Dr. Jeevyn Chahal, right, examines Frank Charlie at the Sto:lo Nation Health Services building in Chilliwack, B.C., in this 2013 file photo. Health officials say 27,000 workers and students have been trained on providing care that takes into account the culture and history of indigenous patients.DARRYL DYCK/The Globe and Mail
Health officials in British Columbia say 27,000 workers and students have been trained on providing care that takes into account the culture and history of indigenous patients – a program that has been spearheaded in the province and has generated interest from elsewhere in the country.
"We know that there is a tremendous need to address the gap in knowledge towards issues and stereotyping around indigenous people," said Cheryl Ward, interim director at the Provincial Health Services Authority's Indigenous Health program.
Ms. Ward has led the organization's work with the San'yas Indigenous Cultural Safety Training program – a course developed by the health agency to address inequalities and obstacles that have emerged within Canada's health-care system.
The goal of the cultural safety training is to offer context – with a focus on Canada's indigenous peoples – along with practical tools to help non-indigenous doctors better communicate with future patients. "Most health-care professionals want to care for indigenous people in a good way and recognize that the training they've had hasn't been as robust as it needs to be," said Ms. Ward.
The training program was developed in a province with roughly one-third of Canada's First Nations. In 2013, the provincial and federal governments and the province's First Nations started the First Nations Health Authority – the only such agency in Canada.
The cultural safety training was made mandatory two years ago for all students who study medicine at the University of British Columbia.
The university's initiative fits in with recommendations made by Canada's Truth and Reconciliation Commission, which called on medical schools to require intercultural competency training, and classes that cover aboriginal history and rights.
Ms. Ward says a week never goes by without a request from an organization, college or university looking for a way to get involved with the training program or support it. "That is the level of interest in this country right now," she said. "This is really positive."
Participants have a window of eight weeks to complete the interactive online program, which takes about 12 hours to finish.
Offering this training as a required – but free – course for medical students at UBC is a pilot project, currently funded by the Provincial Health Services Authority's Indigenous Health program.
The project is now two years into its three-year timeline. The organization is looking for partners and funding so it can continue to offer the program at no cost to students.
As an indigenous physician in Canada, Dr. Nadine Caron, co-director of UBC's Centre for Excellence in Indigenous Health, thinks that health-care providers need to realize that being culturally aware is crucial to their ability to provide proper care to all their patients.
"I think we are at a point now in Canada where this whole element of cultural safety and having that training has gone from being an asset to hopefully becoming more of a necessity, a requirement, an expectation – and that's huge," said Dr. Caron.
About 30,000 people across Canada have now taken the training course, mostly within B.C. That total includes about 3,000 within the government of Ontario. A version of the program is currently being adapted for Manitoba.
Dr. Caron stressed that cultural safety and awareness training is something students need to be actively involved in learning. She said that the material in the San'yas course will raise issues that can't simply be Googled.
"You can always say to a patient, 'I don't know exactly what antibiotic, let me know look into that. …' versus "I don't know whether to respect you or not…'" Dr. Caron said. "There is no room. It is too hard, it is too hurtful."
Joe Gallagher, CEO of the First Nations Health Authority, thinks that with Canada being such a diverse country, offering widespread cultural safety training is something that stands to benefit the entire health system.
He suggested that a standardized approach has not previously served the country well.
Last summer, the heads of all of the B.C. health authorities came together to sign an agreement committing to advancing cultural safety within the province's health systems. On Tuesday, National Aboriginal Day, the First Nations Health Authority planned to launch a campaign promoting the idea of cultural safety within the health-care system.
"By incorporating cultural humility, you approach the work in a certain way that you try to find out who [your patients] are," Mr. Gallagher said. "And that gives you an opportunity to learn about that individual at that point in time, instead of feeling like you need to know it in advance."