ACT Do Now

• Grab the passage• Do what you do best…figure out what’s going

on in the experiment and how to answer the questions.

25 min

Standard

Agenda:1. Do Now: Use 6 reading strategies to attack Fig. 1, filling

in column on left or numbering steps next to psg. (4)2. Class discussion of steps 1-4. (4) 3. Model steps 5 & 6 (Trends & conclusion) for Fig. 1 (4)-Focus on: IV/DV, axes, key (mult. data sets/2nd IV), how to

read trends “as IV…, DV …. for…”, Big 2 4. Practice with Fig 2 (5)5. Review Trends & Conclusions (5-6) for Fig 2 together (4)

Honors

Do Now: Follow Steps 1,2,5,6 for the Facebook Breakups graph (5)

Share out the questions you asked (#2a) (2)Review Purpose & Conclusion (2)Practice w/ 2nd passage (5)Hot Seat student modeling (1 student or 4 diff.

students) (4)

Share with a Neighbor

1. Share what you wrote in your table. Your neighbor should write the notes on his/her table.

2. Together decide, what BOTH patient & physician should do?3. Notebooks: How does this relate to health disparities? Why

do you think that these responsibilities are even more important for U.S.

Minority groups?4. 4. Why might some of the patient 5. responsibilities be challenging for U.S.

Minority groups?

5 min

Copy into your notebooksPatient

ResponsibilitiesBoth Physician

Responsibilities

-Ask questions-Explain language barrier-Explain problem in detail-Get to the medical location-Stop the physician when he/she doesn’t understand the directions-Follow doctors orders-Explain alternative methods being usedPrevention-Eat right-Exercise-Go to regular doctor’s appointments-Don’t smoke or drink-Don’t get too much sun

-Communicate clearly-Ask questions to check for understanding-Trust each other

-Build rapport with the patient so he/she feels comfortable-Educate the patient using the teach back method-Treat each patient individually without making assumptions-Ask questions to learn about the patient-Be sensitive the cultural needs of the population who attend the hospital-Use models & pictures to explain complex concepts.-Question themselves to prevent bias. “How would I treat this same patient if he/she were _______?”

7 min

Do Now (4 min)

1-Should doctors, nurses, health care professionals, etc be expected to memorize information about every race, religion, culture, etc? Why or why not?

2-What would happen if health professionals paid no attention to culture?

Objectives

• Apply cultural competency to a variety of situations.– Define cultural competency– Differentiate between the 5 main issues present in

cultural competency

How do you think this comic relates to medical competence?

What does it mean to be competent?

So what exactly is culture?

What is culture?Integrated patterns of human behavior including:1. Language and communication style2. Health beliefs3. Family relationships4. Gender roles5. Spirituality and religion6. Social issues

What is cultural competency?

The knowledge, skills, and attitudes physicians must be equipped with regarding his/her patient’s culture (language, health beliefs, gender, family relationships, spirituality, and social issues.)

Expectations

• Reminder! Keep in mind that we will be discussing cultures and topics that could hit very close to home for some people in this room. With that in mind, make sure you are discussing all topics with the utmost respect.

5 Main Issues in Cultural Competency

1. Understanding the family’s health and illness beliefs

Explanatory model questions to address issue:

• What do you think has caused your problem?

• What do you call it?• Why do you think it started when

it did?• How does it affect your life?• How severe is it? What worries

you the most?• What kind of treatment do you

think would work?

Example

John doesn’t trust doctors but his wife made him see one because he keeps wheezing. He also believes that any surgery will taint him in his next life. (He has a serious heart condition.)

You be the doctor! Why is this a challenge?

5 Main Issues in Cultural Competency

2. Family decision-making and authority figures

• In many cultures the family makes decisions in a more unified way

• Certain cultures may have a hierarchy of gender, age, birth order, etc.

• Family meetings

ExampleIn John’s family, his grandfather

must be present for any type of family-related decision.

In Juanita’s family, only the mother needs to be present for family-related decisions.

You be the doctor! Why is this a challenge?

5 Main Issues in Cultural Competency3. Traditional/alternative medical

practices

• Patients may avoid using potentially more effective medical treatment due to their use of alternative practices.

• Some may have beneficial effects for patients, whether proven or subjective.

• Trust can be built by being open to patients’ ideas.

• Some alternative therapies may be dangerous.

• Being judgmental about alternative therapies contributes to patients not revealing their use.

ExampleWhen Dr. Jones first met with

John, John agreed that chemotherapy sounded like

the right way to go.Dr. Jones sounded very skeptical about the use of herbal medicine when he met Juanita, so she never

revealed that she was using them and never came back

to the clinic for chemotherapy.

You be the doctor! Which of the bullet points relate to John? Which relate to Juanita? What should Dr. Jones have done when meeting Juanita?

5 Main Issues in Cultural Competency

4. Cross-cultural Negotiation

Involves: • understanding the patient/

family’s perspective• explaining your perspective • being flexible• coming up with creative

ways to meet their needs while aiming for the best possible outcomes.

ExampleJuanita visited a new doctor. Dr.

Torres asked Juanita lots of questions, stayed open-minded,

and eventually got Juanita to open up about herbal medicine.

After a long discussion, they decided that Juanita could use

BOTH herbal medicines and chemotherapy.

You be the doctor! How was this an example of cross-cultural

negotiation?

5 Main Issues in Cultural Competency

5. Barriers to effective communication

• Title VI of the Civil Rights Act prohibits discrimination against any person on the basis of race, color, or national origin in any program receiving federal assistance.

• The U.S. Department of Health and Human Services Office for Civil Rights, in a clarification of title VI in 2000, views inadequate interpretation in the health care setting as a form of discrimination.

Example

At the first hospital visited by Juanita, there was no on-staff interpreter. Juanita’s husband, who only knew English a little better than Juanita,

had to interpret.

You be the doctor! What problems could arise? How does this violate

the Title VI Civil Rights Act?

Example 1

http://www.youtube.com/watch?v=K5d_iPaUrWw&p=6D96BA15FBACC6BA

Which issue(s) do you see in this scenario?

In what ways could the doctor have been more culturally competent?

Example 2

http://www.youtube.com/watch?v=p8u0fx7sa-Q&p=6D96BA15FBACC6BA&index=3&playnext=1Which issue(s) do you see in this scenario?

In what ways could doctors be more culturally competent in these situations?

What should doctors know about the African American population who needs transplants?

Example 3

http://www.youtube.com/watch?v=-MkOiWJdoTI&p=6D96BA15FBACC6BA&index=4&playnext=2

Which issue(s) do you see in this scenario?

In what ways could the doctor have been more culturally competent?

Example 4

http://www.youtube.com/watch?v=JlXd2ictsmY&p=6D96BA15FBACC6BA&index=5&playnext=3

Do you see any of the 5 issues in this example?

If you were the doctor, what other questions would you ask the patient?

Your Turn

Begin answering the questions in your group. What you don’t finish will be your homework.