Lifelong learning is vital to providing culturally safe care

Learning to provide culturally safe care is a lifelong process, says Dr. Kent Saylor—and completing the new eCME on providing culturally safe care for Indigenous patients is a great place to start.

Dr. Saylor, a paediatrician in Kahnawake, Quebec, and chair of the project’s planning committee, is excited to share this new learning opportunity with CPS members.

“The most important thing for paediatricians is to know what they don’t know,” said Dr. Saylor in an interview. “Most people have a huge knowledge gap of the realities—both now and historically—for all Indigenous peoples in Canada.”

The learning module is based on an in-person training program on Indigenous child and youth health developed by the Canadian Paediatric Society (CPS) and the National Collaborating Centre for Indigenous Health (NCCIH). 

The module—available on Pedagogy—examines what culturally safe care is, why it’s important, and how to practice it with Indigenous patients. It explores historical factors, social determinants of health, and power imbalances that affect patient-practitioner interactions.

“If there’s one thing participants can take away from this module, it is to realize how much they have to work at gaining the trust of Indigenous families,” said Dr. Saylor. “There is a lot of mistrust of the medical establishment.”

The module also explores systemic inequities, such as racism within the healthcare system, that act as barriers to care.

It is not only overt racism that is harmful, said Dr. Saylor. Health care providers may unknowingly engage in more subtle forms of racism, such as stereotyping, inherent bias and microaggressions, which can also harm patient health.

“These experiences can be extremely offensive and can really break down the whole trust relationship with families,” said Dr. Saylor.

As well as discussing Indigenous histories and experiences, the module provides practical details that every paediatrician can use in their practice.

It describes the Non-Insured Health Benefits (NIHB) program, which provides health benefit coverage for many (but not all) Inuit and First Nations people. It also describes funding opportunities through Jordan's Principle and the Inuit Child First Initiative, which can be used to help access health, social and educational products, services and supports.

Paediatricians need to know how to help children and youth who qualify for these programs—and it’s equally important to know that Métis patients are ineligible for both.

“To me, it’s a travesty that Métis people are excluded from so many things, but again, that’s a thing for people to learn about,” said Dr. Saylor.  

After completing this module, Dr. Saylor encourages paediatricians to keep learning how to provide culturally safe care—and he seems optimistic that they will.

“I’ve been in practice for about 25 years. When I started, I didn’t see much recognition of the things that physicians and other health care providers need to know. Now, people are realizing that there are many historical factors they did not know about,” said Dr. Saylor.

When asked how paediatricians should continue their learning journey, he recommended consulting the module’s detailed resources section, which includes many materials on Indigenous histories and experiences. He also encourages CPS members to consider attending the biannual International Meeting on Indigenous Child Health (IMICH) at least once.

“At IMICH, we hear about many very positive changes that have taken place over the years, so I think people can learn a lot about Indigenous health and experience there.”

For information about this eCME, visit https://cps.ca/en/pedagogy. For information about IMICH, visit https://cps.ca/en/imich.  

Thanks to all members of the planning committee for their work on this project. See the committee list below.

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