Diversity and culture

1
Diversity and culture

• An introduction

2
Why are we doing this?

• Equality and diversity is a section of the GP
  curriculum
• Relevant to clinical care, relationships with
  patients, working with colleagues
• And to you as an individual and society as a
  whole
• And it makes routine everyday work more
  interesting

3
Equality

• Is about creating a fairer society in which
  everyone has the opportunity to fulfil their
  potential

4
Diversity

• The recognition and valuing of difference between
  people
• Creating a working culture and practices that
  recognise, respect, value and harness difference
  for the benefit of the organisation and
  individual patients.

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Dimensions of Diversity
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Dimensions of Diversity

• Gender
• Age/generation
• Ethnicity
• Nationality
• Language/dialect
• Skin colour
• Religion
• Class (wealth, family background, education)
• Region(N/S, urban/rural)

• Country/region of origin
• Country/region of residence
• Educational level
• Occupation
• Sexual orientation
• Political orientation
• Disability
• Culture (beliefs, expectations, behaviours)
• Subculture

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Ethnicity

• Identification with a social group on grounds of
  culture, common origin, and shared history

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Genetic inheritance (Race?)
Geographical origin
Religion
Ethnicity
Nationality History/ Migration
Culture
Language
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Culture

• Complex social phenomenon
• Shared beliefs, values and attitudes that guide
  behaviour of members
• Dynamic concept - keeps changing
• We are all multicultural, but often dont
  recognise it

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My cultural identity
English
White
Not English
English
Woman
Middle class
Politics left, green, feminist,
internationalist (Guardian reading)
Family member (another slide?)
Well educated
1960s generation
Doctor
Middle aged
Shipley GP
Bradford GP Educator
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Iceberg model Kreps and Kunimoto (1994)
Gender Age Ethnicity Language Skin colour
Sea level
Socio-economic status Occupation Sexual
orientation Political ideology Disability and
health Cultural beliefs, expectations
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Your cultural identity

• Which cultural groups would others say you belong
  to (top of iceberg)?
• Which other cultural groups do you feel you
  belong to (bottom of iceberg)?

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• Which aspects of culture are the most important
  for you? What most defines you?
• How has your ethnicity and class background
  provided strengths / challenges?
• How do cultural factors affect your behaviour and
  communication styles at work and elsewhere?
• What aspects of background, attitudes and values
  do you share as prospective GPs?
• How do these factors affect interaction with your
  patients and colleagues?
• Are these factors likely to cause any
  difficulties, and if so how might they be
  overcome?

14
Well meaning blunders
Cultural competence
Cultural knowledge
Tendency to stereotype
Bigotry
Cultural acceptance
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Flashcard exercise

• Imagine the person on the card as a patient, or a
  colleague, or as someone on the street
• What are your immediate ideas about them?
• Discuss - and challenge your colleagues to think
  of other possibilities

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Diversity in the consultation

• Think of consultations in which differences
  between you and the patient (on any dimension)
  were a significant issue