Best practice requires well organized teaching effort, designed within the phases of care and in consideration of diverse population needs. The goal, promotion of self care and return to their daily routine, may require more than competency in traditional ostomy management. Our urban community, a melding of many ethnic and religious cultures, presents the challenge of integrating technical instruction about an intimate subject to a person with unfamiliar rituals. We explore the process using our experience with a Muslim client. Case History: 40 year old male, Arab, Muslim, post permanent colostomy for rectal cancer. Pt was educated in basic Ostomy principles, verbalized reasonable understanding and demonstrated technical dexterity. Primary language Arabic, some social English. Using the translation phone, the patient acknowledged the information presented, however; the unit staff reported he did no self care and appeared despondent although he had been informed of his “good long term prognosis”. Topics Explored The Muslim Patient : How they perceive illness and healthcare practices How we integrated our new cultural information in ostomy education. Cultural Competence: Have I "ASKED" Myself the Right Questions? Where we found help?