairly

—by Joan C. Williams and Marina Multhaup

How Organizations Are Failing Black Workers—and How to Do Better

—by Adia Harvey Wingfield

To Retain Employees, Focus on Inclusion—Not Just Diversity

—by Karen Brown

From HBR 's The Big Idea:

Toward a Racially Just Workplace: Diversity efforts are failing black employees. Here’s a better approach.

—by Laura Morgan Roberts and Anthony J. Mayo

Cases with Protagonists from Historically Underrepresented Groups

Arlan Hamilton and Backstage Capital

—by Laura Huang and Sarah Mehta

United Housing—Otis Gates

—by Steven Rogers and Mercer Cook

Eve Hall: The African American Investment Fund in Milwaukee

—by Steven Rogers and Alterrell Mills

Dylan Pierce at Peninsula Industries

—by Karthik Ramanna

Maggie Lena Walker and the Independent Order of St. Luke

—by Anthony J. Mayo and Shandi O. Smith

Multimedia Cases:

Enterprise Risk Management at Hydro One, Multimedia Case

—by Anette Mikes

Women and Leadership Around the World

Monique Leroux: Leading Change at Desjardins

—by Rosabeth Moss Kanter and Ai-Ling Jamila Malone

Kaweyan: Female Entrepreneurship and the Past and Future of Afghanistan

—by Geoffrey G. Jones and Gayle Tzemach Lemmon

Womenomics in Japan

—by Boris Groysberg, Mayuka Yamazaki, Nobuo Sato, and David Lane

Women MBAs at Harvard Business School: 1962-2012

—by Boris Groysberg, Kerry Herman, and Annelena Lobb

Beating the Odds

—by Laura Morgan Roberts, Anthony J. Mayo, Robin J. Ely, and David A. Thomas

Rethink What You “Know” About High-Achieving Women

—by Robin J. Ely, Pamela Stone, and Colleen Ammerman

“I Try to Spark New Ideas”

—by Christine Lagarde and Adi Ignatius

How Women Manage the Gendered Norms of Leadership

—by Wei Zheng, Ronit Kark, and Alyson Meister

Is this list helpful to you? What other topics or materials would you like to see featured in our next curated list? Let us know .

Related Articles

case study about cultural diversity

We use cookies to understand how you use our site and to improve your experience, including personalizing content. Learn More . By continuing to use our site, you accept our use of cookies and revised Privacy Policy .

case study about cultural diversity

Understanding Cultural Diversity in Healthcare

Case Studies

See culture in action.  Case studies bring you up close and personal accounts from the front lines of American hospitals and other countries on the issues of cultural diversity in healthcare.

The following case studies are presented by topic and contain quick recaps of some common cultural misunderstandings. More detailed information can be found in Caring for Patients from Different Cultures.

SHARE YOUR STORY HERE

Do you have a case study or field report about cultural diversity in healthcare that you would like to share? We want to hear about it!

Go

  • Stereotyping
  • Communication
  • Time Orientation
  • Religious Beliefs and Customs
  • End of Life
  • Mental Health
  • Traditional Medicine
  • Additional Case Studies

Lamar Johnson, a thirty-three-year-old African American patient had been deemed a “frequent flyer” (a term used to describe those who keep coming to the hospital for the same reason, often assumed to be drug seekers) by the nurses and doctors in the emergency department. Each time he came in complaining of extreme headaches he was given pain medication and sent home. On this last admission, he was admitted to the ICU, where Courtney, a nurse, had just begun working. When she heard him described as a frequent flyer, she asked another nurse why he was thought to be a drug seeker. She was told, “He has nothing else better to do; I’m not sure why he thinks we can supply his drug habits.” Although Courtney says her instincts told her that something else was going on, she saw his tattoos, observed his rough demeanor, and went along with what everyone else was saying. While she was wheeling him to get a CT scan, Mr. Johnson herniated and died. It turned out that he had a rare form of meningitis and truly was suffering from severe headaches. If some of the staff had not stereotyped him as a drug seeker on one of his earlier visits, perhaps his life could have been saved. This incident left a lasting impression on Courtney, who vowed not ever to judge a patient on his looks, and to trust her instincts, rather than let others influence her nursing care.

While taking a course on cultural diversity, Anike Oghogho, a nurse from Nigeria, recognized his tendency to stereotype. He related an example of an African American male patient who presented with a swollen left foot. The patient, Jefferson Bell, kept ringing the call light and asking for more pain medication. Anike said that in the past, he would have assumed Mr. Bell was merely seeking pain meds. This time, however, he reassessed the patient. He discovered that Mr. Bell’s fourth and fifth toes were more red and swollen and had pus. Anike summoned the physician and Mr. Bell was eventually taken to the operating room for incision and drainage of his left foot. Stereotyping could have severely harmed the patient; fortunately, Anike had learned the lesson of not stereotyping in his class.

Hilda Gomez, a monolingual Spanish-speaking patient, came in to the clinic three days in a row to complain of abdominal pain. The first two times, the staff used her young, bilingual daughter to translate. They then treated Mrs. Gomez for the “stomach ache” she described. The staff didn’t understand why she kept returning with the same problem. Finally, on her third visit, the nurse located a Spanish-speaking interpreter. It turned out that Mrs. Gomez needed treatment for a sexually transmitted disease, but was too embarrassed to talk about her sexual activity with her daughter as interpreter. It taught the staff an important lesson.

Helena became very frustrated while caring for Gwon Chin, a seventy-nine-year-old Korean man who had recently suffered a stroke. Her frustration and impatience were aimed at Mr. Gwon’s wife and daughter. Since Mr. Gwon spoke only Korean, she had asked his bilingual daughter to tell her father not to get out of bed because his gait was unsteady. Helena was afraid he would fall and hurt himself. Throughout the day, however, Mr. Gwon continued to attempt to get out of bed. He became very agitated and his wife and daughter seemed almost afraid of him. When Helena questioned the daughter about it, she would only say that her father was “confused.” Eventually Helena called on a Korean nurse to help her. When the nurse told Mr. Gwon not to get out of bed because he might fall, he asked in a surprised tone, “Why would I fall?” When the nurse explained that he was unsteady from the stroke, the patient was shocked. “I had a stroke?!” Helena was in disbelief. He had been on the unit for two days; how could he not know he had had a stroke? When she questioned Mr. Gwon’s daughter about this, she explained that her brother has been out of town. He would be back today and tell him. When Helena, stunned by this, asked the daughter why she didn’t tell her father, she replied, “I could never tell my father what is wrong with him and what he can or can’t do. It would be disrespectful for me to do that when he has always told me what to do and what was wrong.”

Although Helena was angry that Mr. Gwon’s daughter preferred having her father possibly fall and hurt himself than tell him why he was in the hospital and that he must stay in bed, Helena remained silent. She asked the Korean nurse to explain to the patient how the numbness on his left side would make walking difficult so he should remain in bed. She also added that his son would be in later that day and would explain everything to him. After that, the patient remained calm and stayed in bed.  [For more discussion, see Chapter 2 of Caring for Patients From Different Cultures .]

Juanita Avelar was a forty-nine-year-old Mexican woman with kidney failure and diabetes. She relied on her niece and nephew to drive her to the clinic and was often late. In Mexican culture, the needs of the family typically take precedence over those of an individual. The nurses learned to take this into account when scheduling her appointments, and they allowed plenty of time for the family to discuss Mrs. Avelar’s condition as a family. When certain tests and medications required specific timing for accuracy and effectiveness, they stressed the importance of clock time.

Mrs. Mendez, a sixty-two-year-old Mexican patient, had just had a femoral-popliteal bypass graft on her right leg. She was still under sedation when she entered the recovery room, but an hour later she awoke and began screaming, “ Aye! Aye! Aye ! Mucho dolor ! [Much pain].” Robert, her nurse, immediately administered the dosage of morphine the doctor had prescribed. This did nothing to diminish Mrs. Mendez’s cries of pain. He then checked her vital signs and pulse; all were stable. Her dressing had minimal bloody drainage. To all appearances, Mrs. Mendez was in good condition. Robert soon became angry over her outbursts and stereotyped her as a “whining Mexican female who, as usual, was exaggerating her pain.”

After another hour, Robert called the physician. The surgical team came on rounds and opened Mrs. Mendez’s dressing. Despite a slight swelling in her leg, there was minimal bleeding. However, when the physician inserted a large needle into the incision site, he removed a large amount of blood. The blood had put pressure on the nerves and tissues in the area and caused her excruciating pain.

She was taken back to the operating room. This time, when she returned and awoke in recovery, she was calm and cooperative. She complained only of minimal pain. Had the physician not examined her again and discovered the blood in the incision site, Mrs. Mendez would have probably suffered severe complications.

Bobbie, a nurse, had two patients who had both had coronary artery bypass grafts. Mr. Valdez, a middle-aged Nicaraguan man, was the first to come up from the recovery room. He was already hooked up to a morphine PCA (patient-controlled analgesia) machine, which allowed him to administer pain medication as needed in controlled doses and at controlled intervals. For the next two hours, he summoned Bobbie every ten minutes to request more pain medication. Bobbie finally called the physician to have his dosage increased and to request additional pain injections every three hours as needed. Every three hours he requested an injection. He continually whimpered in painful agony.

Mr. Wu, a Chinese patient, was transferred from the recovery room an hour later. In contrast to Mr. Valdez, he was quiet and passive. He, too, was in pain, because he used his PCA machine frequently, but he did not show it. When Bobbie offered supplemental pain pills, he refused them. Not once did he use the call light to summon her. [For more discussion, see Chapter 5 of Caring for Patients From Different Cultures .]

Pepe Acab, a Filipino patient, was being discharged on Coumadin, a blood thinner, to prevent clotting. Vitamin K reverses the effect of the drug and must be avoided. Normally, Libby, his nurse, would tell such patients to avoid foods like liver, broccoli, brussels sprouts, spinach, Swiss chard, coriander, collards, cabbage, and any green, leafy vegetables. She suddenly realized, however, that there might be other foods he should avoid. She spoke with Mr. Acab and his wife, and got a list of foods he commonly ate. She then did some research and discovered that two foods on the list—soybeans and fish liver oils—are very high in Vitamin K. She was then able to educate him properly on what to avoid.

Susi Givens, a thirty-seven-year-old woman with two children, was horseback riding one day when a snake startled her horse. She was thrown off and landed on a stump, resulting in massive internal injuries. She was rushed to the hospital, where the surgical team discovered that there was a large amount of blood in her abdomen and that she needed to have a kidney removed.

Mrs. Givens had a medical alert card identifying her as a Jehovah’s Witness and stating that under no circumstances was she to receive blood. Her physician knew this but felt impelled by his oath to save lives to give her a blood transfusion. The hospital was unable to locate her husband, so the physician decided to transfuse her.

His actions saved her life; however, she was not grateful. She sued her doctor for assault and battery and won a $20,000 settlement. [For more discussion, see Chapter 4 of Caring for Patients From Different Cultures .]

Sol and Deborah Meyers, an Orthodox Jewish couple, came to the hospital late Friday night when Deborah was in active labor. When she gave birth at midnight, the nurses suggested that Sol accompany her to the postpartum unit and then return home to rest. He thanked them, then explained that he could not drive home because it was the Sabbath. The nurses suggested that he call a friend or relative to pick him up. Sol replied that he could not use the phone on the Sabbath, and even if he made a call, no one would answer because all his friends and relatives were also Sabbath-observant. The nurses understood and arranged for him to stay in his wife’s room, but were left wondering why Sol could drive to the hospital but not drive back home.

In the morning, a nurse noticed that Deborah had not received breakfast and was instead eating snacks from the bag she had brought from home. The nurse asked if she needed help ordering food, and Deborah explained that the hospital-provided meals did not adhere to kosher dietary laws. The nurse, trying to be helpful, suggested that Sol purchase kosher food from the gift shop on the first floor, but was told that due to the laws of the Sabbath, Sol was forbidden to ride in an elevator or handle money. The nurse left the room, confused but glad the couple had brought some food of their own.  

Later that afternoon, the nurse returned to check on Deborah, and made friendly conversation by asking how the baby’s nursery was decorated at home. She was surprised to learn that in Orthodox tradition, minimal preparations are made before a baby’s birth, and the baby’s room was not set up at all. Intrigued, she asked Sol to explain some of the laws of Sabbath observance. She learned that the couple had been able to drive to the hospital because, according to halacha (Jewish law), childbirth is considered an emergency requiring the breaking of the Sabbath, but that once the birth was over, they were not allowed to drive home due to the absence of an emergency.

Raj Singh, a seventy-two-year-old Sikh from India, had been admitted to the hospital after a heart attack. He was scheduled for a heart catheterization to determine the extent of the blockage in his coronary arteries. The procedure involved running a catheter up the femoral artery, located in the groin, and then passing it into his heart, where special x-rays could be taken. His son was a cardiologist on staff and had explained the procedure to him in detail.

Susan, his nurse, entered Mr. Singh’s room and explained that she had to shave his groin to prevent infection from the catheterization. As she pulled the razor from her pocket, she was suddenly confronted with the sight of shining metal flashing in front of her. Mr. Singh had a short sword in his hand and was waving it at her as he spoke excitedly in his native tongue. Susan got the message. She would not shave his groin.

She put away her “weapon,” and he did the same. Susan, thinking the problem was that she was a woman, said she would get a male orderly to shave him. Mr. Singh’s eyes lit up again as he angrily yelled, “No shaving of hair by anyone!”

Susan managed to calm him down by agreeing. She then called her supervisor and the attending physician to report the incident. The physician said he would do the procedure on an unshaved groin. At that moment, Mr. Singh’s son stopped by. When he heard what had happened, he apologized profusely for not explaining his father’s Orthodox Sikh customs. [For more discussion, see Chapter 4 of Caring for Patients From Different Cultures .]

Ricky, a five-year-old African American male with asthma, was supposed to take a controller medication (asthma inhaler #1, Steroid) twice a day as a preventative measure. When he was wheezing and/or having breathing problems, he was supposed to take asthma inhaler #2 (Albuterol) as an emergency medication. Dr. Arabel felt that she had given very clear instructions on how to use the two inhalers, but Ricky’s mother kept bring him back to the clinic with a lot of wheezing; his asthma was obviously not being well controlled. As it turned out, Ricky had not been using the inhalers as directed. His mother, who was enrolled in school, was overwhelmed and did not understand the significance of his asthma and the need to use the two inhalers properly. On one of the visits, Dr. Arabel learned that Ricky’s grandmother had accompanied them to the clinic. She brought the grandmother into the exam room, and explained everything to her. Once the grandmother became involved, everything changed. There were no more emergency room/urgent clinic visits and Ricky’s asthma was much better controlled. He only rarely needed the “emergency” Albuterol compared to earlier. Involving the grandmother had made a tremendous difference.  [For more discussion, see Chapter 6 of Caring for Patients From Different Cultures .]

Julia was treating Mrs. Torres, an elderly Hispanic patient who was intubated. When she needed information, she would direct her questions to the eldest son. She assumed he would be the family spokesperson. However, he rarely had an answer for her. While in many cases the eldest son would be the decision-maker, in this case he was not. The youngest daughter held the durable power of attorney for medical decisions. It was several days before anyone even thought to ask the family who held power of attorney. The staff had made the mistake of stereotyping. Once Julia learned that the youngest daughter was responsible for making medical decisions for her mother, such decisions were reached more quickly and without unnecessary strain on the rest of the family. [For more discussion, see Chapter 6 of Caring for Patients From Different Cultures .]

Juan Martinez, a thirty-six-year-old Mexican man with second-degree burns on his hands and arms, posed a problem. The skin grafts had healed, and there was now danger that the area would stiffen and the tissue shorten. The only way to maintain maximum mobility was through regular stretching and exercise. The nurses explained to Mr. Martinez’s wife that feeding himself was an essential therapeutic exercise. The act of grasping the utensils and lifting the food to the mouth stretches the necessary areas. Mrs. Martinez seemed to understand the nurses’ explanation, yet she continued to cut her husband’s food and put it in his mouth.

When Linda, one of his nurses, observed this, she took the fork out of Mrs. Martinez’s hand and told Mr. Martinez to feed himself because he needed to exercise his arms and hands. Linda again explained to Mr. Martinez’s wife how important it was for him to do it himself. Mrs. Martinez appeared skeptical but did not argue. Mr. Martinez looked at Linda peevishly and made a feeble attempt at eating. His wife watched with pity. Linda knew from seeing Mr. Martinez when his wife was not around that he was perfectly capable of feeding himself. Linda left the room. When she looked in five minutes later, she saw Mrs. Martinez once again cutting her husband’s food and putting it in his mouth. [For more discussion, see Chapter 6 of Caring for Patients From Different Cultures .]

Before taking my course in cultural diversity, Jennifer, like all the nurses on her unit, tried to avoid taking care of Naser Assharj, a middle-aged Iranian Muslim patient, because the entire staff found his family to be very “uptight and demanding.” The nurses rotated care for this patient, because no one was willing to care for him more than one day at a time. When Jennifer learned a bit about Muslim culture, however, she understood why his family kept demanding a private room and made such a fuss over his meals. It was their way of showing love and care for their family member. He needed a private room so that, as devout Muslims, the family could pray together five times a day as commanded by Allah. It was also important that his food be halal , or follow the Muslim laws of what is permissible (see Chapter 5). Once Jennifer realized this, she contacted her supervisor and arranged to have the patient moved to a private room and spoke to the dietician regarding his food. The family members were very grateful for her efforts, and became much easier to deal with.

Amira Faroud was a three-year-old Middle Eastern patient, newly diagnosed with type 1 diabetes. Understanding the importance of involving the entire family in the patient’s care, Lisa tried to get the patient’s father, Mr. Faroud, to participate. She had seen other fathers reluctant to learn in the past, but eventually, they all were persuaded. But not Mr. Faroud. He would not even consider it. Eventually, Lisa changed the teaching plan to include Amira’s grandmother rather than her father, and all went well. [For more discussion, see Chapter 7 of Caring for Patients From Different Cultures .]

A female resident could not get a Hispanic mother to sign consent for a procedure for her child; she, too, insisted on waiting for her husband. In this case, however, it was urgent that the procedure be done as soon as possible. The resident asked an older male physician to speak to the mother. Apparently, the combination of his age and gender were enough to convince her to sign consent without speaking first to her husband.

Amiya Nidhi was a young woman in her twenties who had recently immigrated to the United States from India. She was in the hospital to give birth. Her support person was her sister, Marala. Marala kept telling her to get an epidural, but Amiya said that even though she would like one, she could not get one; her husband would not allow it. Cindy, her nurse, overheard the conversation. Having learned that husbands are the authority figure in the traditional Indian household, she went to speak with Mr. Nidhi. She explained why an epidural would be advisable. She said that he seemed pleased that she came to him about it. He said he would think about it, and let her know. About thirty minutes later, he came to Cindy and told her that he would like his wife to have an epidural. Everyone was pleased. By using cultural competence, Cindy helped her patient get the care she wanted, while still respecting the authority structure within the family. [For more discussion, see Chapter 7 of Caring for Patients From Different Cultures .]

An Iranian mother and father admitted their thirteen-month-old child, Ali, to the pediatrics unit. After three days of rigorous testing and examination, it was discovered that Ali had Wilms’ tumor, a type of childhood cancer. Fortunately, the survival rate is 70 to 80 percent with proper treatment.

Before meeting with the pediatric oncologist to discuss Ali’s treatment, Mr. and Mrs. Mohar were concerned and frightened, yet cooperative. Afterward, however, they became completely uncooperative. They refused permission for even the most routine procedures. Mr. Mohar would not even talk with the physician or the nurses. Instead, he called other specialists to discuss Ali’s case.

After several frustrating days, the oncologist decided to turn the case over to a colleague. He met with the Mohars and found them extremely cooperative. What caused their sudden reversal in behavior? The fact that the original oncologist was a woman.

Several weeks later, it became necessary to insert a permanent line into Ali to administer his medication. The nurse attempted to show Mrs. Mohar how to care for the intravenous line, but Mr. Mohar stopped her. “It is my responsibility only. You should never expect my wife to care for it.” Throughout each encounter with the hospital staff, Mrs. Mohar remained silent and deferred to her husband. [For more discussion & explanation, see Chapter 7 of Caring for Patients From Different Cultures .]

A twenty-eight-year-old Arab man named Abdul Nazih refused to let a male lab technician enter his wife’s room to draw blood. She had just given birth. When the nurse finally convinced Abdul of the need, he reluctantly allowed the technician in the room. He took the precaution, however, of making sure Sheida was completely covered. Only her arm stuck out from beneath the blankets. Abdul watched the technician intently throughout the procedure. [For more discussion & explanation, see Chapter 7 of Caring for Patients From Different Cultures .]

Fatima, an eighteen-year-old Bedouin girl from a remote, conservative village, was brought into an American air force hospital in Saudi Arabia after she received a gunshot wound to her pelvis. Her cousin Hamid had shot her. Her family had arranged for her to marry him, as was local custom, but she wanted nothing to do with him. She was in love with someone else. An argument ensued, and Hamid left. He returned several hours later, drunk, and shot Fatima, leaving her paralyzed from the waist down.

Fatima’s parents cared for her for several weeks after the incident but finally brought her to the hospital, looking for a “magic” cure. The physician took a series of x-rays to determine the extent of Fatima’s injuries. To his surprise, they revealed that she was pregnant. Sarah, the American nurse on duty, was asked to give her a pelvic exam. She confirmed the report on the x-rays. Fatima, however, had no idea that she was carrying a child. Bedouin girls are not given any sex education.

Three physicians were involved in the case: an American neurosurgeon who had worked in the region for two years; a European obstetrics and gynecology specialist who had lived in the Middle East for ten years; and a young American internist who had recently arrived. No Muslims were involved. The x-ray technician was sworn to secrecy. They all realized they had a potentially explosive situation on their hands. Tribal law punished out-of-wedlock pregnancies with death.

The obstetrician arranged to have Fatima flown to London for a secret abortion. He told the family that the bullet wound was complicated and required the technical skill available in a British hospital.

The only opposition came from the American internist. He felt the family should be told about the girl’s condition. The other two physicians explained the seriousness of the situation to him. Girls in Fatima’s condition were commonly stoned to death. An out-of-wedlock pregnancy is seen as a direct slur upon the males of the family, particularly the father and brothers, who are charged with protecting her honor. Her misconduct implies that the males did not do their duty. The only way for the family to regain honor was to punish the girl by death.

Finally, the internist acquiesced and agreed to say nothing. At the last minute, however, he decided he could not live with his conscience. As Fatima was being wheeled to the waiting airplane, he told her father about her pregnancy.

The father did not say a word. He simply grabbed his daughter off the gurney, threw her into the car, and drove away. Two weeks later, the obstetrician saw one of Fatima’s brothers. He asked him how Fatima was. The boy looked down at the ground and mumbled, “She died.” Family honor had been restored. The ethnocentric internist had a nervous breakdown and had to be sent back to the United States.

Sofia Toledo, a sixty-five-year-old upper-class Mexican woman, refused to be dialyzed when she learned that her usual dialysis station was unavailable. She said she would wait until her next treatment, when she could have her customary place. Unfortunately, this was not a viable alternative. Missing a treatment could result in serious complications or even death. When Julia, the nurse, asked her why the new station was unacceptable, Mrs. Toledo was very vague.

Julia finally called Mrs. Toledo’s daughter, and together they solved the problem. Mrs. Toledo’s usual station was unusual in that neither the nurses nor the patients at the other dialysis stations could see it very well. The rest of the stations were very open, designed for high visibility by the nurses. To be dialyzed, the patient had to remove her pants and don a patient gown. Her underwear was exposed during the process. Mrs. Toledo’s sense of modesty, a quality very strong in Hispanic women, made the more open station intolerable.

Julia said that at the time she found Mrs. Toledo’s behavior annoying. She and the other nurses saw it as a delay that would prevent them from leaving on time. They did not want to have the extra work of moving machinery or remixing the dialysate. She did not understand the importance of modesty in Hispanic culture, but she did realize that it was important to Mrs. Toledo, a normally “compliant” patient. In this case, a screen or curtain might have alleviated the problem.

Kayla was a staff nurse on a medical-surgical floor when she first met Dr. Ling, an Asian physician. They got along well until Kayla transferred to the diabetes clinic. Clinic protocols allow nurses to order new medications, adjust medications, and order lab work as needed, as long as they get a physician to sign the order. When Kayla asked Dr. Ling for his signature, he would rudely question why she felt the medication was necessary, and on a few occasions refused to sign, stating that he disagreed with the medication she had ordered. After learning more about Asian culture in a cultural competence course, she realized he probably perceived her approach as showing a lack of respect, despite the fact that she was following clinic protocols. She then changed her approach. Rather than just asking him to sign the medication order, she would go to him, explain the situation with the patient, tell him what she was considering, and ask him what he would like done. Kayla reported that Dr. Ling was much more receptive to this approach, probably because it allowed him to feel respected and in control. Taking the extra time to do this repaired the lines of communication between them. Although it could be argued that Dr. Ling is the one who should have changed his behavior, that is probably less realistic than having Kayla apply her cultural knowledge to achieve the results that she wanted.

Josepha, a Filipina nurse, did not get along well with her coworkers. The nursing staff on her unit was composed of two Anglo Americans, two Nigerians, and Josepha. She felt her coworkers were taking advantage of her, because they would ask for assistance whenever they saw her. Josepha was angry over what she perceived as obvious discrimination. She cheered herself by reminding herself that she was a better nurse than the others; she could do her work without their help. In addition, she was not lazy like they were. She took care of her patients; the other nurses insisted that their patients take care of themselves.

One day, Rena, one of the Anglo nurses, was unusually friendly, so Josepha opened up to her. As they got to know each other better, Josepha shared her feelings of being taken advantage of. Rena explained that it was common procedure for the nurses to help each other with their work. Rena confided that the others thought Josepha was being snobbish and proud because she never asked for help. They saw what Josepha had interpreted as laziness on the part of the others as being team players. Rena also explained that American health care providers believe that independence is important and encourage self-care among their patients.

Josepha was stunned by Rena’s revelations. Rena offered to help bridge the communication gap between Josepha and her coworkers. She explained to the others that Josepha was trying to save face by never asking for help; she didn’t want them to think she couldn’t do her job. Josepha began to teach her patients self-care and to ask her coworkers for assistance. Over time, the cross-cultural misunderstandings were resolved, and Josepha’s coworkers became her best friends.

Leslie reported that her hospital had recently hired five new Korean nurses. Unfortunately, they did not get along well with the rest of the nursing staff. They rarely said “please” or “thank you” and were generally perceived as rude. Leslie was reading an earlier edition of this book and suddenly realized that the Korean nurses were older than the other nurses on the unit and probably felt that “please” and “thank you” were implicit. Leslie then showed the other staff nurses the section on “Please” and “Thank You.” She reported that morale on the unit is much improved. Sometimes, all it takes is a little understanding.

An American physician and professor, consulting in Japan, was about to address a group of university physicians; it was fully understood by all that he would give his talk in English. He nevertheless prepared a brief introduction in Japanese, concluding with the statement, “My Japanese is limited, so with your permission, I will continue in English.” When he asked his Japanese secretary if his statement was grammatically correct, she seemed uncomfortable. On further questioning she reluctantly admitted that, grammar aside, it was not appropriate for someone of his stature to ask the audience for permission, and that this would diminish the audience’s ability to respect anything else he said. Instead, she suggested, he should merely announce that he would continue in English. In this context “asking permission” was entirely pro forma in American culture; it would be seen as a polite gesture. In Japan, however, it was considered inappropriate from someone in a position of authority, and would likely result in a loss of respect for the person doing the asking. [For further discussion, see Chapter 8 of Caring for Patients From Different Cultures .]

A labor and delivery nurse reported that the most difficult patient she ever attended was Robabeh Farag, an Iranian woman, who yelled and screamed for the entire duration of her labor. After she delivered their child, her husband presented her with a three-karat diamond ring. When her nurse commented on the expensive gift, she responded dramatically, “Of course. He made me suffer so much!” Iranian custom is to compensate a woman for her suffering during childbirth by giving her gifts. The greater the suffering, the more expensive the gifts she will receive, especially if she delivers a boy. Her cries indicate how much she is suffering. A young Iranian doctor recently told me that when his wife has a baby, he will present her with a diamond ring or a watch. [For further discussion, see Chapter 9 of Caring for Patients From Different Cultures .]

Naomi Freedman, an Orthodox Jewish woman, was in labor with her third child. She had severe pains, which were alleviated only by back rubs between contractions. Her husband asked Marge, a nurse, to remain in the room to rub his wife’s back. Because she had two other patients to care for, Marge began to instruct him on how to massage his wife. To Marge’s surprise, he interrupted her, explaining that he could not touch his wife because she was unclean. Marge, assuming he meant she was sweaty from labor, suggested that he massage her through the sheets. In an annoyed tone, he explained that he could not touch his wife because she was bleeding. Marge was further surprised when, while Naomi began pushing, her husband left the room and did not return until after their baby was born.

Marge later learned from Mrs. Freedman that in halacha (Jewish law), the blood of both menstruation and birth render a woman spiritually unclean and therefore physical contact between husband and wife was prohibited. Mrs. Freedman also explained that in some Orthodox communities, husbands are prohibited from being present at birth in non-emergency situations.

[For further discussion, see Chapter 9 of Caring for Patients From Different Cultures .]

Maria Salazar was a thirty-two-year-old recent immigrant from Mexico with an infected incision from a caesarean section. She asked Tonya, her nurse, for some water. When Tonya grabbed the bedside pitcher to refill it, she discovered it was full. When Tonya pointed this out to her, she answered in Spanish, “Yes, but I have a fever and a cough. If I drink that cold water I will get even more sick.” Tonya, who spoke some Spanish, was taking a course in cultural diversity at the time and was elated to see hot/cold beliefs in action. She then emptied the ice water and refilled it with warm water. Curious, Tonya asked her if there were any changes she would like to see in her treatment. Mrs. Salazar nodded her head. She said she didn’t understand why the nurses kept insisting she do things that would make her ill—things like taking a shower. Didn’t they understand she had a fever and had just delivered a baby? And why did they want her to spend so much time walking, when she knew she should stay in bed and rest as much as possible? [For further discussion, see Chapter 9 of Caring for Patients From Different Cultures .]

Raul Santiago was a Hispanic male in his seventies who had been in the hospital for seven months. He had been admitted for abdominal pain, but it soon became apparent that he had advanced stage pancreatic cancer. Mr. Santiago had 12 children, who all conspired to avoid using the word “cancer” in front of their father or to even acknowledge his fatal prognosis. Instead, they referred to his condition as “abdominal pain.” During the time he was in the hospital, Mr. Santiago became close to the nursing staff. One day while Tiffany was administering his pain medication, he looked directly at her and said with resignation, “I’m going to die, aren’t I?” Without waiting for her to respond, he continued. He explained to Tiffany that he didn’t want his children to suffer because of his illness, and he knew that if they knew that he knew he had cancer, it would cause them great distress. He told her that he was ready to be with his wife who had died two years earlier. He was content to pretend to be ignorant of his disease if it eased his family’s suffering. Whether or not it would have caused his children to suffer if they knew he knew, or if it would have been a relief is unknown. But the nurses honored his decision.

A fifty-two-year-old African American man named William Jefferson was admitted to the critical care unit with a diagnosis of pneumonia. On admission, he was offered an Advance Directive, which he refused, saying that God would help him with his illness. His lung cancer had gone into remission after radiation treatment; he believed that God had helped him through that illness, and would help him through the current one. He thought that signing a Do Not Resuscitate form or Advance Directive would be a sign of giving up or losing faith in God. Unfortunately, he died ten days later, after enduring a great deal of suffering. [For further discussion, see Chapter 10 of Caring for Patients From Different Cultures .]

Ngoc Ly, a twenty-five-year-old Vietnamese man, was hit by a car while riding his bicycle to work. Paramedics were able to resuscitate him, but the physician at the local trauma center determined that Mr. Ly was clinically brain dead. He placed him on life support until the family could be notified.

An interpreter explained Mr. Ly’s condition to his wife and parents. They nodded in understanding and quietly left the hospital. Normally, the staff neurosurgeon would then have pronounced Mr. Ly dead and removed him from the ventilator, but he was suddenly called to surgery.

Later that afternoon, Mr. Ly’s family met with Dr. Isaacs, the physician they had spoken to earlier. Dr. Isaacs intended to tell them of the plan to pronounce Mr. Ly dead and discontinue the ventilator, but the Lys had other plans. They informed him that they had consulted a specialist who said this was not the right time for him to die. Dr. Isaacs was confused. What kind of specialist would make such a recommendation? An astrologer who had read Ngoc Ly’s lunar chart advised that his death be postponed until a more auspicious date.

The physician had never encountered a situation like the one now facing him. Fearing legal repercussions if he did not abide by the family’s request, he agreed to keep Mr. Ly on life support until further notice. A little less than a week later, the Lys called to tell him that Ngoc could now die. [For further discussion, see Chapter 10 of Caring for Patients From Different Cultures .]

Canh Cao was a thirty-four-year-old Vietnamese woman who was treated by a medical student at a public health clinic. She had made several visits for various physical complaints—abdominal pain, backache, headaches. She was diagnosed with somatoform pain disorder—preoccupation with pain in absence of physical findings.

Several months later, Cao attempted suicide. She was sent for evaluation to a psychiatrist, who at that point diagnosed her with depression. She had been depressed all along, but the medical student was both inexperienced and unaware of cultural issues, so he missed it. [For further discussion, see Chapter 11 of Caring for Patients From Different Cultures .]

Amelia avoided a potential child abuse report with a Cambodian family, the Chhets. The child had suspicious burn marks on her body. Instead of assuming child abuse, she first interviewed both parents separately. Both explained that they had treated their child using cupping and coining to make her feel better and help her recover more quickly. Amelia then explained to her supervisor what she had learned from the parents, and they decided it was not a child abuse situation. The Chhets practiced the traditional form of cupping. [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

Mexican American mother refused to use cooling measures in caring for her febrile infant, despite medical instructions to do so. Mrs. Lopez had called the hospital because her infant’s temperature was very high. She was told to give the baby a mild analgesic and a cool bath and then to bring her in. Mrs. Lopez ignored both cooling instructions and, to the consternation of the medical staff, brought the child wrapped in several layers of blankets, outer garments, undershirt, and several pairs of socks. When asked why she did not follow the instructions given her, she replied, “He must sweat the fever out. Besides, he could get pneumonia from the night air and die.” [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

Fariba was asked to interpret for Fereydoon Jalili, an Iranian man who had come to the hospital with gastrointestinal bleeding. Mr. Jalili spoke some English, and when the physician had asked him what medications he was taking, he told him he didn’t take any. When Fariba was brought in to interpret, she began talking to him about his health. During their conversation, he admitted that he took vitamins to stay healthy and he was very proud of the fact that he had never been sick. He also mentioned that he took two aspirins a day for his heart after seeing a commercial on television which said it prevented heart attacks. When Fariba asked him why he didn’t tell the doctor about the vitamins and aspirin, he said that he didn’t consider anything he bought over-the-counter to be a “real” medication. Once the physician learned what he had been taking, he educated Mr. Jalili on appropriate aspirin consumption, since that was the likely cause of his GI bleed. [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

Jen, a second-year medical student, was on a pediatrics visit learning how to perform a newborn exam. As she followed the attending into the patient’s room, she noticed that the baby’s mother was sitting on the side of the crib talking in Spanish to her husband. The attending started to explain to Jen what is important to notice about a baby and what to look for on the physical exam, and proceeded to ask her questions about the causes of pneumonia and meningitis in the newborn period. As they were talking, the infant’s mother came over to the crib. In an attempt to welcome her into their conversation, Jen said “hello,” and proceeded to compliment her on her beautiful child. As soon as she finished the sentence, the mother said “thank you,” but frowned, and her demeanor changed slightly—she stopped smiling, and looked nervous.

Jen wondered what she had done wrong, and suddenly realized that the family was Mexican, and her complimentary words, intended as a tool to gain the mother’s trust, resulted in causing her distress. Remembering what she had learned about Mexican culture and mal de ojo (evil eye), she touched the baby’s hand, and looked back at the mother. The change was remarkable—the mother smiled back at her, and nodded her head. She did not say anything, but her smile and nod tacitly communicated her gratitude for preventing mal de ojo. [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

An eighty-three-year-old Cherokee woman named Mary Cloud was brought into the hospital emergency room by her grandson, Joe, after she had passed out at home. Lab tests and x-rays indicated that she had a bowel obstruction. After consulting with Joe, the attending physician called in a surgeon to remove it. Joe was willing to sign consent for the surgery, but it would not be legal; the patient had to sign for herself. Mrs. Cloud, however, refused; she wanted to see the medicine man on the reservation. Unfortunately, the drive took an hour and a half each way, and she was too ill to be moved. Finally, the social worker suggested that the medicine man be brought to the hospital.

Joe left and drove to the reservation. He returned three hours later, accompanied by a man in full traditional dress complete with feather headdress, rattles, and bells. The medicine man entered Mrs. Cloud’s room and for forty-five minutes conducted a healing ceremony. Outside the closed door, the stunned and amused staff could hear bells, rattles, chanting, and singing. At the conclusion of the ceremony, the medicine man informed the doctor that Mrs. Cloud would now sign the consent form. She did so and was immediately taken to surgery. Her recovery was uneventful and without complications. . [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

Emma Chapman was a sixty-two-year-old African American woman admitted to the coronary care unit because she had continued episodes of acute chest pain after two heart attacks. Her physician recommended an angiogram with a possible cardiac bypass or angioplasty to follow. Mrs. Chapman refused, saying, “If my faith is strong enough and if it is meant to be, God will cure me.”

When Judy, her nurse, asked her what she thought had caused the problem, she said she had sinned and her illness was a punishment. According to her beliefs, illnesses from “natural causes” can be treated through nature (e.g., herbal remedies), but diseases caused by “sin” can be cured only through God’s intervention. Remember, treatment must be appropriate to the cause. In addition, Mrs. Chapman may have felt that to accept medical treatment would be perceived by God as a lack of faith.

Mrs. Chapman finally agreed to the surgery after speaking with her minister, whom Judy called to the hospital. [For further discussion, see Chapter 12 of Caring for Patients From Different Cultures .]

A fifty-year-old Mexican woman named Sandra Ramirez came to the ER with epigastric pain. She told the nurse that she had been experiencing the pain constantly for the past week, but denied any nausea, vomiting, diarrhea, or constipation. There had been no changes in her diet or bladder or bowel function. She revealed that when she had experienced similar pain in the past, she was treated with an unknown medication that helped her greatly. The nurse who was interviewing her had just been introduced in class to the concept of the 4 C’s, so she also asked the patient what she thought the problem was. The patient called her condition “stressful pain,” and elaborated that it wasn’t the pain that caused stress, but that stress caused the pain. It turned out that the medication that had helped her in the past was Xanax. She had stopped taking it eight days earlier; the pain began seven days ago. Had the nurse not gotten the patient’s perspective on her condition—that it was related to stress—they would have done just a standard abdominal workup and perhaps not discovered that it was due to anxiety.

Emma Chapman, a sixty-two-year-old African American woman, was admitted to the coronary care unit because she had continued episodes of acute chest pain after two heart attacks. Her physician recommended an angiogram with a possible cardiac bypass or angioplasty to follow. Mrs. Chapman refused, saying, “If my faith is strong enough and if it is meant to be, God will cure me.” When her nurse asked what she thought caused her heart problems, Mrs. Chapman said she had sinned and her illness was a punishment. Her nurse finally got her to agree to the surgery by suggesting she speak with her minister. If she hadn’t learned about Mrs. Chapman’s religious beliefs while asking what she that was the cause of her heart problems, she might not have thought to contact her clergyman.

Olga Salcedo was a seventy-three-year-old Mexican woman who had just had a femoral-popliteal bypass. Anabel, her nurse, observed that Mrs. Salcedo’s leg was extremely red and swollen. She often moaned in pain and was too uncomfortable to begin physical therapy. Yet during her shift report, her previous nurse told Anabel that Mrs. Salcedo denied needing pain medication. Later that day, Anabel spoke with the patient through an interpreter and asked what she had done for the pain in her leg prior to surgery. Mrs. Salcedo said that she had sipped herbal teas given to her by a curandero (a traditional healer; see Chapter 12); she didn’t want to take the medications prescribed by her physician. Anabel, using cultural competence, asked Mrs. Salcedo’s daughter to bring in the tea. Anabel paged the physician about the remedy and brought it to the pharmacist, who researched the ingredients. Because there was nothing contraindicated, the pharmacist contacted Mrs. Salcedo’s physician, who told her she could take the tea for her pain. The next day, Mrs. Salcedo was able to go to physical therapy and was much more motivated and positive in demeanor. Although it took some time to coordinate the effort, in the end, it resulted in a better patient outcome. Had Anabel not asked what she had been using to cope with her pain, it is likely Mrs. Salcedo would have delayed physical therapy and thus her recovery.

Jorge Valdez, a middle-aged Latino patient, presented with poorly managed diabetes. When Dr. Alegra, his physician, told him that he might have to start taking insulin, he became upset and kept repeating, “No insulin, no insulin.” Not until Dr. Alegra asked Mr. Valdez what concerns he had about insulin did he tell her that both his mother and uncle had gone blind after they started taking insulin. He made the logical—though incorrect—assumption that insulin caused blindness. In this case, the patient expressed his fears, and because the physician was competent enough to pick up on them and explore them, she was able to allay them. In many cases, however, unless the physician specifically asks about concerns, patients will say nothing and simply not adhere to treatment. By asking, the health care provider can correct any misconceptions that can interfere with treatment.

A 35-year-old Jewish woman went in for a baseline mammogram.  A lump was discovered.  When discussing it with the radiologist, the woman questioned him about all the possible treatments if it turned out to be cancerous, as well as all the side effects of the treatment.  The radiologist had little patience for her questions; he repeatedly told her they should wait until after they get the results of the biopsy before they start discussing the side effects of chemotherapy and radiation.  The woman, however, felt that she had to know everything possible about the potential negative outcome; only through knowledge could she feel a degree of control.  The lump turned out to be benign, but she went into the biopsy procedure much more relaxed than she would have had she not known every possible eventuality.

A 27-year-old pregnant Mexican woman who had been living in the US for two years went to see a genetic counselor at the urging of a friend.  XFAP tests indicated the possibility of Down syndrome in her unborn child.  She declined the offer of amniocentisis, however, based upon the manner of the genetic counselor, who told her not to be afraid and to do whatever she wanted.  The patient later said she interpreted the lack of directiveness as an indication that the positive screening was “no big deal” and that if there were any real danger, the counselor would have insisted on the test.

A middle-aged Mexican female patient suffering from acute liver cirrhosis with abdominal ascites, began to experience extreme shortness of breath. The physician, a liver specialist, asked her to sign consent for an abdominal tap.  The patient refused, saying, “I am going to wait until my husband arrives.”  The physician was not happy with her response as he felt it was necessary to do the procedure as soon as possible.  Fortunately, the patient’s husband arrived within an hour, the paracentesis was done, and her shortness of breath was minimized.

An African American man in his 40s, suffering from diabetes and hypertension presented to his physician, complaining of “feeling poorly”.  When questioned, he admitted that he was not taking his insulin regularly; only when he felt that his sugar was high.

A Chinese woman in her 60s was diagnosed with cancer and scheduled to receive chemotherapy.  She was unaware of her diagnosis, due to her son’s insistence.  The staff was uncomfortable with having to withhold this information from her, so they asked her whether she wanted to know her diagnosis and why she was receiving chemotherapy medication.  Her answer was no.  She said, “Tell my son; he will make all of the decisions.”  They resolved the matter by having hersign a Durable Power of Attorney, appointing her son as legal decision-maker.  They were thus able to remove the legal and ethical obstacles to her care.

Bobbie, the nurse, had two patients who had both had coronary artery bypass grafts. Mr. Valdez, a middle-aged Nicaraguan man, was the first to come up from the recovery room. He was already hooked up to a morphine PCA (patient-controlled analgesia) machine, which allowed him to administer pain medication as needed in controlled doses and at controlled intervals. For the next two hours, he summoned Bobbie every ten minutes to request more pain medication. Bobbie finally called the physician to have his dosage increased and to request additional pain injections every three hours as needed. Every three hours he requested an injection. He continually whimpered in painful agony. Mr. Wu, a Chinese patient, was transferred from the recovery room an hour later. In contrast to Mr. Valdez, he was quiet and passive. He, too, was in pain, because he used his PCA machine frequently, but he did not show it. When Bobbie offered supplemental pain pills, he refused them. Not once did he use the call light to summon her.

Nurses usually report that “expressive” patients often come from Hispanic, Middle Eastern, and Mediterranean backgrounds, while “stoic” patients often come from Northern European and Asian backgrounds. As a young Chinese man told me, “Even since I was little boy, my family watched dubbed Chinese movies, and by watching many of the male protagonists state ‘I’d rather shed blood than my tears,’ it is imbedded in my mind that crying or showing pain shows my weakness.” However, simply knowing a person’s ethnicity will not allow you to predict accurately how a patient will respond to pain; in fact, there are great dangers in stereotyping, as the next case demonstrates.

Mrs. Mendez, a sixty-two-year-old Mexican patient, had just had a femoral-popliteal bypass graft on her right leg. She was still under sedation when she entered the recovery room, but an hour later she awoke and began screaming, “Aye! Aye! Aye! Mucho dolor! [Much pain].” Robert, her nurse, immediately administered the dosage of morphine the doctor had prescribed. This did nothing to diminish Mrs. Mendez’s cries of pain. He then checked her vital signs and pulse; all were stable. Her dressing had minimal bloody drainage. To all appearances, Mrs. Mendez was in good condition. Robert soon became angry over her outbursts and stereotyped her as a “whining Mexican female who, as usual, was exaggerating her pain.”

Reports from the Field

Field reports are submitted by students, peers and colleagues in the healthcare profession. Do you have field report to share?   Submit it here. Thank you!

A Filipino Case Study

case study about cultural diversity

Patient safety and satisfaction have always been a priority in nursing, but they can be compromised by nursing priority and time constraint. With higher patient to nurse ratios, increase patient acuity, managed health care system, and higher demands for quality patient care, nurses today are working harder.   Read More

Conditions in Kenya, Africa

case study about cultural diversity

HE DIDN’T ANSWER

Rounds have started. I move from bed to bed with the doctors, three patients at a time. Bed 3 contains Matu, Mugambi and Karanja. Matu’s spine is beginning to curve from six weeks of clutching his knees so he doesn’t touch the cold, contaminated floor. His spot at the foot of the bed is tinged yellow. He’s 4. He was treated for malaria and discharged two weeks ago, but with no family to claim him he’s still hereŠand getting sick again.   Read More

A Case of Polygamy

case study about cultural diversity

This is a case of a 49-year-old Hispanic male who was involved in a motor vehicular accident while not wearing a seat belt. He suffered multiple chest injuries, fractured ribs and humerus and sustained severe subdural bleeding. He was unconscious when brought to the Emergency Department, where a trauma work-up was done. His CT scan of the head revealed severe bleeding and was inoperable. His pupils were fixed and dilated.    Read More

case study about cultural diversity

I was on a pediatrics visit at Harbor-UCLA hospital learning how to perform a newborn exam. As I followed the Peds attending into the patient’s room, I noticed that the baby’s mom was sitting on the side of the crib talking in Spanish to her husband. The attending, I’ll call her Dr. Gabe, started to explain what is important to notice about a baby, what to look for on the physical exam, and proceeded to ask     Read More

Homelessness in our Hometown: The Hidden Community

In today’s society a person’s worth is determined by their material possessions, the size of their home, what kind of car they drive and how well they dress. How are you viewed by society if you have nothing and live on the streets? What kind of treatment do you receive if you chose to live this way?  Read More

Cultural Incompetence

case study about cultural diversity

Maria was a 4-month-old Hispanic infant with a history of Down’s syndrome and an ASD/VSD congenital anomaly. After her cardiac surgery, she had several complications that resulted in a lengthy ICU stay. During that time she had two cardio-pulmonary arrests, which resulted in the need to try to contact her parents. Her parents visited infrequently due to work obligations and the need to care for their other children.   Read More

A Vietnamese Death

case study about cultural diversity

I was invited to do a presentation on cultural competence to the hospice staff and a large, successful, and very white hospital. As part of my preparation, I visited the in patient hospice one afternoon. At the end of my visit I sat with the nurses as they debriefed the shift. One, a leader of some sort, said that she was pleased I would talk to them since she felt that she needed to know more.   Read More

Dangerous Dominican Powder

case study about cultural diversity

An article in the Nov. 6, 2003 issue of the New York Times, written by Richard Pérez-Peña, reported on a highly poisonous powder sold.   Read More

Cultural diversity: a human-centered approach that thrives on openness, curiosity, and respect

Carlos Garcia-Mauriño

Carlos Garcia-Mauriño, European Data Protection Officer, Madrid. Supports McKinsey´s internal functions and client-serving teams in tackling complex data privacy matters in Europe, LATAM and MEA.

 Stephanie Spangler

Stephanie Spangler, Associate General Counsel. Supports McKinsey's internal functions and client-serving teams on data risk and data management issues.

January 11, 2022 Cultural diversity is an integral attribute of McKinsey’s legal department. With our colleagues calling 46 different countries “home” and speaking over 20 different languages, our efforts to promote cultural diversity are driven by both necessity and a desire to celebrate the unique backgrounds and customs of our colleagues. This gives our legal team the ability to dive into the value of our team’s diversity and learn how to incorporate the richness of cultural identity. Today, 54 percent of the more than 250 colleagues in the legal department are based outside of the United States—and many of our members speak English as their second or even third language. For this reason and so many others, cultural diversity is an important part of who we are and impacts every aspect of our work with the firm.

One of the firm’s major values  focuses on embracing diversity with curiosity and respect. While McKinsey has a deep, longstanding commitment to advancing diversity, equity, and inclusion  in business, this resonates equally in McKinsey’s legal department where it continues to support formalized events and initiatives  that provide learning opportunities about other cultures. This allows us to incorporate those lessons into our day-to-day involvements within the department and with other firm colleagues.

Diverse leadership teams are strongly connected to an increase in performance . Recent McKinsey research reaffirms this business case for diversity. For example, in the case of ethnic and cultural diversity, our research shows that in 2019, the top-quartile companies outperformed those in the fourth quartile by 36 percent in profitability .

The benefit of diversity extends beyond profits. In particular, cultural diversity provides the foundation to create a truly rich and rewarding workplace by enabling the exchange of different perspectives to inform decision making. Certainly, there are challenges: scheduling meetings with colleagues across time zones; the late night or early morning Zoom meetings that come with it; communicating within high-context and low-context cultures —and even understanding the meaning of emojis in different countries. But we navigate these challenges by relying on a foundation of respect and curiosity as we engage, communicate, and learn from each other.

Through these events and initiatives, colleagues are proud to bring their whole selves to work, including when it comes to cultural identity and uniqueness. We are privileged to be part of a global team that encompasses such cultural richness, and we relish this fact and are grateful for it. The breadth of the firm’s focus on cultural diversity allows us to respect and support each other in our ongoing reflections, our collective and individual identities, and to deepen our understanding and insight into others. This, in turn, helps reduce misjudgments and builds bridges for healthier, more fulfilling interactions with other colleagues both in and out of the legal department.

The legal department aims to provide world-class legal service, enhanced risk management, and thought partnership to firm colleagues. Our ability to do this relies on a human-centered approach that values each member’s identity and contributions. Our cultural backgrounds are always there with us and influence the way we look at the world, the way we look at others, the way we live, and the way we work. It’s not something we can leave outside the office and then pick up again when the workday is over.

As we continue to embrace our cultural differences, Legal aims to create an inclusive environment that brings out the value in the diverse perspectives of each colleague. This in-depth conversation has only just begun, and we’re excited for the meaningful, inspiring, open dialogue that no doubt lies ahead as we continue to explore and celebrate the cultures that make us strong, unique, and prepared for the future.

Advertisement

Advertisement

Teachers responding to cultural diversity: case studies on assessment practices, challenges and experiences in secondary schools in Austria, Ireland, Norway and Turkey

  • Open access
  • Published: 27 July 2020
  • Volume 32 , pages 395–424, ( 2020 )

Cite this article

You have full access to this open access article

case study about cultural diversity

  • Barbara Herzog-Punzenberger 1 , 2 ,
  • Herbert Altrichter   ORCID: orcid.org/0000-0002-5331-4199 1 ,
  • Martin Brown 3 ,
  • Denise Burns 3 ,
  • Guri A. Nortvedt 4 ,
  • Guri Skedsmo 4 , 5 ,
  • Eline Wiese 4 ,
  • Funda Nayir 6 ,
  • Magdalena Fellner 7 ,
  • Gerry McNamara 3 &
  • Joe O’Hara 3  

24k Accesses

31 Citations

10 Altmetric

Explore all metrics

A Correction to this article was published on 19 August 2020

This article has been updated

Global mobility and economic and political crises in some parts of the world have fuelled migration and brought new constellations of ‘cultural diversity’ to European classrooms (OECD 2019 ). This produces new challenges for teaching, but also for assessment in which cultural biases may have far-reaching consequences for the students’ further careers in education, occupation and life. After considering the concept of and current research on ‘culturally responsive assessment’, we use qualitative interview data from 115 teachers and school leaders in 20 lower secondary schools in Austria, Ireland, Norway and Turkey to explore the thinking about diversity and assessment practices of teachers in the light of increasing cultural diversity. Findings suggest that ‘proficiency in the language of instruction’ is the main dimension by which diversity in classrooms is perceived. While there is much less reference to ‘cultural differences’ in our case studies, we found many teachers in case schools trying to adapt their assessment procedures and grading in order to help students from diverse backgrounds to show their competencies and to experience success. However, these responses were, in many cases, individualistic rather than organised by the school or regional education authorities and were also strongly influenced and at times, limited by government-mandated assessment regimes that exist in each country. The paper closes with a series of recommendations to support the further development of a practicable and just practice of culturally responsive assessment in schools.

Similar content being viewed by others

case study about cultural diversity

Teaching Culturally Diverse Pupils: How Ready Are Scottish Student-Teachers?

case study about cultural diversity

Who Are the Teachers and Who Are the Learners? Teacher Education for Culturally Responsive Pedagogy

case study about cultural diversity

Learning to Be a Culturally Responsive Teacher in the Global North: A Call for Critical Teacher Education

Avoid common mistakes on your manuscript.

1 Introduction and background

Consistent with changing patterns of migration and the belief that school systems have a significant role to play in responding to ‘increasing social heterogeneity’ (OECD 2009 , p. 3), many education systems have developed policy solutions and initiatives for the creation of culturally responsive classrooms (Ford and Kea 2009 ). As stated by the United Nations (UN), education systems around the world should be united in the commitment to ‘ensure inclusive and equitable quality education and promote lifelong learning opportunities for all’ (UN 2016 ). Providing cause for optimism, the 2018 TALIS report indicates that strategies on how to deal with ethnic and cultural discrimination are taught in 80% of the participating schools. On the other hand, giving cause for concern, more than 50% of teachers in the participating countries did not feel well-prepared for the challenges of a multicultural learning environment and were not confident in adapting their teaching to the cultural diversity of students (OECD 2019 , pp. 98).

However, it is not only teaching that offers potential pitfalls for migrant students aiming to achieve to their full potential. There are other connected practices such as assessment that, according to Arbuthnot ( 2017 ) among others, need to be considered in all learning environments, as assessment has the potential to act as a powerful catalyst to improve teaching and learning (Hattie 2009 ) and in most countries also opens up entry to further education and employment (Black and Wiliam 2012 ; Shepard 2006 ; Popham 2009 ). In addition, for migrant students, there is also a historical and cultural dilemma that needs to be overcome, as the dominant modes of assessment, together with the assessment competencies of teachers, are also, by tradition, linked with the cultural, historical and political agendas that exist in migrant-receiving countries and can have a positive or negative effect on student learning (Crichton 1998 ; Isaacs 2010 ; LeMétais 2003 ). Analysis of PISA test scores in mathematics, for example, reveals that students with the same migration background perform differently in some OECD countries compared to others, even when indicators that affect student performance such as socioeconomic status are considered (OECD 2016 ). In other words, the assessment regimes that exist in different countries can, in some way, have a corollary effect on student achievement, indicating a need to re-examine the effects of assessment regimes on classroom practice (Brown 2007 ).

The initial conceptualisation for this research—which was part of a three-year European Union-funded project entitled Aiding Culturally Responsive Assessment in Schools (ACRAS) [1] [1] ERASMUS+-Project 'Aiding Cultural Responsive Assessment in Schools' (ACRAS; 2016-1-IE01-KA201-016889)—came from studying how teachers cope with and adapt to the assessment needs of culturally diverse classrooms. A review of the research on teaching, learning, assessment and diversity revealed that there is a body of literature concerning the educational needs of students not belonging to the respective mainstream culture and about responsive pedagogies aiming to enhance their learning. Such issues have until now been more widely studied in North America and other English-speaking countries than in other European countries (Nortvedt et al. 2020 ). Most of the previous research and conceptual work seems to focus on the implications of cultural and linguistic diversity for teaching and learning, rather than on assessment. So, we find empirical studies of teaching and learning in different subjects and of different minority groups (e.g. Gutiérrez 2002 ; Schleppegrell 2007 ; Lesaux et al. 2014 ), proposals for culturally responsive teaching (e.g. Aceves and Orosco 2014 ; Gay 2010 ; Ladson-Billings 1995a , b ; 2014) and the role of school culture in providing a climate for students where they can experience educational equality and cultural empowerment (Banks and Banks 2004 ). Moreover, there are studies indicating approaches for student-centred pedagogy more generally and responsiveness towards children’s contribution in joint activities (Brook Chapman de Sousa 2017 ) and emphasising preparation for culturally responsive and inclusive practices as part of teacher education (Warren 2017 ; Young 2010 ). In this paper, we cannot do justice to the entire literature on culturally and linguistically responsive teaching but will focus (in the next section) on the much smaller body of research on assessment under conditions of cultural diversity.

In Europe, with some exceptions (e.g. Mitakidou et al. 2015 ), there is only a limited number of studies that have specifically explored the challenges relating to the assessment of migrant students as perceived by teachers. To fill the lacuna of research, the current study sought to explore: aspects of diversity that teachers in European classrooms attend to in assessment situations, the strategies that teachers use in assessment to take account of diversity, and the supportive and inhibiting conditions encountered by teachers when adapting to diversity in their approaches to assessment. While there are huge differences between European countries with respect to the amount and history of their diversity and with respect to the characteristics of their education systems, Europe may offer the opportunity to study a type of cultural and linguistic diversity in education which is different from the one found in North America, i.e. with respect to the number and diversity of newly immigrated, displaced refugees.

The countries participating in this study differ widely with regard to the proportion of migrants in their schools. Austria has the highest average share of students (25.3%) with first languages other than the language of instruction (Statistik Austria 2017 ). In Ireland and Norway, the percentage is between 8 and 15% (Eurostat 2017 ). Whilst no official figures are available for the total proportion of migrant students in Turkey, as a result of the political crisis in Syria, of the 4 million Syrian refugees that currently reside in Turkey, approximately 1.7 million are children of which 645,000 are enrolled in schools (UNICEF 2018 ). Additionally, different types of governance in education are in place in the four countries: While Austria, Ireland and Turkey represent a model of ‘State-Based Governance’ with high levels of bureaucracy and little school autonomy (Windzio et al. 2005 , p. 11–16), Norway has a school system which is characterised by a relatively high degree of local autonomy (Telhaug et al. 2006 ; or in Windzio et al.’s terms: a ‘Scandinavian Governance’).

The first section of this paper describes the different uses and potential implications of assessment, which is followed by an analysis of proposed solutions for the assessment of migration background students. Then, the methodology used in the study is described. The penultimate section provides an analysis of the research findings derived from a series of case studies on assessment practices in 20 lower secondary schools in the four countries. The paper concludes with a discussion of the research findings and implications for further action in the field of assessment and cultural diversity.

2 Assessment and cultural diversity in education

Assessment is one of the basic building blocks of institutionalised schooling. At the classroom level, it can be used formatively to enhance learning (Hattie 2009 ) and to improve teaching (Black and Wiliam 2012 ; Shepard 2006 ). However, assessment can also be used to make distinctions in a field of diverse performances and, either through teachers or through externally devised assessments or a combination of both, can be used to sort students for future education or working life (Eder et al. 2009 ).

The modern ‘meritocratic’ type of schooling is built on the idea that learning opportunities, results and certificates must not be distributed according to social class, economic power, religious denomination, and gender, but solely through a fair appreciation of actual performance (Fend 2009 ). Nevertheless, research shows that this idea of equity is not fulfilled in many cases and that in reality, the grades of students are correlated to categories of social background (Alcott 2017 ). This is also true for language and culture aspects: assessment performance and grades are impaired when the assessment language is not the first language of the student (Nusche et al. 2009 ; Padilla 2001 ). In many cases, assessment practices seem to be in place which deny students the opportunity to achieve their true potential (Brown-Jeffy and Cooper 2011 ). This is because teachers may not have acquired the professional capacity to adapt assessments to the needs of migration background students (Nayir et al. 2019 ) or because there is a limited range of appropriate assessment tasks and support structures available (Castagno and Brayboy 2008 ; Espinosa 2005 ).

In order to ensure equity of assessment for students coming from non-mainstream cultures or migrant families, assessment should be ‘culturally responsive’ (Hood 1998a , b ; Hood et al. 2015 ; Arbuthnot 2017 ; Brown et al. 2019 ). A range of assessment methods that provide additional opportunities for students to demonstrate their learning have been proposed. These include creativity assessment (Kim and Zabelina 2015 ), dynamic assessment (Lidz and Gindis 2003 ), performance-based assessment (Baker et al. 1993 ), peer assessment (Topping 2009 ) and self-assessment (Taras 2010 , p. 606). Culturally responsive assessment practices are also characterised by being student-centred and focusing on ways in which students can contribute using their previous knowledge and experiences in the assessment situation. In doing so, they are narrowing the gap between instruction and assessment situations, as e.g. in assessment for learning (Black and Wiliam 2012 ), which is frequently recommended as an element of a culturally responsive assessment strategy.

The issue of enhancing culturally responsive practices does not relate solely to the provision of extra resources and training. According to Thompson-Robinson et al. ( 2004 ), at a conceptual level, the challenges ‘remain complex, multi-faceted, and context-rich’ (p. 3). Indeed, the literature suggests that for teachers to be serious about being culturally responsive assessors, they also need to be researchers of their own culture and professionalism. This perspective resonates with the American Evaluation Association’s ( 2011 ) statement on cultural competence: ‘Cultural competence is not a state at which one arrives; rather, it is a process of learning, unlearning, and relearning’ (p. 13). This is a daunting task, requiring the professional teacher to reflect on practice in an in-depth manner. As a consequence, the role of a ‘culturally responsive assessor’ seems to converge with that of a ‘reflective practitioner’ (Schön 1983 ) ‘becoming aware of the limits of our knowledge, of how our own behaviour plays into organisational practices and why such practices might marginalise groups or exclude individuals’ (Bolton 2010 , p. 14). Culturally responsive teachers are challenged to be aware of cultural and social diversities, to embed culturally sensitive approaches in their practices (Ford and Kea 2009 ), and to monitor and develop their practices in this respect (Feldman et al. 2018 ).

Nonetheless, teachers can find it difficult to respond positively to the demands of culturally diverse educational contexts (Torrance 2017 ). Culturally responsive assessment strategies can act as a powerful catalyst for effective classroom practice. However, while schools and teachers have a responsibility for the implementation of these practices, they are also dependent on and limited by the assessment policies and regulations that allow for the flourishing of such innovations (Burns et al. 2017 ). To concur with Schapiro ( 2009 ), it is necessary to question whether education policies do in fact ‘improve the student’s access to quality education, stimulate equitable participation in schooling, and lead to learning outcomes at par with native peers’ (p. 33), or conversely restrict and inhibit the ability of schools and teachers to respond imaginatively and generously to new realities.

While many European classrooms, particularly in bigger cities, have been culturally diverse for decades (Crul et al. 2012 ), others have become vastly and quite suddenly more diverse in recent years. Yet, there is little research so far on the actual practices and conditions of assessment in these contexts. Thus, our study was conceived to explore how teachers in European countries cope with and adapt to the challenges created by the assessment of culturally diverse students. The aims of this paper are threefold : Firstly, it aims to uncover the categories teachers use to make sense of potential diversity in their classroom practice. Their perceptions and interpretations of diversity are seen as a precursor for the actions they take when confronted with student diversity in their assessment. Secondly, it analyses the assessment strategies teachers report using as they endeavour to respond to student diversity. Thirdly, we identify inhibiting and facilitating factors that contribute to teachers’ willingness and ability to innovate in assessment methods in the context of student diversity.

3 Methodology

This paper draws on 20 school case studies in which teachers and school leaders explain their assessment challenges and practices at the lower secondary level. The schools are drawn from four different European countries, Austria, Ireland, Norway and Turkey, which represent a wide variety of both teaching and assessment practices and migration experiences (ACRAS 2019 ). However, this paper does not aspire to make comparative claims about typical practices in these countries (for which the database would be too small). Instead, it uses four different school systems as a source for sampling greatly dissimilar contexts and experiences, and illuminating the wide variety of potential teacher responses to the conduct of assessment in diverse classrooms. Secondary schools were chosen as the focus for the study because we expected the grading and certification aspect to be relevant which would not have been the case in primary education in all participating countries.

The sampling of schools within the countries followed the logic of theoretical sampling and aimed to achieve a diversity of cases in order to mirror the heterogeneity of the research field (cf. Kelle and Kluge 2010 ). The schools were characterised by major variations in the percentage of migrant students. These came from different linguistic, cultural and geographical backgrounds but were integrated into the schools attending the same classes as their peers. In the Austrian and Irish case schools, the percentage of migrant students varied between 10 and 60%, in Norway between 5 and 65%, and in Turkey between 5 and 15%. In total, interview data from 115 staff from five secondary schools per country were included in the analysis (including, in each school, the head teacher, a teacher with a particular function for teaching or assessment, a teacher with a particular function for diversity or equality, a language teacher, a STEM teacher, a teacher of a migrant mother tongue and a class teacher).

Interviews were based on a semi-structured interview guide shared between the countries (see Appendix). The guide consisted of questions derived from a conceptual framework on culturally responsive assessment practices that was developed as part of the project (Brown et al. 2019 ). The inclusion of open-ended questions allowed practices and concepts of culturally responsive assessment not foreseen in the conceptual framework to emerge. All interviews were audio-recorded and transcribed verbatim.

Interview data were coded according to the country, case study school, and the position of the interviewee (school leader or teacher). For example, when referring to the code AT_CS4_T1, the first two letters identify the country, the next two letters and numbers identify the case study school, and the final letter and number (which may be omitted when reference is to a case study in general) identifies the position and identity of the interviewee (Table 1 ).

The analysis followed two steps. First, data were analysed according to a case study approach (Yin 2009 ) concentrating on exploring patterns in each country with respect to how interviewees described aspects of diversity that the teachers attend to in assessment situations, and strategies that they apply to respond to diversity. Second, a cross-case analysis was conducted, in order to compare and contrast the emerging data from 20 schools in the four countries. For this paper, the main findings relating to the three research questions outlined above have been condensed into the central ideas and themes reported in the next section. These are illustrated by a series of statements and quotations which focus on important aspects of teachers’ reasoning and actions when they are attempting to engage with cultural diversity in assessment situations.

4 Presentation of findings

The theme of assessment in situations of diversity touches upon the fundamental ‘dilemmas of schooling’ (Berlak and Berlak 2014 /1981). Are all learners to be treated equally, or is it justifiable to give different tasks and use different criteria for evaluating the performance of certain students? Is the focus in classrooms on ‘supporting or is it on monitoring and assessing the student’ (Newman 1997 , p. 263)? Depending on the answers to these questions, the selection of knowledge, organisation of learning and assessment of resulting competencies will be conducted in different ways. The actions of teachers can be viewed as practical responses to such questions in the face of ‘competing and conflicting ideas in the teacher’s mind’ [and in the teachers’ environment; the authors], about the nature of childhood, learning and social justice’ (Berlak and Berlak 2014 , p. 1). In our analysis, we aim to uncover categories and attitudes which teachers employ to make sense of diversity in their classrooms and consequently in their practice. Their perceptions and interpretations of diversity can be interpreted as a precursor which informs the actions they take when engaging with student diversity and in handling possible dilemmas in assessment situations.

4.1 Aspects of diversity

There are a range of dimensions of diversity which impinge on educators as they seek to appropriately respond to the needs of migrant students both in terms of pedagogy and assessment. Those that came to the fore in this research are considered below.

4.1.1 Proficiency in the language of instruction is the main dimension by which diversity in classrooms is perceived, explicitly discussed and processed

Teachers may observe and talk about all kind of differences between their students; however, with respect to their classroom practices, the student’s grasp of the language of instruction was, by far, the leading factor mentioned in our interview data. This is true in all country cases if less pronounced in Ireland, where English is the language of instruction, and it is more likely that many migrant students will have some knowledge of English, before they move to Ireland in comparison to the Norwegian, Turkish and German language in the other cases. If there are special organisational or didactical arrangements for migrant students, they will be organised, in most cases, according to student abilities in the language of instruction (see examples in Table 2 ).

While the focus on competences in the language of instruction is, perhaps, understandable (since this language is the prime instrument of teaching in most subjects), it may also implicitly (and maybe unconsciously) promote both a deficit perspective (‘students lack essential means of learning’) and teacher feelings of having to cope with immense challenges.

The big problem for teachers is that [the students’] language might not be up to the standard that is needed to fully participate in class. (IR_CS5_L1).
The students have problems in Turkish and mathematics classes, and this is due to their lack of language skills. (TR_CS2_T2).

Similar attitudes became apparent, in a different way in the interviews when Austrian and Norwegian teachers—with positive surprise—referred to ‘students’ good aptitude for learning the language of instruction’ (AT_CS4_T3) or described migrant students who mastered the Norwegian language well enough to follow the lessons and take part in ‘ordinary assessment’ as ‘normal students’ (NO_CS2_T2).

4.1.2 In some countries, the aspect of diversity as it relates to the language of instruction was reinforced by analogous administrative distinctions

In Austria and Norway, and to a limited extent in Ireland, language proficiency or lack of it is reinforced by administrative distinctions and labelling. In the case of Austria, when students cannot follow instruction because of a lack of competence in German (i.e. the language of instruction), they are given ‘extraordinary status’. This status allows them to participate in the classroom like regular students from day one onwards. However, they are not obliged to participate in tests, and the teacher is not obliged to grade. Students may be transferred to ordinary status after a year, but the extraordinary status may be (and very often is) extended up to 2 years because of language reasons.

Although the status ‘extraordinary’ is clearly defined by law, teachers have different interpretations, and different routines for translating legal requirements into practice have been established. The legal regulations provide for grading extraordinary students in some subjects they are good at, such as English or Maths (e.g. AT_CS4_T3), while they still may not be graded in other subjects for which the language of instruction may be more important. However, there were teachers and school leaders in the Austrian sample who (wrongly) held the view that the grading of extraordinary pupils was at all forbidden (AT_CS1_L).

This administrative distinction suggests clear categories for teachers: ‘The only distinction for me is: is the child to be tested or not?’ (AT_CS1_T7). The boundary between ‘extraordinary’ and ‘ordinary’ may induce some schools to provide a completely different type of education for extraordinary students by concentrating on language acquisition and neglecting other subjects (AT_CS5_T8).

In the case of Norway, minority language-speaking students who enter lower secondary schools in the last half of a school year are also exempted from grading if the parents agree (Education Act 1998 , §3-21). Moreover, students in lower and upper secondary schools, who, according to the Education Act ( 1998 , §2-8 or 3-12), are entitled to special education in the Norwegian language and offered an introductory course, can be exempted from grading during the period of the course. These students will only receive formative assessments, and the school owner has the responsibility to outline the consequences for the students with respect to receiving grades and being exempted from grading.

Finally, while English is the language of instruction in Ireland, Irish is also a compulsory subject. However, an exemption is granted if a student’s education up to 11 years of age was outside the country or if a newly arrived student has no understanding of English or Irish. One benefit of being exempted from Irish lessons is that those students are given additional tutoring in English during five class periods a week.

4.1.3 Although the acquisition of the language of instruction is a matter of prime interest in all countries, there are different strategies to enable this between and within countries

Arrangements for learning the language of instruction differ across countries with respect to inclusive vs exclusive arrangements (i.e. whether or not immigrant students are learning the language in special classes separate from other students) and duration (i.e. for how long special arrangements for language acquisition are applied). As Table 2 shows, the examples range from no special arrangements (Turkey) to a short language training period (Ireland) to special language instruction for a period of up to 2 years (Austria and Norway). These examples, however, are not in all cases indicative of the whole country, since there may be vast differences between arrangements in different schools within a country. Variations between countries and schools may be connected to the fact that decisions concerning the education of culturally diverse populations are often not taken based on evidence, but that schooling traditions and political considerations play an important role.

4.1.4 Few teachers have acquired competences in teaching the language of instruction as a second language

The ‘language of instruction’ is one of the main instruments of teaching. If teachers cannot use this instrument in the way they are used to, they will experience it as a challenge and—if they do not have strategies to cope with it—it can be viewed as an additional burden on their professional work. Even though proficiency in the language of instruction is perceived as the key aspect of responding to diversity, only a few teachers in the Austrian (and none in the Turkish) case studies seem to have acquired competences in teaching the ‘language of instruction as a second language’ (AT_CS4_T2).

Furthermore, teachers in Norway and Ireland did not generally talk about Norwegian or English as a second language—except for L2 teachers, of which schools reported wanting more in both countries. However, in the majority of case studies, teachers recount some strategies that they use to cope with linguistic diversity. In the case of Ireland, two of the case study schools reported that ‘students are encouraged to use their first language in the classroom’ (IR_CS2_T1), with the belief that ‘students should continue to develop their first language, as it helps them to develop concepts in English and to acquire the English language’ (IR_CS5_L3). Norwegian teachers also pointed to a lack of conceptual understanding as equally challenging.

Lacking language competency is a challenge. The students have much more knowledge than they can express with words (NO_CS4_T5)
There is a challenge with subject-related concepts which has consequences for students’ motivation. If you do not know the concepts, the learning is characterised by being very basic. It is difficult language-wise to reflect, to understand, to compare, to draw parallels. This does not only concern minority language students, but all students who struggle because they lack words and concepts (NO_CS3_T2)

4.1.5 ‘Cultural diversity’ is not often explicitly mentioned in the teachers’ and schools’ efforts to respond to diversity. This seems to relate to the perceived sensitivity and vagueness of the concept

Although classroom diversity is often associated with ‘cultural diversity’ in the public debate, there were very few examples in our data, except for some rare exceptions, in which interviewees explicitly referred to cultural differences when speaking about assessment, teaching and school.

It is interesting, for example, that some pupils, I think it was a Hungarian, do have a different way to do specific calculations, e.g., multiplication is different there, ah, I use that in teaching and tell the other children, make them aware that there are other ways, too. (AT_CS5_T1)
In science, for instance, we have Greek numbers and some words with a Greek origin. So, students coming from Greece recognise some of this. However, as I said, we don’t use it to a large extent. (NO_CS1_T2)

These statements are an indication of intercultural awareness. The first teacher did not refer to an alternative practice of multiplying as a ‘wrong way’, but as a different, even interesting mode, i.e. in a non-judgemental way. Additionally, he used this instance of diversity in his teaching, to raise students’ awareness of the fact that there are different, but equally valid, ways of multiplying (Kaiser et al. 2006 ; Blömeke 2006 , p. 394). This approach of acknowledging differences and doing this in front of the class appeared to strengthen the position of the children with migration backgrounds among their peers. Although this specific instance did not refer to assessment practices, one can imagine that this teacher would not insist on the ‘normal’ way of multiplying when assessing the student; i.e. he possibly would not measure students against culture-specific images of the subject to be learned and of ‘studentness’ (how students behave) in grading situations. In another example, a social science teacher expressed awareness of students whose cultural experiences were out of harmony with curricular content, and empathy that this may make it very challenging for these students to understand some concepts.

So, you have an idea, about democracy and participation for instance, where one of my students, coming from […], had very different ideas about IS and torture for instance, and, sort of, his concepts compared to other students, were very different. And you notice in assessment situations too, that you do not, that you do not manage to see what underlies student responses. You simply think that [the student’s] opinions are rigid, without seeking insights in the cultural background and why the student reacts as he does. (NO_CS3_T3)

All in all, there were comparatively few references to ‘cultural’ differences (other than language differences) in our case studies. What are the possible explanations for this finding? Firstly, cultural differences are sensitive. ‘Language’ offers a more clear-cut distinction, although it often functions as a signifier for a broader ‘otherness’ which may be associated with ‘culture’ and ‘ethnicity’.

Secondly, there is also diversity within the group of migrant students that is challenging to grasp and describe. For example in Ireland ‘newcomers’ are generally very diverse, drawn from heterogeneous ethnic and socioeconomic backgrounds, including some migrants who ‘are already proficient in English and whose parents have high educational aspirations’ (IR_CS2_L1). The label ‘not speaking the language of instruction’ is easier to handle and less prone to misconception. As stated by a Norwegian interviewee,

No, my impression is that they did an exceptionally good job in a primary school in integrating those [students] who have arrived during primary school. So, my impression is that the students are similar in the way they think and behave. (NO_CS4_T2)

Thirdly, many teachers do not have enough intercultural competence to feel well-equipped to address ‘cultural differences’ in interviews (and maybe also in classroom work). As such, the development of intercultural competence in the teaching force seems to be an issue in all countries.

4.2 Assessment strategies for responding to diversity

Concerning the second research aim, we were interested in the ways in which teachers relate to situations of diversity and react to the differences they perceive. While we saw few examples of well-developed and coherent practices of culturally responsive assessment at school level, many teachers across the country cases do take account of those diversities they perceive and use a whole range of strategies by which they aim to help students to demonstrate their competencies.

4.2.1 In order to relate to student diversity in conducting classroom-based assessment, many teachers adapt their assessment procedures and/or their grading

In our case studies, we witnessed a variety of methods that teachers and schools use to cope with student diversity. However, there was no single dominant strategy. Often, these practices were based on either the teachers’ perceptions of the students’ individual needs and/or drawn from the teacher’s classroom experience. These strategies were either ad hoc solutions to the problem of limited proficiency in the language of instruction, or they were long-term strategies of individualisation and differentiation which aimed to increase student responsiveness in general and were not limited to the cultural origin or assumed otherness.

Many of these strategies in each country can be subsumed as versions of formative assessment, such as ‘self-assessment’ or ‘group performance’, together with other types of performance, from pictorial to oral and written, hearing, reading and other formats. Generally, teachers who were competently working informed by a formative assessment philosophy seemed better equipped for culturally responsive assessment (Nortvedt et al. 2020 ). In teaching second language learners, the concept of ‘scaffolding‘ (Ovando et al. 2003 , p. 345) has spread to a number of classrooms. This offers contextual supports for understanding through the use of simplified language, teacher modelling, visuals and graphics, cooperative learning and hands-on learning; similar strategies in assessment may be interpreted as a natural corollary. As such, the strategies reflect teachers’ inventiveness and sensibility; however, they were often intensely individualised and not shared. Additionally, the described instances of flexibility, creativity and reflexivity of some teachers and their students can be seen as components and expressions of intercultural competence even when ‘culture’ was not the issue that was explicitly mentioned.

Looking more closely at the teachers’ strategies, it is possible to distinguish two elements within assessment (Eder et al. 2009 ): ‘procedures of assessment’ which refer to the processes of devising performance situations (such as assignments or tests), assigning them to students and monitoring students’ performance in these situations, and ‘grading’ which refers to the process of attaching evaluative judgements (such as marks, grades or other evaluative descriptions of the performance shown) to the students’ performance. In our data, there were (a) teachers who adapted their procedures of assessment to the needs of the students, (b) others adapted their grading, (c) some adapted both and (d) another group adapted neither assessment procedures nor grading (see Fig.  1 ).

figure 1

Adaptation in assessment procedures and grading

Adapting procedures of assessment

When attempting to meet the needs of migrant students, many teachers in our case schools adapted their assessments by modifying the procedures of assessment in the following ways:

One of the most frequent strategies is time adaptation. Students whose first language is not the language of instruction may use more time for the same questions (e.g. AT_CS1). This is in line with legal regulations in Austria and Norway.

Changing assessment formats

Especially when students were literate in another script and still had difficulties in writing in Latin script, or just had difficulties writing in the language of instruction, teachers changed from a written to an oral format. Teachers in many instances also offered students the possibility of replacing a written or oral assessment by a presentation which they could prepare at home (e.g. AT_CS2_T3).

Changing the test language

When some teachers realised that certain students were more proficient in another language than the language of instruction, students were allowed to complete the test in the other language—provided teachers were themselves proficient in this language or a person was able to translate the test.

We also have students who then change the language to do their Physics test in English, and that is perfectly ok. This is offered by the English teacher, she says, ok, he can speak English much better than German, but with English, he would do it, then we’ll do it in English. (AT_CS1_T3)

Offering additional support

For example, teachers offer a list of keywords in the language of instruction with mother tongue explanations and/or ask other students for mother tongue support (AT_CS1).

I make it possible for them to teach to their friends the meaning of the words they learn in their own language. (TR_CS4_T2)

Many of these activities were ‘not only useful for migrant but for all students’ (IR_CS4_T4), e.g. discussion of ‘keywords before reading the main text’ (IR_CS4_T4) which, in some instances, included different contexts of the word together with an image of the word.

As is the case with state examinations in Ireland, students of a certain language proficiency level were able to use dictionaries during the test ‘to understand what they are being tested on if they don’t understand the meaning of a word. (IR_CS5_L1)

In an iPad-enabled classroom a teacher used electronic translation devices (Google translator) to communicate with a newcomer initially. Norwegian examples show how new teaching material can be used for supporting migrant students.

He often comes to me with something written in Italian, which he has translated for me using Google. I often think; Yes, funny. Yes, but that’s how we communicate, and he feels I understand him, I know if he has a problem …. (AT_CS4_T3)
So, there are some subjects (…) like grade 8 th science that has ‘Eureka’ - a smart-book that can read aloud. They can listen while they read. I think that this is a good resource for minority students and students with language disabilities. (NO_CS1_T1)

Peer assessment

Peer assessment occurred primarily during presentations and group work when students were asked to give feedback. In some instances, students even defined the criteria used for evaluation. In other situations, teachers organised panels with observer roles including brief written reflections:

We often use peer-assessment in groups or with an assessment partner where the students compare their responses and provide feedback to each other on written tasks. We do not use so much self-assessment yet, this we will do later on. Until now, we have focused on developing a “tool box” where they get to see examples of different tests, written assignments, feedback and so on, but we have not let them participate actively yet. (NO_CS1_T1)
So, we have now ... we started with discussion rounds on various topics, and there we always have observer roles to watch the whole thing and then give feedback afterwards. (AT_CS2_T7)

Adapting grading

Another strategy is to adapt the grading to the student’s competence level.

‘Language up-grading’

Some teachers retain the regular procedures of assessment (such as tests, homework and other activities) without any particular adaptation to the special needs of migrant students or any differentiation in general. However, they take the students’ language proficiency into account when they decide on the grade, which is recorded in the report card (e.g. AT_CS4_T1). This is in line with the legal situation in some countries (e.g. in Austria: teachers may take the linguistic situation of the students into account when deciding on the grade), while it is not allowed in other countries, e.g. in Norway where teachers are instead obliged to adapt the assessment.

Teachers who use ‘language up-grading’ explain it as accounting for the fact that written tasks require much more effort from students raised in another language and, even more so, in a different writing system (AT_CS3_T4) similar to Deseniss ( 2015 ).

In more professional terms, ‘language up-grading’ requires teachers to deviate from the social reference norm (considered ‘just’ in traditional schools) and use individual reference norms, i.e. to grade according to individual progress instead of social comparability. ‘Language up-grading’ also requires to distinguish between content and language performance in assessing competencies.

… the [recently immigrated] girl has collected many points because she understood the logic of the assignment, she has numeracy skills, it is only the language competence which is missing: I can be responsive to that, see, she is not able to cope with assignments with a longer written text in the beginning. However, all the other capabilities may be appreciated. (AT_CS1_T3)

No adaption of assessment

In some classrooms, we found no adaptation to the diversity of students at all. Due to the legal requirement in Norway regarding educational adaption to individual needs (Education Act 1998 , § 1-3), teachers are obliged to adapt both their teaching and assessment to individual students. However, there are still individualised practises, and the degree of adaption might, therefore, differ between teachers. In the Turkish cases, teachers in their classroom-based assessment usually ‘use the same tests for all students’ (TR_C4). When we encountered non-adaption in other countries (Austria, Ireland and Turkey), there were different explanations: Some teachers expressed compassion for the situation of newcomer students. They felt that non-adaptation of assessment is unfair to these students and, at the same time, thought that they were forced into non-adaptation by their national assessment system.

The assessment system [used in the school] is not fair in this respect, if they have such a deficit and therefore cannot show the performance expected. However, we cannot help it now, can we? (AT_CS4_T6)
Written papers in state examinations should be screened for appropriate language, as they do not reflect the diversity of language we now have in our secondary schools. … Setters of examination papers should be trained in language matters. (IR_CS3_T2)

Other teachers identified strongly with (what they perceived as) the legal rules or concepts of formal equality and did not consider any alternative:

We cannot do otherwise. It will be difficult ... to judge everyone equally … without going down with the standards. (AT_CS2_T3)
It is very difficult, you know, and would be difficult to have some rules [for] some and some rules for others. (IR_CS5_T3)

A small group in some countries did not seem to care about the problem.

I think nothing should be ‘adjusted’, so just because they are different cultures. Everyone has to be judged the same. (AT_CS1_T1)
It depends on the student. There is not a problem if the student is willing. (TR_CS2_T2)

The wide variation in strategies and in personal interpretations of the legal situation seems to indicate that there is ample leeway for professional development programmes offering teachers support and guidance in a work situation they were not trained for.

4.3 Supportive conditions for responding to diversity

The third aim of this paper is to investigate where teachers can turn to if they need support in responding to student diversity in their assessment work. From the perspective of the teachers, there seems to be little support available. However, the existing assessment practices or regimes represent a resource for teachers.

4.3.1 Different countries are characterised by different assessment regimes: they are a resource for teachers’ responding to diversity in assessment; they open up potential strategies of adaptation.

Countries differ in their legal requirements for assessment, which are transmitted through teacher education and enacted through individual and collegial practices of assessment and grading in schools. These ‘assessment regimes’ form a resource for schools’ and teachers’ individual and collective action, and thereby shape strategies of adaptation .

Assessment in Austrian (‘segregated’ Footnote 1 ) lower secondary schools is purely teacher-based; certificates originating from it are important for access to a differentiated ‘segregated’ upper secondary education system. This special assessment regime seems to limit the options teachers have in coping with diversity. In such a selective system, there is much attention paid to the comparative fairness of assessment, which makes it more difficult to be responsive to the special needs of students than it might be in more inclusive systems (cf. Popham 2009 ). This may have also made it more difficult for formative assessment or assessment for learning to flourish. Even a strategy like ‘language up-grading’ may be understood as a way of achieving ‘comparative fairness’, which would not be possible (or indeed necessary) in a system like Norway’s, which has its traditional focus on supporting individual progress in lower secondary level.

In Ireland, in contrast, assessment at the end of ‘non-segregated’ secondary junior education (referred to as the ‘Junior Cycle’) is based on teacher assessments and externally devised examinations which open up access to a ‘non-segregated’ upper cycle. The upper cycle ends with external state examinations, which are relevant for tertiary access. The external tests tend to focus the attention of teachers and students; however, the teacher’s role is conceived as supporting students’ learning for assessment (instead of ultimately judging students’ results which does not apply in Ireland). In the junior years, there is more freedom to adapt to students’ needs, but the upper secondary leaving certificate is such an important milestone in educational careers that there is a ‘washback effect’; the closer the final examination, the less freedom is experienced by teachers concerning assessment, and the more teachers tend to focus entirely on results. As all students are preparing for the ‘Leaving Certificate’, this has an impact right through secondary schooling (Burns et al. 2017 ). As stated by one interviewee:

I think that the introduction of CBAS (Course Based Assessments) is a very good move for the introduction of Assessment for Learning and for migrant students. But to be honest, the main focus is still the Leaving Cert so a lot of what we hear about is nice and what might be worthwhile assessment strategies goes out of the window when students do the Leaving Cert. The real is what they get in the Leaving Cert. How this fears out for students who have just entered the country, not so well I imagine. (IR_CS2_T3)

In Norway, as with Ireland, assessment at the end of ‘non-segregated’ lower secondary education is also based on teacher assessments and externally devised examinations. Although all students have a guaranteed place in upper secondary education, their results in the lower secondary level will enable them to opt for an academic or a vocational stream of the ‘segregated’ upper secondary cycle. The policy of guaranteed places in upper secondary education, the legal right of students to adapted education according to their individual needs as well as a legal policy for formative assessment in the form of assessment for learning seems to leave more freedom for teachers to apply culturally responsive practices in their assessment.

In Turkey, there is a central state examination at the end of 8th grade. All children, including foreign nationals, have the right to access ‘basic education’ services delivered by public schools. If international students are enrolled in a public school, the Local Education Authorities (LEAs) are responsible for assessing the student’s educational background and determining which education level the child will be enrolled in (Access to Education in Turkey 2019 ). In addition, in-service training for inclusive education is provided for teachers who have Syrian students in their classrooms (Promoting Integration of Syrian Children into the Turkish Education System 2019 ). All these initiatives may be considered as the beginning of culturally responsive practices in the assessment of immigrant students.

4.3.2 Established practices of formative assessment in a country can help individual teachers in adapting to diversity in their assessment

Whether or not practices of formative assessment are stipulated by educational legislation and supported by professional development, teaching material and other support offers may be a particularly relevant aspect of an assessment regime. Norway is a good example of established practices of formative assessment, due to a long-standing policy for adaption to individual student needs since 1975. There are certainly differences between individual teachers, schools and local communities; however, according to national policies, requirements that all schools should implement Assessment for Learning and formative assessment have an even longer tradition. In Ireland, formative assessment was not used as frequently in the past; ‘ten years ago, assessment for learning was never really mentioned at all’ (IR_CS5_L1). It is only in the last few years that formative assessment has attracted more attention with its introduction to the discourse of assessment at primary level (NCCA 2008 ), with its promotion as part of Junior Cycle reform and through influential stakeholder groups in the system, such as the inspectorate. In these cases, it is easier for individual teachers to practice formative assessment than in Austrian and Turkish schools, where formative assessment has a weak tradition connected with the prevalence of teacher-based assessment for certification.

4.3.3 An established discourse in the profession on both diversity and assessment helps individual teachers adapt to diversity in their assessment

Teachers’ work is not well understood if one looks only at the individual level. It takes place in a ‘community of practice’ (Lave and Wenger 1991 ), which may be more or less well developed. These communities of practice offer a ‘background web’ of understandings, interpretations, strategies and instruments which individual teachers can draw on in their daily work and in their attempts to cope with new situations. If there is an established professional discourse on diversity and/or on assessment, then it is supportive of teachers finding solutions for creating diversity in assessment. Although the awareness of diversity in classrooms is rising in Austria and Turkey, there is not really a discourse on this issue that involves much of the profession. In Ireland, the professional discourse on evaluation has increased as a result of new inspection practices and may stimulate awareness concerning diversity and assessment (IR_CS5).

4.3.4 A school policy on diversity and/or on assessment and formal and informal practices of teacher collaboration can help individual teachers adapt to diversity in their assessment

In some of the Norwegian schools, there are school policies in place which staff have agreed upon. School leaders give teachers resources accordingly; in these schools, it is easier to use formative practices. In case school 5, for example, a specific school policy of adaptive assessment has been implemented, which has teachers assessing tests together with the students (NO_CS5). This practice is supported by the Education Act ( 1998 ), which gives students a general right to participate in their own assessments.

Three of the Irish case schools have policies on multiculturalism and respect for everyone, and these policies seem to shape the learning environment in these schools (e.g. IR_CS5). Turkish case schools may or may not have some collaboration concerning assessment; however, they do not have any consistent school policy concerning assessment or migrant students or diverse classrooms (TR_CS4).

During the last decade, Austrian education policy has promoted increased attention to the individual needs of students, and differentiation and individualisation of teaching (Altrichter et al. 2009 ). Nevertheless, there is a wide variation of practices of assessment and grading. Only a few schools have consistent assessment policies, and in those that do exist, the aspect of linguistically or culturally responsive assessment is not covered (e.g. AT_CS1_T2). The obligatory development plans (which schools have to negotiate with their regional administrators as a part of ‘contract management’; see Altrichter 2017 ) may include elements which are helpful for culturally responsive assessment. Thus, in case school 5, an active and quite interventive system of diagnosis and support has been established, which is useful for responding to student diversity (AT_CS5).

5 Discussion and conclusion

This paper provided an exploratory analysis of the perceptions and strategies that teachers use to assess students in diverse classrooms. Interview and documentary data from 20 schools, and 115 teachers and school leaders in four European countries—Austria, Ireland, Norway and Turkey (five schools per country)—were used to study some features of the challenges teachers face when assessing students from diverse cultural backgrounds. While the situation in these countries, and even between schools in these countries, varied in many respects, it seems possible to come up with some insights to the problem of culturally responsive assessment that may be relevant—if to varying degrees—for many European countries and classrooms.

A key finding is that ‘proficiency in the language of instruction’ is the main dimension by which diversity in classrooms is perceived, explicitly discussed and processed by teachers. Contrary to the public debates in many countries, there is much less reference to ‘cultural differences’ in our case studies, probably because ‘culture’ is a much more difficult concept to handle in classroom work. However, the massive emphasis placed on ‘proficiency in the language of instruction’ is worth interrogating further.

Historically, schools have been a major instrument of supporting the idea that nations are monolingual by promoting a ‘standard language ideology, which elevates a particular variety of a named language spoken by the dominant social group to a (H)igh status while diminishing other varieties to a (L)ow status.’ (Ricento 2013 , p. 531). While the acceptance of language variety in European schools seemed to have increased in the wake of sociolinguistic research and globalisation, the contemporary waves of migration seem to be countered by a re-emergence of the ideology of monolingualism which ‘sees language diversity as largely a consequence of immigration. In other words, language diversity is viewed as imported.’ (Wiley and Lukes 1996 , p. 519).

The insistence on proficiency in the language of instruction is a variety of the concept “language-as-resource” (Ruiz 1984 ) which many teachers often implicitly and benevolently seem to subscribe to, because they want to open up participation opportunities for their students. On the other hand, there is more in languages than ‘their utilitarian benefit’ (Ricento 2013 , p. 533). Those whose language is tacitly considered secondary or openly devalued, will experience their identity, status and place in life challenged (Baker 2006 ; Blommaert 2006 ). ‘Language first’ policies Footnote 2 insisting that migrant students have to learn the language of instruction before they can participate in mainstream classes with all other students seem to reinforce monolingual attitudes in the teaching force.

‘Language proficiency’ also seems to shift the responsibility for demonstrating learning to the student and, thus, implicitly alleviates challenges for teachers which many of them experience as difficult and demanding. Additionally, it seemed that only a few teachers in our cases had been explicitly trained for teaching the language of instruction as a second language or for coping with cultural diversity in teaching, and even more so in assessment.

Secondly, while some teachers did not feel that assessment should take account of student diversity, most teachers tried to adapt their assessment procedures and grading to help students from diverse backgrounds to show their competencies and to experience success. Rarely were these responses organised and supported by school policies, institutionalised in-school teacher collaboration or regional/national policies focusing on culturally responsive assessment. More often, teachers used their educational repertoire or developed ad hoc solutions to do justice to individual students’ needs and potential.

Yet, national policies for individualisation and differentiation and in a small number of cases in-school policies on assessment and/or cultural diversity did give some limited support to individual teachers in their attempts to cope with a situation experienced as challenging by many. Overall, in most interviews, teachers did not feel well-prepared for a diverse education system either from their pre-service teacher education or from the policies and supports provided by schools or education authorities.

What are the potential consequences and recommendations to enhance culturally responsive assessment that can be drawn from this situation?

5.1 Clarifying the concept of ‘responsiveness to cultural diversity’ in the professional discourse in education

The case studies indicated that the term ‘cultural diversity’ is often avoided in explicit in-school discourse and only used implicitly to point to ‘increased difficulties’ for the teaching profession. Responding to cultural diversity is indeed a difficult concept, and it is undoubtedly in need of further clarification, in particular as it applies to classroom practice. In our view, the OECD’s ( 2016 ; Burns et al. 2017 ) work on global competence provides a formulation of culture which neither reifies ‘cultures’ as a given, nor loses itself in an incomprehensible array of customs, attitudes, artefacts, and so on. What is described is a concept of culture which does not limit students to narrow, pre-conceived perceptions but allows for the development of both the students and the culture. However, it is important to communicate such an understanding to the teaching force and the public, and to equip teachers and schools with feasible strategies for translating such an understanding into practice.

5.2 Teaching material and teaching resources are helpful for teachers, as they show teachers appropriate ways of positively engaging with cultural diversity

In many case schools, teachers reported a lack of adequate support material. On the other hand, we found other teachers pointing to appropriate and relevant resources which were publicly available but were rarely used. There is some indication that this discrepancy between support material available and used may be connected with a lack of sensitivity to the problem in general and lack of expertise with respect to intercultural and multilingual education and culturally responsive assessment. At times, this lack of expertise may also be connected with a lack of leadership, ignorance or xenophobic attitudes. Teachers with knowledge in this field seem to find adequate resources in most countries and schools and to support their colleagues in this respect. Accessible resource persons with specialised knowledge could ultimately help to enhance the schools’ expertise in this regard.

Internet- and ICT-based media may be more readily accessible to teachers who know about their existence and know how to use it. Another advantage is their potential flexibility which allows different types of use even in initially unforeseen situations (e.g. the Norwegian language support app CD-ORD is used as a translation device; NO_CS4_T2).

5.3 Professional development for intercultural competence and culturally responsive assessment is an issue in all countries

The case studies indicated that many teachers and schools have difficulties in constructively engaging with the challenges of the cultural diversity of students, and also the results of international tests strongly point in that direction (Herzog-Punzenberger, 2019 ). Nevertheless, it is not only teachers who require professional knowledge of culturally responsive education. According to an EC-commissioned study on diversity in initial teacher education, there are few initiatives in Europe to train teacher educators in linguistic and cultural diversity including responsive assessment strategies (Dumcius et al. 2017 , pp. 6870). As long as teacher educators are not well-equipped for preparing teachers to do this work, it is doubtful that adapted curricula and resource material will directly impact classroom practice. Therefore, the leadership of teacher training institutions concerning linguistic and cultural diversity is one of the most important steps towards improving culturally responsive assessment.

While there are several options for professional development concerning multicultural education and second language learning available in Austria, Ireland and Norway, their impact on the work in schools and classrooms was not entirely convincing in these case studies. New in-service formats (e.g. coaching and long-term development processes of both school policy and classroom practice; Timperley et al. 2007 ; Lipowsky and Rzejak 2014 ) are needed. Indeed, some schools were not aware of both the availability of professional development on culturally responsive practices and the need for such competences (e.g. AT_CS4_T2).

It may well be that both are necessary: relevant and accessible teaching material and professional development made readily accessible on the one hand, and a system-wide strategy which makes school leaders and teachers aware that these resources are available and that building up such competencies is part of each school’s professional responsibility, on the other.

5.4 As responsive forms of assessment are new in many cases and may vary between classrooms, students’ and parents’ understanding is essential

Significant classroom diversity usually entails that the school’s parents vary widely with respect to their expectations, aspirations, competencies and prior school experiences. While immigrant parents were in some cases characterised by low education levels and low income with vague educational aspirations (TR_CS5), there were other cases in which immigrant parents and students held high expectations and actively pursued them (AT_CS5).

For example, teachers in one school observed that some of the well-motivated parents with a migrant background were very focused on their children performing well in the state examinations and were not interested in any assessment other than tasks that prepared them for the state exams. As stated by one teacher, ‘these students just say …, just give me the notes so I can learn them off for the exam’ (IR_CS2_T2).

In any case, diversity of parent expectations may increase in a way that is not always clearly visible. As ‘justice in assessment’ and the success of students (giving the right of entry to further education and employment) are prime criteria by which parents evaluate a school’s work, it will be necessary that schools proactively work with parents if they want to introduce new forms of assessment. In Norway, primary and lower secondary education teachers are legally required to hold ‘learning development dialogues’ (similarly ‘parent-student-teacher conversations’ in Austria) with students about performance, progress and potential improvement actions at least twice a year, for which they prepare a written report on the students’ learning progress. As migrant parents may have problems in understanding the report or the overall procedure, some schools provide courses for parents on how to participate in these meetings.

In conclusion, it is acknowledged that the findings and recommendations of this study are limited by the number of cases and its exploratory nature. Sampling of countries and schools was mainly based on opportunity and did not aspire to give a full picture of the culturally responsive assessment practices in these countries. Nevertheless, we claim that we have collected insights into the thinking and practices of schools and teachers trying to engage with cultural diversity in their classrooms and how this diversity shapes, to varying and often limited extents, the teaching and assessment methodologies employed. The response in many schools and classrooms to increased diversity is still short of anything that approaches culturally responsive pedagogy and assessment, a finding which supports the outcomes of larger quantitative studies on cultural and linguistic diversity in the teaching profession and in schools (OECD 2019 ). Nonetheless, this study also, and most importantly, indicates that many schools and teachers are well disposed, on the whole, to embracing diversity and adapting assessment to being more culturally responsive. It is not a lack of goodwill but more the limitations and constraints of existing assessment policies, together with inadequate training and limited supports which are inhibiting a great leap forward in this most urgent area.

Change history

19 august 2020.

The original version of this article unfortunately contained a mistake.

The term ‘segregated’ points to a system in which parallel educational options for the same age group are in a hierarchy with respect to further educational options (e.g. access to tertiary education).

For example, in 2018/19, the Austrian government introduced separate classes for immigrant students in which they have to learn the language of instruction for one to four semesters. Students can only be mainstreamed if they pass a special language test which is administered at the end of every semester (BMBWF 2020 ).

Access to Education in Turkey (2019). Accessed 1 Dec 2019, from https://www.asylumineurope.org/reports/country/turkey/access-education-1

Aceves, T. C., & Orosco, M. J. (2014). Culturally responsive teaching (Document No. IC-2). Accessed 20 Oct 2019 from http://ceedar.education.ufl.edu/tools/innovation-configurations/

ACRAS. (2019). Characteristics of school systems and student assessment in Austria, Ireland, Norway, and Turkey . Retrieved November, 19th, 2019, from https://www.acras.eu

Alcott, B. (2017). Might progress assessments hinder equitable progress? Evidence from England. Educational Assessment, Evaluation and Accountability, 29 (3), 269–296.

Google Scholar  

Altrichter, H., Trautmann, M., Wischer, B., Sommerauer, S., & Doppler, B. (2009). Unterrichten in heterogenen Gruppen: Das Qualitätspotenzial von Individualisierung, Differenzierung und Klassenschülerzahl. In W. Specht (Ed.), Nationaler Bildungsbericht. Österreich 2009: Band 2 (pp. 341–360). Leykam: Graz.

Altrichter, H. (2017). The Short Flourishing of an Inspection System. In J. Baxter (Ed.), School Inspectors: Policy Implementers, Policy Shapers in National Policy Contexts (pp. 206–230). Cham: Springer.

American Evaluation Association (AEA) (2011). Statement on cultural competence on evaluation. Accessed 19 March 2019, from http://www.eval.org/p/cm/ld/fid=92

Arbuthnot, K. (2017). Global perspectives on educational testing: examining fairness, high-stakes and policy reform . Bingley: Emerald.

Baker, C. (2006). Psycho-sociological analysis in language policy. In T. Ricento (Ed.), An introduction to language policy. Theory and method (pp. 210–228). London: Blackwell.

Baker, E. L., O’Neil Jr., H. F., & Linn, R. L. (1993). Policy and validity prospects for performance-based assessment. American Psychologist, 48 (12), 1210–1218.

Banks, J. B., & Banks, C. A. M. (Eds.). (2004). Handbook of research on multicultural education (2nd ed.). NewYork: Macmillan.

Berlak, A. & Berlak, H. (2014; originally 1981). Dilemmas of schooling: teaching and social change . London & New York: Routledge.

Black, P., & Wiliam, D. (2012). Assessment for learning in the classroom. In J. Gardner (Ed.), Assessment and learning (2nd ed., pp. 11–32). London: Sage.

Blömeke, S. (2006). Struktur der Lehrerausbildung im internationalen Vergleich. Zeitschrift für Pädagogik, 52 (3), 393–416.

Blommaert, J. (2006). Language policy and national identity. In T. Ricento (Ed.), An introduction to language policy: theory and method (pp. 238–254). Malden: Blackwell.

BMB [Bundesministerium für Bildung]. (2016). Lehrplanbestimmungen für Deutsch als Zweitsprache (DaZ): Fachlehrpläne für den muttersprachlichen Unterricht. Unterrichtsprinzip “Interkulturelles Lernen” . Vienna: BMB.

BMBWF [Bundesministerium für Bildung, Wissenschaft und Forschung] (2020). Deutschförderklassen und Deutschförderkurse. Accessed 17 May 2020, from https://www.bmbwf.gv.at/Themen/schule/schulpraxis/ba/sprabi/dfk.html

Bolton, G. (2010). Reflective practice: writing and professional development . London: Sage.

Brook Chapman de Sousa, E. (2017). Promoting the contributions of multilingual preschoolers. Linguistics and Education, 39 , 1–13. https://doi.org/10.1016/j.linged.2017.04.001 .

Article   Google Scholar  

Brown, M. (2007). Educating all students: Creating culturally responsive teachers, classrooms, and schools. Intervention in school and clinic, 43 (1), 57–62.

Brown-Jeffy, S., & Cooper, J. E. (2011). Toward a conceptual framework of culturally relevant pedagogy: an overview of the conceptual and theoretical literature. Teacher Education Quarterly, 38 (1), 65–84.

Brown, M., Altrichter, H., Nayir, F., Nortvedt, G., Burns, D., Fellner, M., Gloppen, S. K., Helm, C., McNamara, G., O'Hara, J., Herzog-Punzenberger, B., Skedsmo, G., & Wiese, E. F. (2019). Classroom Assessment that Recognises Cultural Difference - A European Perspective . Dublin: EQI. https://doi.org/10.13140/RG.2.2.14346.52164/2 .

Burns, D., Brown, M., Altrichter, H., Nortvedt, G., McNamara, G., O’Hara, J., & Nayir, F. (2017). Aiding Culturally Responsive Assessment in Schools (ACRAS) - Summary: Conceptual Framework. Retrieved October, 20, 2019, from http://www.acras.eu/3-framework

Castagno, A. E., & Brayboy, B. M. J. (2008). Culturally responsive schooling for indigenous youth: a review of the literature. Review of Educational Research, 78 (4), 941–993.

Crichton, J. (1998). Book review: engines of educational change: examination systems in small states. In M. Bray & L. Steward (Eds.). Assessment in Education: Principles, Policy and Practice , 6(2), 305–307.

Crul, M., Schneider, J., & Lelie, F. (2012) (eds.). The European second generation compared. Does the integration context matter? Accessed 9 Feb 2020 from http://www.tiesproject.eu/component/option,com_docman/task,cat_view/gid,44/Itemid,142/ .

Deseniss, A. (2015). Schulmathematik im Kontext von Migration: Mathematikbezogene Vorstellungen und Umgangsweisen mit Aufgaben unter sprachlich-kultureller Perspektive . Wiesbaden: Springer.

Dumcius, R., van Driel, B., Herzog-Punzenberger, B., Kerzil, J., Wood, E., Siarova, H. Sternadel, D., Tsutskiridze, L., & Buinauskas, D. (2017). Preparing teachers for diversity. The role of initial teacher education. Accessed 9 Feb 2020, from http://www.readyproject.eu/uploads/files/1502579119PreparingTeachersforDiversity.pdf

Eder, F., Neuweg, G. H., & Thonhauser, J. (2009). Leistungsfeststellung und Leistungsbeurteilung. In W. Specht (Ed.), Nationaler Bildungsbericht. Österreich 2009. Band 2 (pp. 247–267). Leykam: Graz.

Education Act. (1998). Education Act, 20 . Oslo: Government of Norway.

Espinosa, L. M. (2005). Curriculum and assessment considerations for young children from culturally, linguistically, and economically diverse backgrounds. Psychology in the Schools, 42 (8), 837–853.

Eurostat (2017). Migration and migrant population statistics. Accessed 20 Oct 2019, from http://ec.europa.eu/eurostat/statistics-explained/index.php?title=File:Non-national_population_by_group_of_citizenship,_1_January_2017_.png

Feldman, A., Altrichter, H., Posch, P., & Somekh, B. (2018). Teachers investigate their work (3rd ed.). London & New York: Routledge.

Fend, H. (2009). Neue Theorie der Schule . VS: Wiesbaden.

Ford, D. Y., & Kea, C. D. (2009). Creating culturally responsive instruction: for students’ sake and teachers’ sake. Focus on Exceptional Children, 41 , 1–18.

Gay, G. (2010). Culturally responsive teaching: theory, research, and practice (2nd ed.). New York: Teachers College Press.

Gutiérrez, R. (2002). Beyond essentialism: the complexity of language in teaching mathematics to Latina/o students. American Educational Research Journal, 39 (4), 1047–1088.

Hattie, J. A. C. (2009). Visible learning: a synthesis of over 800 meta-analyses relating to achievement . New York: Routledge.

Herzog-Punzenberger, B. (2019). Mehrsprachige Schüler_innen im deutschsprachigen Raum – Kontextbedingungen und Lernerfolge. In A. Ender, U. Greiner, & M. Strasser (Eds.), Deutsch im mehrsprachigen Umfeld (pp. 58–83). Hannover: Klett Kallmeyer.

Hood, S. (1998a). Introduction and overview: assessment in the context of culture and pedagogy: a collaborative effort, a meaningful goal. The Journal of Negro Education, 67 (3), 184–186.

Hood, S. (1998b). Culturally-responsive performance-based assessment: conceptual and psychometric considerations. The Journal of Negro Education, 67 (3), 187–196.

Hood, S., Hopson, R. & Frierson, H. (2015). Introduction: this is where we continue to stand. In S. Hood, R. Hopson & H. Frierson (Eds.), Continuing the Journey to Reposition Culture and Cultural Context in Evaluation Theory and Practice. (pp. ix-xviii). Charlotte, NC: Information Age.

Isaacs, T. (2010). Educational assessment in England. Assessment in Education: Principles, Policy and Practice, 17 (3), 315–334.

Kaiser, G., Hino, K., & Knipping, C. (2006). Proposal for a framework to analyse mathematics education in Eastern and Western traditions. In F. Leung, K. Graf, & F. Lopez-Real (Eds.), Mathematics education in different cultural traditions (pp. 319–351). New York: Springer.

Kelle, U., & Kluge, S. (2010). Vom Einzelfall zum Typus . Opladen: Lesek+ Budrich.

Kim, K. H., & Zabelina, D. (2015). Cultural bias in assessment: can creativity assessment help? International Journal of Critical Pedagogy, 6 (2), 129–147.

Ladson-Billings, G. (1995a). But that’s just good teaching! The case for culturally relevant pedagogy. Theory Into Practice, 34 (3), 159–165.

Ladson-Billings, G. (1995b). Toward a theory of culturally relevant teaching. American Educational Research Journal, 32 (3), 465–491.

Lave, J., & Wenger, E. (1991). Situated learning . Cambridge: Cambridge University Press.

LeMétais, J. (2003). International developments in upper secondary education: context, provision and issues. In National Foundation for Educational Research . Dublin: National Council for Curriculum and Assessment.

Lesaux, N. K., Kieffer, M. J., Kelley, J. G., & Harris, J. R. (2014). Effects of academic vocabulary instruction for linguistically diverse adolescents: evidence from a randomised field trial. American Educational Research Journal, 51 (6), 1159–1194.

Lidz, C., & Gindis, B. (2003). Dynamic assessment of the evolving cognitive functions in children. In A. Kozulin, B. Gindis, V. Ageyev, & S. Miller (Eds.), Vygotsky’s educational theory in cultural context (pp. 293–357). Cambridge: Cambridge University Press.

Lipowsky, F., & Rzejak, D. (2014). Lehrerfortbildungen lernwirksam gestalten. Lernende Schule, 17 (68), 9–12.

Mitakidou, S., Tressou, E., & Karagianni, P. (2015). Implementing culturally sensitive assessment tools for the inclusion of Roma children in mainstream schools. In S. Hood, R. Hopson, H. Frierson, & K. Obeidat (Eds.), Continuing the journey to reposition culture and cultural context in evaluation theory and practice (pp. 233–250). Charlotte: Information Age.

Nayir, F., Brown, M., Burns, D., Joe, O. H., McNamara, G., Nortvedt, G., & Wiese, E. F. (2019). Assessment with and for Migration Background Students-Cases from Europe. Eurasian Journal of Educational Research, 19 (79), 39–68.

NCCA (National Council for Curriculum and Assessment). (2008). Assessment in the primary school: guidelines for teachers . Dublin: NCCA.

Newman, E. (1997). Primary teachers’ dilemmas in initial teacher training. Teacher Development, 1 (2), 253–268.

Nortvedt, G.A., Wiese, E., Skedsmo, G., Brown, M., Burns, D., McNamara, G., O’Hara, J., Altrichter, H., Fellner, M., Herzog-Punzenberger, B., Nayir, F., & Taneri, P.O. (2020). Aiding culturally responsive assessment in schools in a globalising world. Educational Assessment, Evaluation and Accountability, (online first), Retrieved February, 3 rd , 2020, from https://doi.org/10.1007/s11092-020-09316-w

Nusche, D., Shewbridge, C. & Lamhauge Rasmussen, C. (2009). OECD reviews on migrant education: Austria . Accessed 3 Feb 2017, from http://www.oecd.org/austria/44192225.pdf

OECD (2009). OECD toolkit on teaching for diversity. for teaching on diversity. Accessed 5 Sept 2019 from http://www.oecd.org/general/searchresults/?q=Toolkit%20for%20teachers%20of%20diversity

OECD. (2016). Global competency for an inclusive world . Paris: OECD.

OECD. (2019). TALIS 2018 results (Vol. I): teachers and school leaders as lifelong learners . Paris: OECD.

Ovando, C., Collier, V., & Combs, M. (2003). Bilingual and ESL classrooms: teaching multicultural contexts . Boston: McGraw-Hill.

Padilla, A. M. (2001). Issues in culturally appropriate assessment. In L. A. Suzuki, J. G. Ponterotto, & P. J. Meller (Eds.), Handbook of multicultural assessment (pp. 5–27). San Francisco: Jossey-Bass.

Popham, W. J. (2009). Assessment literacy for teachers: faddish or fundamental? Theory into practive, 48 (1), 4–11.

Promoting Integration of Syrian Children into Turkish Education System (2019). Accessed 1 Dec 2019, from https://www.avrupa.info.tr/en/project/promoting-integration-syrian-children-turkish-education-system-7010

Ricento, T. (2013). Language policy, ideology, and attitudes in English-dominant countries. In R. Bayley, R. Cameron, & C. Lucas (Eds.), The Oxford Handbook of Sociolinguistics (pp. 552–544). Oxford: Oxford University Press Retrieved May, 5th, 2020, from https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199744084.001.0001/oxfordhb-9780199744084-e-26 ; 5.5.2020.

Ruiz, R. (1984). Orientations in language planning. NABE Journal, 8 (2), 15–34.

Schapiro, K. A. (2009). Migration and educational outcomes of children. In Human development research paper 57 . New York: UN Development Programme.

Schleppegrell, M. J. (2007). The linguistic challenges of mathematics learning and teaching: a research review. Reading and Writing Quarterly, 23 , 139–159.

Schön, D. A. (1983). The reflective practitioner: how professionals think in action . New York: Basic Books.

Shepard, L. (2006). Classroom assessment. In R. L. Brennan (Ed.), Educational measurement (pp. 623–646). Westport: Greenwood.

Statistik Austria (2017). Schülerinnen und Schüler mit nicht-deutscher Umgangssprache im Schuljahr 2016/17. Retrieved August, 8 th , 2018 from https://www.statistik.at/web_de/statistiken/menschen_und_gesellschaft/bildung_und_kultur/formales_bildungswesen/schulen_schulbesuch/index.html

Taras, M. (2010). Student self-assessment: processes and consequences. Teaching in Higher Education, 15 (2), 199–209.

Telhaug, A., Mediås, O., & Aasen, P. (2006). The Nordic model in education: education as part of the political system in the last 50 years. Scandinavian Journal of Educational Research, 50 (3), 245–283.

Thompson-Robinson, M., Hopson, R. K., & Sen Gupta, S. (2004). Editors’ notes. New Directions for Evaluation, 102 , 1–4.

Timperley, H., Wilson, A., Barrar, H., & Fung, I. (2007). Teacher professional learning and development . Wellington: Best Evidence Synthesis Iteration (BES).

Topping, K. J. (2009). Peer assessment. Theory Into Practice, 48 (1), 20–27.

Torrance, H. (2017). Blaming the victim: assessment, examinations, and the responsibilisation of students and teachers in neo-liberal governance. Discourse: Studies in the Cultural Politics of Education, 38 (1), 83–96.

UN (2016). Sustainable development goal 4: targets and indicators [webpage]. New York: UN. Accessed 8 Nov 2018 from https://sustainabledevelopment.un.org/sdg4#targets

UNICEF (2018). UNICEF Turkey 2018 Humanitarian Results. Accessed 8 Oct 2018 from https://reliefweb.int/sites/reliefweb.int/files/resources/UNICEF%20Turkey%20Humanitarian%20Situation%20Report%20No.%2028%20-%20January-December%202018.pdf

Warren, C. A. (2017). Empathy, teacher dispositions, and preparation for culturally responsive pedagogy. Journal of Teacher Education, 69 (2), 169–183.

Wiley, T. G., & Lukes, M. (1996). English-only and standard English ideologies in the U.S. TESOL Quarterly, 30 (3), 511–535.

Windzio, M., Sackmann, R., & Martens, K. (2005). Types of governance in education – a quantitative analysis. TranState Working Papers No.25 Bremen: University.

Yin, R. K. (2009). Case study research. Design and methods . London: Sage.

Young, E. (2010). Challenges to conceptualising and actualising culturally relevant pedagogy: how viable is the theory in classroom practice? Journal of Teacher Education, 61 (3), 248–260.

Download references

Open access funding provided by Johannes Kepler University Linz.

Author information

Authors and affiliations.

Linz School of Education, Johannes Kepler University, Linz, Austria

Barbara Herzog-Punzenberger & Herbert Altrichter

University of Innsbruck, Innsbruck, Austria

Barbara Herzog-Punzenberger

Dublin City University, Dublin, Ireland

Martin Brown, Denise Burns, Gerry McNamara & Joe O’Hara

University of Oslo, Oslo, Norway

Guri A. Nortvedt, Guri Skedsmo & Eline Wiese

Schwyz University of Teacher Education, Goldau, Switzerland

Guri Skedsmo

Pamukkale University, Denizli, Turkey

Funda Nayir

Danube University Krems, Krems an der Donau, Austria

Magdalena Fellner

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Herbert Altrichter .

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix: Interview guidelines

1.1 information about individual schools.

Collect beforehand through webpages or in interview with headperson

Size ( N of students and teachers)

Proportion of migrant students

Location (rural)

Special features (e.g. in curriculum and history)

1.2 Questions for staff interviews

Information about interviewee: m/f, subject teacher, years of teaching experience

In your experience: Has the student composition in your school recently changed? Is there an increased/decreased number of students from minority/migration background? What minority groups do the students in your school come from?

Has this changed the atmosphere/climate in your classrooms? If yes, what kind of change happened?

How many different languages are spoken by your students?

How can teachers best cope with diversity of students? Can you give some practical examples for what you are doing to cope with diversity of students?

Is there teaching material which is helpful for teaching in diverse classrooms? Who is providing/producing this material?

How can teachers use the languages of their students as a resource in the classroom?

If you think of assessment: Are students from minority/migration background reacting differently to assessment situations?

Is it appropriate to adapt assessment situations to the needs of students from minority/migration background?

If yes, in what way assessment can be adapted? What types of assessment can be adapted, are there other types which cannot? Can you give practical examples for what you are doing to adapt assessment to the needs of students from minority/migration background?

Is there assessment material which is helpful for assessment in diverse classrooms? Who is providing / producing this material?

Are there other support measures (e.g. professional development, consultants etc.) which are helpful for teaching and assessment in diverse classrooms? Who is providing / producing support measures?

Is there special collaboration among staff with respect to teaching and assessment in diverse classrooms? What are the focus and the results of this collaboration? Is it helpful for your teaching and assessing in diverse classrooms?

Policies/strategies

Does your school have an explicit policy on assessment? Or an agreement within staff?

If yes, what are the main ideas? Is this relevant for students with a migration background? In what respect?

Does your school have an explicit policy on coping with diversity? Or an agreement within staff?

If yes, what are the main ideas?

Evaluations

In general, do you think that the knowledge and competences of students with minority/migration background are fairly recognised by the usual assessment strategies in your schools?

For what proportion of the group of migrant students in your class will academic success be possible? Why is that?

What do you see as the benefits of teaching and learning with students who have a migration background?

What do you see as the challenges of teaching and learning with students who have a migration background?

What support measures would be really helpful for coping with diversity in your classrooms?

1.3 Questions for student group interviews

Information about interviewees (collect during sampling, not in group interview): m/f, rough indicators for socio-ec background/education level/vocational background [different in different countries], migration background, function: student representative

Do you like to go to school? Why (not)? What are the good sides and the awkward sides of going to school?

How many languages are spoken by this class group?

Do you have opportunity to use all of the languages you speak?

How is assessment usually done in your class? Are there situations other than tests in which you can show what you know?

How do you experience typical assessment situations? Are they easy, difficult? Can you show to the teacher and your peers what you know?

Are teachers interested in your knowledge? Do teachers realise what you know and what you can do—not just with respect to school knowledge, but also to other knowledge acquired in non-curricular situations?

1.4 Questions for parent interviews (a selection of these question is chosen by each national team)

Information about interviewees (collect during sampling, not in group interview): m/f, rough indicators for socio-ec background/education level/vocational background [different in different countries], migration background, function: parent representative, local politician.

Do your children like to go to school? Why (not)? What are the good sides and the awkward sides of going to school? What problems do you encounter with respect to schools?

Do you observe your children growing in the appreciation and use of language?

Do you support your child with his/her school homework?

Do you know how the competencies of your child are assessed?

Is the knowledge of your children appreciated by the school?—not just with respect to school knowledge, but also to other knowledge acquired in non-curricular situations?

Do you know what measures teachers are taking to assess the competencies of all children with fairness and sensitivity?

Do you participate in school activities? Are you encouraged to do so?

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Herzog-Punzenberger, B., Altrichter, H., Brown, M. et al. Teachers responding to cultural diversity: case studies on assessment practices, challenges and experiences in secondary schools in Austria, Ireland, Norway and Turkey. Educ Asse Eval Acc 32 , 395–424 (2020). https://doi.org/10.1007/s11092-020-09330-y

Download citation

Received : 16 February 2020

Accepted : 13 July 2020

Published : 27 July 2020

Issue Date : August 2020

DOI : https://doi.org/10.1007/s11092-020-09330-y

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Cultural diversity
  • Cultural bias
  • Linguistic diversity
  • Find a journal
  • Publish with us
  • Track your research
  • For Middle management & Operational staff
  • Negotiations
  • Presentation Techniques
  • Teambuilding
  • Organisational Development
  • Cheat Sheet

Culture Matters

Cultural Diversity Case Study

by Chris Smit | Sep 10, 2018 | Business

  • StumbleUpon

This Cultural diversity case study describes the impact that cultural differences can have on a large multinational (travel) organization. It also covers the effect that cultural competence training can have to, ultimately, save time and money.

[4-min read]

What Are The Key Take Aways? After following a two-day cultural competency workshop this is what came out: Nobody is right or wrong, we are all just different, so we all need to be open and compromise. We often “ joke ” about our differences, which really helps break down barriers & frustrations which we definitely didn’t know how to deal with before. When I’m recommending your courses to others I often tell a story (a true one) of a conversation I had after I attended the course and a French colleague of mine attended the one in Belgium later in the week. After discussing how much we had enjoyed and learned from the course, I then asked Laurent for some information. His response was “ But Irene, you now know that as I’m French I can’t just give you the information I must verify with my manager first!” I responded, “ But Laurent you know I’m British so I need it NOW! ” After much laughter, we did agree on a compromise date to suit both our needs. The openness and the appreciation for each other’s culture certainly helps support our working relationship and mutually agree on an action plan.

The company name, numbers, and other specifics have been slightly modified to make it more suitable for describing this Cultural diversity case study.

The Company Description

  • Name: Universal International Travel
  • British based, founded in 1932 with head office in London
  • Number of employees: 76,000 mainly European based
  • Revenue: €23.000 billion
  • Products: Chartered and scheduled flights; hotels; travel services

Change Management at its Best

Since the beginning of time, Universal International Travel had been run on a “ per-country-basis “. The Germans took care of the Germans, the Dutch of the Dutch, the French of the French, the Belgians of the Belgians, and the Brits of the Brits. Oh, I forgot the Nordic region…

Cultural diversity case study; boeing dreamliner

  • North America

In 2015, the top management of the company decided that it was time for a major restructuring. This is to make the company ready for the future of demanding business and leisure travelers and also to better deal with increasing (low-cost) competitors.

The French, Germans, Dutch, Belgians, Nordics, and the Brits all had to go and do things together

On paper, that sounds easy. Even if you take out language difficulties, because everyone spoke and speaks English, right?

But in practice, it turned out different…

The Biggest Surprise for Management

In 2016 the HR department of Universal International Travel (UIT) distributed a questionnaire among its first three layers of management. From C-level management to Project management. This is to find out what specific skill needs their management still needed in order to facilitate this cross-border integration.

Their initial expectation was that topics like:

  • Communication,
  • Presentation skills,
  • Negotiation skills,

would be the outcome. But that was not the case. Much to their surprise, almost unanimously these three layers of management suggested the one skill that they were missing was… How to Deal With Other Cultures .

Most people were not so much against the new company structure. But they struggled with the different cultures they now had to deal with. For some reason colleagues from other companies acted strangely; replied in weird ways; didn’t work logically, were wasting time (yes, and money ) by doing so.

And the trouble was that they all thought this of each other. Back and forth. Criss-cross…

Not Everyone Needs to Know Everything

Sandra, who worked in the London head office, contacted me to see if I could be of help to them. I could. We discussed at length what the objectives should be:

  • Awareness of one’s own culture.
  • Understanding other cultures.
  • Being able to communicate effectively with each other.
  • Specific management skills (like negotiations, teamwork, leadership).

But not for everyone. For some people, it would suffice just to be aware of one’s own culture and a better understanding of other cultures. But for some, the level of knowledge should go deeper.

For that reason, I designed a one-day and a two-day workshop.

These workshops were promptly executed in three locations:

Some other workshops, shorter, were held in Spain, Turkey, Bangkok, Mexico, and Amsterdam.

On average, there were about 15 to 20 people per workshop. Enough to give each individual enough “ air-time ” but also to create the necessary group dynamics.

Did C-Level Management Get Involved?

Yes, they did. At one of the workshops in Berlin, Peter, COO based in London, sat in on the two-day workshop. He realized that his C-level colleagues also had to go through this for real change and cultural competence starts at the top.

So, that’s what happened. A couple of weeks later all the big shots (15 of them) had cleared their agenda to spend two days with me in Brussels.

We had good fun but also covered a lot of ground. Management finally realized that wishing an integration to happen doesn’t make it so.

How Did It Trickle Down the Organization?

Something must have been right about the design and execution of the workshops because soon after the first batch of workshops was given, other departments (Aviation, Accounting, Destinations, and IT) started requesting their workshops as well.

I must have seen hundreds of people over the course of two years.

What Were the Main Pain Points?

Here are a couple of typical pain points that kept coming back. Throughout all organizational disciplines:

  • The Brits couldn’t deal with the detailed planning that the Germans wanted; they thought the Germans were far too rigid.
  • The Germans didn’t like that the Brits simply wanted to “ get on with it ” without really knowing what to get on with; there was no plan.
  • The Brits also couldn’t deal with the indecisiveness of the Nordics. They just kept on talking and talking and talking without ever reaching a decision.
  • The Nordics, as the Germans did, found the Brits just wanting to move and move and move. They didn’t involve anyone, which, according to them, they should.
  • The French and Belgians said that the Dutch were just lawless and didn’t listen to anyone, but simply did their own thing.
  • While at the same time the Dutch said about the French and the Belgians that they couldn’t make a decision if their boss wasn’t there.

And of course, there was a lot more that was covered.

What’s the outcome Cultural diversity case study? Who benefitted?

The proof of the pudding is always in the eating. So, I did a little tour through the organization to see how they benefited from being better culturally competent.

Here’s what they had to say:

  • There’s a lot less frustration now when I work with my colleagues from other countries. It has become much more relaxed to communicate.
  • I managed to save quite some time because I now could approach my colleagues much more targeted; I would distribute certain tasks and projects to colleagues whose culture would better support that specific task.
  • And of course, with the above, I managed to save time and therefore also money… the throughput time of certain projects got reduced, which of course means more cost-effective and less cost overall. Which would lead to people having more time to work on other projects, which would make things move faster. Well, you get the point.
  • Many people have also fed back that one of the biggest learnings they have from the course is how others view them and their culture. This makes you very mindful of how others see you and when appropriate impact the way to contribute to meetings and projects.
  • As a native English speaker, I’m very mindful of the words and phrases I use. I can no longer say “ interesting ” even if I do think something is really interesting! [/et_bloom_locked]

What Can You Do?

This real case study does not only pertain to the travel industry. Think about global regional companies like:

  • Netflix (American with its European head office in Amsterdam, the Netherlands)
  • Spotify (Swedish with a global audience)
  • ASML (Dutch company, operating internationally)

Cultural diversity case study; ASML Logo

  • Hotel chains
  • Car manufacturers

Realize that Culture Matters and that you can become culturally competent too.

Keyword: Cultural diversity case study

Get in Touch

If you want to read more read this article:  9 Signs You’re Not Getting It (It’s Culture Stupid!)

An example of a retail business can be  found here.

An article about how the travel business can benefit from cultural awareness can be found here.

The cultural divide between Boing and Airbus. Read the article here.

Get a Taste of How Chris Presents, Watch his TEDx Talk

Email Address

Phone Number

Call Direct: +32476524957

European office (paris) whatsapp: +32476524957, the americas (usa; atlanta, ga; también en español):  +1 678 301 8369, book chris smit as a speaker.

If you're looking for an Engaging, Exciting, and Interactive speaker on the subject of Intercultural Management & Awareness you came to the right place.

Chris has spoken at hundreds of events and to thousands of people on the subject of Cultural Diversity & Cultural Competence.

This is What Others Say About Chris:

  • “Very Interactive and Engaging”
  • “In little time he knew how to get the audience inspired and connected to his story”
  • “ His ability to make large groups of participants quickly and adequately aware of the huge impact of cultural differences is excellent”
  • “ Chris is a dedicated and inspirational professional”

In addition, his presentations can cover specific topics cultural topics, or generally on Cultural differences.

Presentations can vary anywhere from 20 minutes to 2 hours and are given World Wide.

Book Chris now by simply sending an email.  Click here to do so .

Read more about what Chris can do for you.

  • Percentage of People Rating a Presentation as Excellent 86% 86%
  • Rating the Presentation as Practical 89% 89%
  • Applicability of Chris' presentation 90% 90%

About Peter van der Lende

Peter van der Lende International business development

Peter has joined forces with Culture Matters.

Because he has years and years of international business development experience joining forces therefore only seemed logical.

Being born and raised in the Netherlands, he has lived in more than 9 countries of which most were in Latin America.

He currently lives in Atlanta, Georgia (USA) with his family.

You can find out more at https://expand360.com/

Or find out what Peter can do for you here.

  • Recent Posts

Chris Smit

  • 177 Mark Steinberg - 22 February 2024
  • Japanese versus Western Culture - 24 January 2024
  • 176 James Kennedy on Dutch culture - 15 September 2023

Make sure to read at least one more article:

  • How Cultural Similarities Can Lead to Cultural Difficulties. A Case Study Twitter LinkedIn Facebook reddit StumbleUpon buffer Gmail Author Recent Posts Chris SmitChris is passionate about Cultural Differences. He has been...
  • Cultural Diversity in International Business (part 1) Twitter LinkedIn Facebook reddit StumbleUpon buffer Gmail Author Recent Posts Chris SmitChris is passionate about Cultural Differences. He has been...
  • Does Cultural Diversity make You Smile or Cry? Twitter LinkedIn Facebook reddit StumbleUpon buffer Gmail 1 Author Recent Posts Chris SmitChris is passionate about Cultural Differences. He has...
  • Most Common Cultural Diversity Mistakes; 9 Signs You’re Not Getting It Twitter LinkedIn Facebook reddit StumbleUpon buffer Gmail Author Recent Posts Chris SmitChris is passionate about Cultural Differences. He has been...

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

We're looking for new Podcast Guests!

We're looking for new Podcast Guests!

If you think you or someone you know would make a good guest for our Culture Matters on International Business, drop us an email.

(make sure you or the person you know will be able to talk about International affairs!)

Thanks, we'll be back to you soon!

We noticed you're visiting from Belgium. We've updated our prices to Euro for your shopping convenience. Use United States (US) dollar instead. Dismiss

Cultural diversity drives innovation: empowering teams for success

International Journal of Innovation Science

ISSN : 1757-2223

Article publication date: 22 September 2020

Issue publication date: 1 October 2020

Though there is broad agreement on the beneficial impact of diversity in management and leadership roles, much of the innovative capacity of an organization is realized at the unit level in working teams. Recent research points to cultural diversity having an especially significant impact on innovation team performance. The reports also highlight the need for the optimal team operating principles to derive maximum benefit. To prepare such innovation teams for success, it is valuable to understand the dynamics of team diversity at the project level and the underlying barriers and opportunities presented.

Design/methodology/approach

This paper reviews the literature and case studies on cultural inputs to ideation and innovation, assessing team diversity through readily available instruments and the deployment of the science of team science (SciTS) principles in innovation teams.

The key learnings include the importance of establishing communication standards, SciTS principles, team assessment of thinking styles and the utility of cultural awareness instruments.

Practical implications

Diversity provides a creative advantage for innovation teams. However, team dynamics play an important role in maximizing these advantages, and cross-cultural competence of team members is required. Deployment of appropriate assessment tools and team methodologies enhances the likelihood of successful outcomes including in remote team settings.

Originality/value

Literature from diverse functional areas is summarized including the science of team science, organizational management, diversity and inclusion methodologies and ethnocultural dynamics. It provides pointers for the optimal formation and operating principles with highly culturally diverse teams.

  • Implementation
  • Team science

Jones, G. , Chirino Chace, B. and Wright, J. (2020), "Cultural diversity drives innovation: empowering teams for success", International Journal of Innovation Science , Vol. 12 No. 3, pp. 323-343. https://doi.org/10.1108/IJIS-04-2020-0042

Emerald Publishing Limited

Copyright © 2020, Graham Jones, Bernardita Chirino Chace and Justin Wright.

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) license. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this license may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

Numerous studies confirm the positive impact of diversity at board level, executive leadership and managerial roles in organizations. In the case of innovation, in addition to strategic leadership, one must of course consider the innovation process itself, which typically involves ideators and entrepreneurs from varied backgrounds who work in smaller teams driven by strategic goals ( Nelson, 1991 ). Diversity of thought and approach are naturally assumed to be beneficial to the innovation process, which by its very nature thrives on creative tension and alternating viewpoints. Despite the potential to have a major influence on productivity and impact, relatively few dedicated studies have been reported on the links between diversity and innovation ( Joecks et al. , 2013 ). Factors to consider include, gender, cultural, ethnic, country of origin, geographic location and disciplinary diversity. Studies on gender diversity have modeled the performance impact of uniform, skewed, tilted and balanced groups, often assessed using the Blau index ( Blau, 1977 ). Although not specifically addressing innovative potential, there is overwhelming evidence that gender heterogeneous teams produce higher quality technical and scientific outputs ( Campbell et al. , 2013 ) but concerted engagement is also needed to realize these benefits fully within organizations ( Zheng, 2013 ). One study by the Boston Consulting Group modeled the impact of six components of diversity on innovation team performance (BCG, 2018). Conducted through a survey of >1,700 employees in 8 countries (Austria, Brazil, China, France, Germany, India, Switzerland and the USA) the study examined perceptions of diversity components at management level (gender, age, the nation of origin, career path, industry background and education). Two features are noteworthy. First, a statistically significant correlation was observed between innovation performance and the diversity of management teams across all six diversity indicators (approximately 20% improvement in innovation revenues). Second, the most pronounced impact driver was the nation of origin of team members ( Table 1 ).

If substantiated, this has potentially far-reaching consequences in the pharmaceutical industry where numerous multinational corporations are headquartered around the globe, and routinely assemble and engage teams (both physically and remotely) from vast and highly diverse populations. The revelation even prompted the quote “for management teams there are few slam dunks in the business world – this is one of them” (BCG, 2018). The cultural dimensions uncovered in this survey have been the subject of other research. In an unrelated study, conducted through a survey of 500 corporate executives one in two respondents believed there exists a positive correlation between cultural diversity and innovation drivers ( Bertelsmann, 2018 ). Despite this admission, some 42% of respondents indicated that their organizations did not focus on hiring diverse workforces. The study goes on to conclude that the more varied an innovation team is in terms of country of origin the greater the impact. The authors ascribe this to employees with diverse backgrounds having specific cultural knowledge, which can be deployed to assess and solve problems in different ways, and they may also have a higher tolerance for taking risks. Caution is also signaled in that different cultural methods of interpretation and values can present challenges in team settings, as there exists the potential for misunderstanding among members. This underscores the importance of studying team dynamics to maximize potential and fully exploit the value of team diversity ( vide infra ). Accordingly, the impetus for assembling this review was to highlight studies, which assess the origins and impact of cultural diversity on innovation team performance, readily available instruments, which assess cultural contributions and tools which can be deployed to optimize team dynamics. Our focus area is on innovation teams and it is of course recognized that corporate innovation is guided by business drivers which may determine the composition, scope and success factors of any given team ( Nelson, 1991 ). Nonetheless, given the significance and implications of the subject matter across various industries (BCG, 2018) it is instructive to examine even in the most general sense.

Power distance index (PDI):

“The extent to which people expect and agree that power should be shared unequally.”

A higher degree signifies hierarchy is clearly established, a lower degree that people question authority.

Individualism vs collectivism (IDV):

“Degree to which society rewards individual versus collective action.”

Higher degrees, individualistic societies, emphasize the “I” versus the “we.”

Uncertainty avoidance (UAI):

“A society’s tolerance for ambiguity.”

A higher degree suggests societies, which opt for stiff codes of behavior, guidelines and laws.

Masculinity vs femininity (MAS):

“Societal preference for achievement, heroism, assertiveness and material rewards for success.”

Its counterpart values cooperation, modesty, caring for the weak and quality of life.

Long-term orientation vs short-term orientation (LTO-STO):

“A societies’ connection of the past with the current and future actions/challenges.”

In high preference, LTO traditions are honored, whereas in STO adaptation is viewed as a necessity.

Indulgence vs restraint (IND):

“Degree of freedom societal norms afford to citizens in fulfilling their human desires.”

In its counterpart, society controls gratification and regulates by means of strict social nor.

Specimen dimensions data are presented for the six most populous nations in the world, plus Switzerland, highlighting the wide scoring ranges typically observed ( Figure 1 ). Implicit within the data are myriad dynamic factors including religious preferences, governmental structures, historical backgrounds, philosophical beliefs, coupled with socio-economic drivers e.g. education, health, poverty, incarceration rates, etc. Obviously, due caution and judgment need to be exercised when viewing such data, as individual choices, behaviors and attitudes that are contrary to those implied by the indices will be expected and stereotypes should be avoided. Additionally, great regional differences can exist within individual countries (e.g. the USA and Switzerland) and even cities (urban v suburban). It is also recognized that nations continually evolve – the disintegration of the former Yugoslavia into culturally distinct countries being a case in point. Moreover, individuals who live in different countries during their formative years would be expected to be influenced by the multiple environments and a single point of reference could be entirely misleading.

There is a negative relationship between power distance and innovation.

There is a negative relationship between uncertainty avoidance and innovation.

There is a positive relationship between individualism and innovation.

There is a negative relationship between masculinity and innovation.

Significantly, H1, H2 and H4 were supported by data regarding patenting intensity. In the case of H3 , though partially supported by data the authors concluded that the impact of family collectivism versus corporate collectivism complicated data sets, precluding a definitive outcome ( Kaasa and Vadi, 2010 ). The authors advance that a reliable link between cultural dimensions and patenting intensity does exist. Obviously, caution needs to be exercised using patents as a surrogate for innovation activity as decisions to pursue are complex undertakings, requiring significant capital investment, often describing inventions a long way prior to market introduction and which in some cases are used defensively ( Martínez-Piva, 2009 ). Nonetheless, they are generally accepted as one of several measures of performance at the so-called “fuzzy front end” of innovation or FFEI ( Gassmann and Schweitzer, 2014 ). Additional studies have examined the impact of culture on innovation ( Herbig and Dunphy, 1998 ), including national ( Shane, 1993 ) and multi-nation studies ( Dakhli and de Clercq, 2004 ), downward trends in cultural differences in Europe ( Gooderham and Nordhaug, 2002 ) and the impact of national networks ( Ahuja, 2000 ). Related work has mapped national culture correlations to two individual components of innovation, namely, the initiation and implementation phases ( Nakata and Sivakumar, 1996 ). For example, the contribution of individualism (ranked high in the USA) to the first, initiation stage of innovation can be understood (ideation and concept testing), as equally can be the value of collectivism (ranked high in Japan) to the second, implementation phase of innovation (product development and launch) which requires concerted, group effort. These studies are insightful, and, coupled with comparative re-assessments between Eastern and Western cultures ( Wu, 2006 ), have allowed researchers to correlate observed contributions to innovation with national propensities ( Smale, 2016 ).

Though understanding the drivers and proclivities of individual contributors is instructive, an obvious challenge lies in managing the dynamics of innovation teams to establish the most creative and productive environment. Studies suggest that published outputs from diverse teams are cited more frequently than from those with less heterogeneity, and the notion that ethnic diversity reflects idea diversity has been advanced ( Freeman and Huang, 2014 ). It has also been suggested that the management of teams with high cultural diversity may warrant special considerations within organizations ( Mannix and Neale, 2005 ). Accordingly, when capitalizing on opportunities imbued by cultural diversity in innovation teams, attention to cultural competence of assembled teams (cultural intelligence (CQ)) should also be studied, alongside traditional evaluative (EQ and IQ) measures.

Cross-cultural competence in innovation teams

Assembling teams who hail from a multitude of diverse cultural backgrounds is a routine occurrence in modern multinational corporations, and especially prevalent in the global pharmaceutical sector. Accordingly, a degree of cross-cultural awareness and competence could be considered a natural advantage to a team member. In addition to working within the team, cross-cultural competence could also be valuable for interactions external to the organization e.g. customers, suppliers, regulators and patients in the myriad markets the team is engaged in ( Ramalu et al. , 2010 ). For these reasons, it is logical that an assembled team considers the cultural awareness and competence (CQ) of its members ( Ang and van Dyne, 2008 ). Such insights could be reasoned to help the team establish itself and function more effectively, and would have added value within innovation teams. Creative tensions are expected and encouraged in such environments, and CQ competence could reduce the likelihood of any ad hominem behaviors by reducing potential misunderstandings and miscommunications which have cultural origins. These cultural touchpoints can range from subtle, interpersonal nuances through to organizational edicts and operating models and team members with experience would be able to mentor and socialize new colleagues. For example, when communicating decisions stemming from teams and units, in certain countries (e.g. India and Japan) they are sometimes pre-socialized in smaller groups to secure buy-in prior to formal announcements, whereas in others (e.g. the USA) external advisors are often engaged to make recommendations which are subsequently announced ( Gibson and Gibbs, 2006 ). Navigating these norms requires due diligence and skill, best gained from exposure to the cultural elements in person or through structured training. Even at the most basic level, conversational styles need to be mindful of cultural norms ( Ang and Van Dyne, 2008 ). For example, in some countries pauses in conversations are deliberate, injected to allow the parties to reflect upon and honor what was just said. Conversely, some cultures seem to promote the rapid exchange of conversational points as a sign of productivity and alignment (the USA is a good example). Accordingly, one needs to be mindful not to unintentionally show disrespect to a person based on the cadence of a conversation ( Fussell and Setlock, 2012 ). As diligent employees will no doubt be mindful of these issues in a global corporation, they can become of special significance for the effective functioning of culturally diverse teams. Another example can be observed in the way different cultures use facial expressions to communicate ( Barrett et al. , 2019 ). While in certain western countries an exaggerated smile may be offered to an individual to express welcoming and project a degree of confidence, in other countries it can be deemed inappropriate ( Coles et al. , 2019 ). Japanese business culture values humility and suppression of emotions to convey trust, and fewer emotions are communicated using the mouth (Stanford, 2016). Smiling at a stranger in other countries can be interpreted as a sign of stupidity, insanity, insincerity or even dishonesty ( Krys et al. , 2016 ). Likewise, the application of direct eye contact can be interpreted as a sign of confidence and respect in some countries whereas in others it can signal disrespect and insubordination, requiring cultural context and awareness ( Uono and Hietanen, 2015 ). In-depth studies have been conducted on the perceptions of facial expressions, including the so-called “Duchenne” smile and apparent disconnects between people’s self-reported degree of happiness and smile tendency ( Gunnery and Hall, 2014 ). It has also been determined that of a possible total of 16,384 possible facial configurations, only 35 are used to transmit emotive information across cultures and within these 8 are dominant in most cultures ( Srinivasan and Martínez, 2018 ). Correlations with the Hofstede cultural dimensions have also been explored. In countries with low scores on the uncertainty avoidance dimension (UAI) non smiling individuals were deemed as more intelligent ( Hareli and Hess, 2010 ), and second, in countries with high corruption indicators, smiling correlated with reduced levels of trust ( Ozono, 2010 ). Another crucial factor for team members relates to communication style ( Figure 2 ). Under the principles outlined by Hall ( Hall, 1977 ), individuals can be categorized as either direct or indirect communicators and there are cultural underpinnings for each ( Gudykunst and Ting-Toomey, 1988 ). Under this framework, direct communicators are seen to operate with a low situational context, with a high emphasis on actual words being spoken irrespective of any possible nuances ( Hall, 1977 ).

Conversely, an indirect communicator will place a high degree of context to the conditions under which words are spoken including tone, body language and what is not said in addition to spoken word ( Clyne et al. , 2009 ). Though most people function as a blend of the two, extreme differences between the two approaches can naturally lead to conflict or misunderstanding in team settings, e.g. where an email communication might be interpreted as blunt or obtuse by one member or straight to the point/not beating about the bush by others ( Management, 2014 ). The more culturally diverse the team, the more important it becomes to understand each member preferred communication styles, to the point of which guidelines may become appropriate ( Mayer and Bello, 2012 ). In an attempt to codify/quantitate our capacity to function effectively in culturally diverse settings, a cultural intelligence index or CQ has been developed ( Van Dyne et al. , 2012 ).

The cultural intelligence four-factor model

Metacognitive CQ, which represents a person’s consciousness and awareness of cultural cues during interactions with people from other cultural backgrounds. It has also been described as representing the processes we use to acquire and understand cultural knowledge.

Acquired through a combination of education and personal experience, cognitive CQ represents our level of competence of the conventions, practices and norms used in different cultural settings. This can include social systems and structures of other cultures and their value systems.

Motivational CQ assesses the level of interest and energy directed toward learning and functioning in situations characterized by cultural differences people with high motivational CQ express confidence in their personal cross-cultural effectiveness.

Behavioral CQ measures peoples’ ability to exhibit appropriate verbal and nonverbal behavior when interacting with people from different cultures. This may include, for example, the use of culturally appropriate words, tones, gestures and facial expressions.

Significantly within the context of this paper, a study of 73 teams with over 327 members revealed that high levels of CQ within multi-cultural teams had a positive benefits, equipping the teams to overcome numerous obstacles and potential barriers ( Moon, 2013 ). A number of scales and assessment modalities have been developed to gauge CQ competence, including the Intercultural Adjustment Potential Scale (ICAPS) ( Matsumoto et al. , 2001 ), the Cultural Intelligence Scale (CQS) and the Intercultural Developmental Inventory (IDI) ( Matsumoto and Hwang, 2013 ). While the IDI is often deployed for individuals engaging on overseas assignments and the ICAPS for individuals in global leadership roles ( Rose et al. , 2010 ), the CQS is seen as a useful assessment for multicultural teams and has been studied globally with different audiences ( Ng et al. , 2009 ). Pioneered by the Cultural Intelligence Center in the USA, the assessment focuses on specific capabilities, namely, CQ drive (motivation), knowledge (cognition), strategy (metacognition) and action (behavior) ( Figure 3 ; SHRM, 2015 ).

Respondents receive an integrated assessment including the four key dimensions, and also personal orientation on a total of 10 culture value dimensions, which are compared against tendencies within the 10 largest cultural cluster groupings recognized globally as illustrated in Table 2 ( Jung, 1933 ; Pittenger, 1993 ). Outputs from the assessment consist of a scoring regimen (0–100 scale) for each of CQ drive, knowledge, strategy and action with 3 or 4 sub-categories in each grouping. A reference scale is provided against worldwide norms for each category and sub-category, recorded as low (bottom 25%), moderate (middle 50%) and high (top 25%). The assessment comes with a workbook allowing respondents to develop and deploy strategies and tactics to address low scoring areas.

The roots of the culture value dimensions used in the CQS assessment instrument have origins in other models, including the PDI, IDV, UAI and LTO indices advanced in the Hofstede analyzes. Though necessarily inexact based on personal circumstances, environment and beliefs, the value dimensions have been mapped against the major cultural clusters into high, medium and low tendencies based on analysis of published studies ( Ng et al. , 2009 ; SHRM, 2015 ). The mere suggestion of potential differences across the dimensions and the purported range of preferences serves to raise awareness of cross-cultural complexities which can factor into team dynamics and signals the importance of CQ knowledge ( Figure 4 ).

The relative contributions of the four CQ dimensions to work-related functions have been investigated and highlight distinct relationships between components. Through consistent patterns, metacognitive CQ and behavioral CQ predict task performance, metacognitive CQ and cognitive CQ predict both cultural judgment and decision-making ability and motivational CQ plus behavioral CQ predict cultural adaptation. Accordingly, CQS assessment would seem particularly useful for members of newly formed culturally diverse teams, and for individuals relocating to a new (cultural) environment ( Ang et al. , 2007 ). More recent studies have attempted to correlate relationships between CQ and individual personality traits ( Lievens et al. , 2003 ). The prevailing taxonomy on human personality is commonly referred to as the “Big Five” model ( Murugesan and Jayavelu, 2017 ).

The big five model of personality

Extraversion (sociable, assertive, ambitious).

Agreeableness (friendly, trusting, cooperative).

Conscientiousness (responsible, organized, dependable).

Emotional stability (control, calm, secure).

Openness to experience (imaginative, inquiring, artistic).

As the Big Five model has been validated across cultures, there is a natural interest in associations between individual factors and the “four factors” of CQ dimensionality. Based on a number of studies in different settings, relationships have been correlated which allow connections between personality and cultural competence to be made ( Ang et al. , 2006 ). Such has far-reaching consequences, given the expanding diversity and mobility of the global workforce and may have special connotations within innovation teams ( Elenkov and Manev , 2008, 2009 ). Research has also been conducted to validate the correlations by studying team coaches ( Devin, 2017 ).

Conscientiousness and metacognitive CQ.

Agreeableness and emotional stability with behavioral CQ.

Extraversion with cognitive, motivational and behavioral CQ.

Openness with all four factors of CQ.

Assessing the composition of teams

The majority of projects conducted in the pharmaceutical industry are through divisional channels with personnel who were hired based on specific skill sets. Teams within these sub-organizations (often called line functions) will be pre-formed and ready to deploy or will assemble then disassemble as needed as projects are identified. Considerable effort has been devoted to our understanding of team dynamics and the contributions of individual members through the assessment of personality traits and modes of engagement. The origins of personality typing date back to the Greco-Roman era with the description of the “four temperaments” by Hippocrates (c.460–c.370 BC). According to this proto-psychological theorem, four medical determinants (sanguine, choleric, melancholic and phlegmatic temperaments) were assigned as personalities based on the relative prevalence of bodily fluids and the possibility of mixed categories advanced were personality types overlapped ( Merenda, 1987 ). Some 2,300 years later, application of personality classification and typing became of prime importance in the post-industrialized business world where tasks began to involve diverse teams of workers. One of the most widely used assessment tools is the Myers-Briggs type indicator (MBTI) which is designed to highlight specific personality factors, which may influence behavior in a team ( Jung, 1933 ). Based on the theories of Swiss psychologist Carl Jung the instrument provides an assessment of individuals’ preferred stances within team environments, with binary categorization in terms of attitudes ( I ntrovert/ E xtrovert), lifestyle ( J udging/ P erceiving) and functions ( S ensing/ I ntuition and T hinking/ F eeling) ( Pittenger, 1993 ). The various combinations of tetrads (16 total) are assigned monikers which serve as terms of reference for the individual and team members who will interact with the person ( Table 3 ). Of interest to innovation communities, it is suggested that Apple CEO Steve Jobs was an ENTJ (“Field Marshall”), Albert Einstein INTP (“Architect”) and Thomas Edison an ENTP (“Inventor”).

In terms of diversity elements, based on an analysis in >30 countries all of the type preferences (E/I, S/N, T/F and J/P) have been observed in each culture studied, however, distribution of the 16 types differ across cultures but retain patterns within these cultures. Across all cultures, (X)STJ is the predominant triad and men in each culture typically respond for T (c.f. F) at rates ranging from 10–25% higher than for female respondents ( Seegmiller and Epperson, 1987 ). Jung’s work also extended to the related DISC assessment tool, which scrutinizes four areas of behavior, namely, D ominance (in approach to problem-solving), I nfluence (approach to people), S teadiness (pace and attitude to change) and C ompliance (procedures, standards) ( Jones and Hartley, 2013 ).

Another popular assessment tool is the team roles system introduced by Belbin (2010) . The instrument is derived from analysis of clusters of behaviors and skills that are required to produce team results and is embodied in a total of nine teams “roles” which stem from three centricities, namely, thinking, action and people-oriented ( Table 4 ).

Belbin role assessment allows team members to identify their preferred roles in a team and also uncover inherent strengths, which they may be unaware of. Though no concrete correlations between the MBTI and Belbin system are evident, the use of the former to gain insight to personality factors and the latter for behavioral pointers has been advocated for effective team building ( Higgs, 1996 ). Although the Belbin and MBTI assessments provide useful pointers for the assembly and successful working of cross-functional teams, for innovation-centric programs the Four Sight Thinking Profile has gained popularity. Its basis is that four fundamental forms of thinking roles are used in creative processes (clarification, ideation, development and implementation) and the relative preferences for each allow categorization for team building ( Bratsberg, 2012 ). Team members develop a chart, plotting high and low preferences for each of the four categories, providing a holistic view on preferences and proclivities that the individual and team can use ( Figure 5 ). For individuals with a single high preference (against statistical means), they are assigned a designation from one of the four categories. Individuals with two or three high preferences are designated into sub-categories and were equivalent in all four categories, as an integrator ( Figure 6 ).

Similarly to other evaluative instruments, the Four Sight program provides participants guidance on the best mode of interaction with colleagues in each of the 15 possible categories, which can be pivotal for team building. For example, it is suggested that ideators who are often regarded as “spontaneous,” “imaginative” and “adventurous” should be afforded “constant stimulation,” “variety and change” and “scope to dream” by other teams members. Equally importantly, the instrument points to areas where ideators may cause friction for the team e.g. by drawing attention to themselves, being impatient or too abstract, allowing them to modify their approach. The utility of the instrument for innovation teams is underscored by the fact that two of the preferences (ideator, implementer) map directly to the two phases of innovation (initiation, implementation). In terms of relationships with other assessment tools, the communicating author recorded high preference as a driver under Four Sight, typed as ENTJ ( Field Marshall ) with Myers-Briggs and shaper with Belbin, suggesting action-oriented roles in all three.

While MBTI, Belbin and Four Sight represent assessment tools useful for team assembly and functioning, some other more reflective team profiles have also been advanced including the 9 innovation team personality types articulated by the Mayo Clinic Center for Innovation ( Figure 7 ) ( Van Wulfen, 2009 ). It is easy to recognize and identify with some of these characters, and many will map onto Belbin and MBTI profiles readily. In a similar vein and with a degree of comedic interpretation (inspired by characters in a children’s book series), in their award-winning innovation text The Corporate Startup , Viki, Toma and Gons identify eight innovation characters/caricatures which allow people to relate to Viki et al. (2017) . Though certain team members may naturally exude one such persona it is also an interesting proposition to have team members deliberately adopt one for the purposes of role-play discussion or order that all viewpoints represented by the characters are articulated and appreciated.

No discussion of team roles would be complete without mention of de Bono’s six hats ( Table 5 ). The so-called six thinking hats model is a tool to promote parallel then lateral thinking in groups and teams. Each imaginary hat ascribes a designated mindset of an individual, and discussions are choreographed by the wearer of the blue hat, who is the group/team controller ( Kivunja, 2015 ). On socializing the particular topic for discussion, the white hat bearer seeks to clarify information, the red hat bearer delivers an emotional response, the yellow hat bearer positive elements, the black hat bearer cautions and concerns and the green hat bearer creative opportunities. This can be an effective tool for entire teams to adopt a single hat/thinking mode (with the exception of blue which is singular) to align on parallel thinking and then be assigned assorted hats for lateral thinking. The added benefit of this approach is that if conducted with random assignments, individuals may be forced to act outside their comfort zones, promoting personal growth and empathy for team members with differing natural preferences.

The science of developing diverse innovation teams: the science of team science

Forming : The team is established using either a top-down or bottom-up approach.

Storming: Team members establish roles and responsibilities. This can often be the onset of turf battles as persons from diverse backgrounds exchange views through a combination of dialog and debate. If the pressure to reach consensus prematurely is avoided, this phase can be particularly creative as the full team is more likely to input.

Norming: Team members begin to work together effectively and efficiently, start to develop trust and comfort with one another and learn they can rely on each other.

Performing: The team works together seamlessly, focuses on a shared goal and efficiently resolves issues or problems that emerge.

Teams may come to a natural end. The team’s dissolution should be celebrated and the accomplishments recognized and rewarded.

The team may take on a new project with a new goal, applying its ability to work together to solve a new problem.

Absence of trust.

Fear of conflict.

Lack of commitment.

Avoidance of accountability.

Inattention to results.

Within these, fear of conflict is often seen as the most pervasive and insurmountable issue. On any challenging project, the team will be continually exchanging viewpoints from differing perspectives and vulnerability and trust are key issues that need to be addressed. Individuals have widely differing approaches to conflict resolution, and the Thomas-Kilmann Conflict Mode Instrument was developed to help team members identify their most natural style. The five styles categorized are, namely, competing, accommodating, avoiding, collaborating and compromising ( Thomas and Kilmann, 1974 ). Another key success factor for teams is to understand and navigate the boundaries of dialog and debating schemas ( Table 6 ). As articulated by Berman, very different drivers are associated with each and recognizing these behaviors upfront can allow a team to steer clear of potential conflict forming activities ( Berman et al. , 1997 ). Collectively, these SciTS learnings have been found to be equally applicable from fundamental through to translational research and have become recommended reading for any cross-functional and/or diverse team ( NIH, 2010 ).

Equipping innovation teams for success

The process of innovation has been described using a variety of terms, but within the context of the pharmaceutical industry, we refer to the ideation, design, initiation and subsequent implementation of novel scientific and technological approaches for the development of new products. Innovation within the industry is typically confined to a restricted number of products, which vary from company to company based on expertise, therapeutic areas and collaborative agreements and the products themselves can be either branded or generic. In the strictest sense, it has been argued that the business does not routinely engage in white space or open innovation and instead largely innovate in areas of competence and familiarity ( Nelson, 1991 ). However, from time to time there are groundbreaking advances that open new avenues in health-care and disrupt the industry e.g. life-saving gene therapies, CAR-T immunotherapies and drug-free all digital therapies which were introduced in the past few years alone. What is well understood within organizations, however, is that competition is ever-present and the discovery, production and management of new medications represents a global challenge that requires continuous forms of innovation throughout the organization. For this reason, organizations study the structure, formation, operation and performance of teams very closely to derive maximum benefit. Measuring the outputs of innovation within a team can sometimes be challenging given the incubation period for marketed products can often exceed a decade, by which time a team’s composition will have changed many times. Another more focused approach to innovation within the industry can be to deliberately establish designated innovation teams assigned to tackle specific problems rapidly. In this case, there is a degree of control that can be exerted in the selection of the team, and it is commonly recognized that the diversity of the team (across multiple dimensions) leads to myriad benefits. Fortunately, the modern global pharmaceutical industry is blessed with a highly diverse workforce, making individual team diversity a routine expectation. Our interest and motivation behind the writing of this review are to begin to understand how aspects of team diversity benefit innovation teams. In this context we refer to teams, which have been assembled to execute on a project within a fixed time period, and where the expected outputs will include generation of new knowledge, reducing to practice a new process or product or development of proprietary principles. In each case, a metric could be a generation of a patentable idea, trade secret or publishable concept related to a product intended to enter the marketplace. The recent reports on the correlation between a team’s cultural diversity and higher innovation performance (BCG, 2018; Bertelsmann, 2018 ; Kaasa and Vadi, 2010 ) are intriguing and are readily relatable. Teams composed of members from diverse backgrounds may approach problems from different perspectives and have different tolerances for risk-taking, both of which are essential attributes needed in creative, innovative teams. A corollary exists, however, in that the more diverse the team, the more potential for culturally inspired misunderstandings to occur, which may be exacerbated under conditions where creative tensions are heightened and time constraints are omnipresent. Accordingly, it is likely that a study of dynamics and operating principles can benefit the entire team, and thus forms a substantial component of this review. Equally importantly, many scientists and engineers will be unaware of the cultural origins of different decision-making processes or communication preferences which over time might be detrimental to the team. For teams established over a long period, it could be expected that members learn each other’s preferences, proclivities and idiosyncrasies which attenuates the potential for conflict. In contrast, a freshly formed culturally diverse (innovation) team might need to adapt very quickly, underscoring the need for active assessment and coaching during the onboarding process.

Many of the excellent tools and approaches described herein can provide key learnings for teams and offer unique perspectives tailored to individual circumstances. Through a series of systematic evaluations of the tools and instruments described herein, our internal innovation program selected the CQS assessment, FourSight preference and SciTS framework for deployment in innovation teams ( Jones et al. , 2020 ). They are being made available to all newly formed teams, actively supported by coaches who are versed in deploying their learnings in mentoring activities and initial results are encouraging ( Jones et al. , 2020 ). The formation and normalizing of an innovation team represent two important phases in its development, but it is also imperative that the team’s operating principles are appropriate. For any innovation team, openness, trust, candor and psychological safety are pre-requisites for success and to monitor the health of the team an anonymous/confidential scorecard tool is advocated ( Figure 8 ). Adapted from SciTS principles, this is used to record progress or signal advanced warnings at specific intervals during the project, allowing intervention by the assigned coach if necessary ( Jones et al. , 2020 ). Aggregate analyzes from these surveys (issued with regular frequency) are shared with teams with emphasis placed on driving to full inclusivity for all team members. We believe with these guidance teams have the maximum chances of success and a framework is in place to monitor impact over extended periods and multiple cycles. We intend to report the long term findings and implications from these studies in due course ( Jones et al. , 2020 ).

Conclusions and implications

A considerable body of literature supports the notion that cultural diversity in teams correlates with improved innovation performance. Creative tensions in these teams need to be managed appropriately and numerous excellent instruments and strategies are available to leaders. Ideally, these should include cultural assessment (awareness and competence), team dynamics (individual and team integration) and inclusive and transparent operating principles grounded in team science methodology. Systematic analysis using appropriately powered studies and controls will ultimately help quantitate the impact of various components in innovation teams and across programs, although initial observations from our internal innovation program are encouraging ( Jones et al. , 2020 ). Such learnings could then be used to inform and guide team development and ultimately allow correlation of diversity elements with predictive outcome metrics. The high levels of cultural diversity in the global pharmaceutical industry make it ideally suited to study these key topics. Another principle to study is whether the behaviors learned in diverse innovation teams are then transferred to new teams that the individuals participate in. Equally interesting is to study whether diverse, established teams diminish their innovative capacity over time due to a normalization process. This could lead to the concept of regular rotations through different teams helping maximize the impact and learnings. With the steady globalization of industries and the increasingly diverse workforce, studies of this nature can play an important role in the success of innovation programs. Scientists, engineers and technologists may seldom read the social science or management literature, but the availability of intuitive tools and instruments to empower their teams to success will ensure continual progress is made. Finally, successful adaptation to remote working conditions mandated by social distancing requires consideration of intra- and inter-team dynamics and the learnings can provide additional benefit for innovation teams operating virtually for extended periods.

case study about cultural diversity

Cultural Dimension maps for the six most populous nations plus Switzerland

case study about cultural diversity

Cultural Relationships to Communication Preferences proposed by Hall ( 1977 )

case study about cultural diversity

Components of the CQS Profile developed by the Cultural Intelligence Center

case study about cultural diversity

A total of 10 culture value dimensions used in CQS assessment

case study about cultural diversity

Specimen Four Sight thinking preferences plot

case study about cultural diversity

The 15 Four Sight Thinking Profiles

case study about cultural diversity

Hypothetical Team Characters from the Mayo Clinic CFI (left) and The Corporate Startup (right)

case study about cultural diversity

Team Performance and Inclusivity Tracking Tool

% Leadership team appointments needed to effect a 1% increase in innovation revenue

The 10 largest cultural groupings globally

The 16 Myers-Briggs type indicators

The nine Belbin team roles

The six hats of de Bono

The dialog and debating schemas articulated by Berman (Berman et al. , 1977)

Ahuja , G. ( 2000 ), “ Collaboration networks, structural holes, and innovation: a longitudinal study ”, Administrative Science Quarterly , Vol. 45 No. 3 , pp. 425 - 455 .

Ang , S. and Van Dyne , L. ( 2008 ), “ Handbook of Cultural Intelligence: Theory, Measures and Applications , ”, Armonk .

Ang , S. , Van Dyne , L. and Koh , C. ( 2006 ), “ Personality correlates of the four-factor model of cultural intelligence ”, Group and Organization Management , Vol. 31 , pp. 100 - 123 .

Ang , S. , Van Dyne , L. , Koh , C. , Ng , K.Y. , Templer , K.J. , Tay , C. and Chandrasekar , N.A. ( 2007 ), “ Cultural intelligence: its measurement and effects on cultural judgment and decision making, cultural adaptation and task performance ”, Management and Organization Review , Vol. 3 No. 3 , pp. 335 - 371 .

Barrett , L.F. , Adolphs , R. , Marsella , S. , Martinez , A.M. and Pollak , S.D. ( 2019 ), “ Emotional expressions reconsidered: challenges to inferring emotion from human facial movements ”, Psychological Science in the Public Interest , Vol. 20 No. 1 , pp. 1 - 68 .

Belbin ( 2010 ), Roles at Work, Meredith Belbin , 2nd ed. , Imprint Routledge , London , doi: 10.4324/9780080963242 .

Berman , S. , Burt , L. , Mayo-Smith , D. , Stowell , L. and Thompson , G. ( 1997 ), Dialogue: turning Controversy into Community , Educators for Social Responsibility , Cambridge, MA .

Bertelsmann. ( 2018 ) “ Cultural diversity has a positive impact on innovation ”, Bertelsmann Stiftung , available at: www.bertelsmann-stiftung.de/en/our-projects/living-diversity/project-news/cultural-diversity-has-a-positive-impact-on-innovation/

Bezrukova , K. ( 2013 ), “ Understanding and addressing faultlines ”, Presented at the National Research Council’s Workshop on Science Team Dynamics and Effectiveness , Washington, DC , available at: http://sites.nationalacademies.org/cs/groups/dbassesite/documents/webpage/dbasse_083763.pdf .

Blau , A. ( 1977 ), Inequality and Heterogeneity: A Primitive Theory of Social Structure , Free Press , New York, NY .

Bratsberg , H.M. ( 2012 ), “ Empathy maps of the four sight preferences ”, Creative Studies Graduate Student Master's Projects. Paper 176 , available at: https://pdfs.semanticscholar.org/d4e9/e13a43847ce1ecebec806206f2d8fe676dad.pdf

Bücker , J. , Furrer , O. and Lin , Y. ( 2015 ), “ Measuring cultural intelligence (CQ): a new test of the CQ scale ”, International Journal of Cross Cultural Management , Vol. 15 No. 3 , pp. 259 - 284 .

Campbell , L.G. , Mehtani , S. , Dozier , M.E. and Rinehart , J. ( 2013 ), “ Gender-heterogeneous working groups produce higher quality science ”, PLoS One , Vol. 8 No. 10 , pp. e79147 .

Carton , A.M. and Cummings , J.N. ( 2013 ), “ The impact of subgroup type and subgroup configurational properties on work team performance ”, Journal of Applied Psychology , Vol. 98 No. 5 , pp. 732 - 758 , doi: 10.1037/a0033593 .

Clyne , M. , Norrby , C. and Warren , J. ( 2009 ), Language and Human Relations: Styles of Address in Contemporary Language , Cambridge University Press .

Coles , N.A. , Larsen , J.T. and Lench , H.C. ( 2019 ), “ A Meta-analysis of the facial feedback literature: effects of facial feedback on emotional experience are small and variable ”, Psychological Bulletin , Vol. 145 No. 6 , doi: 10.1037/bul0000194 .

Dakhli , M. and de Clercq , D. ( 2004 ), “ Human capital, social capital, and innovation: a multi-country study ”, Entrepreneurship and Regional Development , Vol. 16 No. 2 , pp. 107 - 128 .

Devin , H. ( 2017 ), “ Investigating the relationship between big five personality traits and cultural intelligence on football coaches ”, Human and Social Studies , Vol. 6 No. 3 , pp. 116 - 131 .

Elenkov , D.S. and Pimentel , J.R.C. ( 2008 ), “ Social intelligence, emotional intelligence, and cultural intelligence: an integrative perspective ”, In Ang , S. and Van Dyne , L. (Eds) Handbook of Cultural Intelligence , M.E. Sharpe , Armonk, New York, NY , pp. 289 - 305 .

Elenkov , D.S. and Manev , I.M. ( 2009 ), “ Senior expatriate leadership’s effects on innovation and the role of cultural intelligence ”, Journal of World Business , Vol. 44 No. 4 , pp. 357 - 369 .

Freeman , R.B. and Huang , W. ( 2015 ), “ Collaborating with people like me: Ethnic coauthorship within the United States ”, Journal of Labor Economics , Vol. 33 (Suppl. 1), pp. S289 - S318 .

Freeman , R.B. and Huang , W. ( 2014 ), “ Collaborating with people like me: Ethnic Co-Authorship within the U.S ”, NBER Working Paper No. 19905 , National Bureau of Economic Research , Cambridge, MA , available at: www.nber.org/papers/w19905

Fussell , S.R. and Setlock , L.D. ( 2012 ), “ Multicultural teams ”, In Bainbridge , W.S. (ed.), Leadership in Science and Technology: A Reference Handbook , Vol. 1 , Sage , Thousand Oaks, CA , pp. 255 - 263 .

Gassmann , O. and Schweitzer , F. ( 2014 ), “ Managing the unmanageable: the fuzzy front end of innovation ”, In: Gassmann , O , Schweitzer , F (eds) Managing of the Fuzzy Front End of Innovation , Springer , Heidelberg, New York, NY , pp. 3 - 14 .

Gibson , C.B. and Gibbs , J.L. ( 2006 ), “ Unpacking the concept of virtuality: the effects of geographic dispersion, electronic dependence, dynamic structure, and national diversity on team innovation ”, Administrative Science Quarterly , Vol. 51 No. 3 , pp. 451 - 495 , available at: www.crito.uci.edu/papers/2006/VirtualInnovation.pdf

Gooderham , P. and Nordhaug , O. ( 2002 ), “ Are cultural differences in Europe on the decline? ”, European Business Forum , Vol. 8 , pp. 48 - 53 .

Gudykunst , W.B. and Ting-Toomey , S. ( 1988 ), Culture and Interpersonal Communication , SAGE Publications .

Gunnery , S.D. and Hall , J.A. ( 2014 ), “ The duchenne smile and persuasion ”, Journal of Nonverbal Behavior , Vol. 38 No. 2 , pp. 181 - 194 .

Hall , E.T. ( 1977 ), Beyond Culture , Anchor Press/Doubleday , Garden City, N.Y .

Hall , K.L. , Vogel , A.L. , Huang , G.C. , Serrano , K.J. , Rice , E.L. , Tsakraklides , S.P. and Fiore , S.M. ( 2018 ), “ The science of team science: a review of the empirical evidence and research gaps on collaboration in science ”, American Psychologist , Vol. 73 No. 4 , pp. 532 - 548 .

Hampden-Turner , C. and Trompenaars , F. ( 2006 ), “ Cultural intelligence: is such a capacity credible? ”, Group and Organization Management , Vol. 31 No. 1 , pp. 56 - 63 .

Hareli , S. and Hess , U. ( 2010 ), “ What emotional reactions can tell us about the nature of others: an appraisal perspective on person perception ”, Cognition and Emotion , Vol. 24 No. 1 , pp. 128 - 140 .

Herbig , P. and Dunphy , S. ( 1998 ), “ Culture and innovation ”, Cross Cultural Management: An International Journal , Vol. 5 No. 4 , pp. 13 - 21 .

Higgs , M. ( 1996 ), “ Overcoming the problems of cultural differences to establish success for international management teams ”, Team Performance Management: An International Journal , Vol. 2 No. 1 , pp. 36 - 43 .

Hofstede , G. ( 2010 ), “ The GLOBE debate: back to relevance ”, Journal of International Business Studies , Vol. 41 No. 8 , pp. 1339 - 1346 .

Horwitz , S.K. and Horwitz , I.W. ( 2007 ), “ The effects of team diversity on team outcomes: a Meta-analytic review of team demography ”, Journal of Management , Vol. 33 No. 6 , pp. 987 - 1015 .

Jackson , S.E. , May , K.E. and Whitney , K. ( 1995 ), “ Understanding the dynamics of diversity in decision-making teams ”, In Guzzo , R.A. and Salas , E. (Eds), Team Decision-Making Effectiveness in Organizations , Jossey-Bass , San Francisco , pp. 204 - 261 .

Joecks , J. , Pull , K. and Vetter , K. ( 2013 ), “ Gender diversity in the boardroom and firm performance: what exactly constitutes a “critical mass? ”, Journal of Business Ethics , Vol. 118 No. 1 , pp. 61 - 72 .

Jones , C.S. and Hartley , N.T. ( 2013 ), “ Comparing correlations between four-quadrant and five-factor personality assessments ”, American Journal of Business Education , Vol. 6 No. 4 , pp. 459 - 470 .

Jones , G.B. , Chirino-Chace , B. and Wright , J.M. ( 2020 ), “ Cultural diversity drives innovation: modeling in the global pharmaceutical industry ”, International Journal Innovation and Science , Vol. 12 .

Judge , T.A. , Heller , D. and Mount , M.K. ( 2002 ), “ Five-factor model of personality and job satisfaction: a meta-analysis ”, Journal of Applied Psychology , Vol. 87 No. 3 , pp. 530 - 541 .

Jung , C.G. ( 1933 ), Psychological Types , Harcourt, Brace , New York, NY .

Kaasa , A. and Vadi , M. ( 2010 ), “ How does culture contribute to innovation? Evidence from european countries ”, Economics of Innovation and New Technology , Vol. 19 No. 7 , pp. 583 - 604 , doi: 10.1080/10438590902987222 .

Kivunja , C. ( 2015 ), “ Using De Bono’s six thinking hats model to teach critical thinking and problem solving skills essential for success in the 21st century economy ”, Creative Education , Vol. 6 No. 3 , pp. 380 - 391 , doi: 10.4236/ce.2015.63037 .

Koehne , G. , Shih , P.C. and Olson , J.S. ( 2012 ), “ Remote and alone: Coping with being the remote member on the team ”, In Proceedings of the ACM Conference on Computer Supported Cooperative Work , ACM , New York, NY , pp. 1257 - 1266 .

Krys , K. , Melanie Vauclair , C. and Capaldi , C.A. ( 2016 ), “ Be careful where you smile: culture shapes judgments of intelligence and honesty of smiling individuals ”, Journal of Nonverbal Behavior , Vol. 40 No. 2 , pp. 101 - 116 .

Lencioni , P. ( 2002 ), The Five Dysfunctions of a Team , Jossey-Bass , San Francisco .

Lievens , F. , Harris , M.M. , Van Keer , E. and Bisqueret , C. ( 2003 ), “ Predicting cross-cultural training performance: the validity of personality, cognitive ability, and dimensions measured by an assessment center and a behavior description interview ”, Journal of Applied Psychology , Vol. 88 No. 3 , pp. 476 - 489 .

Lorenzo , R. Voigt , N. Tsusaka , M. Krentz , M. and Abouzahr , K. ( 2018 ), “ How diverse leadership teams boost innovation ”, Boston Consulting Group , available at: www.bcg.com/publications/2018/how-diverse-leadership-teams-boost-innovation.aspx .

McSweeney , B. ( 2002 ), “ Hofstede’s model of national cultural differences and their consequences: a triumph of faith – a failure of analysis ”, Human Relations , Vol. 55 No. 1 , pp. 89 - 118 .

Management ( 2014 ), available at: www.management-issues.com/opinion/6948/cultural-misunderstandings-and-the-elephant-in-the-room/

Mannix , E. and Neale , M.A. ( 2005 ), “ What differences make a difference? The promise and reality of diverse teams in organizations ”, Psychological Science in the Public Interest , Vol. 6 No. 2 , pp. 31 - 55 .

Martínez-Piva , J.M. (ed) ( 2009 ), “ Knowledge generation and protection: intellectual property, innovation and economic development ”, Springer , New York, NY .

Matsumoto , D. and Hwang , H.C. ( 2013 ), “ Assessing cross-cultural competence: a review of available tests ”, Journal of Cross-Cultural Psychology , Vol. 44 No. 6 , pp. 849 - 873 .

Matsumoto , D. , LeRoux , J. , Ratzlaff , C. , Tatani , H. , Uchida , H. , Kim , C. and Araki , S. ( 2001 ), “ Development and validation of a measure of intercultural adjustment potential in Japanese sojourners: the intercultural adjustment potential scale (ICAPS) ”, International Journal of Intercultural Relations , Vol. 25 No. 5 , pp. 483 - 510 .

Mayer , M. and Bello , Y. ( 2012 ), “ Leading cross cultural teams in today's global marketplace ”, PMI Global Congress 2012—EMEA , Project Management Institute , Marseilles, France. Newtown Square, PA .

Merenda , P.F. ( 1987 ), “ Toward a Four-Factor theory of temperament and/or personality ”, Journal of Personality Assessment , Vol. 51 No. 3 , pp. 367 - 374 .

Moon , T. ( 2013 ), “ The effect of cultural intelligence on performance in multicultural teams ”, Journal of Applied Social Psychology , Vol. 43 No. 12 , pp. 2141 - 2425 .

Murugesan , R. and Jayavelu , R. ( 2017 ), “ The influence of big five personality traits and self-efficacy on entrepreneurial intention: the role of gender ”, Journal of Entrepreneurship and Innovation in Emerging Economies , Vol. 3 No. 1 , pp. 41 - 61 , doi: 10.1177/2393957516684569 .

Nakata , C. and Sivakumar , K. ( 1996 ), “ National culture and new product development: an integrative review ”, Journal of Product Innovation and Management , Vol. 13 , pp. 462 - 463 .

National Research Council ( 2015 ), Enhancing the Effectiveness of Team Science. Committee on the Science of Team Science , The National Academies Press , doi: 10.17226/19007 .

Nelson , R.R. ( 1991 ), “ Why do firms differ, and how does it matter? ”, Strategic Management Journal , Vol. 12 No. S2 , pp. 61 - 74 .

Ng , K.-Y. , Van Dyne , L. and Ang , S. ( 2009 ), “ From experience to experiential learning: Cultural intelligence as a learning capability for global leader development ”, Academy of Management Learning and Education , Vol. 8 , pp. 511 - 526 . Vol,

NIH ( 2010 ), Collaboration and Team Science: A Field Guide , Bennett , L.M. , Gadlin , H. and Levine-Finley , S. (eds), National Institutes of Health publication

O’Leary , M.B. and Cummings , J.N. ( 2007 ), “ The spatial, temporal, and configurational characteristics of geographic dispersion in teams ”, MIS Quarterly , Vol. 31 No. 3 , pp. 433 - 452 .

Ozono , H. ( 2010 ), “ What’s in a smile? Cultural differences in the effects of smiling on judgments of trustworthiness ”, Letters on Evolutionary Behavioral Science , Vol. 1 No. 1 , pp. 15 - 18 .

Pittenger , D.J. ( 1993 ), “ Utility of the Myers-Briggs type indicator ”, Review of Educational Research , Vol. 63 No. 4 , pp. 467 - 488 .

Ramalu , S.S. , Rose , R.C. , Kumar , N. and Uli , J. ( 2010 ), “ Doing business in global arena: an examination of the relationship between cultural intelligence and cross-cultural adjustment ”, Asian Academy of Management Journal , Vol. 15 , pp. 79 - 97 .

Rose , R.C. , Ramalu , S.S. , Uli , J. and Kumar , N. ( 2010 ), “ Expatriate performance in international assignments: the role of cultural intelligence as dynamic intercultural competency ”, International Journal of Business and Management , Vol. 5 No. 8 , pp. 76 - 85 .

Seegmiller , R.A. and Epperson , D.L. ( 1987 ), “ Distinguishing Thinking-Feeling preferences through the content analysis of natural language ”, Journal of Personality Assessment , Vol. 51 No. 1 , pp. 42 - 52 .

Shane , S. ( 1993 ), “ Cultural influences on national rates of innovation ”, Journal of Business Venturing , Vol. 8 No. 1 , pp. 59 - 73 .

SHRM ( 2015 ), “ Cultural intelligence: the essential intelligence for the 21st century ”, available at: https://culturalq.com/wp-content/uploads/2016/05/SHRM-report.pdf

Smale , T. ( 2016 ), “ Why national culture should be at the heart of innovation management ”, Technology Innovation Management Review , Vol. 6 No. 4 , pp. 18 - 25 .

Srinivasan , R. and Martínez , A.M. ( 2018 ), “ Cross-Cultural and Cultural-Specific production and perception of facial expressions of emotion in the wild ”, ArXiv, abs/1808.04399 .

Stanford , ( 2016 ), available at: https://news.stanford.edu/news/2016/february/smiles-jeanne-tsai-021516.html .

Thomas , K.W. and Kilmann , R.H. ( 1974 ), Thomas-Kilmann Conflict Mode Instrument , Xicom, a subsidiary of CPP , Mountain View, CA .

Tuckman , B.W. and Jensen , M.A. ( 1977 ), “ Stages of small-group development revisited ”, Group and Organization Studies , Vol. 2 No. 4 , pp. 419 - 427 .

Uono , S. and Hietanen , J.K. ( 2015 ), “ Eye contact perception in the west and east: a cross-cultural study ”, PLoS One , Vol. 10 No. 2 , pp. e0118094 .

Van Dyne , L. , Ang , S. , Ng , K.-Y. , Rockstuhl , T. , Tan , M.L. and Koh , C. ( 2012 ), “ Sub-dimensions of the four factor model of cultural intelligence: expanding the conceptualization and measurement of cultural intelligence ”, Social and Personality Psychology Compass , Vol. 6 No. 4 , pp. 295 - 313 .

Van Wulfen , G. ( 2009 ), “ The perfect innovation team”, from innovation: putting ideas into action (best practices report) ”, APQC , Houston , available at: https://innovationmanagement.se/2013/07/10/the-perfect-innovation-team/

Viki , T. , Toma , D. and Gons , E. ( 2017 ), “ The corporate startup how established companies can develop successful innovation ecosystems ”, Vakmedianet .

Villago , S.T. , Lukasik , A.J. , Belau , M.A. and Briggs , A.L. ( 2011 ), “ Getting specific about demographic diversity variable and team performance relationships: a metaanalysis ”, Journal of Management , Vol. 37 No. 3 , pp. 709 - 743 .

Wu , M.-Y. ( 2006 ), “ Hofstede’s cultural dimensions 30 years later: a study of Taiwan and the United States ”, Intercultural Communications Studies XV , Vol. 1 , pp. 33 - 42 .

Zheng , L. ( 2013 ), “ How to show white men that diversity and inclusion efforts need them ”, Harvard Business Review .

Further reading

De Abreu Dos Reis , C.R. , Sastre Castillo , M.Á. and Roig Dobón , S. ( 2007 ), “ Diversity and business performance: 50 years of research ”, Service Business , Vol. 1 , p. 257 .

Novartis ( 2020 ), available at: www.fastcompany.com/company/novartis .

Acknowledgements

The authors wish to thank Elena Rodriguez, Anastacia Awad, Ivonna Demme, Nancy Long, Christian Pihlgren, Unmesh Deodhar, Rahul Sharma and Clara Fernandez de Castro for inputs on the manuscript.

Corresponding author

Related articles, we’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

  • Browse All Articles
  • Newsletter Sign-Up

Diversity →

case study about cultural diversity

  • 26 Apr 2024

Deion Sanders' Prime Lessons for Leading a Team to Victory

The former star athlete known for flash uses unglamorous command-and-control methods to get results as a college football coach. Business leaders can learn 10 key lessons from the way 'Coach Prime' builds a culture of respect and discipline without micromanaging, says Hise Gibson.

case study about cultural diversity

  • 04 Mar 2024
  • Research & Ideas

Want to Make Diversity Stick? Break the Cycle of Sameness

Whether on judicial benches or in corporate boardrooms, white men are more likely to step into roles that other white men vacate, says research by Edward Chang. But when people from historically marginalized groups land those positions, workforce diversification tends to last. Chang offers three pieces of advice for leaders striving for diversity.

case study about cultural diversity

  • 27 Feb 2024

Why Companies Should Share Their DEI Data (Even When It’s Unflattering)

Companies that make their workforce demographics public earn consumer goodwill, even if the numbers show limited progress on diversity, says research by Ryan Buell, Maya Balakrishnan, and Jimin Nam. How can brands make transparency a differentiator?

case study about cultural diversity

  • 02 Jan 2024
  • Cold Call Podcast

Should Businesses Take a Stand on Societal Issues?

Should businesses take a stand for or against particular societal issues? And how should leaders determine when and how to engage on these sensitive matters? Harvard Business School Senior Lecturer Hubert Joly, who led the electronics retailer Best Buy for almost a decade, discusses examples of corporate leaders who had to determine whether and how to engage with humanitarian crises, geopolitical conflict, racial justice, climate change, and more in the case, “Deciding When to Engage on Societal Issues.”

case study about cultural diversity

10 Trends to Watch in 2024

Employees may seek new approaches to balance, even as leaders consider whether to bring more teams back to offices or make hybrid work even more flexible. These are just a few trends that Harvard Business School faculty members will be following during a year when staffing, climate, and inclusion will likely remain top of mind.

case study about cultural diversity

  • 21 Nov 2023

Cold Call: Building a More Equitable Culture at Delta Air Lines

In December 2020 Delta Air Lines CEO Ed Bastian and his leadership team were reviewing the decision to join the OneTen coalition, where he and 36 other CEOs committed to recruiting, hiring, training, and advancing one million Black Americans over the next ten years into family-sustaining jobs. But, how do you ensure everyone has equal access to opportunity within an organization? Professor Linda Hill discusses Delta’s decision and its progress in embedding a culture of diversity, equity, and inclusion in her case, “OneTen at Delta Air Lines: Catalyzing Family-Sustaining Careers for Black Talent.”

case study about cultural diversity

  • 31 Oct 2023

Beyond the 'Business Case' in DEI: 6 Steps Toward Meaningful Change

Diversity and inclusion efforts that focus on business outcomes alone rarely address root causes. Jamillah Bowman Williams, a visiting fellow at the Institute for the Study of Business in Global Society, offers tips for companies navigating their next stage of the DEI journey.

case study about cultural diversity

  • 24 Oct 2023

When Tech Platforms Identify Black-Owned Businesses, White Customers Buy

Demand for Black-owned restaurants rises when they're easier to find on Yelp. Research by Michael Luca shows how companies can mobilize their own technology to advance racial equity.

case study about cultural diversity

  • 16 Oct 2023

Advancing Black Talent: From the Flight Ramp to 'Family-Sustaining' Careers at Delta

By emphasizing skills and expanding professional development opportunities, the airline is making strides toward recruiting and advancing Black employees. Case studies by Linda Hill offer an inside look at how Delta CEO Ed Bastian is creating a more equitable company and a stronger talent pipeline.

case study about cultural diversity

  • 10 Oct 2023

In Empowering Black Voters, Did a Landmark Law Stir White Angst?

The Voting Rights Act dramatically increased Black participation in US elections—until worried white Americans mobilized in response. Research by Marco Tabellini illustrates the power of a political backlash.

case study about cultural diversity

  • 26 Sep 2023

Unpacking That Icky Feeling of 'Shopping' for Diverse Job Candidates

Many companies want to bring a wider variety of lived experiences to their workforces. However, research by Summer Jackson shows how hiring managers' fears of seeming transactional can ultimately undermine their diversity goals.

case study about cultural diversity

  • 14 Sep 2023

Working Moms Are Mostly Thriving Again. Can We Finally Achieve Gender Parity?

The pandemic didn't destroy the workplace advancements moms had achieved. However, not all of the positive changes forced by the crisis and remote work have stuck, says research by Kathleen McGinn and Alexandra Feldberg.

case study about cultural diversity

  • 12 Sep 2023
  • What Do You Think?

Who Gets the Loudest Voice in DEI Decisions?

Business leaders are wrestling with how to manage their organizations' commitment to diversity, equity, and inclusion. If you were a CEO, which constituency would you consider most: your employees, customers, or investors? asks James Heskett. Open for comment; 0 Comments.

case study about cultural diversity

  • 08 Aug 2023

Black Employees Not Only Earn Less, But Deal with Bad Bosses and Poor Conditions

More than 900,000 reviews highlight broad racial disparities in the American working experience. Beyond pay inequities, research by Letian Zhang shows how Black employees are less likely to work at companies known for positive cultures or work-life balance.

case study about cultural diversity

  • 26 Jul 2023

STEM Needs More Women. Recruiters Often Keep Them Out

Tech companies and programs turn to recruiters to find top-notch candidates, but gender bias can creep in long before women even apply, according to research by Jacqueline Ng Lane and colleagues. She highlights several tactics to make the process more equitable.

case study about cultural diversity

  • 18 Jul 2023

Diversity and Inclusion at Mars Petcare: Translating Awareness into Action

In 2020, the Mars Petcare leadership team found themselves facing critically important inclusion and diversity issues. Unprecedented protests for racial justice in the U.S. and across the globe generated demand for substantive change, and Mars Petcare's 100,000 employees across six continents were ready for visible signs of progress. How should Mars’ leadership build on their existing diversity, equity, and inclusion efforts and effectively capitalize on the new energy for change? Harvard Business School associate professor Katherine Coffman is joined by Erica Coletta, Mars Petcare’s chief people officer, and Ibtehal Fathy, global inclusion and diversity officer at Mars Inc., to discuss the case, “Inclusion and Diversity at Mars Petcare.”

case study about cultural diversity

  • 05 Jul 2023

How Are Middle Managers Falling Down Most Often on Employee Inclusion?

Companies are struggling to retain employees from underrepresented groups, many of whom don't feel heard in the workplace. What do managers need to do to build truly inclusive teams? asks James Heskett. Open for comment; 0 Comments.

case study about cultural diversity

  • 01 Jun 2023

A Nike Executive Hid His Criminal Past to Turn His Life Around. What If He Didn't Have To?

Larry Miller committed murder as a teenager, but earned a college degree while serving time and set out to start a new life. Still, he had to conceal his record to get a job that would ultimately take him to the heights of sports marketing. A case study by Francesca Gino, Hise Gibson, and Frances Frei shows the barriers that formerly incarcerated Black men are up against and the potential talent they could bring to business.

case study about cultural diversity

  • 31 May 2023

Why Business Leaders Need to Hear Larry Miller's Story

VIDEO: Nike executive Larry Miller concealed his criminal past to get a job. What if more companies were willing to hire people with blemishes on their records? Hise Gibson explores why business leaders should give the formerly incarcerated a second chance.

case study about cultural diversity

From Prison Cell to Nike’s C-Suite: The Journey of Larry Miller

VIDEO: Before leading one of the world’s largest brands, Nike executive Larry Miller served time in prison for murder. In this interview, Miller shares how education helped him escape a life of crime and why employers should give the formerly incarcerated a second chance. Inspired by a Harvard Business School case study.

Your browser is ancient! Upgrade to a different browser or install Google Chrome Frame to experience this site.

Master of Advanced Studies in INTERCULTURAL COMMUNICATION

MIC website

Case Studies in Intercultural Communication

Welcome to the MIC Case Studies page.

Case Studies Intercultural Communication

Here you will find more than fifty different case studies, developed by our former participants from the Master of Advanced Studies in Intercultural Communication. The richness of this material is that it contains real-life experiences in intercultural communication problems in various settings, such as war, family, negotiations, inter-religious conflicts, business, workplace, and others. 

Cases also include renowned organizations and global institutions, such as the United Nations, Multinationals companies, Non-Governmental Organisations, Worldwide Events, European, African, Asian and North and South America Governments and others.

Intercultural situations are characterized by encounters, mutual respect and the valorization of diversity by individuals or groups of individuals identifying with different cultures. By making the most of the cultural differences, we can improve intercultural communication in civil society, in public institutions and the business world.

How can these Case Studies help you?

These case studies were made during the classes at the Master of Advanced Studies in Intercultural Communication. Therefore, they used the most updated skills, tools, theories and best practices available.   They were created by participants working in the field of public administration; international organizations; non-governmental organizations; development and cooperation organizations; the business world (production, trade, tourism, etc.); the media; educational institutions; and religious institutions. Through these case studies, you will be able to learn through real-life stories, how practitioners apply intercultural communication skills in multicultural situations.

Why are we opening our "Treasure Chest" for you?

We believe that Intercultural Communication has a growing role in the lives of organizations, companies and governments relationship with the public, between and within organizations. There are many advanced tools available to access, analyze and practice intercultural communication at a professional level.  Moreover, professionals are demanded to have an advanced cross-cultural background or experience to deal efficiently with their environment. International organizations are requiring workers who are competent, flexible, and able to adjust and apply their skills with the tact and sensitivity that will enhance business success internationally. Intercultural communication means the sharing of information across diverse cultures and social groups, comprising individuals with distinct religious, social, ethnic, and educational backgrounds. It attempts to understand the differences in how people from a diversity of cultures act, communicate and perceive the world around them. For this reason, we are sharing our knowledge chest with you, to improve and enlarge intercultural communication practice, awareness, and education.

We promise you that our case studies, which are now also yours, will delight, entertain, teach, and amaze you. It will reinforce or change the way you see intercultural communication practice, and how it can be part of your life today. Take your time to read them; you don't need to read all at once, they are rather small and very easy to read. The cases will always be here waiting for you. Therefore, we wish you an insightful and pleasant reading.

These cases represent the raw material developed by the students as part of their certification project. MIC master students are coming from all over the world and often had to write the case in a non-native language. No material can be reproduced without permission. ©   Master of Advanced Studies in Intercultural Communication , Università della Svizzera italiana, Switzerland.

Subscribe Us

If you want to receive our last updated case studies or news about the program, leave us your email, and you will know in first-hand about intercultural communication education and cutting-edge research in the intercultural field.

case study about cultural diversity

Cart

  • SUGGESTED TOPICS
  • The Magazine
  • Newsletters
  • Managing Yourself
  • Managing Teams
  • Work-life Balance
  • The Big Idea
  • Data & Visuals
  • Reading Lists
  • Case Selections
  • HBR Learning
  • Topic Feeds
  • Account Settings
  • Email Preferences

Getting Serious About Diversity: Enough Already with the Business Case

  • Robin J. Ely
  • David A. Thomas

case study about cultural diversity

Leaders may mean well when they tout the economic payoffs of hiring more women and people of color, but there is no research support for the notion that diversifying the workforce automatically improves a company’s performance. This article critiques the popular rhetoric about diversity and revisits an argument the authors made 25 years ago: To fully benefit from increased racial and gender diversity, organizations must adopt a learning orientation and be willing to change the corporate culture and power structure.

Four actions are key for leaders: building trust and creating a workplace where people feel free to express themselves; actively combating bias and systems of oppression; embracing a variety of styles and voices inside the organization; and using employees’ identity-related knowledge and experiences to learn how best to accomplish the firm’s core work.

It’s time for a new way of thinking.

Idea in Brief

The context.

Business leaders often make a business case for diversity, claiming that hiring more women or people of color results in better financial performance.

The Problem

There’s no empirical evidence that simply diversifying the workforce, absent fundamental changes to the organizational culture, makes a company more profitable.

A Better Approach

Companies can benefit from diversity if leaders create a psychologically safe workplace, combat systems of discrimination and subordination, embrace the styles of employees from different identity groups, and make cultural differences a resource for learning and improving organizational effectiveness.

“The business case has been made to demonstrate the value a diverse board brings to the company and its constituents.”

  • RE Robin J. Ely is the Diane Doerge Wilson Professor of Business Administration at Harvard Business School and the faculty chair of the HBS Gender Initiative.
  • DT David A. Thomas is the president of Morehouse College. He is also the H. Naylor Fitzhugh Professor Emeritus at Harvard Business School and the former dean of Georgetown University’s McDonough School of Business.

case study about cultural diversity

Partner Center

University at Buffalo Logo

  • Browse by collections
  • Arts, Design, Entertainment + Communications
  • Data, Analytics, Technology + Engineering
  • Government, Law, International Affairs + Policy
  • Healthcare, Public Health, Life + Lab Sciences
  • Management, Sales, Consulting + Finance
  • Nonprofit, Education + Social Impact
  • BIPOC (Black Indigenous People of Color)
  • International Students
  • Neurodiverse & Students with Disabilities
  • Proud to be first

13 Benefits and Challenges of Cultural Diversity in the Workplace

  • Share This: Share 13 Benefits and Challenges of Cultural Diversity in the Workplace on Facebook Share 13 Benefits and Challenges of Cultural Diversity in the Workplace on LinkedIn Share 13 Benefits and Challenges of Cultural Diversity in the Workplace on X

Author: Kattie Reynolds| April 17th, 2024 | 13 Minute Read

case study about cultural diversity

As national politics and discourse seem to grow more inward-looking and divisive across America and Europe, successful businesses must continue to think inclusively and globally. Embracing cultural diversity in the workplace is an important first step for businesses that want to be competitive on an international scale.

From the Virgin Group to Disney and PricewaterhouseCoopers, organizations across industries are embracing the benefits of a diverse workforce. But with benefits necessarily come challenges of working across borders, cultures, and languages.

At Hult, diversity and global mindedness are integral to our DNA. Our mission is to prepare our students to thrive in a fast-paced, unpredictable, and fundamentally international business environment. As our students develop into the global business leaders of tomorrow, they can certainly expect to encounter these  13 key benefits and challenges of cultural diversity in the workplace .

  • Diverse cultural perspectives can inspire creativity and drive innovation
  • Local market knowledge and insight makes a business more competitive and profitable
  • Cultural sensitivity, insight, and local knowledge means higher quality, targeted marketing
  • Drawing from a culturally diverse talent pool allows an organization to attract and retain the best talent
  • A diverse skills base allows an organization to offer a broader and more adaptable range of products and services
  • Diverse teams are more productive and perform better
  • Greater opportunity for personal and professional growth

Challenges :

  • Colleagues from some cultures may be less likely to let their voices be heard
  • Integration across multicultural teams can be difficult in the face of prejudice or negative cultural stereotypes
  • Professional communication can be misinterpreted or difficult to understand across languages and cultures
  • Navigating visa requirements, employment laws, and the cost of accommodating workplace requirements can be difficult
  • Different understandings of professional etiquette
  • Conflicting working styles across teams

1. Benefit: Diverse cultural perspectives can inspire creativity and drive innovation

Our culture influences the way in which we see the world. A variety of viewpoints along with the wide-ranging personal and professional experience of an international team can offer new perspectives that inspire colleagues to see the workplace—and the world—differently.

Diversity of thought has been shown to breed creativity and drive innovation, helping to solve problems and meet customer needs in new and exciting ways. For example, cosmetic giant L’Oréal attributes much if its impressive success in emerging markets to its multicultural product development teams.

Multiple voices, perspectives, and personalities bouncing off one another can give rise to out-of-the-box thinking. By offering a platform for the open exchange of ideas, businesses can reap the biggest benefits of diversity in the workplace. A recent study from Forbes echoed this notion, concluding that  “the best way to ensure the development of new ideas is through a diverse and inclusive workforce.”

2. Benefit: Local market knowledge and insight makes a business more competitive and profitable

A multicultural workforce can give an organization an important edge when expanding into new markets. Often, a product or service needs to be adapted to succeed overseas. Understanding local laws, regulations, and customs, as well as the competitive landscape, can help a business to thrive. Moreover, local connections, native language skills, and cultural understanding can boost international business development exponentially.

And being more competitive ultimately means being more profitable. Diversity Inc annually recognizes the top 50 most diverse companies and measures their success against the broader market. Recent research from McKinsey also underscores the fact that diversity is good for a business’s bottom line. In fact, ethnically diverse companies were shown to be 35% more likely to have financial returns above the national industry median.

3. Benefit: Cultural sensitivity, insight, and local knowledge means higher quality, targeted marketing

Cross-cultural understanding, along with local market knowledge, lends itself the production of more effective marketing strategy and materials. For example, high quality and culturally sensitive translations of websites, brochures, and other assets are essential. But these can be overlooked without the input of a native speaker.

Even brand taglines can get badly lost in translation. A frequently cited example is from KFC in China, whose chicken was marketed as so tasty, you’ll “eat your fingers off!” (A poor translation of their brand tagline, “Finger lickin’ good.”)

Market-specific knowledge and insight is invaluable when it comes to for imagery and design, too. What might work well on a billboard for a British company could fail or offend elsewhere. A memorable McDonalds print ad in Finland may have been considered clever locally, but it was seen as confusing and even grotesque by foreign audiences.

The danger of making a serious marketing blunder, which can cause irreparable damage to a brand or business abroad, can be mitigated by employing a diverse workforce with local marketing savvy.

4. Benefit: Drawing from a culturally diverse talent pool allows an organization to attract and retain the best talent

According to a Glassdoor survey, two thirds of job hunters indicated that diversity was important to them when evaluating companies and job offers. In a competitive global job market, demonstrating that your business is invested in fostering a multicultural and inclusive environment can make you stand out to the right candidates. Making diversity an important part of the recruiting process will broaden your talent pool of prospective employees.

Not only does hiring from a more diverse talent pool makes your business attractive to ambitious, globally minded candidates, it also helps you to keep them on board. Diversity, including diversity of gender, religion, and ethnicity, has been shown to improve retention and reduce the costs associated with employee turnover.

In a diverse workplace, employees are more likely remain loyal when they feel respected and valued for their unique contribution. This, in turn, fosters mutual respect among colleagues who also value the diverse culture, perspectives, and experiences of their team members. An inclusive atmosphere of cross-cultural cooperation is an excellent way to bond colleagues and teams across the business.

5. Benefit: A diverse skills base allows an organization to offer a broader and more adaptable range of products and services

By drawing from a culturally diverse talent pool, companies benefit from hiring professionals with a broad range of skills that are often not accessible when hiring locally. Globally oriented companies can add to their service range by leveraging the skills and experience their international employees bring to the table.

A broader skills base and a more potentially diverse offering of products and services can help your business to have the competitive advantage of adaptability. In today’s volatile and uncertain global business environment, nimble and adaptable organizations are the ones that thrive.

Adaptability means faster and more effective planning, development, and execution. A company with cultural and cognitive diversity can be quicker to spot a gap in the market. It will also have the global (or market-specific) insight and experience to help a new or adapted product to meet changing consumer behavior—and succeed.

6. Benefit: Diverse teams are more productive and perform better

The range of experience, expertise, and working methods that a diverse workplace offers can boost problem-solving capacity and lead to greater productivity. In fact, studies have shown organizations with a culture of diversity and inclusion are both happier and more productive.

Where working in homogeneous teams can seem easier, it can cause a business to settle for the status quo. Diversity, on the other hand, can breed healthy competition, stretching a team in a positive way to achieve their best. This atmosphere of healthy competition can lead to the optimization of company processes for greater efficiency. As a recent article in the  Harvard Business Review  argues, the challenges of working in a diverse team are one of the reasons why diverse teams perform better:  “working on diverse teams produces better outcomes precisely because it’s harder.”

7. Benefit: Greater opportunity for personal and professional growth

Fundamentally, an inclusive and culturally diverse business will attract talented, ambitious, and globally minded professionals who will appreciate the opportunity for personal and professional growth.

Working across cultures can be a truly enriching experiencing, allowing others to learn about perspectives and traditions from around the world. Bonding over similarities and differences can help you to become a global citizen, abandoning prejudices or an ethnocentric world view—something that is increasingly valuable.

A diverse set of colleagues can be professionally enriching too—exposing you to new skills and approaches to work, and developing an international network that can take your career in exciting new directions or abroad.

8. Challenge: Colleagues from some cultures may be less likely to let their voices be heard

However, the presence of diverse brain power alone is not enough. It’s also critical to create an open and inclusive workplace environment, so all team members feel empowered to contribute.

This can be particularly challenging for colleagues from polite or deferential cultures. For instance, professionals from Asian countries such as Vietnam or Japan may feel less comfortable speaking up or sharing ideas, particularly if they are new to the team or in a more junior role.

Conversely, assertive colleagues from the U.S. or Western Europe, or those from Scandinavian countries who emphasize flat organizational hierarchy, may be more inclined to speak up meetings or negotiations when others don’t.

9. Challenge: Integration across multicultural teams can be difficult in the face of prejudice or negative cultural stereotypes

While local expertise is an invaluable asset, it’s also important to foster integration among teams to avoid colleagues from different countries working in isolation and limiting knowledge transfer.

This can be a challenge to overcome, particularly if there are underlying prejudices between cultures, making them less inclined to work together. Negative cultural stereotypes can be seriously detrimental to company morale and affect productivity. For instance, the centuries-long antipathy between the British and French, or the Polish and Germans can sometimes creep into the workplace.

Although not all stereotypes are necessarily negative—like the notion that Americans are confident or Asians are intelligent—all are simplifications that can prove limiting or divisive in the workplace. And while outright prejudice or stereotyping is a serious concern, ingrained and unconscious cultural biases can be a more difficult challenge of workplace diversity to overcome.

10. Challenge: Professional communication can be misinterpreted or difficult to understand across languages and cultures

While quality translations are key for effective marketing, there can also be a real risk of communication getting lost in translation among multicultural colleagues. Language barriers are just one challenge. Even in an office where everyone speaks English, comprehending a range of accents, or understanding a native-speaker’s use of idioms, can be difficult.

Moreover, effective cross-cultural communication comes down to much more than just words spoken. Non-verbal communication is a delicate and nuanced part of cultural interaction that can lead to misunderstandings or even offense between team members from different countries. Things like comfortable levels of physical space, making or maintaining eye contact, and gesturing can all be vastly different across cultures.

Even something as simple as a greeting or handshake has cultural implications that should be considered in a work environment. Business Insider put together this useful infographic to highlight the differences in handshakes and professional greetings around the world:

11. Challenge: Navigating visa requirements, employment laws, and the cost of accommodating workplace requirements can be difficult

Despite the clear benefits, hiring talent from overseas can present an HR challenge. Not least among this is the complicated process of navigating employment laws and visa requirements for international workers. Requirements and regulations are different in each country and between countries, and can change frequently.

Beyond visas, further accommodations for a recruiting and retaining a culturally diverse workforce should be taken into account. For instance, providing a quiet space for prayer can make a workplace more welcoming and inclusive for employees with a range of beliefs, as can taking into account different cultural or religious holidays. Of course, these considerations and accommodations can sometimes be an added business cost as well as a logistical challenge.

12. Challenge: Different understandings of professional etiquette

Colleagues from different cultures can also bring with them different workplace attitudes, values, behaviors, and etiquette. While these can be enriching and even beneficial in a diverse professional environment, they can also cause misunderstandings or ill feelings between team members.

For instance, the expectation of formality (or relative informality), organizational hierarchy, and even working hours can conflict across cultures. Where a Japanese colleague may not feel it appropriate to leave work before their manager (or, indeed, anyone else), a Swedish professional may be used to a 6-hour working day.

Additionally, different approaches to punctuality, confrontation, or dealing with conflict can prove an issue.

13. Challenge: Conflicting working styles across teams

However, working styles and attitudes towards work can be very different, reflecting cultural values and compounding differences. If not recognized and accounted, conflicting approaches to work can put the brakes on productivity.

For instance, approaches to teamwork and collaboration can vary notably. Some cultures, including many in Asia and Central America, value collective consensus when working towards a goal. Whereas others, such as Germany and America, put emphasis on the independence of the individual. Likewise, emphasis on order, rigor, and organization in the workplace versus flexibility and spontaneity can also reflect underlying cultural values.

IMAGES

  1. (PDF) A case study: Issues of culture, diversity and difference in art

    case study about cultural diversity

  2. Why is cultural diversity important in the hotel sector?

    case study about cultural diversity

  3. PPT

    case study about cultural diversity

  4. Cultural Diversity Presentation by M. B. on Prezi

    case study about cultural diversity

  5. Indian Society

    case study about cultural diversity

  6. 19 Cultural Diversity Examples (2024)

    case study about cultural diversity

VIDEO

  1. "Exploring Cultural Diversity: Celebrating Differences"

  2. Understanding the Collective Experience: Culture in DEI

  3. Chandler McCoy

  4. Hofstede cultural dimensions: a case of the United Arab Emirates

  5. [Product Design] Information Seminar: Non-JUPAS Senior Year Admissions

  6. Is cultural diversity THAT important in the university selection process?

COMMENTS

  1. Case Study: What Does Diversity Mean in a Global Organization?

    Case Study: What Does Diversity Mean in a Global Organization? by. David S. Lee. From the Magazine (May-June 2022) Anuj Shrestha. Post. Post. Share. Save.

  2. 22 Cases and Articles to Help Bring Diversity Issues into Class

    T he recent civic unrest in the United States following the death of George Floyd has elevated the urgency to recognize and study issues of diversity and the needs of underrepresented groups in all aspects of public life.. Business schools—and educational institutions across the spectrum—are no exception. It's vital that educators facilitate safe and productive dialogue with students ...

  3. Research: How Cultural Differences Can Impact Global Teams

    They find that contextual diversity is key to aiding creativity, decision-making, and problem-solving, while personal diversity does not. In their study, teams with higher contextual diversity ...

  4. Why diversity matters even more

    Diversity Matters Even More is the fourth report in a McKinsey series investigating the business case for diversity, following Why Diversity Matters (2015), Delivering Through Diversity (2018), and Diversity Wins (2020). For almost a decade through our Diversity Matters series of reports, McKinsey has delivered a comprehensive global perspective on the relationship between leadership diversity ...

  5. PDF IMPROVING WORKPLACE CULTURE THROUGH Evidence-Based Diversity, Equity

    years, the "business case for diversity" has guided investment in diversity in the U.S. Specifically, the business case rationalizes the need for diversity in terms of its positive relationship to innovation, better decision-making, and more favorable financial outcomes.10 Yet, as reaching more diverse audiences

  6. How diversity, equity, and inclusion (DE&I) matter

    For deeper insights, download Diversity wins: How inclusion matters, the full report on which this article is based (PDF-10.6MB). Although the business case for diversity, equity, and inclusion (DE&I) is stronger than ever, many companies' progress has stalled. A systematic approach and bold action can help.

  7. Case Studies

    24. See culture in action. Case studies bring you up close and personal accounts from the front lines of American hospitals and other countries on the issues of cultural diversity in healthcare. The following case studies are presented by topic and contain quick recaps of some common cultural misunderstandings.

  8. Cultural diversity: a human-centered approach that thrives on openness

    For example, in the case of ethnic and cultural diversity, our research shows that in 2019, the top-quartile companies outperformed those in the fourth quartile by 36 percent in profitability. The benefit of diversity extends beyond profits. In particular, cultural diversity provides the foundation to create a truly rich and rewarding workplace ...

  9. Teachers responding to cultural diversity: case studies on assessment

    The case studies indicated that many teachers and schools have difficulties in constructively engaging with the challenges of the cultural diversity of students, and also the results of international tests strongly point in that direction (Herzog-Punzenberger, 2019). Nevertheless, it is not only teachers who require professional knowledge of ...

  10. Full article: Promoting cultural diversity and inclusion in

    The cultural diversity of students themselves is a strength that brings diversity of perspectives and experience relevant to working with patients, communities and healthcare teams. Primary care should adopt inclusive, evidence-based learning strategies that take account of the needs, preferences, circumstances and strengths of diverse students ...

  11. THE ROLE OF CULTURAL DIVERSITY AND HOW THEY IMPACT WORK ...

    Cherian, Gaikar and Paul (2020) conducted a study on "The role of cultural diversity and how they impact work team performance in Abu Dhabi University. A quantitative survey data technique was ...

  12. Cultural Competence and Beyond: Working Across Cultures in Culturally

    Culture is a term that draws on concepts of ethnicity, race and shared identity, and is often based on factors of differentiation such as nationality, religion, language, and caste to name a few (Fish & Brooks, 2004; Gopalkrishnan, 2014).For the purposes of this article, 'culture' is used as referring to the shared concrete and abstract meanings and patterns, including the norms, values ...

  13. Cultural Diversity Case Study

    Cultural Diversity Case Study. by Chris Smit | Sep 10, 2018 | Business. This Cultural diversity case study describes the impact that cultural differences can have on a large multinational (travel) organization. It also covers the effect that cultural competence training can have to, ultimately, save time and money.

  14. Cultural diversity drives innovation: empowering teams for success

    To prepare such innovation teams for success, it is valuable to understand the dynamics of team diversity at the project level and the underlying barriers and opportunities presented.,This paper reviews the literature and case studies on cultural inputs to ideation and innovation, assessing team diversity through readily available instruments ...

  15. Diversity and Inclusion Efforts That Really Work

    Diversity and Inclusion Efforts That Really Work. Five best practices. by. David Pedulla. May 12, 2020. Rusty Hill/Getty Images. Summary. A Stanford and Harvard professor convened a symposium on ...

  16. Diversity: Articles, Research, & Case Studies on Diversity- HBS Working

    by Michael Blanding. More than 900,000 reviews highlight broad racial disparities in the American working experience. Beyond pay inequities, research by Letian Zhang shows how Black employees are less likely to work at companies known for positive cultures or work-life balance. 26 Jul 2023. Research & Ideas.

  17. PDF Multicultural Competence: Criteria and Case Examples

    frequently" addressed cultural issues. In another study (Ladany, Inman, Constantine, & Hofheinz, 1997), no relationship was found between coder-rated multicultural case conceptualization skills and the completion of a multicultural graduate course or the amount of professional experience with ethnically diverse clients.

  18. PDF Case Studies in Cultural Competency

    The following case studies were entries in Cultural Competency Case Study Competitions for optometry students and residents implemented in 20 14, 2015, and 2020 by the Diversity and Cultural Competency Committee of the Association of Schools and Colleges of Optometry (ASCO). * Entrants in each of the three

  19. Working in multicultural teams: A case study

    This Case Study aimed to examine the diverse range of perspectives about working in a multicultural team, from the team members themselves, to the team manager and the client. ... Cultural diversity can indirectly encourage project members to rethink their usual working habits and expectations, behave with fewer assumptions about the "right ...

  20. Cultural diversity and group dynamics in a professional women's

    Abstract In this study, we explored athletes' perceptions of cultural diversity regarding teammate interactions and team functioning. Specifically, we explored cultural diversity in relation to national and racio-ethnic diversity. A constructivist qualitative case study approach was employed with a professional women's volleyball team comprising 11 athletes (Mage = 27, SD = 3.13 ...

  21. 50 Case Studies in Intercultural Communication

    Welcome to the MIC Case Studies page. Here you will find more than fifty different case studies, developed by our former participants from the Master of Advanced Studies in Intercultural Communication. The richness of this material is that it contains real-life experiences in intercultural communication problems in various settings, such as war, family, negotiations, inter-religious conflicts ...

  22. ATI: Video Case Study RN: Cultural Diversity Flashcards

    Study with Quizlet and memorize flashcards containing terms like A nurse is counseling a couple who is Japanese and whose daughter is a client in an acute-care facility following a suicide attempt. When providing culturally sensitive care to this family, which of the following beliefs in traditional Japanese culture should the nurse consider?, A nurse is planning care for several clients who ...

  23. Getting Serious About Diversity: Enough Already with the Business Case

    This article critiques the popular rhetoric about diversity and revisits an argument the authors made 25 years ago: To fully benefit from increased racial and gender diversity, organizations must ...

  24. 13 Benefits and Challenges of Cultural Diversity in the Workplace

    In fact, studies have shown organizations with a culture of diversity and inclusion are both happier and more productive. Where working in homogeneous teams can seem easier, it can cause a business to settle for the status quo. Diversity, on the other hand, can breed healthy competition, stretching a team in a positive way to achieve their best.

  25. ATI Video Case Study RN Diversity: Cultural Diversity 3.0 Case Study

    ATI Video Case Study RN Diversity: Cultural Diversity 3.0 Case Study Test. A nurse is caring for a client who refuses all medications and treatments due to their cultural beliefs. Which of the following actions should the nurse take? Click the card to flip 👆. Adjust the goals to reflect the client's decision.