Efficiency is also central to the definition of cultural competence although it is not usual to find this concept in a constructivist perspective. Tardif (2006) stresses that an “effective action is thus a necessary and inevitable outcome of a competence” (trans., p. 19). Since a competence is contextual and evolutionary, efficiency remains dynamic and related to the context of the action. Calvillo et al. (2009) argue that the care must be of a certain quality to be effective, and to say that a nurse is culturally competent. Quality refers to the provision of care and services that increase the likelihood of desired health outcomes that are consistent with current professional knowledge (Institute of Medicine, 1990). Following the Institute of Medicine definition, efficiency refers to the professional’s or the organization’s perspective on quality care.Cultural competence defined as dynamic and complex, varying according to the individual and the social contexts is in line with the constructivist ontology described by Guba and Lincoln (1994, 2005). Moreover, because the constructivist epistemology is transactional and subjectivist, the interrelations between individuals are central to the construction of meanings and realities. The definition presented in this article suggests that understanding a culture and developing cultural competence occurs through human interactions. The partnership between the caregiver and the person living the health experience, families, and communities is crucial in the proposed definition. It focuses on the space created by the professional and the individual, families, or communities involved. Carpenter-Song et al. (2007) point out that, through dialogue, it is possible for people to transform and enrich their perspective by promoting a common understanding of the context in which they find themselves. As care is the result of dialogues and interactions between the professional and the patient, the dominant hierarchy of knowledge is questioned. The space created should allow partnership and power sharing for a joint action.