Diversity and culture An introduction

Why are we doing this? Equality and diversity is a section of the GP curriculum Relevant to clinical care, relationships with patients, working with colleagues And to you as an individual and society as a whole And it makes routine everyday work more interesting

Equality Is about creating a fairer society in which everyone has the opportunity to fulfil their potential

Diversity The recognition and valuing of difference between people Creating a working culture and practices that recognise, respect, value and harness difference for the benefit of the organisation and individual patients.

Dimensions of Diversity

Dimensions of Diversity Gender Age/generation Ethnicity Nationality Language/dialect Skin colour Religion Class (wealth, family background, education) Region(N/S, urban/rural) Country/region of origin Country/region of residence Educational level Occupation Sexual orientation Political orientation Disability Culture (beliefs, expectations, behaviours) Subculture

Ethnicity Identification with a social group on grounds of culture, common origin, and shared history

Ethnicity Genetic inheritance (‘Race’?) Geographical origin Religion Nationality History/ Migration Culture Language

Culture Complex social phenomenon Shared beliefs, values and attitudes that guide behaviour of members Dynamic concept - keeps changing We are all multicultural, but often don’t recognise it

My cultural identity White English Not English English Woman Middle class Politics: left, green, feminist, internationalist (Guardian reading) Family member (another slide?) Well educated 1960s generation Doctor Middle aged Shipley GP Bradford GP Educator

“Iceberg model” Kreps and Kunimoto (1994) Gender Age Ethnicity Language Skin colour Sea level Socio-economic status Occupation Sexual orientation Political ideology Disability and health Cultural beliefs, expectations

Your cultural identity Which cultural groups would others say you belong to (top of iceberg)? Which other cultural groups do you feel you belong to (bottom of iceberg)?

Which aspects of culture are the most important for you Which aspects of culture are the most important for you? What most defines you? How has your ethnicity and class background provided strengths / challenges? How do cultural factors affect your behaviour and communication styles at work and elsewhere? What aspects of background, attitudes and values do you share as prospective GPs? How do these factors affect interaction with your patients and colleagues? Are these factors likely to cause any difficulties, and if so how might they be overcome?

Cultural competence Well meaning blunders Cultural knowledge Tendency to stereotype Bigotry Cultural acceptance

Flashcard exercise Imagine the person on the card as a patient, or a colleague, or as someone on the street What are your immediate ideas about them? Discuss - and challenge your colleagues to think of other possibilities

Diversity in the consultation Think of consultations in which differences between you and the patient (on any dimension) were a significant issue