Developing Cultural Competence Irena Papadopoulos Head of Research Centre for Transcultural Studies in Health

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 We will discuss… 1.the meaning of cultural competence: Definition, Model 2.the reasons why cultural competence has become a requirement in midwifery? 3.is cultural competence being taught to undergraduate midwifery students? 4.is the assessment and care of the woman and baby culturally competent where you work. 5. My message

My definition of cultural competence I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 The capacity to provide effective and COMPASSIONATE healthcare taking into consideration people's cultural beliefs, behaviours and needs.

Self awareness Cultural identity Heritage adherence Ethnocentricity Stereotyping Ethno-history CULTURAL AWARENESS Health beliefs & behaviours Anthropological, Socio- political, Psychological & Biological understanding Similarities and differences Health inequalities CULTURAL KNOWLEDGE Empathy, Appropriateness Interpersonal/communicati on skills Trust, Respect, Acceptance Barriers to cultural sensitivity CULTURAL SENSITIVITY Assessment skills Diagnostic skills Clinical Skills Challenging & addressing prejudice, discrimination and inequalities CULTURAL COMPETENCE Papadopoulos, Tilki & Taylor The Papadopoulos, Tilki & Taylor model of transcultural health and cultural competence (1998, 2006) COMPASSION COURAGE 4

REFLECTIVE QUESTIONS Cultural awareness What are my cultural values on this, how do they differ from the client and how do they influence my interaction with him/her? ‘…small things like asking about my family…these made such a difference and made me feel like a person not a patient’ Cultural knowledge Does my professional knowledge and status clashes with that of the client’s and how can I level the power differentials? How can I empower the client? “…I changed from being an articulate patient advocate [Jason Leitch,National lead for quality in the Scottish government] to being a disempowered grandson who could not speak up to protect his grandmother from potential infection issues”. Dealing with the challenges in a culturally competent and compassionate way

Cultural sensitivity How can I best communicate and connect with this client? How can I ask the client about the things I know very little about? How can I gain his/her trust? Do I have the courage to be compassionate to people whose world views and values are different to mine? Cultural competence How can I provide care that is competent, compassionate and acceptable? Are there any professional and /or organisational structures and practices which exclude and /or discriminate about the client? Do I have the courage to challenge them? Do I have the wisdom and courage to challenge substandard, insensitive and unkind care which I encounter?

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Cultural competence is also… both a process and an output, and results from the synthesis of knowledge and skills which we acquire during our personal and professional lives and to which we are constantly adding.

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Why should cultural competence be a requirement for midwifery?

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 The NMC Code

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Human Rights

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 The Equality and Diversity agenda

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 NHS economics

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Staff satisfaction Happier teams

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Is cultural competence being taught (and what)to undergraduate midwifery students?

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Is the assessment and care of the woman and baby culturally competent where you work?

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 MUST DOCulturally competent care is no longer an option but a MUST DO. HABITS PRACTICE, PRACTICE, PRACTICE.We must develop the HABITS of courage, compassion and cultural competence by PRACTICE, PRACTICE, PRACTICE. culture-generic knowledge appropriate culture-specific questionsHaving culture-generic knowledge will help us ask the appropriate culture-specific questions. not about accepting all practices DON’T BE AFRAID TO CHALLENGECultural Competence is not about accepting all practices in the name of culture. DON’T BE AFRAID TO CHALLENGE… My message to you…

I. Papadopoulos, Maternity Midwifery & Baby conference, London 4 th February 2016 Thank you