Reflection 2

What is the reflective focus?

The reflective focus is on my level of cultural competence and how an improved

understanding of different cultures will help to enhance the quality of my patient care.

What is the real problem? Do I have the skills/knowledge to address the central concern?

The central concern is that as Australia becomes more diverse chiropractors, along with
other health care practitioners will increasingly see patients with a broad range of perspectives
regarding health, which are often influenced by their social or cultural backgrounds (Saha, Beach &
Cooper, 2008). Without an understanding of other cultures beliefs patient care can be significantly
hindered.

Currently, I am aware that other cultures have different beliefs regarding healthcare,
although I am not across what those beliefs are. To be involved in a health care system and
workforce that can deliver the highest quality care to all patients, regardless of their race, ethnicity,
culture or language, it is important that I become culturally competent.

Where do I find the information and skills I need? Can I trust the new information source?

In reviewing the literature some of the major problems faced with treating patients from
other cultures may be a limited English proficiency, different threshold for seeking care or
expectations about their care, and unfamiliar beliefs that influence whether or not they adhere to
provider recommendations (Betancourt, Green, Carrillo & Park, 2005).

While awareness of and respect for different cultures are valued, familiarity with all cultural
perspectives you may encounter as a chiropractor is impractical. Also, when viewing patients as
members of ethnic groups or cultural groups, rather than as individuals with unique experiences and
perspectives, it might lead to stereotyping patients and making inappropriate assumptions about
their beliefs and behaviours (Betancourt, Green, Carrillo & Park, 2005).

To ensure this does not occur, a patient centred clinical method should be implemented, in
which you as the provider aim to gain an understanding of the patient as well as the disease, as
opposed to an approach focusing strictly on the disease. As a chiropractor you should incorporate a
balance, between acquiring some background knowledge of the specific cultural groups you may
encounter in clinical practice and developing attitudes and skills that are not specific to any one
culture but can be used universally. These skills include, 1) respecting patients health beliefs and
recognising their role in effective healthcare delivery; 2) viewing patients complaints as occurring
within a psychosocial context rather than stemming from a disease occurring within their organ
systems; 3) eliciting the patients explanations of the illness and its perceived causes; 4) explaining to
the patient your understanding of the illness and its perceived causes in language accessible to the
patient and 5) negotiating an understanding within which a safe, effective and mutually agreeable
treatment plan could be implemented (Betancourt, Green, Carrillo & Park, 2005).

Do I need a team approach to this? Who do I recruit into my management team?

To ensure that I am improving my cultural competence within the healthcare system I can
ensure that I improve my knowledge in understanding the meaning of culture and its importance in
healthcare delivery. I can also ensure that I have the right attitude and have respect for variations in
cultural norms, and I can ensure that I continue to improve my skills in eliciting patients explanatory
models of illness (Saha, Beach & Cooper, 2008).

How can I be sure this new approach has addressed the central concern or resulted in a positive
change-outcome?

Throughout the research it is clearly shown that effective provider-patient communication

has a positive effect of patient satisfaction, adherence to medical instruction and positive health
outcomes (Saha, Beach & Cooper, 2008). It is therefore likely that poorer health outcomes may
result when sociocultural differences between patients and providers are not sorted out in the initial
encounter (Saha, Beach & Cooper, 2008).

Apply my renewed approach next time around

I believe that by the time I graduate the program I will have a sound knowledge of different
cultures beliefs, and have the essential skills to practice with a patient centred clinical approach in
understanding and treating the patient as well as the disease.

References

Betancourt, J., Green, A., Carrillo, J., & Park, E. (2005). Cultural Competence And Health Care
Disparities: Key Perspectives And Trends. Health Affairs, 24(2), 499-505. doi:
10.1377/hlthaff.24.2.499

Saha, S., Beach, M., & Cooper, L. (2008). Patient Centeredness, Cultural Competence and
Healthcare Quality. Journal Of The National Medical Association, 100(11), 1275-1285. doi:
10.1016/s0027-9684(15)31505-4