Cultural Competency

-Respect & affirm TGNC identities -respect chosen names & pronouns - respect privacy - don't assume a persons pronoun - use gender neutral language when you don't know - apologize, make correction, move forward - ask how you can best support the person - treat every person as an individual - self-educate

What are some Trans-Gender - Best Practices *may be on exam*

- people w/ disabilities - military veterans - cancer survivors - patients of children w/ cerebral palsy

What are some examples of subcultures

1. Accountability - participating in the achievement of health goals of patients and society 2. Altruism - providing PT services to under-served & under represented populations 3. Excellence- PT practice that integrates the patient/client perspective 4. Professional Duty - the commitment to positive influence in the health of society 5. Social Responsibility

What are some of the core values that relate to cultural competence?

1. Awareness - appreciation of the importance of the issue 2. Knowledge - factual info on cultural demographics 3. Skills - awareness and knowledge in action

What are the 3 Stepping Stones to Cultural Competency ?

1. It values diversity 2. assess cultural climate 3. Adapts delivery of healthcare services for diverse groups 4. understands interactions between cultures 5. institutionalizes cultural knowledge

What are the 5 Traits of a Culturally Competent Organization?

47% Asian 22% Latino/Hispanic 13% African American (and "Other") 3% American Indian/Alaskan Native 2% Pacific Islander/Native Hawaiin

What are the percentages of minority membership in the APTA (as of 2016)?

culturally and linguistically appropriate services

What does CLAS stand for ?

underrepresented minorities

What does URM stand for

The collective personality of the organization which includes: -attitudes -beliefs -experiences -Does not include values or goals

What is Organizational Culture?

Tip of the iceberg: race, gender, physical attributes, communication styles Below: culture, ideology, sexual orientation, education, status, mental health etc.

What is the Iceberg Analogy of Culture ? What traits are at the tip of the iceberg? What is bellow the water?

2007

When (what year) was the APTA Strategic Plan on Cultural Competence adopted

gender identity

a person deeps internal understanding of their own gender. (there's no wrong answer)

FTM (female to male )

a person who has transitioned from a female assigned sex to male

MTF (male to female)

a person who has transitioned from a male assigned sex to female

cisgender

a person whose gender identity is the same as or similar to their sex assigned at birth

2:1

Female members of the APTA out-number male members more than ____ and have over the last 20 years.

1. provide patients care with respect for their culture 2. recruit, retain, promote diversity in staff 3. promote & impliment plan for culturally & linguistically appropriate services 4. ensure all staff provide ongoing education 5. perform initial and ongoing self-assessment 6. collet information on culture in the patients medical record 7. maintain demographic assessment of patient population 8. ensure that conflict and grievance resolution can be used by all regardless of culture or language

For accreditation from most accrediting bodies, facilities must

17% 30%

Hispanic and African American enrollment declined by nearly __% and ___&, respectively from 2004 to 2011

43% 12.3%

Hispanic and African American populations have grown by ___% and ___% between 2000-2010

1.4 million people

How many people in the US identify as transgender?

gender nonconforming

a person whose gendered expression is somehow different from what is traditionally expected of their biological/ assigned sex and/or gender identity

transgender

a person whose identity is different from their sex assigned at birth

cultural competence

accepting and respecting differences, continual self assessment regarding culture

prejudice

adverse or hostile attitude because a person belongs to a group

stereotyping

applying false attributes to an entire group is called?

cultural destructiveness

attitudes and practices that are destructive to cultures and individuals in that culture (such as denial of services or treating patients in a dehumanizing manner)

cultural blindness

believing that culture or race make no difference in how services are provided. Belief that approaches traditionally used by dominant culture are universally acceptable (English should be understood by all or a causal greeting by first name is friendly)

yes!

can you be sued if you are non compliant when treating a trans individual ?

assigned sex

the biological sex that someone is labeled at birth, usually based only on the appearance of genitals(Whats on your birth certificate)

increasing!

the chances of having a patient who is transgender is ?

cultural imposition

the intrusive projection of ones values or behavior patterns onto others

acculturation

the process of adopting the cultural traits or social patterns of another group

Ethnocentricity

the tendency of people to think that their way of thinking, acting and believing are the only right, proper, and moral way to act

competence

the word ______ is used because it implies having a capacity to function effectively within that culture.

gender expression

things a person does- how they dress, act, behavior - that are coded as gender

- interpretation based on culturally derived meaning - strongly affects health care views, participation, and goals. e.g. pain management, end of life, healthcare seeking - cultural differences are almost always present

three points about cultural bias

cultural blindness

treats everyone the same, regardless of culture which essentially implicitly reinforces the dominant culture

discrimination

unjust treatment based on culture alone (and all that goes with culture)

URM

what applicants were significantly more likely to apply to programs with minority faculties

- prescription of special diets without regard to cultural beliefs about food - restricting family contact for a patient in the hospital who believes that family support is necessary for recovery

what are some examples of cultural imposition ?

- increased market share of patients - improved patient/employee satisfaction(reduce malpractice) - reduce health disparities - decreased lengths of stay

what are the benefits of CLAS standard implementations

1. awareness of the importance of the culture 2. understanding of cultural differences in care you provide 3. improved skills to assess verbal and nonverbal cues 4. increased self confidence in working with patients of a different culture

what are the benefits of cultural competence for the health care provider ? (4)

- a barier to cultural competence - may compromise care if we over look patients needs - can lead to cultural impositions * - may have serious ramifications in the healthcare setting

what can ethnocentrism cause?

cultural imposition

what else can ethnocentrism lead to?

cultural competence

what is a key goal of the APTA's Vision 2020?

to reduce overall costs of healthcare by decreasing errors or malpractice secondary to cultural or linguistic misunderstandings through: - culturally competent care - language access services - organizational support for cultural competency

what is the goal of CLAS Standards?

Hispanic students

what students were significantly more likely to apply to programs within their state to residence

cultural incapacity

when an individual or organization believes in the superiority of the mainstream culture . Stereotypes and paternalism are reinforced by the dominant culture but they do not seek to destroy the minority culture

cultural destructiveness

when an individual or organization views cultures as complematic and may seek to destroy that minority culture

stigmatization

when individuals are depersonalized by negative labels e.g. gimp or cripple, this is called?

marginalization/oppression

when victims are subjected to unfair or unequal treatment this is called?

- language -thoughts -communication - actions -customs -beliefs -values -religious groups - racial groups -ethnic commonalities - religious groups - social groups

Culture, which is an integrated patter of human behavior that is seen within and includes a combination of ?

demographics

cultural competence can help us meet the demands of every changing _______ of cities in America

- better overall functions outcomes - more likely to adhere to prescribed health care instructions -more likely to continue going to that particular provider

what are the benefits of cultural competence for the patient ?(3)

stigmatization stereotyping marginalization/oppression

what are three types of prejudice ?

80%

white student enrollment has maintained steady at ___%

15%

In 2011-2012 minorities comprised a meager __% of enrolled students in accredited physical therapist education programs

culture

The word ______ is used because it implies the integrated pattern of human thoughts, communication, actions, customs, beliefs, values and institutions of a racial ethnic, religious or social group

Subgroups

A group that does not hold all values of the dominant group is called what

LGBT

According the Evans & Karpatkin PT in Motion June 2011, the APTA has overlooked what group from its definition of cultural competence ?

close to 40%

According to the 2019 Census Estimate, what percent of US populations self-identified as part of a racial or ethnic minority?

2.7%

According to the 2019 Census Estimate, what percent of US populations self-identified with more than one race or ethnic group ?

interactions

Awareness of unconcious and conscious biases allow you to be more controlled of your __________

40% today: 76.6%

By the year 2100, whites (Caucasian) will make up only what percent of the US population? What percent do they make up today?

cultural proficiency cultural competence culture pre-competence cultural blindness cultural incapacity cultual destructiveness

Cross' Cultural Competence Contium (top to bottom - positive to negative)

1. provide language assistance to all patients at no cost to the patient 2. provide written and verbal notification of these services (includes ASL interpretation) 3. not use family and friends as interpreters unless requested by the patient 4. ensure competence of interpreters must be done periodically 5. make patients materials and signage available in language commonly encountered in the service area

CLAS mandates: Any facility which receives federal funding must :

55%

Enrollment in PT programs has increase ____ % since 2003, overall.

- avoid general assumptions - consider traits or organizations individually

Organizations have unique organization cultures and ?

-skin color -bone structure -eye color hair color

Race is defined by what four things?

- a commitment to respectful interactions with all persons - is grounded in respect for self and others - transcends race, socioeconomics and lifestyle choices - recognizes the dignity of being human - essentially = good sandbox skills

Ruth Portillo coined the phrase Unconditional Positive Regard which includes?

attitudes, perspectives, behaviors, policies

culturally competent programs maintain a set of ______, _______, _______, and ________ that promote positive and effective interactions with diverse cultures.

cultural proficiency

difference are held in high regard, others are educated about the differences

-language -beliefs -ancestry -customs

ethnicity is defined by ?

bias

feeling in favor of or against one thing, person, or group compared with another

cultural proficiency

holds cultural differences in high regard, educates others, develops skills to address cultural differences and forms partnerships with other cultures

- using common idioms may confuse non-native English speakers - miscommunication can affect the relationship between practitioner and patients/clients and their families

in what ways can culture affect your communication

CLAS standards

mandates developed by the Us dept. of human services to reduce disparities in quality of care and improve healthcare for all people living in the US

1. patient's culture 2. practitioner's culture 3. organization's culture 4. medial culture

organizational culture within healthcare is defined by more than colleagues & co-workers and include:

cultural pre-competence

realizing ones weakness in serving others and attempting to improve aspects of ones cultures services to a specific population or culture

cultural pre-competence

recognizes cultural differences and their own weaknesses in addressing them. Seeks to educate themselves about these differences

cultural copetence

respects cultural differences and accommodates them. engages in analysis of cultural interactions