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Bresnahan M, Zhuang J. Culturally safe healthcare: changing the lens from provider control to patient agency. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024:1-10. [PMID: 38426444 DOI: 10.1080/17538068.2024.2323856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND GOAL Marginalized patients often feel unwelcome in healthcare. The concept of culturally safe healthcare (CSH) represents an important paradigm shift from provider control to patients who feel safe voicing health concerns and believe that they are heard by providers. This study has five goals: review works describing CSH, identify CSH themes, describe provider behaviors associated with CSH, describe interventions, and discuss how health communication can advance CSH. METHODS A scoping review was conducted for articles published between 2019 and 2023 following modified PRISMA guidelines. Online databases included Pubmed (Medline), CINAHL, Web of Science, Google Scholar, and Redalyc. Thematic analysis was also conducted. RESULTS Twenty-one articles meeting inclusion criteria were identified and analyzed. Of these, five explained features of CSH, four were empirical studies, seven were content analyses, and five were interventions. Five themes were identified including (1) how patients perceive CSH, (2) sociocultural determinants of health inequity, (3) mistrust of care providers, (4) issues with the biomedical model of healthcare, and (5) the importance of provider-patient allyship. Care provider communication behaviors fostering CSH were discussed. Three CSH interventions were highlighted. Finally, there was a discussion for how health communication scholars can contribute to CSH. CONCLUSIONS CSH offers a paradigm shift from provider control to marginalized patients' experience of patient-provider communication. Recommendations for how health communication scholars can contribute to the implementation of CSH included developing guiding theories and measurement, evaluation of CSH outcomes, and conducting focus groups with patients to assess the meaning of cultural safety.
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Affiliation(s)
- Mary Bresnahan
- Department of Communication, Michigan State University, East Lansing, MI, USA
| | - Jie Zhuang
- Department of Communication Studies, Texas Christian University, Fort Worth, TX, USA
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Moecke DP, Holyk T, Beckett M, Chopra S, Petlitsyna P, Girt M, Kirkham A, Kamurasi I, Turner J, Sneddon D, Friesen M, McDonald I, Denson-Camp N, Crosbie S, Camp PG. Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States. J Telemed Telecare 2023:1357633X231158835. [PMID: 36911983 DOI: 10.1177/1357633x231158835] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review aims to map and characterize the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships. METHODS A search for published and gray literature, written in English, and published between 2000 and 2022 was completed in 17 electronic databases. Two reviewers independently screened retrieved records for eligibility. For included articles, data were extracted, categorized, and analyzed. Synthesis of findings was performed narratively. RESULTS A total of 321 studies were included. The most popular type of telehealth used was mHealth (44%), and the most common health focuses of the telehealth interventions were mental health (26%) and diabetes/diabetic retinopathy (13%). Frequently described barriers to effective telehealth use included concerns about privacy/confidentiality and limited internet availability; meanwhile, telehealth-usage facilitators included cultural relevance and community engagement. Although working in collaboration with Indigenous communities was the most frequently reported way to achieve cultural safety, 40% of the studies did not report Indigenous involvement. Finally, difficulty to establish trusting therapeutic relationships was a major concern raised about telehealth, and evidence suggests that having the first visit-in-person is a potential way to address this issue. CONCLUSION This comprehensive review identified critical factors to guide the development of culturally-informed telehealth services to meet the needs of Indigenous people and to achieve equitable access and positive health outcomes.
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Affiliation(s)
- Débora Petry Moecke
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, Canada
| | - Madelaine Beckett
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Sunaina Chopra
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | | | - Mirha Girt
- 1974Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Ivan Kamurasi
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Justin Turner
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Donovan Sneddon
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | | | - Ian McDonald
- University of British Columbia (UBC), Vancouver, Canada
| | | | | | - Pat G Camp
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
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Bessette N, Reade M, McGregor L, Berti J, Naokwegijig B, Maar M. Culturally Safe Practices in the Co-creation of Medical Education Curriculum with Indigenous Animators: Outcomes From an Indigenous Learning Circle. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231219430. [PMID: 38106516 PMCID: PMC10725153 DOI: 10.1177/23821205231219430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To explore the experiences of Indigenous patient actors who co-created and enacted Indigenous patient scenarios in collaboration with medical school faculty. We critically examine the structures and systems in a medical school that mediate cultural safety for Indigenous patient actors. The Truth and Reconciliation Commission of Canada has called on medical schools and healthcare institutions to help address the intergenerational harms inflicted on Indigenous people by the Indian residential school (IRS) system. Institutions are striving to incorporate cultural competency, conflict resolution, human rights, and anti-racism education into their curricula. However, the structural inequities within undergraduate, postgraduate, and continuing medical education practices must be identified and challenged to ensure that medical education is authentic and culturally safe for those involved in the development and delivery of the Indigenous health curriculum. To explore potential structural inequities in the co-creation process of simulated cultural communication scenarios (SCCS), the Indigenous animators at Debajehmujig Storytellers and collaborating faculty and professional staff at the Northern Ontario School of Medicine University (NOSM U) examined cultural safety in their curriculum design and delivery process. METHODS We utilized the qualitative Indigenous research methodology of the Learning Circle to deconstruct the co-creation process and to explore the experience of cultural safety from the Indigenous animators' perspective throughout the curriculum design and delivery process. RESULTS A framework for culturally safe co-creation practices with Indigenous people, rooted within Indigenous teachings of the Medicine Wheel, emerged from the qualitative data. CONCLUSIONS This framework has the potential to guide the practice of culturally safe co-creation of Indigenous patient simulations in medical education and healthcare workplace learning. While the Medicine Wheel teachings are held by specific Indigenous nations, we anticipate that the results and recommendations of this study will apply to Indigenous co-creators and academic medical educators internationally.
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Affiliation(s)
- Nicole Bessette
- Undergraduate Medical Education, Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Maurianne Reade
- Faculty of Medicine, Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Lorrilee McGregor
- Faculty of Medicine, Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Joahnna Berti
- Debajehmujig Theatre Group, Debajehmujig Creation Centre, Manitowaning, ON, Canada
| | - Bruce Naokwegijig
- Debajehmujig Theatre Group, Debajehmujig Creation Centre, Manitowaning, ON, Canada
| | - Marion Maar
- Faculty of Medicine, Northern Ontario School of Medicine University, Sudbury, ON, Canada
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Lachman N, Pawlina W. Reconsidering laboratory-based anatomy within the backdrop of digital transformation: Bringing an old practice into a new world. ANATOMICAL SCIENCES EDUCATION 2022; 15:439-446. [PMID: 35429369 DOI: 10.1002/ase.2182] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Nirusha Lachman
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Wojciech Pawlina
- Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
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