Briefing Paper – Finding Common Ground
FINDING COMMON GROUND – AVOIDING THE TERMINOLOGY TRAP
Identifying and applying the critical elements of Cultural Competence/Humility/Safety for effective cross-cultural work
About Poche Centres for Indigenous Health
Poche Centres for Indigenous Health are an example of the power of partnership in achieving real change and genuinely contributing to closing the gap in life expectancy.
Established and funded by philanthropists Greg Poche AO and Kay Van Norton Poche, Poche Centres seek to leverage the best of the best in Universities with communities and governments to seek solutions to address complex health problems faced by Aboriginal people. The Poches have gifted more than $50m to Aboriginal health over the past six years.
The Poche model is unique. Located within universities, Poche Centres work with leading researchers, alumni, faculty and students to bring their knowledge together with communities to find sustainable, workable, affordable solutions to health issues including oral health, specialist medical, Foetal Alcohol Spectrum Disorders, allied health, social and emotional well- being, chronic disease, workforce development, leadership and health promotion.
Finding Common Ground – Background
This is not a new conversation.
In 1989, cultural competence was defined Cross et al as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations. i Nine years ago, Professor Tom Calma AO, the then Race Discrimination Commissioner with the Australian Human Rights Commission said:
“Through the work on cultural competency, equality is more than a set of ideals that we aspire to in our relationships with each other; more too than a set of normative standards that can be legally enforced.
It is also a set of skills, capabilities and knowledge that individuals and organisations can acquire and apply. With this purpose and utility comes a methodology that enables organisations to integrate equality into the value system of the particular organisation. Mechanisms for instance for developing best practice in providing services to an ethnically diverse clientele: performance indicators that assess the cultural competency of an employee.
…in order for cultural competence to flourish within a nation, beyond a particular organisation or institution, there needs to be an understanding of how cultural competence as a set of organisational objectives and practices relates to the universal and inalienable right to equality”.
Both set out the need for a systematic and multifaceted approach to building the cultural competence of systems, organisations and individuals.
The conversation about cultural competence has become increasingly complex and nuanced. This reflects our post modern world where the type and use of language shapes our understanding.
The complexity of language and the ways we are interpreting language related to cross-cultural work is leading to a ‘terminology trap’. This Key Thinkers’ Forum will consider the terminology trap and how we may be able to create a shared understanding or common ground, irrespective of the language we use.
To exemplify the problem, in 2011, Universities Australia released a 400 page document addressing Indigenous Cultural Competency, a National Best Practice Framework for
Indigenous Cultural Competency in Australian Universities (the Framework), which cited eleven definitions under an introductory heading: “What is Cultural Competence?” iii. The document then went on to refer to, roughly, the same number of additional definitions in considering “What is Professional Cultural Competence?” and again in the pursuit of “What is Institutional Cultural Competence?” before turning towards an only slightly smaller number of “Models of Cultural Competence?”.
￼Student and staff knowledge and understanding of Indigenous Australian cultures, histories and contemporary realities and awareness of Indigenous protocols, combined with the proficiency to engage and work effectively in Indigenous contexts congruent to the expectations of Indigenous Australian peoples.
Although this definition arguably distils, not only many of the currents within the accepted international literature on cultural competence but also, many of the qualities desired of graduates by Indigenous Australian community and academic perspectives, it highlights two of the pressing issues that this Key Thinkers’ Forum may need to address in its search for common ground. The first revolves around questions of ‘proficiency’, the second around questions of the direction of ‘knowledge and understanding’ acquisition. Is it more important to know reams about the ‘other’, or better know and understand the self? The National Framework goes on to include self-reflection as an attribute of cultural competence, but it appears secondary to the thrust of the work required by the core definition.
A multitude of similar examples exist. This means that individuals and organisations need to sift through the array of cross-cultural models to navigate a path between competing frameworks, including cultural awareness / respect / appropriateness / competence / capability /sensitivity / safety / security / humility / ease. Definitive answers on which language and models offer the most effective outcomes are hard to come by, the evidence available is limited and made less-reliable by widespread inconsistency in how frameworks are defined and applied.
In attempting to find common ground, this forum begins with an opportunity to explore different ways of conceptualising, then responding to, approaches to effective cross-cultural work – with particular reference to the Indigenous health context – then seeks ways out of the ‘terminology trap’. This forum will bring together a number of key thinkers in
this area to clarify our understanding of which elements, across the array of models, are critical to success, along with identifying any less-obvious barriers to effectiveness. Together, we will seek sharper understanding of good practice in identifying, integrating, and applying the key dimensions of successful approaches.
Questions to assist the discussion on the day
1. Do we have a terminology trap and does it matter?
2. Do we need agreed terminology?
3. Is it possible to find common ground by agreeing to a set of processes that improve and inform cross-cultural work,
even if we can’t agree on the terminology?
4. Does each model or approach bring something crucial for effective cross-cultural work? If so, what is it?
5. What do some models foreground as crucial that others do not?
6. Which areas are contentious or in need of clarification to enable productive dialogue?
7. What is the most productive way to have such a dialogue without short-changing the real caveats that some models
raise about other approaches?
i Cross T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, volume I. Washington, D.C.: Georgetown University Child Development Center, CASSP Technical Assistance Center
Details of the Key Thinkers’ Forum
Medical Foundation Auditorium
University of Sydney
27 April 2015
At the conclusion of each forum a paper will be produced which summarises the issues raised and makes comment or presents an opinion about the topic discussed. This will then be published as a ‘Poche Opinion paper’. Poche Opinions will be a tool to contribute to knowledge and to draw the wider community into the key debates and issues in Aboriginal health.