Equity, Diversity and Inclusion Virtual Learning Exchange

This session will introduce the importance of focusing on Black health through the exploration of the history of anti-Black racism in healthcare in Canada. Understanding privilege and critical allyship will connect with the profound impacts of anti-Black racism in healthcare systems. Topics that will be covered include the structural impacts of white supremacy and privilege, scientific racism, anti-Black racism in medicine and healthcare, and Black health equity in the workforce.

In this second session, participants will delve into the application of critical race theory related to the structural and social determinants of Black health, including discussions on race-based data collection and an introduction to the Black Health Primer developed by the Black Health Education Collaborative.

Building on our Exploring Anti-Oppression Practices and Unconscious Bias in Our Work series, we’ll nurture new habits of mind to inform action.

Participants will reason through strategies to foster equity and inclusion in healthcare through anti-oppression practices and peacemaking. We will draw on the lessons within the Two-Row Wampum Belt Treaty and the Coin Model of Privilege and Critical Allyship to make sense of and strategize on common challenges in equity, diversity and inclusion work.

Healthcare Excellence Canada (HEC) would like to thank Dr. Ed Connors (Mohawk) for providing a Thanksgiving address as part of Deepening Our Understanding of Anti-Oppressive Practice and Peacemaking. HEC recognizes that Traditional and Indigenous Knowledge is different than Western Knowledge. “Traditional Knowledge” refers to the knowledge systems, know-how, creations, innovations, skills, practices, stories and other cultural expressions generally regarded as pertaining to First Nations, the Inuit, the Métis and/or their members (Traditional Knowledge Holder) which have been developed, sustained and passed on from generation to generation of First Nation, Inuit, or Métis members and their ancestors.

In order to honour and respect Traditional Knowledge we ask that you seek permission before sharing this knowledge with others. Please contact Ed Connors (econnors0507@gmail.com) if you wish to learn about this version of the Thanksgiving Address/Prayer of Gratitude in order to share it with others. Please do not share this knowledge with others without first doing so.

About the speakers

Ed Connors is of Mohawk (from Kahnawake Mohawk Territory) and Irish ancestry. He is a psychologist who has worked with First Nations communities across Canada since 1982 in both urban and rural centres. Dr. Connors' most recent work has involved development of Indigenous Life Promotion projects, including Feather Carriers Leadership for Life Promotion. While developing the above services, Dr. Connors has worked with Elders and apprenticed in traditional First Nations approaches to healing. Today his practice incorporates traditional knowledge about healing while also employing his training as a psychologist. His work has also included consultation and community training to assist with Peacemaking, Reconciliation and Anti-oppression.

Stephanie Nixon is Vice-Dean (Faculty of Health Sciences) and Director (School of Rehabilitation Therapy) at Queen’s University. Stephanie is a straight, white, middle class, able-bodied, cisgender, settler woman who tries to understand the pervasive effects of privilege. She explores how systems of oppression shape health care, research and education, and the role of people in positions of unearned advantage in disrupting these harmful patterns.

Building on previous sessions that explore anti-oppression frameworks, this session looks more deeply at the impact of unconscious bias within a healthcare environment. Participants will learn about trauma-informed, relationship-based approaches to patient engagement that have helped build trust, promote safety and foster inclusion within a health region.

As part of creating a meaningful learning experience, participants will be invited to complete pre-work associated with each session, such as reviewing short videos or doing personal reflection. This will be emailed to participants in advance of the session.

Key resources (currently in English only):

• Working in good ways | University of Manitoba (umanitoba.ca) 

• Beyond Inclusion: Equity in Public Engagement  

• Valuing All Voices: refining a trauma-informed, intersectional and critical reflexive framework for patient engagement in health research using a qualitative descriptive approach  

This session (part 1 of 2) introduces participants to the Coin Model of Privilege, Critical Allyship and other approaches to anti-oppressive practice. These frameworks help deepen our understanding of the impact of unearned advantage and disadvantage in different contexts. Participants will reflect on their relationship with different systems of oppression, and ways to foster equity and inclusion in their patient engagement work and the healthcare system more broadly.

Healthcare Excellence Canada would like to thank Dr. Ed Connors (Mohawk) for providing a Thanksgiving address as part of Opening Ourselves: An introduction to anti-oppression practices and frameworks (part 1). Healthcare Excellence Canada recognizes that Traditional and Indigenous Knowledge is different than Western Knowledge. “Traditional Knowledge” refers to the knowledge systems, know-how, creations, innovations, skills, practices, stories and other cultural expressions generally regarded as pertaining to First Nations, the Inuit, the Métis and/or their members (Traditional Knowledge Holder) which have been developed, sustained and passed on from generation to generation of First Nation, Inuit, or Métis members and their ancestors.

In order to honour and respect Traditional Knowledge we ask that you seek permission before sharing this knowledge with others. Please contact Ed Connors (econnors0507@gmail.com) if you wish to learn about this version of the Thanksgiving Address/Prayer of Gratitude in order to share it with others. Please do not share this knowledge with others without first doing so.

About the Speakers

Ed Connors is of Mohawk (from Kahnawake Mohawk Territory) and Irish ancestry. He is a psychologist who has worked with First Nations communities across Canada since 1982 in both urban and rural centres. His work over this time has included Clinical Director for an Infant Mental Health Centre in the city of Regina and Director for the Sacred Circle, a Suicide Prevention Program developed to serve First Nations communities in Northwestern Ontario. Ed’s most recent work has involved development of Indigenous Life Promotion projects, including Feather Carriers Leadership for Life Promotion. While developing this service, Ed worked with Elders and apprenticed in traditional First Nations approaches to healing. Today his practice incorporates traditional knowledge about healing while also employing his training as a psychologist. His current work includes consultation and community training to assist First Nations in the development of Restorative Justice programs.

Stephanie Nixon is a Full Professor in the Department of Physical Therapy and Dalla Lana School of Public Health at the University of Toronto. She completed her PhD in Public Health in 2006 at the University of Toronto, and a post-doc at the University of KwaZulu-Natal in South Africa in 2008. Stephanie is a straight, white, middle class, able-bodied, cisgender, settler woman who tries to understand the pervasive effects of privilege. Stephanie developed the Coin Model of Privilege and Critical Allyship as a way to translate core ideas about anti-oppression and anti-racism to people in positions of unearned advantage. She has conducted workshops on the Coin Model with more than 100 groups including universities, hospitals, community-based organizations, and professional associations across Canada and internationally.

This session (part 2 of 2) will build on the concepts introduced in the first session. Through engaging and reflective activities, participants will apply the Coin Model of Privilege to develop a practice of critical allyship based on an understanding of the impact of their actions on those who have historically been marginalized. Participants will be supported to build capacity for change at the individual, institutional and systemic level.

About the Speakers

Ed Connors is of Mohawk (from Kahnawake Mohawk Territory) and Irish ancestry. He is a psychologist who has worked with First Nations communities across Canada since 1982 in both urban and rural centres. His work over this time has included Clinical Director for an Infant Mental Health Centre in the city of Regina and Director for the Sacred Circle, a Suicide Prevention Program developed to serve First Nations communities in Northwestern Ontario. Ed’s most recent work has involved development of Indigenous Life Promotion projects, including Feather Carriers Leadership for Life Promotion. While developing this service, Ed worked with Elders and apprenticed in traditional First Nations approaches to healing. Today his practice incorporates traditional knowledge about healing while also employing his training as a psychologist. His current work includes consultation and community training to assist First Nations in the development of Restorative Justice programs.

Stephanie Nixon is a Full Professor in the Department of Physical Therapy and Dalla Lana School of Public Health at the University of Toronto. She completed her PhD in Public Health in 2006 at the University of Toronto, and a post-doc at the University of KwaZulu-Natal in South Africa in 2008. Stephanie is a straight, white, middle class, able-bodied, cisgender, settler woman who tries to understand the pervasive effects of privilege. Stephanie developed the Coin Model of Privilege and Critical Allyship as a way to translate core ideas about anti-oppression and anti-racism to people in positions of unearned advantage. She has conducted workshops on the Coin Model with more than 100 groups including universities, hospitals, community-based organizations, and professional associations across Canada and internationally.

Learnings

This webinar featured a practice change story of how the Fraser Health Authority developed and implemented Trauma and Resiliency Informed approaches (TRIP program) at the individual, team, organizational and systems levels. Here are some of the key learnings shared by the speakers:   

1. Healthcare is a trauma-organized system. Healthcare is a living system, and its organization can be affected by chronic and repetitive stress. An effect is health and social care organizations tend to have problems that parallel or mirror the problems of their clients.

2. High levels of occupational stress can lead to poorer quality of care. If we do not acknowledge and address this trauma, we risk creating relationships and environments where people may be retraumatized – creating further barriers to working together to improve health outcomes. 

3. An evaluation of the TRIP program showed promising findings. Stigma and compassion fatigue were reduced after the workshop and continued to be reduced three months later. Resiliency and self-compassion increased.  

Resources 

• Webpage: Engaging staff using a trauma and resilience informed approach for an evaluation of the COVID-19 response. (Fraser Health) 

• Journal article: How a shared humanity model can improve provider well-being and client care: An evaluation of Fraser Health’s Trauma and Resiliency Informed Practice (TRIP) training program. (Knaak S, Sandrelli M, Patten S., SAGE Journals) 

Learnings 

This webinar featured speakers with lived experience of receiving, providing and leading care. This virtual learning event focused on: 

• How structures of inequity, privilege and oppression amplify and re-create trauma by prioritizing the needs of specific groups (i.e. white, able-bodied, cis-gender, non-Indigenous).   

• Intergenerational and historical trauma and its effects in the context of engaging with those with lived experience of the health system. 

• The role of the healthcare system in inducing or perpetuating trauma among those who have past experiences of trauma. 

Resources 

• Article: The coin model of privilege and critical allyship (Stephanie A. Nixon, BMC Public Health) 

• PDF: CMA Patient Voice Guide: Trauma Informed Engagement & Resources (CMA) 

• Webpage: The First Nations Principles of OCAP (FNIGC/CGIPN) 

• Book: Have You Filled a Bucket Today? (Carol McCloud) 

Learnings

This webinar featured two examples of initiatives designed to address inequity in healthcare organizations and systems: the UNITE project and Equity-Mobilizing Partnerships in Community (EMPaCT). This virtual learning event focused on:

• How recognizing intersecting identities is key to understanding the complexity of individual healthcare experiences and enabling meaningful engagement.

• How prioritizing relationships and creating a sense of community helps foster safe spaces for people to share their lived experiences and provide meaningful input.

• Storytelling as a powerful tool for challenging stereotypes and stigma, and improving the way care is provided.

Resources

• Webpage: Equity Mobilizing Partnerships in Community (EMPaCT) (Women’s College Hospital)

Learnings

This session featured two examples of initiatives designed to address inequity and offer more inclusive care: Doctors of the World and Caring Community. This virtual learning event highlighted the importance of:

• Valuing multiple perspectives in care by creating space for patients to share their insights and perspectives in a judgement free environment.

• Enabling patients to be the key decision maker in their care and an integral member of the care team. Health professionals should actively engage patients in their own care.

• Fostering trust among the members of the care team by building welcoming environments and meaningful interactions among all members of the care team. This helps ensure the best possible experience of care.

Resources

• Webpage: Doctors of the World

• Webpage: Caring Community