Presented By: Dr. Melinda Fowler Faculty Advisor

Aboriginal Students Health Sciences (ASHS) office

Family PhysicianDe dwa da dehs nye>s Aboriginal Health

Centre

Developed By: D. Soucy @ NAHO

Aboriginal Health Elective: Session 3

January 25, 2013Cultural Competency and Safety

Objectives1) Review the social & broader

determinants of health2) Define Cultural Safety (CS) & Cultural

Competency (CC)3) Disseminate why there is a need for

CS/CC4) Identify Culturally Unsafe vs. Safe

educational approaches5) Identify Learner & Educator

responsibilities within a CS environment

Social Determinants of Health

Genetic endowment Healthy child

development Gender Personal health

practices & coping skills

Access to health services

Culture

Education Income & social

status Social support

network Social environment Employment & working

conditions Physical environment

Broader Determinants of Health for Aboriginal

Peoples

Colonization Globalization Migration Cultural continuity Access Territory Poverty Self-determination

Woven together, these factors affect the quality of

life for First Nations, Inuit and Métis.

Background: Cultural Safety

Developed in the 1980s in New Zealand in response to the Maori people’s discontent with nursing care

Maori nursing students & Maori national organizations supported the theory of cultural safety

They uphold political ideas of self-determination & decolonization of Maori people & is based within a framework of dual cultures

Cultural Safety

CS refers to the patient/learner’s feelings in the health care/ learning encounter

CS is crucial to the establishment of trust between health care provider & patient OR the establishment of a productive teaching relationship between educator and learner

Cultural Competency

CC refers to the skills required by a provider/educator to ensure that the patient/learner feels safe

Is there a need for CS/CC?

Misunderstanding can exist between health professionals & their clients, which can impact the ability of health professionals to achieve the goal of optimizing the health for their clients (Dowling 2002).

Adopting a culturally safe approach to health care can benefit individuals, providers & health care systems.

Culturally unsafe educational

experiences occur because…

Values & ethics for FN/I/M maybe different than mainstream

Indigenous knowledge (IK) is not acknowledged, or is treated as inferior to western knowledge

Negative portrayal of FN/I/M peoples in curricula

Historical experience & effects of colonization on FN/I/M peoples is not acknowledged

Basic access (geographic, linguistic, cultural) barriers exist.

Culturally Safe Approaches

Cosmology

Acknowl-edgement

ProtectionOf IK

Quality of Life

Reciprocity

Intent

Respect

Integrity/Honesty

Language

IK =

Health

Western Forms Western Forms

of of

Health Health knowledgeknowledge

A A

CC/CS CC/CS

SpaceSpace

Culturally Safe Education

Learner responsibilities: Self evaluation Identify pre-existing attitudes Transform attitudes

Educator responsibilities: Dismantle barriers Honest curricula Recognition/respect of IK

Ensure a CS environment…

Learn about health & social challenges facing FN/I/M peoples & expect that these issues maybe of particular interest to Aboriginal students

Be aware of the determinants of health that may apply to FN/I/M peoples

Learn about the history of colonization and its impact on current health & social status of FN/I/M peoples

Be self aware

A CS Approach…

Communication

Decision-making

Understanding/misunderstanding

Beliefs

CS/CC Guidelines1. Create Aboriginal rooms: FN/I/M 2. Ceremony, Song & Prayer 3. Patients’ Sacred/Ceremonial Items 4. Information & Support 5. Family Support 6. Food, Toiletries & Constitutions7. Body parts/tissues/substances (removal,

retention or disposal of, including the placenta & genetic material)

8. Pending & Following Death

The following Guidelines are adapted from the Tikanga Best Practice Guidelines produced by the Waikato District Health

Board, New Zealand

Accessing Resources and Services for FN/I/M Clients

National organizations can provide direction to regional centres/organizations who deal with Aboriginal

healing and wellness (western and traditional)

NICCHRO National Indian and Inuit Community Health Representative Organizations A.N.A.C Aboriginal Nurses Association of Canada IPAC Indigenous Physicians Association of Canada *NWAC Native Women’s Association of Canada *AFN Assembly of First Nations *MNC Métis National Council *ITK Inuit Tapairit Kanatami *CAP Congress of Aboriginal Peoples NAFC National Association of Friendship Centres AHF Aboriginal Healing Foundation AHRNetS Aboriginal Health Research Network Secretariat IAPH Institute of Aboriginal Peoples Health NEAHR Network Environments for Aboriginal Health Research AWHHRG Aboriginal Women’s Health and Healing Research Group Pauktuutit Pauktuutit Inuit Women’s Association of Canada CAAN Canadian Aboriginal Aids Network AHWS Aboriginal Healing and Wellness Strategy NMHAC Native Mental Health Association of Canada

* The five federally recognized national Aboriginal organizations of Canada. Each has regional/territorial offices and health committee’s who can direct query’s regarding their specific populations.

Conclusion Be self aware Be respectful of IK Be willing to transform and adapt Be an active listener

Resource List http://www.naho.ca/english/pub_culturalComp.php

http://www.ipac-amic.org/publications.php

http://www.anac.on.ca/publications.html

http://www.niichro.com/

ASHS Contact Information

ASHS Student Space: HSC 2A1E Elders-in-Residence: 3 Aboriginal Mentorship Program: 3 Administrative Assistant: Valerie Pare

905.525.9140 ext: 23935 or ashs@mcmaster.ca

ASHS Office: HSC 3H46B Danielle N. Soucy, Director & Program Coordinator: ext: 22824 or soucy@mcmaster.ca

Dr. Melinda Fowler, Faculty Advisorext: 22824 or ashsfa@mcmaster.ca

http://fhs.mcmaster.ca/ashs