HCA 545 Topic 8 Assignment: Addressing Diversity

Assignment: Addressing Diversity

1) Providers must learn new tools to eliminate disparities, build trust with patients, and understand how international biases and pre-established stereotypes affect quality of care. Write a paper (1,000-1,250 words) that identifies and defines various tools and measurements that can be used to measure the effectiveness of diversity programs and policies established by the organization.

2) Address how each of the following must be considered when considering how to implement an environment of diversity:

a) Government regulations.

b) Social pressures.

c) Industry and company ethical codes.

d) Tension between personal standards and the goals of the organization.

3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

Course Code Class Code Assignment Title Total Points
HCA-545 HCA-545-O500 Addressing Diversity 80.0

Criteria Percentage Unsatisfactory (0.00%) Less than Satisfactory (65.00%) Satisfactory (75.00%) Good (85.00%) Excellent (100.00%)
Content 100.0%
In-text citations and a reference page are complete and correct. The documentation of cited sources is free of error. 40.0% Does not demonstrate understanding of the issues surrounding diversity, including the implications. Does not demonstrate critical thinking and analysis of the situation, and does not develop effective answers to the questions, with rationale. Demonstrates only minimal understanding diversity. Demonstrates only minimal abilities for critical thinking and analysis of the case study, and develops weak answers to the questions, with minimal rationale Demonstrates knowledge of issues surrounding diversity, but has some slight misunderstanding of the implications. Provides a basic idea of critical thinking and analysis for the questions, answers, and rationale. Does not include examples or descriptions. Demonstrates acceptable knowledge of the issues surrounding diversity (in your own words). Develops an acceptable response and rationale for it. Utilizes some examples. Demonstrates thorough knowledge of the issues surrounding diversity and their implications. Clearly answers the questions and develops a very strong rationale. Introduces appropriate examples.

Integrates Information From Outside Resources Into the Body of Paper 30.0% Does not use references, examples, or explanations. Provides some supporting examples, but minimal explanations and no published references. Supports main points with examples and explanations, but fails to include published references to support claims and ideas. Supports main points with references, explanations, and examples. Analysis and description is direct, competent, and appropriate of the criteria. Supports main points with references, examples, and full explanations of how they apply. Thoughtfully, analyzes, evaluates, and describes major points of the criteria.

Assignment Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear. Thesis and/or main claim are apparent and appropriate to purpose. Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. HCA 545 Topic 8 Assignment: Addressing Diversity

Mechanics of Writing (Includes spelling, punctuation, grammar, language use.) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present. Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Writer is clearly in command of standard, written, academic English.

Several studies have shown that diversity is important in delivery of health care. The understanding of diversity by medical students, who are the medical practitioners of the future, will help to bridge the existing health disparities existing across ethnic or racial cultures. Diversity in the medical field is increasingly being stepped up. This is because studies have shown that there exists a diversity gap between composition of health profession and the general population as it is the case in United States. The groups categorized as minority are increasingly becoming more populous. However this is not reflected in the composition of health profession as the number of minority health professional is not increasing at the same rate. In enhance diversity in medical schools some states have embarked on affirmative action. HCA 545 Topic 8 Assignment: Addressing Diversity

Medical students like all other people hail from different cultural background that shapes their beliefs, knowledge set, decisions and their behavior. Many at times it is difficult for the students to appreciate teachers, fellow students and patients of different cultural background or even create trusting relationships with them. Interactions with people of different cultures help to broaden the students’ knowledge about other cultures and even appreciate them. When students have an understanding of diversity, communication with people of other cultural backgrounds is enhanced and hence ability to create lasting relationships with them.

Student body diversity is important for developing a culturally competent medical workforce. Cultural competency goes beyond cultural awareness or sensitivity and may be defined as the ability to utilize cultural knowledge efficiently in cross-cultural situations (Kundhal et al, 2003). Health professionals have their own values by the virtue of their cultural background as mentioned earlier. Sometimes thy may be unable to work with the patients cultural values in the circumstance of use of conventional medical practices. Lack of cultural competence will then lead to taking for granted patients’ values which can lead to detrimental effect on the patients’ health due to poor adherence. Therefore diverse student body in the medical field enhances the ability of students to provide medical services in culturally diverse societies. HCA 545 Topic 8 Assignment: Addressing Diversity

The importance of understanding diversity

Profound demographic change especially in United States continues to accelerate especially due to increasing number of immigrants (Kosoko-Lasaki et al 2009, p.75). The latest census in United States revealed that the so called minority groups presently make up the majority in almost all most populous counties in United States. The census even projects that within 40 years the groups categorized as minority will form the bulk of American citizenry. What is astonishing is that the healthcare professional tapestry remains unrepresentative of the general population. Moreover the diversity gap between health professions and general population continues to widen. Reducing the existing diversity gap would greatly contribute to reduction of health inequalities.

The changing American demographics create a compelling need for medical workforce to practice across culturally and racially diverse society. Some research findings have suggested that attitude of medical students on culture and health issues associated with diversity are shaped by student’s medical school experiences. Inclusion of Cross-Cultural Education (CME) can help develop certain cultural competency skills such as inclusion of family and community members in the discourse to understand the dynamics of patient symptoms (Kundhal et al, 2003). HCA 545 Topic 8 Assignment: Addressing Diversity

Cross-cultural education for medical students is important in preparing them to meet the health needs of ever growing and diverse population (Smedley et al, 2003). Definition of disease and health differs across different societies. Some diseases may be stigmatized in a community and this affects health seeking behavior regarding the diseases. For example depression is stigmatized in Asian society. As a result patients suffering from depression will tend to leave out symptoms of the diseases and present those that are less stigmatized to the clinician. An understanding of Asian culture would therefore significantly help in delivery of health care to Asians.

Prevalence of diseases varies across cultures. There are also beliefs and practices surrounding every disease and curative approaches in every society. Some may believe in folk healers or prayers as initial steps of obtaining healing. Some diseases may not seem serious enough to elicit need for medical treatment. Often than not the community believes that such diseases are best treated by traditional healers. This calls for coordination of care with traditional healers which can be achieved through cross-cultural education. HCA 545 Topic 8 Assignment: Addressing Diversity

Communication between provider and a patient is very important. This because communication plays a key role in adherence and trustful relationship between the provider and the patient necessary to achieve good health outcomes without which this cannot be achieved. Diversity in the student body creates a good opportunity for the students to interact with other students from different cultural background. This helps to exposes students to a broad range of ideas, experiences, and perspectives, thus better preparing them to meet the needs of a multicultural populace (Soha et al, 2008).

Why students experience difficulties in handling diverse ethnic backgrounds

As earlier mentioned cultural diversity is rapidly rocking many populations and as a result significant challenges face practice of health profession in culturally diverse societies. Defining culture itself is challenging. Culture is so broad that it becomes difficult to design a curriculum for cultural diversity education. Lack of concrete information on cultural diversity has also contributed to difficulties in designing cultural diversity education curriculum. As a result teaching of cultural diversity in medical schools is challenging and hence the full benefits of cultural diversity education are not fully realized. Little research exists to verify that change in altitudes as a result of cultural diversity education actually converts into clinical skills. If cultural diversity education does not translate into clinical skills then the student cannot handle ethnic differences between him and the patient. HCA 545 Topic 8 Assignment: Addressing Diversity

Medical students like all other people differ in culture; different language, varying expectations, knowledge sets and habits of mind (Kosoko-Lasaki et al, 2009). Students who are ethnocentric find it difficult to interact and appreciate students, teachers and patients of different cultural backgrounds. Ethnocentrism mainly stems from where an individual grew up. For example if a student grew up in a neighborhood that was predominantly whites, then it will be difficult for such a student to interact and appreciate colored people.

Diversity in the medical school also contributes to a student ability to handle ethnic differences. In America for example some medical schools are predominantly white while others are colored. Studies have shown that students in less diverse college have a flimsy understanding of cultural diversity as compared to those from more diverse medical schools. Students from medical schools that are predominantly white are more likely to choose to work in areas that predominantly occupied by whites and verse versa. This is because the students are not prepared enough to work in other societies. Therefore lack of diversity in medical schools can lead to students having difficulties in handling difference in ethnic background between him/her and the patient. HCA 545 Topic 8 Assignment: Addressing Diversity

Lack of cultural diversity in medical schools also makes it difficult for students to accommodate students from different cultural background. Students in less diverse medical schools have been found associate more with students of similar cultural background and look down on students of different cultures. The same case applies to teachers. Students learn to appreciate and interact with teachers of different cultures if the teaching staff is culturally diverse. Students tend to have negative attitude towards teachers of a different cultural background if the teaching staff is not diverse. This in turn impacts negatively on the student performance of the coursework taught by a teacher of different culture.

Identity is closely related to the idea of culture. Even though identity is not shaped from culture per se identity draws from culture (Dogra & Karim, 2005). Students from cultural backgrounds regarded as “minority” may have poor identity of themselves as compared to other students. As a result such students find it difficult to interact with other students of “majority” cultural backgrounds because they see them as being superior. Such students will not want to work in areas that are predominantly occupied by the majority ethnic group even on completion of their studies. They are afraid they will not be appreciated by patients and more so they would not feel adequately prepared to work in areas occupied by other ethnic groups. However this may not be the case for all minority students. Some have a strong personality such that they are able to rise above inferiority complex. HCA 545 Topic 8 Assignment: Addressing Diversity

Conclusion

Cultural diversity continues to be an important aspect of health care delivery. Considering the rapidly changing demographics which as seen increase in minority groups, the need for closing existing health profession diversity gap is inevitable. This is important in that composition of health profession becomes representative of the larger public. Despite this need culture is very broad such that there is no universal definition of culture as a result it has become difficult for medical schools to develop a curriculum for cultural-diversity education. Cultural diversity education is important for developing cultural competency such as inclusion of family and community members in the discourse to understand the dynamics of patient symptoms (Kundhal et al, 2003).

Cultural competency can be defined as the ability to utilize cultural knowledge efficiently in cross-cultural situations (Kundhal et al, 2003). Cultural competency goes beyond cultural awareness or sensitivity. Cultural competency is important for good delivery of health care to minority ethnic groups and hence reducing health disparities existing between minority groups and the general public. Cultural competency helps a health provider to communicate well with patients and build lasting relationship necessary for good health outcomes in the patient. HCA 545 Topic 8 Assignment: Addressing Diversity

Diversity in the student body creates a good opportunity for the students to interact with other students from different cultural background. This helps to exposes students to a broad range of ideas, experiences, and perspectives, thus better preparing them to meet the needs of a multicultural populace (Soha et al, 2008). Attitude and perception of students concerning other ethnic groups change as a result. The beneficial effect of diversity in student body has led to many medical schools advocating for it. Some have even embarked on affirmative action in the effort to increase the enrollment of students from minority ethnic groups.

However students sometimes find it difficult to embrace cultural diversity. These difficulties stem from their cultural background and medical schools. Diversity in medical school is important in addressing the difficulties. Understanding of Cultural diversity therefore plays a major role in delivery of health care. HCA 545 Topic 8 Assignment: Addressing Diversity

The Office of National Statistics (2014) displays how the population of Britain is becoming increasingly diverse due to migration, with 560,000 people migrating to Britain between March 2013 and March 2014; a significant increase from 492,000 people in the previous 12 months. Globalisation; which is the increasing integration of economies and societies has a profound effect on migration and health. For example the ease of accessibility of borders for services and trade removes the boundaries for migration and increases the production and marketing of products such as tobacco which have an adverse effect on health (Wamala and Kawachi 2007). The increasing movement of countries into the European Union (EU) also removes the boundaries to migration as the European commission state that individuals who hold European citizenship have rights to free movement and residency within the EU(EU 2014). HCA 545 Topic 8 Assignment: Addressing Diversity

The acceleration of globalisation and the growth in migration means the NHS have to care for an increasingly diverse service-user population who have a range of health needs which presents many issues and challenges for nursing care. Blakemore (2013) recognised how research by Macmillan cancer support found that patients from Black minority ethnic (BME) groups experience increased challenges and poor treatment compared to white British cancer patients; such as lack of compassion and poor and ineffective communication.

This is an example of how diverse groups can receive poor quality care and highlights the need for nurses to understand and apply the concepts of diversity, cultural competence and equality to evade this diminished care. This essay will explore, discuss and critique these concepts when looking at how they can improve the quality of nursing care in today’s diverse healthcare settings for a diverse service-user population. HCA 545 Topic 8 Assignment: Addressing Diversity

Diversity is defined by Dayer-berenson (2014) as the ‘individual differences of the human race’ which should be ‘accepted, respected, embraced and celebrated by society’. The differences encompass many factors such age, religion, ethnicity and sexual orientation, all which shape an individual to be unique. This definition however fails to acknowledge that differences exist within each unique factor. For example in ethnic groups; where although common characteristics such as language and origin are shared, differences within the ethnic group still do exist such the extent to which the individual practices their religion, and the culture to which the individual identifies to (Henley and Schott 1999).

The National Health Service (NHS)(2011) expand on this definition by recognising that diversity includes ‘visible and non-visible’ differences. Recognition of this is important in clinical practice as non –visible differences such as values and beliefs will not be established unless nurses effectively communicate and assess there patients values, needs and prefences. This will prevent the assumption that all members of one ethnicity act as another as mentioned previously, and therefore avoid stereotyping. Henley and Schott (1999) recognise how stereotyping will result in inadequate nursing care as people distance themselves from those they see as different, causing them to have a lack of consideration and respect for the individual, thus diminishing care. HCA 545 Topic 8 Assignment: Addressing Diversity

Furthermore, when assessing the values and beliefs of diverse patients, nurses must avoid holding an ethnocentric attitude. Ethnocentrism is when people identify their own cultural ways as superior to others, creating an attitude that any other beliefs and values are wrong. This leads to inadequate care as other diverse beliefs, values and therefore needs; will be rendered as insignificant and may be ignored (Royal college of Nursing (RCN) 2014). Ethnocentric behaviour however is not always recognised by the individual and is therefore difficult to challenge, as through socialisation into their own cultural values and beliefs a viewpoint of what is ‘normal’ and ‘appropriate’ is created. This viewpoint is then used to often negatively judge diverse cultures that the individual comes across (Henley and Schott 1999).

On the other hand Sharif (2012) views ethnocentrism as having a positive influence on healthcare in the United Kingdom. When looking at BME groups, South Asians are a high risk group for public health diseases such as cardiovascular disease, diabetes and chronic kidney disease. Sharif recognises the need for ethnocentric interventions to educate South Asian communities and to distinguish them as a group to further investigate the differences in epidemiology, pathophysiology and health outcomes. HCA 545 Topic 8 Assignment: Addressing Diversity

This view is opposed by The Nursing and Midwifery Council (NMC)(2010) who state in their standards for pre-registration nurses that nurses must strive for culturally diverse nursing care by practicing as holistic, non-judgemental and sensitive nurses, avoiding assumption, recognising individual choice and acknowledging diversity. Therefore nurses must adhere to this code by avoiding stereotypical and ethnocentric attitudes which can be done through assessing and recognising patients as individuals. This will result in high quality care which is essential for a diverse service user population. HCA 545 Topic 8 Assignment: Addressing Diversity

Respecting individual patient diversity results in respecting equality which is the elimination of discrimination and disadvantage through respecting the rights of individuals and promoting equal opportunity for all. Nurses working within an organisation must comply to the Equality Act 2010 which protects 12 diverse characteristics such as age, disability and religon from discrimation and disadvantage (Equality and Human Rights Commison 2014). In healthcare this is done through the implementation of policies and guideance, however Talbot and Verrinder (2010) highlight how equality policies can express the need for patients to receive equal care regardless of characteristics and background. This ignores personal choice and therefore disregardards individuality and diversity; producing poor quality care. HCA 545 Topic 8 Assignment: Addressing Diversity