Stories of Pediatric Practitioners with/in Indigenous Communities: A Guide to Becoming Culturally Safer

Abstract

In this presentation we will discuss cultural safety practices in remote Indigenous communities and how we as practitioners can be culturally safer when working with these communities. We will explore the journey of several practitioners who work with Indigenous communities across Canada and New Zealand.

Background:

Indigenous peoples receive lower quality healthcare services than non-Indigenous peoples within a demonstrated context of systemic racism. Despite increasing recognition of the importance of implementing Cultural Safety, there is still a lack of research on how to practice it within specific Indigenous communities and contexts. This project was in partnership with the Cree Neurodevelopmental Diagnostic Clinic.

Purpose:

Explore culturally safe rehabilitation practices around neurodevelopmental diagnoses in children and their families, within rural or remote Indigenous communities.

Methods:

An anti-colonial research framework was used. Eighteen definitions of cultural safety from literature were thematically analyzed. Narrative interviews (n=17) were conducted with practitioners, administrators, and Elders working in and around rehabilitation in isolated Indigenous communities. Their stories were narratively interpreted and compared to the literature.

Findings:

Definitions of cultural safety in literature includes four common elements: (1) reflexive practice relating to one’s social characteristics, (2) power dynamics within a sociopolitical-historical context, (3) safety defined by the patient, (4) patient self-determination. While overlapping with practitioners’ perspectives, the consultants named trauma-informed approaches and complexity of relationship building. Practitioners experience cultural safety as an on-going journey to becoming part of the communities they work with.

Conclusion:

These findings demonstrate the need for further exploration of how safer practices are understood and embodied across various healthcare contexts, and what kinds of languages or frameworks, educational preparation, and organizational supports are helpful. Consultants' stories question and resist the use of standardized pediatric assessments within Indigenous communities, ideological assumptions of Eurocentric evidence-based practices, and Western notions of ‘professionalism’.

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McGill University is located on land which has long served as a site of meeting and exchange amongst Indigenous peoples, including the Haudenosaunee and Anishinabeg nations. McGill honours recognizes and respects these nations as the traditional stewards of the lands and waters on which peoples of the world now gather. Today, this meeting place is still the home to many Indigenous people from across Turtle Island. We are grateful to have the opportunity to work on this land.

Learn more about Indigenous Initiatives at McGill.

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