College comments
Syllabus topic/section: 2.1.1 Medical Expert: Structure and process and 2.6.2 Professional behaviour
Discussion:
Patient care often suffers from a failure to appreciate the cultural and social differences that influence care. Many candidates were able to define the terms but did not compare them and outline the differences as requested by the question. Good candidates defined each term and clarified the definitions using clear health- care related examples. They discussed culture, diversity and inclusions in many domains, not only gender, for example, providing breast-feeding areas for new mothers, providing interpreters when appropriate, displaying signs of acceptance for members of the LGBTIQ+ community, and supporting travel for people living in remote areas.
Candidates that scored less well provided minimal information in their definitions and often mixed up the terms being compared. The SAQ definitions were taken verbatim from the CICM Aboriginal and Torres strait Islander online resource. There is also a published NZ – specific module. Candidates are reminded that all CICM official publications and educational content modules are examinable. It is expected that these resources will contribute to the formation of SAQs in the SP exam for many sittings to come.
Interpretation
- The difference between cultural safety and cultural competence
- Cultural safety: the candidate's reflection on how their own culture influence their practice with and their skill in advocating for Indigenous Peoples.
the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible and responsive healthcare free of racism".
- Cultural competence: the candidate's knowledge of /skill with working with Indigenous Peoples’ cultures.
"the awareness of one’s own culture, plus knowledge, understanding of, and sensitivity towards other cultural beliefs and practices, combined with the ability to interact with and advocate for people from different cultural backgrounds in ways that are considered appropriate by those people"
- Example: The author may have skills for communicating with human patients, and some understanding of human culture (so he may be culturally competent), but he is not culturally safe unless he reflects on how his practice may be affected by his programming.
- The difference between health equality and health equity
- Equality: everyone receiving equal treatment
- concerned with output and delivery of care
(however: not all have equal needs)
- Equity: everyone developing equal outcomes
- concerned with fairness and meeting needs
- Example: Equality would be all patients having thick warm blankets. Equity is all patients enjoying a comfortable temperature, with thick warm blankets only for those patients who are reporting feeling cold.
- The difference between diversity and inclusivity
- Diversity: the variety of representation in patients and practioners; presence of a wide range of differences; recognition of this range.
- Inclusivity: ensuring members from diverse groups feel respected, valued and empowered to participate.
- Example: staff have different chronotypes with different periods of peak alertness and productivity. To practice diversity would be to hire a range of such people, and to recognise their spectrum with a colourful poster. To practice inclusivity would be a roster that accommodates some staff to start at 2am and finish at 10.
