COVER STORY / CHIROPRACTIC FOR TODAY'S CANADA
he or she is providing great care by
operating a highly efficient assessment
and treatment that “gets right to the
point.” For members of societies that are
highly individualistic, such as Canadian or
American societies, this is likely effective
and may support positive outcomes.
Patients from collectivist societies, such as
Asian and Middle Eastern societies, may
prefer a more circular communication
style that places greater importance on
allowing the patient and the doctor to “save
face.” Certain patients may be reticent to
directly contradict or question a doctor.
“
a written list of home exercises; rather
they are more likely to follow up with
independent treatment plan components
if you are sure to reinforce their value and
provided additional demonstration on an
ongoing basis.
Keeping track of all of these
variables can seem overwhelming. Some
formalized support and training may be
very beneficial. As pointed out above,
knowledge about “categories” or groups in
your community is just part of the process.
Like all aspects of chiropractic education,
both theory and practice are essential to
Research shows that practice and
coaching is an essential part of
developing a full skillset and the
confidence required for cross-cultural
care.”
It may take more effort for chiropractors
from individualistic cultures to create
relationships of trust with patients whose
identities are rooted in collectivist cultures,
but once achieved those relationships are
likely to be strong and long lasting.
Learning Styles
Similar to communication styles,
learning styles are strongly tied to cultural
influences. Some patients are likely to want
to take notes, review written texts and
ask a lot of questions. Others may learn
best through listening and demonstration.
Such a patient is less likely to benefit from
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the learning process. Engaging with a more
diverse patient population and learning
by doing is invaluable. You may want to
seek out a specialized mentor who can
observe your interactions with specific
patient cohorts and provide an objective
perspective on your progress.
Hamilton Health Science has
pulled together an extensive array of
online, free resources that may help
as well (http://www.hhsc.ca/body.
cfm?id=1782). A specialized, facilitated
training program focused on Indigenous
Cultural Competency is offered online
by the British Columbia Provincial
Health Services Authority (http://www.
culturalcompetency.ca/training).
When looking for training that will
empower you in practice, the experiences
of chiropractors Kim Khauv and Joel
Alcantara may be informative. Working
out of Life Chiropractic College West,
Drs. Khauv and Alcantara published an
analysis in 2012 of cultural competence
training of chiropractic students in public
health courses. The study followed the
experiences of third-year chiropractic
students who were required to complete
a six-hour cultural diversity lecture and
classroom exercise. The course was based
on a program that had previously been
offered by the Public Health Program at
the University of California, Los Angeles.
The course incorporated three modules:
1 lecture on concepts related to
A
culture, ethnicity, religion and
socialization, an overview of the
diversity of the American population,
concepts of health and illness, and
health traditions.
2 second lecture on healing traditions,
A
health care delivery, cultural
phenomena affecting health care and
a comparison of the health and illness
in American Indian, Alaskan Native,
Asian, black, Latin/Hispanic and
white populations.
3 series of classroom exercises and a
A
cultural diversity video that exposed
students to cultural blind spots,
biases, preconceptions and possible
solutions.
This combination of activities fits with
the recommendations of other researchers.
The simulated hands-on component
contained in the exercises is especially