Cultural competency in otolaryngology-head and neck surgery training in Aotearoa, New Zealand.

Abstract

Worldwide, indigenous communities experience diminished health status and poorer health outcomes in comparison to the dominant non‐indigenous population. Four phenomena – historical trauma, institutionalized racism, social determinants of health and culturally inaccessible or unfriendly health services – contribute to this health inequality. To fulfil RACS vision of serving our community with excellence, achieving indigenous health equity must become one of the core values of RACS. This novel survey demonstrates that both OHNS supervisors and trainees largely understand and acknowledge the importance of providing culturally appropriate health services for Māori but are less familiar with the importance of appraising personal and institutional attitudes towards culture. In conjunction with the New Zealand based surgical training committees, the Māori Health Advisory Group is developing a formalized cultural safety teaching and assessment programme to meet this need and which will form part of a broader RACS strategy to address Māori health equity. However, while skills can be developed through courses and educational material, meaningful change only occurs when we enact this in our offices, on our wards and in our operating theatres. The informal and hidden curriculum guides our learners – unless we model the importance and value of delivering culturally safe care and actively engage in the improving the health of Māori, the changes needed will not occur.