From a training event on the critical incidents methodology to a reader on Anthropology for healthcare professionals, and an event for doctors, nurses, and staff from healthcare institutions in the UK, France, Hungary, Italy, Austria and Denmark. Keep tabs on Healthy Diversity project progress, read what we have been up to in this first year of activities and see if there is anything interesting in it for you!

Read Now Healthy Diversity - Culture Shakes!

Dear Reader,

some months ago we started working on this exciting project! The Healthy Diversity Team met up in Rugby to learn together the Critical Incident methodology developed by Margalit Cohen-Emerique, in order to be prepared to meet people working in the healthcare sector and dealing with diversity. So after 5 days together in WREP’s offices, we went back home and invited participants coming from different health sectors (patients, nurses, doctors, caregivers etc…) to join us for a Critical Incident workshop.

During these 6-hour workshops organized by the project partners in their countries, we invited our participants to reflect on culture and tried to answer together the question “do cultural differences matter?”. The participants shared and answered the question based on their own experiences, whether anything surprised them, have they lived experiences they could not explain at first. Here are a few examples to illustrate how differences can matter:

“A child in the care of community nurses died (the death was expected, prepared for and managed well).  In the days following, a nurse visited the family to offer support and remove equipment. The family had prepared a room, with the child’s body on view where food was left.  The nurse was invited to come and spend time in the room, and share the food.  She found this very unsettling, and the fact that the food was of a type she wasn’t used to eating added to her discomfort.”

“I was admitted to hospital for a suspected heart attack.  I was on the emergency ward on the first day and was transferred to another ward on the second day.  As I had not chosen my meal option, I had to choose from what was left over. The Health Care Assistant (HCA) automatically assumed that I would want chicken curry for dinner.” 

The Diversity Reader will soon be ready to share with you, stay tuned!

Healthcare professionals experience culture shocks

What happens if a doctor, a nurse, or administrative staff from a hospital is confronted with diversity? What would you, healthcare professional, do if you entered a hospital room to find that the floor has been covered with salt intentionally? Can your practice be threatened or jeopardised by a cultural ritual you were not expecting to see performed in your workplace?

All over Europe, Healthy Diversity project staff are collecting ordinary stories where healthcare professionals have felt challenged by an unexpected way of dealing with or conceiving health issues. Hospital and clinic professionals have told us about their experiences of culture shock, or what we call “critical incidents” (CI), after the name of the methodology we apply in the project.

In the UK, France, Italy, Hungary and Austria, the project organisations have organised workshops addressing the issue of culture shocks and providing professionals with a methodology for recognising and dealing with such shocks. The same goal was reached by the Danish partner organisation through one-on-one interviews with professionals.

The feedback gathered among the participants in the workshops was enormously positive and included:

“… made me understanding how important the cultural context is of patient’s health-related behaviour and how it can enable healthcare professionals to improve patient communication, expectations and healthcare outcomes.”

”The workshop gave us an open and safe environment to discuss and explore issues relating to equality and diversity that impact on clinical decisions and processes and to look at those decisions from a different perspective. The CI methodology enabled me to think about decisions that I have made when delivering care, to reflect on how I could change these in the future to better consider my patients’ views, beliefs and cultural characteristics. 

… to be able to challenge our own views and beliefs and to think about how our actions can be perceived by others. It made us discuss issues that are sensitive and maybe shocking but are usually not addressed for fear of causing offence … ”

Overall, about 300 professionals and some patients (users of the healthcare system) were contacted in the project countries, and they provided the project with about 120 critical incident descriptions, i.e. stories about their culture shocks in the workplace. This wealth of knowledge and of first-hand experiences with diversity was recorded and organised in a final collection of incidents that makes up the Reader of Critical Incidents, the first product of the Healthy Diversity project, soon available on the project website www.healthydiversity.eu.

Anthropology and Healthcare – Expanding the Understanding of Diversity

The Healthy Diversity partnership is working on the development of a Medical Anthropology Reader. Why would healthcare professionals need to learn about anthropology?

Cultural Anthropology is the science par excellence studying manifestations of culture.  It is therefore naturally interested in specific cultural features, such as healing practices or conceptualization of health and sickness.  Medical Anthropology is the sub-discipline specialized in such questions.  For this reason it appeared logical to us that introduction to Medical Anthropology should be part of a training program for health professionals who wish to better understand cultural encounters and their possible consequences.  There are a lot of good introductory books, so our intention was not to propose a general overview of the subject ;  rather we wished to give a taste, offering a sample of the problems that Medical Anthropology treats or has treated recently in the partner countries.  There is a good chance that practicing health professionals in these countries will also meet similar situations, similar dilemmas or similar puzzles, so besides satisfying their theoretical interests we hope that the texts of the Reader will offer practical help in the analysis of critical incidents taken from real life.

In the last few months our national teams have been busy scanning the production of Medical Anthropology of the last 15 years in their respective countries. Instructed and supported by the editing group, they first chose about a dozen of papers and books to present.  Out of these we have chosen 2 interesting titles and national teams are asked to produce a short summary of these for the non-initiated reader who, on the top of that does not necessarily speak the language of the publication.  These presentations will not substitute the original texts of course, but will offer an easy access to very complicated and highly relevant themes concerning directly the daily work of health professionals.

Intercultural Good Practice in European Healthcare

As one of the products in the Healthy Diversity project, we are going to search, analyze and assess examples of good practice from the healthcare system in all partner countries.

For quite many years, we saw a strong focus on the collection and documentation of good practices within many different sectors and professions in Europe. Thus, we may today find a huge variety of good practice catalogues in the European context. However, a common challenge for many good practice collections seems to be that it is, indeed, very difficult to ensure a real transfer value to other countries, sectorial contexts, target groups and local frame conditions etc. In many cases, we are left with a descriptive review of what the good practice implies. But we hardly know anything about the function of the good practice: how it works for the specific target group – and why it has a positive impact and effect.

In the light of past experience, our aim in the project is to develop a good practice material that would be applicable for professional healthcare institutions as well as projects and efforts with a healthcare perspective. Instead of the mere collection and documentation of intercultural and diversity promoting good practices, our aim is to build a practical and transferable tool for analysis and assessment of good practice in the healthcare sectors all over Europe. Thus, the idea is to develop an analysis and assessment tool, which provides healthcare professionals and other actors related to the healthcare sector with good practice indicators and methodical instructions for the analysis of healthcare practices in order to assess how they function, why they have an intended impact on certain target groups and why they come provide a long-term effect for the target groups etc. From this kind of analysis and assessment, we hope to promote a deeper understanding of:

  • Why a practice turns out to be a good practice
  • How good practices operate and functions for the target groups
  • Why good practices ensure a long-term effect

By doing so, we hope to strengthen the transfer value of existing good practices.