Module three: Experiences of bias

Summary

This module delves into the experiences of bias in healthcare, highlighting the importance of cultural sensitivity for Māori and Pacific communities. It underscores the significance of understanding equity versus equality, recognizing one's privilege, and the impact of implicit biases on patient care. Personal narratives reveal the need for clinicians to engage empathetically, pronounce names correctly, and value cultural nuances to foster trust and improve health outcomes.

Takeaways

• 🌟 The module emphasizes the importance of understanding and addressing both implicit and explicit bias in healthcare to ensure culturally safe care for Māori and other minority groups.
• 🌐 Learning a few words in te reo Māori and understanding different worldviews can significantly contribute to providing culturally safe care.
• 🔑 It's crucial to recognize the difference between equity and equality in healthcare, acknowledging that not everyone starts from an equal position.
• 🤔 Clinicians should be aware of their own privileges and biases, as this awareness can improve the quality of care provided to all patients.
• 👩‍⚕️ Patients from minority cultures sometimes feel they receive inadequate care and may choose to only see doctors from their own cultural background for a sense of understanding and trust.
• 🕰️ Allocating more time to listen and engage with patients, especially those from Pacific cultures, can lead to better healthcare outcomes.
• 😃 A warm and compassionate approach during initial patient contact can significantly impact how patients perceive their care.
• 🗣️ Clinicians are encouraged to make an effort to pronounce patients' names correctly, as it shows respect and can enhance patient/provider relationships.
• 🧠 The script suggests techniques like focusing on breathing to manage biases, promoting a more mindful approach to patient care.
• 📚 The module is part of a series, and viewers are encouraged to explore additional resources for a deeper understanding of bias in healthcare.

Q & A

What is the focus of the third module in the series on understanding bias in healthcare?

The focus is on consumers' and clinicians' real-life experiences of bias, both implicit and explicit.

What does the journey to providing culturally safe care for Māori entail?

It involves using a small amount of te reo, understanding other people's worldviews, and the difference between equity and equality.

Why is it important for healthcare providers to understand their privilege?

Understanding one's privilege helps in providing equitable care to all patients, acknowledging that not everyone has the same advantages.

How does the speaker suggest healthcare providers can improve their connection with patients?

By being aware of their biases and understanding that they may have different worldviews from their patients.

What is the impact of bias on the patient's experience, as described by the speaker?

Bias can lead to different treatment, as the speaker felt they were treated differently due to not being pākehā, and received inadequate care and advice.

Why does the speaker choose to only visit Pacific doctors or clinicians?

The speaker feels more confident that Pacific doctors will take the time to listen and understand their condition and cultural background.

What is the significance of the clinic atmosphere described by the speaker?

The family-like atmosphere helps create a sense of belonging and trust, which is crucial for effective healthcare interactions.

What simple changes can Pākehā doctors make to better engage with Pacific patients?

They can give more time, show compassion, and ensure the initial contact is warm and engaging.

How does the speaker's name, Tonumaipe’a, reflect the challenges of cultural identity in healthcare?

The speaker's name was shortened to 'Pe’a', which means 'bat' in Samoan, altering its original meaning and sacredness, illustrating how cultural identity can be unintentionally diminished.

What recommendations does the speaker have for clinicians to improve their practice with Pacific patients?

Clinicians should make an effort to pronounce names correctly, learn Pacific vowels, and ask questions to understand the patient's values and priorities.

What is the final advice given to healthcare providers to help them combat bias?

To focus on their breathing, exhale bias, and inhale mindfulness, suggesting a moment of reflection and intention to approach patients without bias.

Outlines

00:00

🌟 Understanding Bias in Healthcare

This paragraph introduces the third module of a series focusing on bias in healthcare. It emphasizes the importance of understanding both implicit and explicit biases from the perspectives of consumers and clinicians. The module highlights the journey towards culturally safe care for Māori, suggesting that it requires minimal effort but can significantly improve patient care. It touches on the use of te reo (Māori language), understanding different worldviews, and the distinction between equity and equality. The paragraph also addresses the concept of privilege and the impact of biases on patient care. Personal experiences of patients are shared, illustrating the raw emotions and the critical nature of the issue. The narrative suggests that clinicians can improve care by being more compassionate, taking time to understand patients, and creating a familial atmosphere in clinics.

05:02

🌱 Prioritizing Cultural Engagement in Healthcare

The second paragraph discusses the benefits of prioritizing cultural engagement in healthcare practices, particularly with Pacific communities. It suggests that making an effort to pronounce names correctly and learning about Pacific vowels can significantly enhance patient interactions. The paragraph also recommends asking questions to understand the values and priorities of Pacific patients. It concludes with a call to action for healthcare professionals to engage in mindful practices to exhale bias and inhale mindfulness. The module encourages viewers to continue their learning about bias in healthcare by watching the other modules in the series and visiting the Health Quality & Safety Commission's website for more information. The paragraph ends with a Māori blessing, emphasizing the importance of unity and well-being.

Keywords

💡Culturally safe care

Culturally safe care refers to the practice of providing healthcare in a manner that respects and acknowledges the cultural identity and values of the patient. In the video, it is emphasized as a rewarding journey that requires minimal effort but can significantly improve patient care, particularly for Māori and Pacific communities. It involves understanding and respecting cultural differences, which can lead to better health outcomes.

💡Implicit and explicit bias

Implicit bias refers to unconscious attitudes or stereotypes that affect our understanding, actions, and decisions. Explicit bias, on the other hand, is the conscious and overt expression of prejudice. The video discusses the experiences of both consumers and clinicians with these types of bias, highlighting the importance of recognizing and addressing them to ensure equitable care.

💡Te reo

Te reo is the Māori language. The script mentions the use of a small amount of te reo as a way to connect with Māori patients and to show respect for their culture. This can be a simple yet powerful step towards culturally safe care, as it acknowledges the importance of language in cultural identity.

💡Equity vs. Equality

Equity and equality are often confused, but they have distinct meanings. Equity refers to fair treatment, access, and opportunity for all, which necessitates different treatment for different people to achieve the same outcomes. Equality, in contrast, means treating everyone the same, regardless of their needs. The video points out that understanding the difference is crucial for providing culturally safe care.

💡Privilege

Privilege in the context of the video refers to the unearned advantages or rights that some individuals have over others based on factors such as race, gender, or social class. Recognizing one's own privilege and how it may impact patient interactions is a step towards addressing bias and providing equitable care.

💡Pacific doctors

Pacific doctors are healthcare providers who are culturally attuned to the needs of Pacific Islander patients. The script mentions that patients may choose to see Pacific doctors because they feel more understood and heard, highlighting the importance of cultural competence in healthcare.

💡Cultural aspect

The cultural aspect in healthcare refers to understanding and incorporating a patient's cultural background, values, and beliefs into the care provided. The video emphasizes the importance of this in building trust and rapport with patients, particularly from minority cultures.

💡Compassion

Compassion in healthcare is the ability to empathize with patients and respond to their needs with kindness and understanding. The script suggests that showing compassion, especially towards patients from Pacifika cultures, can greatly enhance the patient experience and outcomes.

💡Pronouncing names

Pronouncing patients' names correctly is highlighted in the video as a simple yet significant act of respect and cultural acknowledgment. It demonstrates that healthcare providers are making an effort to connect with patients on a personal level, which can help build trust and rapport.

💡Bias brain vs. Mindful brain

The video introduces the concept of 'exhaling bias brain' and 'inhaling mindful brain' as a metaphor for letting go of preconceived notions and embracing a more open, aware, and present mindset. This practice is suggested as a way to counteract implicit bias and improve patient care.

Highlights

The module explores real-life experiences of bias in healthcare, both implicit and explicit.

Culturally safe care for Māori is a rewarding journey that requires minimal effort.

Using te reo and understanding different worldviews can improve healthcare equity.

Clinicians should understand the difference between equity and equality in healthcare.

Awareness of one's privilege can enhance patient care across different cultures.

Being aware of biases can improve the care provided to all patients.

Personal experiences of feeling treated differently due to not being pākehā.

The impact of a critical healthcare situation and the perceived lack of comprehensive advice.

Preference for Pacific doctors due to perceived cultural understanding and attentiveness.

The importance of the initial contact and engagement with Pacific patients.

Recommendations for Pākehā doctors to give more time and show compassion.

The significance of a name and the impact of its pronunciation on cultural identity.

The health system's structure and its potential unfriendliness towards the Pacific community.

The importance of clinicians making an effort to engage with Pacific people for better health outcomes.

Simple recommendations for clinicians include pronouncing names correctly and asking questions to understand patient values.

Encouragement to continue learning about bias in healthcare through further modules and resources.

The module concludes with a Māori blessing, emphasizing the importance of unity and mindfulness in healthcare.

Transcripts

Tēnā koutou.

Welcome to the third module in this series on understanding bias in health care.

This module looks at consumers' and clinicians' real-life experiences of bias, both implicit and explicit.

The journey to providing culturally safe care for Māori

is a rewarding journey that takes very little effort.

To start using a small amount of te reo,

understanding other people's world views,

understanding the difference between equity and equality.

And to those that say 'I treat everyone equally'

there are people that aren't on equal footing.

Understanding your privilege that you have

and that other people don't necessarily have that privilege.

And just the connection that you can make with patients

across all different areas.

Being aware of your biases and realising that there are

many other people there that have a different world view to you

will actually improve the care you provide to all patients, not just Māori.

Yes.

I believe I am treated differently

because I'm not pākehā.

And for this particular incident that happened to me

is still very raw.

And I can still...

When I reflect on it

the experience was horrendous.

It's a situation that is very critical and it

impacts on your life.

And yet I believe that I did not receive the

comprehensive advice from the clinician

in terms of my care

and in terms of the course of action

that was prescribed for me to take.

I only go to Pacific doctors now or clinicians.

That has been a conscious decision on my part

and that of my family and whānau.

Primarily because one, I feel the confidence that they are

able to sit and take time to hear me out,

to talk about my condition.

There's the cultural aspect because they know who I am

and where I've come from.

They've taken the time to listen.

And there's a...

it's like a family.

A family atmosphere that is created in this clinic.

Some of the things that Pākehā doctors could do is as

basic as giving a little bit more time.

Ensuring that the person before them is not just any person.

That they must show some compassion

when dealing with people, particularly of Pacifika cultures.

Pacific people when we engage, your initial contact is very important.

It's how we would.

If you come out and meet and greet the patient and you're smiling

and you look that you're wanting to engage.

So immediately we respond.

We know that you care.

Being Samoan, and I was born in Invercargill.

And, um...

I was raised up Samoan but you go out leaving

being educated and socialising in a very

white environment.

My name, my maiden name, is Tonumaipe’a.

There is a legend behind this name and

for a lot of people it was very hard for them to pronounce.

And so they shortened it to ‘Pe’a’.

So what I recognised is that

unconsciously they were shortening a name

to suit them.

And I know that wasn't intentional

but when you shorten someone's name

and that they shortened it to ‘Pe’a’

and ‘Pe’a’ means bat in Samoan.

And it totally gives a different meaning to a name

that has a lot of legacy to it, a lot of sacredness to it.

And it can sort of take someone's identity away.

The health system is structured in a way where

sometimes it's not so friendly towards our Pacific community.

I think a lot of clinicians are very busy

and taking time out to engage with our Pacific people

can take a big toll on them.

But making this a priority in their practice

can make a big difference in the long-term of

engaging well with Pacific people

and gaining better health outcomes.

So some of the simple things that I could recommend

for our clinicians is to

pronounce names.

Make an effort to learn the Pacific vowels.

Make an effort to pronounce the names well.

And this really helps.

It lifts a person knowing that someone's made an effort to get to know their name

or even pronounce the name.

And I think one of the other tips that I'd also suggest is

is to, is to do some...

is ask questions.

Ask questions to the Pacific patient of

and gain clarity of what's important to them, what's their values.

So when you're working, focus on your breathing.

Slow down your breathing.

Exhale bias brain.

and inhale mindful brain.

Now you've watched this module we invite you to make

this just the start of your learning about bias in health care.

To find out more make sure you have watched the other two modules in the series of three

and see the Health Quality & Safety Commission's website for further information.

Kia ora tātou.

Unuhia, unuhia, unuhia te uru tapu nui.

Kia māmā, kia wātea te ngākau, te hinengaro, te wairua i te ara takatū.

Koia rā e Rongo, whakairia ki runga.

Āe rā, kua wātea.

Haumi e, hui e, tāiki e.