Literature on Diversity in the Workforce

“Diversity will only be achieved if the primary focus is on: what is happening within the pipeline…Emphasizing talent development opens up many new approaches for science training outside of traditional degree programs.”

(McGee, Saran, & Krulwich, 2012)

Literature is scarce on the long-term benefits of workplace diversity in OT:o (Kirsh, Trentham, & Cole, 2006)o (Trentham, Cockburn, Cameron, & Iwama, 2007)

Literature on Diversity in the Workforce

Imbed cultural competency training into OT curriculums (Nochajski, & Matteliano, 2008)

Fieldwork education with underserved populations and international fieldwork opportunities (Kirsh et al., 2006)

Promote self-reflection into OT students’ own cultural identities (Kirsh et al., 2006)

Explore qualitative literature which depicts the experiences of minority groups who receive OT (Kirsh et al., 2006)

Include discussions in academia of discrepancies in Westernized versus non Westernized cultural values (Iwama, 2003; Kinebanian & Stomph, 1992)

Models of Cultural Sensitivity

Podsiadlowski et al., 2013:o Organizational paradigms to diversity

• Discrimination and fairness• Access and legitimacy • Learning and effectiveness

Suarez-Balcazar et al., 2011:o Self-reflectiono Integrating culture in the occupational therapy processo Developing organizational support for change

Dass and Parker, 1999:o Resistance to organizational support for change

Cultural Competence vs. Cultural Humility

Dynamic between client and provider can be compromised by sociocultural mismatches

Competence connotes a theory that can be mastered Cultural humility indicates:

o Lifelong commitment to self-evaluation and self-critiqueo Addressing power imbalances in the provider/client dynamico Developing partnerships with communities

Focus on student education to examine individual patterns of unintentional and intentional racism, classism, homophobia

(Tervalon & Murray-Garcia, 1998)

New Recommendations for Competence

…transculturally competent therapists are skilled at working with the client to: o identify how meanings are created and/or expressed

through occupationo acknowledge systemic barriers to inclusion and are able

to advocate for their ameliorationo open to learning about the lived experience of their

clients o knowledgeable about their {clients} values and health

beliefs o insightful about their own values and assumptions

regarding what are good and right and true o can monitor their own tendency towards ethnocentricity

(Trentham, Cockburn, Cameron, & Iwama, 2007)

Developing Terminology Cultural fluidity (Shippy, 2009):

o Able to adapt to different cultures--expert and learner Cultural humility (Tervalon & Murray-Garcia,

1998):o Every interaction is multicultural; must be aware of

personal bias Transcultural competence (Kirsh et al., 2006):

o Ability to function effectively within a given role with a diversity of individuals whose cultural perspectives differ from one’s own • Cultural sensitivity is viewed as one aspect of

transcultural competence. Cultural proficiency (AAFP, n.d.):

o Knowledge, skills, and attitudes which enable people to work well with, effectively respond, and support people in cross-cultural settings

Strategies for Clinical Implementation

“Another promising strategy might be to make use of “influential” therapists….In our opinion, knowledge brokers could be very important, especially in the last stages of implementation—change and maintenance.”

(Ketelaar, Russell, & Gorter, 2008)

“For research findings to effectively influence health services’ delivery of care needs an intermediary…an emerging role therefore exists for knowledge brokers, supported by knowledge brokering resources and agencies, to fill the gap.”

(Lomas, 2007)

Strategies for Clinical Implementation

Therapists value interactive and hands-on continuing education but rely most heavily on their peers when accessing, evaluating, and implementing new knowledge.

Trials involving educationally influential therapists are indicated.

Continuing education research is needed to identify organizational conditions conducive to therapists’ learning and knowledge translation.

(Rappolt & Tassone, 2002)

Focus Group Results & Discussion

Focus Group Discussion Questions

1. What does diversity mean to you?2. How do you define diversity?3. What are 2-3 things that you have observed,

done or could do to promote diversity in the workforce?

4. What do you feel is the importance of diversity in the workforce?

5. Is there anything else you would like to share?

Focus Group Results

17 (23%) 21 (28%)

Participants by region (n=75): 32 (43%)

1 (1%)

Not reported 3 (4%)

Focus Group Survey Responses (n=75)

Yes 33%No 67%

20-29 41%30-39 23%40-49 17%50-59 13%60-69 5%

Student33%OTR/L 49%COTA 3%Research 7%Educator 8%

Focus Group Survey Responses (n=75)

Focus Group Survey Responses (n=75)

Sample Qualitative Responses

“I am reminded that we as a profession need to keep our eyes fresh to continually adjust our modes of operation. Only then can we provide the best patient care and more fully promote a richer QOL.”

“Diversity tends to be boxed into groups, but it is a really broad concept on more than race, gender, religion and sexuality.”

It is extremely important. No pt is the same meaning having diversity in the workforce helps us as OTs provide more pt centered practice and increases the comfort and relatability pts feel with us.

Sample Qualitative Responses

Its important for patients of different cultures to see we have employee diversity as well

“Equality does not equal diversity -> makes working together interesting.”

I realize there are many types of diversity, as we discussed. Some areas, such as rural may only have 1 OT for hundreds of miles. In these cases there is not a lot of opportunity for a diverse professional pool. I feel the therapist needs to be diverse in their understanding of cultures that they do not belong to. There is such an opportunity to learn from our clients too. Maybe this is considered cultural sensitivity, but we also need to be diverse in our own self to be effective.

Focus Group Discussion Themes

Politically-correct

Phenomenon vs.

Problem

Changing terminolog

y