In February 2022, the College Board endorsed a new practice standard: Indigenous Cultural Safety, Cultural Humility, and Anti-racism in collaboration with the BC College of Nurses and Midwives. This was just one step in an ongoing journey to end Indigenous-specific racism in health care, where patient experiences continue to demonstrate its prevalence.
One case was recently shared in a report dedicated to the memory of Heather Winterstein, an Indigenous woman who died in an Ontario hospital. The report asserts that the circumstances of Heather’s health issues and lifestyle factors were the lens through which staff assessed and judged her, missing the symptoms and signs of critical illness. Like so many similar reports, a number of useful and actionable recommendations were gifted to Niagara Health, including that they allocate time, resources and energy to instill cultural safety throughout the organization’s staff, physicians and volunteers.
In BC, health authorities, health regulators and Doctors of BC all signed the Declaration of Commitment to Cultural Safety and Humility with First Nations Health Authority. As part of our commitment to continue this work, the College is assessing registrants’ awareness of the Indigenous Cultural Safety, Cultural Humility and Anti-racism practice standard and seeking to understand how they are applying the core principles in practice. Several research methods have been used.
Registrant survey
- 532 registrant responses
When asked about the awareness of the practice standard, 57% of respondents indicated that they were aware of the practice standard. Of those, only 48% had read or referenced it.
When asked about applying the standard in practice, 35% of respondents indicated that the standard aided them in providing culturally safe and humble care for Indigenous patients.
When asked which principles in the standard were helpful, the most common response was that the standard prompted deeper self-reflection on current practices.
When asked which barriers get in the way of applying the principles in the standard, the most common responses were limited time and resources, systemic issues, and difficult team dynamics.
Registrant interviews
Six registrants who expressed an interest in this process agreed to participate in a one-on-one interview with an external consultant to discuss in more detail how they are applying the principles in their practice.
Focus groups
Two focus groups were held: one with non-Indigenous registrants and one with Indigenous registrants, aided by an Indigenous physician and knowledge keeper.
Topics discussed included:
- barriers in the system that may prevent registrants from applying the principles in practice
- opportunities to further promote awareness of the standard
- ideas for additional supports and resources for registrants
Next steps
The College is expecting a final report from the consultant shortly that will summarize the findings from the interviews and focus groups and offer recommendations for increasing awareness about the College’s expectations related to cultural safety and humility.
As the new registrar and CEO, I am committed to this journey and look forward to meeting with health leaders at FNHA, and the VPs of Indigenous Health in all health authorities to collaborate on initiatives that promote culturally safe care for Indigenous patients across the province.
The practice standard and learning resources
Providing anti-racist, culturally safe and humble care requires continuous work. As a reminder, the College has resources available to enhance learning.
- Indigenous Cultural Safety, Cultural Humility and Anti-racism practice standard
- Frequently asked questions
- Learning resources
- Educational videos
Patrick Rowe, MD, CCFP (EM), FCFP
Registrar and CEO
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