July 2023 Newsletter

Indigenous-Specific Racism | OAC Connect | Business Addresses
 

Registrant perspectives on Indigenous-specific racism in healthcare

On September 30, 2022, eleven BC health profession regulatory colleges adopted an Indigenous Cultural Safety, Cultural Humility, and Anti-Racism practice standard. Standard 4 sets clear expectations for how registrants are to provide culturally safe and anti-racist care to Indigenous clients.

We at COBC understand that dismantling Indigenous-specific racism and other barriers in opticianry services and their regulation does not stop with the implementation of a practice standard. We continue to work with a professional consultant to enhance Indigenous Anti-Racism in a number of COBC functions, from quality assurance to the complaints system. More information about some of the Indigenous Anti-Racism projects underway at COBC can be found on our Cultural Safety resource page. To better understand the urgency behind this work, we strongly recommend reviewing the 2020 In Plaint Sight report.

Earlier this year, we reconvened with our fellow colleges to assess the progress that we and our registrants have made in implementing the new practice standard. A survey was developed and circulated to registrants. With input obtained from both Indigenous and non-Indigenous respondents, we now have a better understanding of the areas that will require our focus as we work to further integrate Indigenous Cultural Safety and Humility into the healthcare services we provide and regulate.

Purpose of the survey

Acknowledging that Standard 4 had already been in place for several months, we felt it important to establish a baseline of non-Indigenous registrants’ attitudes, perceptions, and perspectives related to Indigenous-specific racism in general, and particularly in healthcare settings. We also sought to gather information from Indigenous and non-Indigenous registrants about barriers to the implementation of the standard in their practices, as well as their learning needs related to Indigenous Cultural Safety and Humility.

Although a survey cannot capture the nuance of every viewpoint, it can offer valuable insights into how individuals think and feel about important issues. Gathering this type of data is an essential first step for colleges supporting their registrants in systemic improvements.

The survey, initially administered in February of 2023, will be re-administered to measure change over time.
 

Survey development

The survey questions were developed collaboratively by Pivotal Research (research consultants), Qoqoq (Indigenous consulting firm), and the ten participating regulatory colleges. Included were questions about:

  • Attitudes and perceptions about Indigenous-specific racism
  • Perspectives on Indigenous-specific racism in healthcare settings
  • Current behaviours that reflect the principles of the practice standard
  • Implementation of the practice standard
    • Guidance and/or education required to implement the standard
    • Learning intention (when learning will begin)
    • Preferred education delivery method
  • Overall perceptions of the new standard
  • Behaviours observed in practice settings (Indigenous respondents only)
  • Stereotypes of Indigenous peoples (non-Indigenous respondents only)

Non-Indigenous respondents were asked to consider their own attitudes, perceptions, perspectives, and behaviours; Indigenous respondents were asked to consider the attitudes, perceptions, perspectives, and behaviours of non-Indigenous colleagues within their profession. Some questions were asked only of non-Indigenous respondents; others were asked only of Indigenous respondents. A trigger warning was included in the introduction, acknowledging that the survey would present harmful statements that may be triggering for some participants.
 

Respondents

We heard from 3,361 registrants across ten colleges, representing 12.2% of those who received a link to the survey. Three percent (3%) of respondents chose to self-identify as Indigenous.

TRIGGER WARNING: The results of the survey presented below contain statements that describe harmful stereotypes about Indigenous peoples and communities which are based in racial prejudice and racism. Reading these harmful statements may be upsetting and triggering to some people. Please proceed with discretion and reach out to culturally relevant mental health support resources if needed.


What we learned1

These results are a summary of the themes observed within the survey responses. While there were some differences in responses between colleges, these differences were not substantial enough to warrant reporting separately. In general, input was similar regardless of health profession.

  1. A continuum of attitudes and perceptions about Indigenous-specific racism was reported by non-Indigenous respondents. Some agreed or strongly agreed with statements that represent stereotyping and contribute to the perpetuation of unsafe health services and health inequities for Indigenous people. For example:
    • 7% of non-Indigenous respondents strongly agreed/agreed with the statement “Colonialism is old news, we’ve all lived here for hundreds of years now, Indigenous Peoples should get over it."
    • 10% of non-Indigenous respondents strongly agreed/agreed with the statement “As a society, we’re being too accommodating to Indigenous Peoples.”
    • 20% of non-Indigenous respondents strongly agreed/agreed with the statement “Indigenous people have problems with drugs and alcohol.”
    • 13% of non-Indigenous respondents strongly agreed/agreed with the statement “Indigenous people get a lot of stuff for free that others have to work hard for.”
  2. The longer a non-Indigenous health professional has been in practice, the more likely they are to:
    • Say that leaders in the workplace setting have set accountability outcomes to ensure the elimination of Indigenous-specific racism.
    • Agree with the stereotype that Indigenous people have issues with drugs and alcohol.
    • Indicate that they learn about Indigenous communities located where they work.

      ...and the less likely they are to:
    • report acts of racism to leadership and/or the relevant health regulatory college.2
    • believe the new Standard should have been adopted much sooner.
  3. The attitudes, perceptions, perspectives, and behaviours of non-Indigenous respondents as self-reported differ from the words and behaviours observed by their Indigenous colleagues. This was consistent to various degrees throughout the results. While many non-Indigenous respondents believe their intentions and actions reflect safe and respectful care, their Indigenous colleagues’ interpretations are less positive. For example:

11%–12% of Indigenous respondents indicated that in the past year they have observed culturally unsafe behaviours in their non-Indigenous colleagues, such as failing to communicate adequately with Indigenous clients and minimizing the concerns of Indigenous clients.

  1. Indigenous-specific racism exists beyond public healthcare settings. Eighty percent (80%) of all respondents recognize that Indigenous-specific racism is a problem in public and private healthcare settings alike.
     
  2. Commonly reported barriers to implementation of the new standard included competing priorities, overwhelming workload, and being unsure of what learning opportunities are available/appropriate. However, 33% of respondents reported they have no barriers to implementation.
     
  3. Between 13% and 31% of respondents (varied based on the different topics addressed in the standard) feel that they require further guidance and/or education to implement the standard. The preferred delivery methods for educational offerings are webinars and short reads. Of those who indicated a need for further guidance and education, 50% intended to start or continue their learning within three months.
     

Summary

These results provide an important baseline measure of the attitudes, perceptions, perspectives, and behaviours of registrants against which progress and change will be measured in the future. Tracking this information over time is one of many tools COBC will use to ensure that Standard 4 is integrated into every optician’s practice. Within a strategic framework of Indigenous Anti-Racism and Cultural Safety initiatives, this work ensures we continue to move in the right direction.

The value of the information collected from respondents self-identifying as Indigenous cannot be overstated. As we work together as health professionals and health profession regulators to ensure culturally safer care for Indigenous clients, only Indigenous clients can confirm that we are achieving that outcome. Indigenous health professionals can also help colleges understand and reflect upon our progress (or lack thereof) by offering their perspectives on how their colleagues and the system are performing.
 

Next steps

These results also help COBC to understand what barriers may be preventing effective implementation of Standard 4 and what guidance and education our registrants need to proceed. We will now work together to meet those needs.

We will also continue working to incorporate Indigenous Anti-Racism into other aspects of the regulatory process, including quality assurance and complaints. We recognize that Cultural Safety is an ongoing journey—not a destination.
 

Learning resources

Registrants are encouraged to become familiar with the content, expectations, and intent of Standard 4 in order to meet their regulatory commitments. COBC’s Cultural Safety resource page offers further guidance and information. Additionally, the BC College of Nurses and Midwives (BCCNM) and the College of Physicians and Surgeons of BC (CPSBC) have generously granted access to resources they created to support their registrants in the implementation of their own Indigenous Cultural Safety, Cultural Humility and Anti-Racism standard. These can be found at the links below.
Indigenous Cultural Safety, Cultural Humility and Anti-Racism Practice Standard Companion Guide
Introduction to the New Standards
Self-Reflective Practice (It starts with me)
Building Knowledge Through Education

Indigenous Cultural Safety, Cultural Humility and Anti-Racism Practice Standard Companion Guide

Introduction to the New Standards

Self-Reflective Practice
(It starts with me)

Building Knowledge Through Education
Anti-Racist Practice (Taking action)
Creating Safe Healthcare Experiences
Person-Led Care
Strengths-Based and Trauma-Informed Practice (Looking beneath the surface)

Anti-Racist Practice
(Taking action)

Creating Safe Healthcare Experiences

Person-Led Care

Strengths-Based and Trauma-Informed Practice (Looking beneath the surface)

1 Interpretation of survey results
The overall margin of error was +/- 1.76%, 19 times out of 20. Comparisons between Indigenous and non-Indigenous respondents should be interpreted cautiously given the sensitivity of the topic and the relatively small number of Indigenous respondents. The individual responses to the survey were kept confidential by Pivotal Research and were not reported or shared with any of the colleges. All reporting was in aggregate.

2 Reporting acts of racism to a health regulatory college
COBC is actively working to make its complaints process more accessible, more relevant, and safer for Indigenous opticians and clients to report racism. Please watch for updates on this work in the coming months.
 

What's going on at COBC

This month, our team is working on:

Annual report
Under the Health Professions Act, COBC is required to publish an annual report detailing our activities and financials from the preceding year. We generally release this report in the summertime, once our annual financial audit is complete; we look forward to sharing the 2022–2023 report with you soon! In the meantime, we invite you to review past reports on our website.

Right-to-title audit
Following the annual renewal period, COBC suspends any registrant who has not renewed their licensure. Once the registrant and their listed employer have been notified of the suspension—and given the opportunity to make any applicable updates to their websites or other public-facing resources—COBC conducts an audit to ensure these individuals and businesses are not using protected titles like "optician" or "contact lens fitter" without authorization to do so.
 
OAC Connect

OAC Connect Event

The OAC's next webast will be held on Wednesday, July 19 at 4:00 PM PDT. The topic is From Boomers to Gen Z – Building a Harmonious and Inclusive Workplace Culture.

If you're working on a learning goal related to communication or collaboration in the workplace, this webcast could be an excellent activity for your Continuing Competency Program!

Learn more and register
 
COBC Standards of Practice

Did you know?

As a regulated health professional, you have certain obligations related to how you report your place(s) of work and how you represent yourself to the public within your workplace(s).

  • You are responsible for keeping your business addresses up to date on your COBC profile. If you work in more than one location, you must include a business address for each one.
    • If COBC becomes aware that opticianry services are being offered by a particular business, but our database does not show any opticians employed there, we may pursue legal action for title use or unauthorized practice.
    • Recording all of your business addresses is good for business! Members of the public use COBC's Public Register to find opticianry services near them.
  • You must display your Certificate(s) of Registration in every location where you work. If you need to order an additional set of certificates, you can do so using our Certificate Order Form.

College of Opticians of BC operates on the traditional, ancestral and unceded Coast Salish territories of the Sḵwx̱wú7mesh (Squamish), səl̓ílwətaʔɬ (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations.

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