Amélie Blanchet Garneau

Bio: Amélie Blanchet Garneau is an academic researcher from Université de Montréal. The author has contributed to research in topics: Health care & Health equity. The author has an hindex of 9, co-authored 18 publications receiving 334 citations. Previous affiliations of Amélie Blanchet Garneau include University of British Columbia.

Cultural Competence: A Constructivist Definition

Abstract: In nursing education, most of the current teaching practices perpetuate an essentialist perspective of culture and make it imperative to refresh the concept of cultural competence in nursing The purpose of this article is to propose a constructivist definition of cultural competence that stems from the conclusions of an extensive critical review of the literature on the concepts of culture, cultural competence, and cultural safety among nurses and other health professionals The proposed constructivist definition is situated in the unitary-transformative paradigm in nursing as defined by Newman and colleagues It makes the connection between the field of competency-based education and the nursing discipline Cultural competence in a constructivist paradigm that is oriented toward critical, reflective practice can help us develop knowledge about the role of nurses in reducing health inequalities and lead to a comprehensive ethical reflection about the social mandate of health care professionals

Disruption as opportunity: Impacts of an organizational health equity intervention in primary care clinics.

Abstract: The health care sector has a significant role to play in fostering equity in the context of widening global social and health inequities. The purpose of this paper is to illustrate the process and impacts of implementing an organizational-level health equity intervention aimed at enhancing capacity to provide equity-oriented health care. The theoretically-informed and evidence-based intervention known as ‘EQUIP’ included educational components for staff, and the integration of three key dimensions of equity-oriented care: cultural safety, trauma- and violence-informed care, and tailoring to context. The intervention was implemented at four Canadian primary health care clinics committed to serving marginalized populations including people living in poverty, those facing homelessness, and people living with high levels of trauma, including Indigenous peoples, recent immigrants and refugees. A mixed methods design was used to examine the impacts of the intervention on the clinics’ organizational processes and priorities, and on staff. Engagement with the EQUIP intervention prompted increased awareness and confidence related to equity-oriented health care among staff. Importantly, the EQUIP intervention surfaced tensions that mirrored those in the wider community, including those related to racism, the impacts of violence and trauma, and substance use issues. Surfacing these tensions was disruptive but led to focused organizational strategies, for example: working to address structural and interpersonal racism; improving waiting room environments; and changing organizational policies and practices to support harm reduction. The impact of the intervention was enhanced by involving staff from all job categories, developing narratives about the socio-historical context of the communities and populations served, and feeding data back to the clinics about key health issues in the patient population (e.g., levels of depression, trauma symptoms, and chronic pain). However, in line with critiques of complex interventions, EQUIP may not have been maximally disruptive. Organizational characteristics (e.g., funding and leadership) and characteristics of intervention delivery (e.g., timeframe and who delivered the intervention components) shaped the process and impact. This analysis suggests that organizations should anticipate and plan for various types of disruptions, while maximizing opportunities for ownership of the intervention by those within the organization. Our findings further suggest that equity-oriented interventions be paced for intense delivery over a relatively short time frame, be evaluated, particularly with data that can be made available on an ongoing basis, and explicitly include a harm reduction lens.

Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for nursing.

Abstract: Although nursing has a unique contribution to advancing social justice in health care practices and education, and although social justice has been claimed as a core value of nursing, there is little guidance regarding how to enact social justice in nursing practice and education. In this paper, we propose a critical antidiscriminatory pedagogy (CADP) for nursing as a promising path in this direction. We argue that because discrimination is inherent to the production and maintenance of inequities and injustices, adopting a CADP offers opportunities for students and practicing nurses to develop their capacity to counteract racism and other forms of individual and systemic discrimination in health care, and thus promote social justice. The CADP we propose has the following features: it is grounded in a critical intersectional perspective of discrimination, it aims at fostering transformative learning, and it involves a praxis-oriented critical consciousness. A CADP challenges the liberal individualist paradigm that dominates much of western-based health care, and the culturalist and racializing processes prevalent in nursing education. It also situates nursing practice as responsive to health inequities. Thus, a CADP is a promising way to translate social justice into nursing practice and education through transformative learning.

Critical Reflection in Cultural Competence Development: A Framework for Undergraduate Nursing Education.

Abstract: Background: Nursing faculties are urged to adopt a curriculum that supports culturally competent care and to mentor students to provide care that promotes social justice, particularly for the marginalized members of society. This article describes the development of a framework for critical refl ection in cultural competence development among undergraduate nursing students. Method: Following the Medical Research Council guidelines for developing complex interventions, empirical and theoretical literature was reviewed to defi ne the framework rationale and its components. Results: The resulting framework is grounded in Blanchet Garneau’s constructivist model of cultural competence development and Mezirow’s transformative learning theory. It clarifi es the desired outcomes, the main steps to foster critical refl ection among students, and the contextual conditions and prerequisites for teachers and learners. Conclusion: Education oriented toward critical refl ective practice promotes a full refl ection about Western social and clinical practices and points out the role of nurses in reducing health inequities. [J Nurs Educ. 2016;55(3):125-132.] M any researchers in nursing science stress the importance of cultural encounters in the development of cultural competence. International clinical placements, as well as service-learning, have been traditionally identifi ed as effective ways to develop this competence (Amerson & Livingston, 2014). However, for this encounter to be effective in terms of learning and to result in changes to nursing practice, one must critically refl ect on his or her experience in a culturally diverse context of care (Amerson & Livingston, 2014). Indeed, Dewey’s experiential learning theory claims that learning occurs at the intersection of refl ection and action (Dewey, 1933). Furthermore, Mezirow’s transformative theory of adult learning emphasizes that becoming critically refl ective of one’s assumptions is the key to transforming one’s frame of reference (Mezirow, 1991). Therefore, by questioning one’s assumptions and clinical practices, critical refl ection could promote transformative learning and concrete changes in nursing practice toward culturally competent care. This article describes the development of a framework for critical refl ection in cultural competence development among undergraduate nursing students. BACKGROUND

经验与教育 = Experience and education

Abstract: Experience and Educationis the best concise statement on education ever published by John Dewey, the man acknowledged to be the pre-eminent educational theorist of the twentieth century. Written more than two decades after Democracy and Education(Dewey's most comprehensive statement of his position in educational philosophy), this book demonstrates how Dewey reformulated his ideas as a result of his intervening experience with the progressive schools and in the light of the criticisms his theories had received. Analysing both "traditional" and "progressive" education, Dr. Dewey here insists that neither the old nor the new education is adequate and that each is miseducative because neither of them applies the principles of a carefully developed philosophy of experience. Many pages of this volume illustrate Dr. Dewey's ideas for a philosophy of experience and its relation to education. He particularly urges that all teachers and educators looking for a new movement in education should think in terms of the deeped and larger issues of education rather than in terms of some divisive "ism" about education, even such an "ism" as "progressivism." His philosophy, here expressed in its most essential, most readable form, predicates an American educational system that respects all sources of experience, on that offers a true learning situation that is both historical and social, both orderly and dynamic.

Can the Subaltern Speak

Abstract: In the present paper a research has been done on the essay ‘Can the Subaltern Speak’ by’ Gayatri Chakravorty Spivak’. It has been explained into much simpler language about what the author conveys for better understanding and further references. Also the criticism has been done by various critiques from various sources which is helpful from examination point of view. The paper has been divided into various contexts with an introduction and the conclusions. Also the references has been written that depicts the sources of criticism.

Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition

Abstract: Eliminating indigenous and ethnic health inequities requires addressing the determinants of health inequities which includes institutionalised racism, and ensuring a health care system that delivers appropriate and equitable care. There is growing recognition of the importance of cultural competency and cultural safety at both individual health practitioner and organisational levels to achieve equitable health care. Some jurisdictions have included cultural competency in health professional licensing legislation, health professional accreditation standards, and pre-service and in-service training programmes. However, there are mixed definitions and understandings of cultural competency and cultural safety, and how best to achieve them. A literature review of 59 international articles on the definitions of cultural competency and cultural safety was undertaken. Findings were contextualised to the cultural competency legislation, statements and initiatives present within Aotearoa New Zealand, a national Symposium on Cultural Competence and Māori Health, convened by the Medical Council of New Zealand and Te Ohu Rata o Aotearoa – Māori Medical Practitioners Association (Te ORA) and consultation with Māori medical practitioners via Te ORA. Health practitioners, healthcare organisations and health systems need to be engaged in working towards cultural safety and critical consciousness. To do this, they must be prepared to critique the ‘taken for granted’ power structures and be prepared to challenge their own culture and cultural systems rather than prioritise becoming ‘competent’ in the cultures of others. The objective of cultural safety activities also needs to be clearly linked to achieving health equity. Healthcare organisations and authorities need to be held accountable for providing culturally safe care, as defined by patients and their communities, and as measured through progress towards achieving health equity. A move to cultural safety rather than cultural competency is recommended. We propose a definition for cultural safety that we believe to be more fit for purpose in achieving health equity, and clarify the essential principles and practical steps to operationalise this approach in healthcare organisations and workforce development. The unintended consequences of a narrow or limited understanding of cultural competency are discussed, along with recommendations for how a broader conceptualisation of these terms is important.

Culture Care Diversity and Universality: A Theory of Nursing

Abstract: Culture Care Diversity and Universality: A Theory of Nursing edited by Madeleine M. Leininger, PhD, RN, FAAN; Sudbury, MA: Jones and Bartlett, 2001; 448 pages, $34.95 This new release of a book published 10 years ago by the National League for Nursing is said to be the definitive and comprehensive source for Leininger's culture care theory. It is presented in three parts: Part I is a description of the theory and its underpinnings by Leininger. Part II, in nine chapters, describes the research method to study culture care, by Leininger, followed by research by various authors who have used the theory and method. Part III, in three chapters, all by Leininger, focuses on findings from research that have used the theory and the method and use of the theory in education and administration. A final chapter addresses the relevance of the culture care theory in projecting the future of nursing. The reissue of this book is both timely and welcome. Leininger has almost single-handedly transformed our thinking about the need for culture care in all domains, whether it be in nursing care, in educational programs, or administration of patient care services. As our country has become more and more multicultural, and as we have come to see the impact of events in other parts of the world on our daily lives, the theory of "culture care diversity and universality" assumes an importance not previously felt or understood. The author makes some attempt to place her culture care theory within the framework of the broader theory development enterprise in nursing and the different approaches used to develop theory. She concludes that culture care theory does not fit well with existing thinking on theory development approaches, and that theories in nursing have been conceptualized within the logical positivist and quantitative paradigm. Culture care theory, on the other hand, was "conceptualized within the qualitative discovery paradigm with largely inductive emic (people-centered) views and not from the researcher's a priori hypotheses" (p. 24). The central issue of concern to this reviewer is not with the utility and elegance of this theory, for it has both. It is rather, that it claims too much for itself and does not recognize the place, utility, co-existence, or indeed, complementarity, of other theoretical approaches, especially if they are developed within the positivist paradigm, and worse yet, if they demand quantitative approaches for verification of hypotheses derived from them. The book appears to claim that culture care theory and knowledge are sufficient to address all dimensions of nursing. …