Projects and Programs
Supported by C.I.N.A.

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C.I.N.A. Cultural Competency
Cultural Competence & Cultural Safety in Nursing Education Introduction - Framework & Related Literature Review

Cultural Competency Image

The overarching goal for this initiative is to improve the health delivery and outcomes for First Nation, Inuit and Métis peoples. As such, a related goal is the recruitment and retention of Aboriginal student nurses to Canadian Schools of Nursing, to support the retention of First Nation, Métis and Inuit nurses and other health professionals currently in the workplace and to provide a resource tool for researchers.

Based on earlier work on cultural competence and safety done by the C.I.N.A., in conjunction with national Aboriginal organizations, the Canadian Nurses Association (CNA), and the Canadian Association of Schools of Nursing (CASN) as well as planning work done on cultural competency by the Indigenous Physicians Association of Canada (See http://www.ipac-amic.org/publications.php), C.I.N.A. successfully obtained funding from Health Canada (Aboriginal Health Human Resources Initiative) for an extensive literature review and consultation with national Aboriginal organizations. The final result was the "Cultural Competence and Cultural Safety in Nursing Education: A Framework for First Nations, Inuit and Métis Nursing" which was launched on June 11, 2009, the first Anniversary of National Reconciliation Day.

This seminal Framework is now being used as the basis for the further development and implementation of new curricula in Canadian Schools of Nursing as well as for the development and implementation of courses to meet the continuing education needs for health services delivery personnel working with First Nation, Inuit and Métis clients. This important work would not have been done without the ongoing support and funding provided by the Aboriginal Health Human Resources Initiative, First Nations & Inuit Health Branch of Health Canada.

Background – Phase One

  • In 2007, the Canadian Indigenous Nurses Association (C.I.N.A.), the Canadian Association of Schools of Nursing (CASN) and the Canadian Nurses Association (CNA), convened a meeting of key stakeholders and content experts, including representatives from various First Nation, Inuit and Métis organizations, to explore approaches that would encourage recruitment, retention and support of First Nation, Inuit and Métis nurses.
  • With the input gathered from this meeting, C.I.N.A., along with the Canadian Association of Schools of Nursing (CASN) and the Canadian Nurses Association (CNA), developed a proposal that would facilitate curriculum changes in Nursing Schools through the development of a cultural competence and cultural safety framework. The overall objective of the framework is to enable all Nurses to provide optimal care for all First Nation, Inuit and Métis clients.
  • C.I.N.A., CASN and CNA formed a partnership initiative in 2008 and worked with an ongoing National Advisory Committee to jointly develop the Framework.
  • Eight national Aboriginal, First Nation, Inuit and Métis organizations form part of our Advisory Committee. They have provided input on the competencies and on what success would look like when fully integrated.
  • Other members vary depending on the project phase but they also include input from Aboriginal nursing students and representatives from community, education and regulatory organizations.

Phase Two

A. Nursing School Curriculum Projects:

Six nursing schools were selected from a "Call for Proposals" to develop methods on how they would utilize the Cultural Competence and Cultural Safety Framework into curriculum at the pre-licensure level in their program. The schools selected were:

  1. St. Francis Xavier University (Nova Scotia)
  2. Nova Scotia Community College
  3. Laurentian University (Ontario)
  4. Trent University (Ontario)
  5. University of Alberta
  6. Langara College (British Columbia)

Langara College is currently working on incorporating a case study centering on the same families into each term to assist with learning activities. Additionally, the college is looking at incorporating potential courses, such as an Aboriginal studies elective and a mandatory Culture and Health course into the curriculum.

The University of Alberta has included cultural safety theory and practice into the first year clinical experience to enable nursing students. During this experience, students learn about Aboriginal history and culture while building relationships enabling the students to provide culturally safe care to the Plains Cree of Alberta.

Trent University has been working on a curriculum map that includes the six core competencies identified in the framework, abstract submissions to disseminate the project, submission of a manuscript, partnerships, and knowledge translation materials. Trent has also appointed an Aboriginal Enrolment Advisor to assist Aboriginal nursing students and their families who are considering enrolling at the University.

Laurentian University developed learning resources for students to be able to provide culturally competent and safe practice with Aboriginal peoples including "Nursing Practice with Aboriginal Peoples: A Nursing Student’s Guide to Cultural Competence and Cultural Safety".

Nova Scotia Community College (NSCC) developed a course (30 hours) called ‘Aboriginal Cultural Competence and Cultural Safety’ which will enable students to provide culturally safe care, build relationships and understanding of Aboriginal clients. They are currently doing an evaluation of the courses for potential expansion to other campuses at NSCC.

Saint Francis Xavier University held a one day workshop entitled ‘Integrate Cultural Competency and Cultural Safety into Curriculum’ which Aboriginal community members attended. They are currently adding more Aboriginal content into their curriculum.

The reports from the six schools of nursing are now available in the resource "Cultural Competency and Cultural Safety Curriculum for Aboriginal Peoples".

B. Continuing Education Project with Canadian Healthcare Association:

C.I.N.A worked with the Canadian Healthcare Association on the development, implementation and evaluation of distance learning continuing education materials. The ‘Cultural Competence and Cultural Safety in Health Services’ course is now available through the Canadian Healthcare Association (CHA). Registration for the course is ongoing, see the CHA for details.

Phase Three

Research and Information Dissemination Project:

The C.I.N.A is working on a research project (2010-2012), titled ‘Cultural Readiness in Schools of Nursing’. Information will be available at the 2011 National Forum "Sustaining a healthy Future: from Indigenous Knowledge to Cultural Safety" and the final report will be available in spring of 2012. This study involved a survey of English speaking schools of Nursing affiliated with CASN as well as in-depth interviews with selected schools of nursing. As a part of this project, C.I.N.A has completed an annotated bibliography on cultural safety which can be used as part of a research project or stand alone as a source of current research on cultural safety.

It is hoped that a similar study can be done in the near future with Francophone schools of nursing as well as with Practical Nursing programs.