Rural Health

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Cultural competence and safety requires a number of strategies across various levels of the health system. This assessment is designed to begin exploring YOUR cultural competency and ability to provide culturally safe care as a health professional. Understanding of culture and the way it operates is fundamental to understanding what it means to be culturally competent and provide safe practice.
There are some premises underlying this assessment:
§ Rural and remote populations are made up of culturally diverse populations.
§ As well as sharing many attributes, humans have significant cultural distinctions.
§ Valuing cultural diversity & cultural competence is part of a responsive and
equitable health care system1.
§ What “really matters to the person at the centre of care is how the health
professional responds to them in any particular encounter”2.
Cultural Safety refers to “more or less — an environment that is safe for people: where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning, living and working together with dignity and truly listening.”3
• Cultural safety is relevant to all groups of people and individuals, not just those who identify as Indigenous Australians or are refugees. There is a tendency for people to view these groups as relatively homogenous. Instead they are culturally diverse.
• There can be both similarities and differences within and across cultural groups. Being sensitive to this diversity aids in providing quality, safe, and equitable care. Be mindful of not slipping into stereotype language. For example: say what the statistics are for drinking in rural areas rather than saying that men in rural areas drink a lot.
• Cultural safety is about the experience of the patient/client – what impact might you as a practitioner have in creating a culturally safe service?
§ Please ensure that you have your name, student number, course, and year level clearly in the footer.
§ This assignment should be submitted via LMS as a Word or PDF document.
§ This is equivalent to 1000 words ( + or – 10%).
§ As this is a reflective piece it is expected that you write in the first person (eg. use
words such as ‘I’, ‘me’, ‘my’), where appropriate.
1 NHMRC (2006). Increasing cultural competency for healthy living and environments. https://www.nhmrc.gov.au/guidelines- publications/hp19-hp26
2 McMillan, F. (2013). Improving cultural responsiveness of health professionals through education reform. 12th National Rural Health Conference. https://www.ruralhealth.org.au/12nrhc/wp-content/uploads/2013/06/McMillan-Faye_ppr.pdf
3 Williams, R. (1999) Cultural safety: What does it mean for our work practice? Australian & New Zealand Journal of Public Health. 23(2): 213-214
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Some important things to remember before you write:
Assignment Submission

The Assessment

Assessment Purpose:
To begin critically reflecting on your own cultural competence and apply the concept of culturally safe practice to rural health outcomes.
1. Part of being able to provide culturally safe practice is being aware of social and cultural factors.
a. Identify a cultural factor you may encounter in a rural or remote setting that would be a challenge for you in a professional setting. E.g. you do not believe in same sex attraction but a young man attends your clinic to talk about his issues with this. Or you believe in equal rights for men and women and find yourself working in a very conservative and traditional community that does not share your views.
b. Given that “Valuing cultural diversity & cultural competence is part of a responsive and equitable health care system” how would you approach the above situation?
c. Briefly outline how such a cultural factor impacts on the health of rural populations or a specific rural population.
2. Developing culturally safe practice requires continued reflection and attention. Develop a plan for achieving cultural safety as a health professional in rural Australia.
a. Briefly outline your understanding of cultural safety AND how this applies to working in rural/remote Australia.
b. Create and complete a table to outline your plan to continue developing your cultural competency and safety for working in rural and remote areas of Australia.
Assessment Tips
Presentation and Logic
It is expected that your piece be neatly presented, with clear margins and 11?2 spacing for readability.
You should still reference any source that you use, using APA format (eg. When you are discussing the steps or principles of cultural safety).
There are significant areas to consider in your writing
There are two (2) parts to this assessment.
Preparing for and completing Part 1
Part a.
It may be useful for you to draw on previous experiences of cultural factors or those you have witnessed. Cultural factors for you to consider include aspects of language, behaviours, attitudes, and values. You will need to briefly identify the cultural factor and describe a relevant interaction you may encounter in a rural or remote setting in your profession. It will also be useful to provide a brief rationale for why you would encounter this. An example would be that you will be providing care for someone with an Indigenous background who holds a holistic view of health. For example, some (not all) rural and remote areas have a high proportion of Indigenous people. Specify what the proportion would be in the community you are talking about. You will also
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Part b.
need to identify what is it about your own culture that makes this a challenge.
You will need to do some reflection on your own culture. To get to know how you feel about a range of cultural differences you could engage in discussions about challenging topics, do some research on rural culture, do some research on population groups you may encounter in rural and remote locations, read stories about challenging encounters, watch videos on cross-cultural communication. In your response you might like to draw on aspects of communication skills.
Eckermann et al (2010 Binan Goonj: Bridging cultures in Aboriginal health, Ch 5 Culture Shock) provides some interesting information on culture shock, communication, and working in partnership.
For this part you will be considering the role of culture in the determinants of health and issues of equity in rural Australia.
Demonstrated understanding of rural culture and application of Cultural Safety Theory (principles, steps, language)
You should demonstrate your understanding of rural culture and cultural safety theory. For example, do not just simply state that rural culture reflects the “she’ll be right” attitude. I would like you to explain what this means to you, or how you have experienced this. This should be done in the context of what you know about rural Australia and practice within your discipline. Remember that rural culture, like all culture, has both beneficial and challenging aspects for achieving health.
Given limitations with the word count this does not have to cover all aspects of cultural safety but may reflect your consideration of some of the key ideas and assumptions of cultural safety (e.g. basis, principles, steps).
For further information please read ‘Eckermann et al (2010), Binan Goonj: Bridging cultures in Aboriginal health, Ch. 6’ AND ‘Dade Smith (2016) Australia’s rural and remote health, Ch. 3’.
In preparing for your Plan to achieve Cultural Safety
Your Table should include learning needs (objectives), what actions you will take to achieve them, resources you may need to do this – including where you could source them. Please see example table at the end of this document.
In this section you should be reflecting on the principles and steps of cultural safety.
Cultural competence is an ongoing and incremental lifelong process, thus a number of steps and processes will lead you on this journey.
The NHMRC (2006, Increasing cultural competency for healthy living and environments. https://www.nhmrc.gov.au/guidelines-publications/hp19- hp26) provides some insight into cultural competency, albeit applied to obesity prevention.
Part c.
Part a.
Preparing for and completing Part 2
Part b.
To do this well you will need to have reflected on your own cultural norms, expectations, values, and experiences.
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You may like to reflect on these4:
§ What do you know about the cultures of various population groups you may
work with?
§ How and when would you work with interpreters or family?
§ How can you come to understand cultural safety? What does it look like on a
daily basis?
§ How do you ensure you remain aware of your own worldview and attitudes
towards diversity and difference?
§ How do you ensure that particular cultural knowledge and practices are not
given more value or importance than others?
§ How do you remain curious in your relationships with people within and across
cultures?5
§ If someone is telling you a story what are you doing? What clues do you pick up?
How are you focussing your attention?

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