structural competency

Page 1: Introduction to Structural Competence

  • Course Title: Structural Competence OCCU 5003: Dimensions of Professional Practice

  • Institution: Dalhousie University

Page 2: Course Outline

  • Main Topics:

    • Structural Competence

    • Social Determinants of Health

    • Core Competencies

    • TRC Calls to Action

    • Implications for Practice© Crystal Dieleman 2024

Page 3: Culture, Equity & Justice (COTC C1)

  • Objective: Promote equity in practice

  • Key Strategies:

    • Identify ongoing effects of colonization on Indigenous Peoples' occupational opportunities.

    • Analyze systemic and historical factors affecting occupational possibilities.

    • Challenge societal biases and structures that marginalize communities.

    • Address social determinants of health that affect well-being and occupational opportunities.

    • Reduce effects of unequal power distribution on occupational therapy services.

    • Support factors that foster health and well-being. © Crystal Dieleman 2024

Page 4: Culture, Equity & Justice (COTC C2)

  • Objective: Promote anti-oppressive behaviour and inclusive relationships

  • Key Strategies:

    • Cultivate a culturally safer and anti-racist practice environment.

    • Practice self-awareness to mitigate personal biases.

    • Engage with respect and humility, integrating clients' health understandings into service plans.

    • Pursue resources for culturally safer approaches.

    • Collaborate with local interpreters and community leaders. © Crystal Dieleman 2024

Page 5: Culture, Equity & Justice (COTC C3)

  • Objective: Contribute to equitable access in occupational therapy

  • Key Strategies:

    • Enhance clients' awareness of their rights to occupational participation.

    • Facilitate client participation in health-promoting occupations.

    • Assist clients with accessing support networks and resources.

    • Navigate systemic barriers to enhance client support.

    • Engage in critical dialogue on social injustices affecting occupational opportunities.

    • Advocate for sustainable environments and policies.

    • Be aware of data biases in occupational therapy practice. © Crystal Dieleman 2024

Page 6: Cultural vs. Structural Competency

  • Cultural Competency: Focus on clinician bias and communication during clinical interactions.

  • Structural Competency: Recognizes the socio-political conditions that underpin health inequalities.

    • Calls for understanding how institutions shape healthcare experiences and advocating for systemic change. © Crystal Dieleman 2024

Page 7: Definition of Structural Competence

  • Concept: The ability to see how clinical symptoms reflect broader social decisions and structures.

    • Focus: Understanding how institutional structures produce health inequities.

    • Goal: To address the social determinants of health through active engagement and advocacy. © Crystal Dieleman 2024

Page 8: Five Core Competencies of Structural Competence

  1. Recognizing Structures: Awareness of factors influencing clinical interactions.

  2. Extra-clinical Language: Ability to relate clinical presentations to social and institutional contexts.

  3. Cultural Re-articulation: Framing clinical issues through cultural and structural lenses to acknowledge disparities.

  4. Structural Interventions: Identifying and influencing decisions for structural change.

  5. Structural Humility: Recognizing personal limits and valuing clients' lived experiences. © Crystal Dieleman 2024

Page 9: Engaging with TRC Calls to Action

  • Quote: Importance of critical engagement with occupational theories in relation to Indigenous health inequities.

    • Reflection: Occupational therapists must be aware of their values and the societal structures that sustain inequities. © Crystal Dieleman 2024

Page 10: Interpersonal and Systemic Racism

  • Issues: Myths of accessible services (healthcare, housing) versus reality of inequities.

    • Anticipation of racism by Indigenous people in healthcare settings.

    • Concept of racial fatigue: Stress from continual discrimination leading to mental and physical exhaustion. © Crystal Dieleman 2024

Page 11: Implications for Practice

  • Advocation: Responsibility to address systemic issues affecting health outcomes.

  • Shift in Perspective: From individual client blame to societal accountability for inequities.

  • Critical Inquiry: Questions to consider regarding structural influences on health and clinical interactions. © Crystal Dieleman 2024

Page 12: Examples of Structural Issues

  • Service Access: Centralization of services in urban areas limits access for rural populations.

  • Primary Care Limitations: Insufficient mental health resources in rural communities.

  • Myths of Free Services: Perpetuation of stereotypes affecting minorities. © Crystal Dieleman 2024

Page 13: Case Scenario 1

  • Situation: A client with hemiplegia can’t be supported at a local nursing station due to resource shortcomings.

    • Care Recommendations: Discussion on the disconnect between urban and rural service provision. © Crystal Dieleman 2024

Page 14: Case Scenario 2

  • Situation: Cultural discomfort faced by an Indigenous client in an inpatient rehabilitation setting.

    • Reflection on Practice: Need for sensitivity and respect in clinical observations and assessments. © Crystal Dieleman 2024

Page 15: References

  • A compilation of literature related to truth and reconciliation and structural competency in occupational therapy. © Crystal Dieleman 2024

Page 16: Upcoming Class

  • Next Topic: Advocacy in occupational therapy practices at Dalhousie University. © Crystal Dieleman 2024

robot