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Achieving Quality through Equity Pedagogy Managing Workforce Diversity through Equity Pedagogy
Rani Srivastava & Janet Mawhinney
Diversity RX
March 2013
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GoalWithin the context of broad diversity &
equity organizational change strategy...
To describe an innovative approach to equity education being used to guide the development of individual and organizational capacity of cultural competence and equity in health care
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Context: Toronto, Canada
one of the most diverse cities in the world 5.5 million residents in Greater Toronto50% are not Canadian born 8 per cent of Canada's population30 per cent of all recent immigrants
the largest Aboriginal & LGBT populations in Canada50% of the city residents are racialized peopleOver 160 languages spoken24.5% below LICO (impact greatest among people of colour)
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Canada's largest mental health and addiction academic health science centre Over 2,800 staff, 388 physicians, over 25,000 unique clients Extensive experience in diversity/equity organizational change & professional practice strategies
Centre for Addiction and Mental Health (CAMH)
F1
Slide 4
F1 Faye, 5/1/2012
Formal federal multicultural policiesMosaic philosophy Constitutional and provincial human rights law
In services: bilingual French/English and sign language mandated
Context: Canada Legislation & Orientation
Dual focus: Workplace/organizational culture
Clinical Care
CAMH Equity & Diversity Organizational Change
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CAMH Equity & Diversity Organizational Change
Education cannot be a stand alone initiativeCAMH structural supports include:
Executive Leadership Formal accountability in Office of Nursing and Professional Practice, HR Diversity and the Health Equity OfficeDiversity measures part of all performance reviews & job interviewsMultiple initiatives (clinical, workplace culture, manager capacity, pathways to care, research)With mandatory (and optional) training as a backbone
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The Partnership University of Toronto (FIFSW)
Factor Inwentash Faculty of Social Work, University of Toronto (est. 1914)Graduate Program (MSW & PhD) 5 specializations:Children and their Families, Social Justice and Diversity, Mental Health and Health, Social Work in Gerontology, Social Service AdministrationApprox. 400 students/ 26 faculty
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The ProjectA 2-year partnership between academic and practice organization to strengthen the Faculty capacity to educate on and navigate issues of diversity and equitySeconded the Chief of Nursing & Professional Practice (Rani Srivastava)and the Manager Diversity & Equity (Janet Mawhinney) to provide expertise in
organizational change practice development diversity, equity and cultural competence in clinical care
Quality & Workplace Diversity
Both CAMH & FIFSW reviewed structures, policies & processesEducation being just one platform for capacity building and change
Our focus here is on the Education component of the strategy
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NEXT: our Equity Pedagogy Model
Share our diversity and equity frameworkSome key components of our pedagogical approachDiscuss experiences delivering core workshops to CAMH front line staff, managers and to all incoming MSW students at FIFSW U of T
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Our equity frameworkHuman rights based: anchored in human rights law and (Canadian) constitution which recognizes the systemic nature of discriminationAnchored in professional practice expectations and organizational standards/ codes of behaviourEnsures the focus is not on whether we address inequity but how
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Race*Culture Ethnic origin* Colour*Socio-economic status/ classLanguage/ accent Sex*Gender Gender identity Sexual orientation*
Age*Citizenship*Religion* - Creed Disability* Literacy level Immigration/ refugee statusAncestry*Place of Origin*Marital Status*Family Status*
Broad definition of diverse &marginalized groups
* Included in Ontario Human Rights Code
Unique status of Aboriginal Peoples
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Focus on Equity PedagogyAnchored in a truly broad definition of diversity and culture means that no-one is ever an expert on all aspects of diversityWe all have knowledge to contribute and we all have gaps, ignorance and much to learnCritical to embrace a positive learning edge in interdisciplinary education and practiceIs an expectation in law, practice and organizational culture
A note re: terminology
Equity Equality Diversity Culture Cultural competence
Terms mean different things to different people…Need to develop a shared understanding
Equality: treat all same Equity: customize for = Outcome
Equality & Equity
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Our equity frameworkCulture is viewed broadly, (not only race and ethnicity)Culture as consisting of both patterns and powerGrounded in concepts of privilege and marginalization Integrates an adult education and developmental approach to issues of power and inequality – always maintain a learning edge Thus cross-cultural practice must navigate differences in world view as well as power and hierarchy
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ABC(DE) of Cultural Competence ©
AFFECTIVE
BEHAVIOURAL COGNITIVE
Dynamics of difference
EQUITYEnvir
onment
©R. Srivastava, 2011
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Focus on Equity PedagogyThere is NO singular correct viewpoint including that of anti-oppression/equity educationAnalysis of systemic power relations including the impact of Social Determinants of Health Establish an expectation of ongoing learning, pride in one’s knowledge & humility about inevitable partiality of that wisdom
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DIVERSITY
DIVERSITY
The Diversity Flower has been adopted from the Power Flower (Source: Arnold, R., Burke, B., James, C. & Martin, D. (1991) Educating for a Change, Toronto, ON: Between The Lines)
Socioeconomic
Status
Language/AccentSe
xual
Orie
ntat
ion
Immigrant/Refugee Status
Lite
racy
Leve
l
Racialized
Spirit
uality
/
Religi
on
Other, etc.
Mental/PhysicalAbilities
Gender id
entity
Cultu
re/
Ethn
icity
Gender
Age
Power &Privilege
Marginalization Privilege
DebriefVisible, less visible, invisibleIntersectional – alwaysSome ‘fixed’ or static, some change over timeImpact may vary by contextInside view (how I see myself) vs outside view (how others/ or dominant culture situates me)Not equally salient at all times – Some have added significance and weight (e.g. poverty & nexus of race, gender, disability and immigration) We all have degrees of power and degrees of marginalization. And this is not equally weighted.
STRENGTH, RESILIENCY and core aspects of identity are also rooted in non dominant social locations. This is not a
deficit model – but a portrait of systemic power.
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Focus on Equity PedagogyEquity & diversity competencies are learnt and are about awareness, knowledge, andskills that are applied in practice.By definition this is a developmental and ongoing processEquity and Diversity competencies are critical aspects of professional practice for ALL health and social service disciplines
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Core Domains for Equity Competency©
Knowledge
Skills
Awareness
ApplicationIn Practice
POWER & EQUITY
©CAMH, 2005
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Personal
Diversity Implementation Framework©
Societal
Professional
Organizational
POWER & EQUITY
Barriers & Exclusion andStrategies &
Inclusion
©CAMH, 2011
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Continuum of Equity Learning
Harm, Destructive
Proficiency, Inclusion,
Celebration
• Not finite
• Dynamic
• Can be at more than one point (on different issues / skills)
Workshop Strategies
ExperientialKnowledge basedCollective
Workshop strategiesData and statistics – demonstrate SDOH and health (in)equity impactsPersonal reflection and ‘mapping’ of social locationApplication through discussion, case studies and scenariosInteractive, short teaching, with activities and group learningMoves from global and local context, personal location, to application in practice27
Focus on equity pedagogy
Seek to avoid traps of identity silos and hierarchies of oppressionFocus on multiplicity and interrelatedness of diversity issues and identitiesAnd the impact on health access, health outcomes, and organizational culture
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Experience from the workshops
Facilitators model and demonstrate this blend of pride/humility in how training is designed and deliveredWide range of participant comfort and familiarity with diversity and equity issues Anchored as a learning process; skill that is acquired and practiced means a responsibility to engage others well (vs. nail a political point)Tied to practice and quality expectations
Experience from the workshopsw students
Those with political and advocacy experience bring an activist stanceChallenge to bring newer learners along in respectful mannerHow to maintain a positive learning edge while navigating diverse identities and equity capacities?
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Mindfulness of equity and power issues in teams, service and leadershipHow to navigate different marginalized identities – in conflict or tension – each claiming primacy of identityWhen culture or identity is used to explain exclusion or behaviour
Experience from the workshopsw managers
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Evaluation and Feedback
Feedback from students, faculty, and managers very positive Difficult to measure the amount of application to practice in a consistent way Has some longitudinal impact –based on anecdotal comments from faculty How else to measure practice change???
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Summary
Successful partnership between academia and practiceModel of equity and pedagogical strategy worked well in both settingsEquity and Diversity competence is critical for health and social service practice Regardless of where one is on their equity / diversity journey -- need to maintain humility and foster learning
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Summary
Our equity pedagogy is grounded in human rights (& a broad definition), combined with practice standards for quality care
Must be able to identify and navigate Personal, Professional, Organizational, and Societal issues
Move from awareness to practice