Cultural Influences on UK General Practice
Date of presentation
Culture and how it affects
UK GP General Practice
Anjla Sharman
PD Equality in Training
Objectives
•
Discuss the different dimensions of culture
and identify key differences between ‘the
East and West’
•
Consider how culture impacts on
relationships with patients and colleagues
•
Discuss linguistic and cultural capital
•
Tips for success
Introductions
•
What is your name?
•
Who named you?
•
Does your name have any meaning, if so
what?
Culture
‘Collective programming of mind which
distinguishes the members of one group of
people from another and leads them to live
their lives in ways that are shaped by
unwritten social codes...’
Social codes are revealed in patterns of thinking,
feeling and acting...’
(Hofstede 1991)
Differences between East and West
Dimensions of Culture
•
An aspect of culture which can be
measured relative to other cultures:
•
Five dimensions:
–
Authority v submission
–
Individualism v collectivism
–
Uncertainty v certainty
–
Short-term v longterm
–
Masculinity v femininity
Dominant Cultural Themes
East
•
Large power distance
•
Collectivist
•
Masculine
•
Uncertainty avoiding
•
Short-term orientation
West
•
Small power distance
•
Individual
•
Feminine
•
Uncertainty accepting
•
Long-term orientation
to future
Cultural Dimensions – patient
presentations
East
•
Emotion can be shown
•
Fear of ambiguous
situations
•
Resistance to innovation
•
Structured environment
with clear solutions
•
Doctor must supply right
solution promptly
•
Belief in experts and
specialization
•
Few nurses, many doctors
West
•
Emotion not to be shown
•
Comfortable with ambiguous
situations
•
Curiosity re innovations
•
Open-ended situation with
discussion
•
Dr may say: ‘I don’t know’
•
Belief in generalists
•
Many nurses, few doctors
Cultural Dimensions – doctor
presentations
East
•
Doctors are gurus and take
initiative
•
Leaders should be
assertive and decisive
•
Relationships prevail
•
Effectiveness measured in
short-term – fast results
•
Direct confrontation
avoided
•
Concern with maintaining
personal face
West
•
Patient expected to have an
opinion
•
Doctors use intuition and strive
for consensus
•
Task prevails over relationship
•
Effectiveness measured over
longer term
•
Direct confrontation tolerated
•
Concern with maintaining
professional relationship
Cultural Dimensions – educational
presentations
Eastern students
•
Competitive with peers
•
Educators are ‘wise
parents’ – tendency to
subservience
•
Historically used to passive
learning - may struggle
with self directed learning
•
Maybe uncertain re their
progress compared with
peers.
•
Fear of ‘losing face’
Western Educators
•
Value co-operation and team-
work
•
Enjoy students who question and
debate
•
Seek student participation –
shared learning
•
Expect students to undertake self
directed learning
•
Learning from mistakes
Language and Communication
•
Different aspects to consider, including:
–
Language (colloquialisms, pronunciation, accent)
–
Style of language
–
Language use eg humour, irony, understatement
–
Non verbal behaviour
–
Paralinguistic features eg emphasis, tone, pace...
–
Conversation structure eg silence, taking turns...
–
Manners – cultural rules eg greetings, politeness,
expressing emotions, saying no...
Linguistic and cultural capital
•
Linguistic capital – mastery of language and
non verbal communication
•
Social capital – personal resources based on
group membership, relationships, support
•
Cultural capital – knowledge , skills,
education
Implications
•
Stress affects your ability to use linguistic
capital
•
With less linguistic capital, trainees may
over-model (formulaic phrases)
•
May affect ability to demonstrate empathy
and sensitivity
General solutions
•
Recognise issues at an early stage and
recognise need to be pro-active re solutions
•
Language - listening to UK tv and radio, read
English papers
•
Speak English at home, with peers
•
Culture – join social groups eg book clubs,
sports teams...
•
Get involved in informal aspects of life – eg
practice and scheme social events
In the practice
•
Communication skills
–
Give trainers permission to discuss English
language/style
–
Joint surgeries
–
Increased use of videos/COTS
•
Tutorials on ethics, professionalism,
sensitive areas such as sex, death
•
Be curious about patient’s lives
•
Practice ways to explain conditions
Summary
•
Culture is a factor in the way in which learning
and subsequent work is approached
•
Behaviours are influenced by culture and relate to
differing ways of perceiving situations
•
Be aware of importance of linguistic and cultural
capital and actively work to improve both
Explore the impact of culture on UK general practice, delving into the dimensions of culture, differences between East and West, and dominant cultural themes. Learn how cultural dynamics affect patient presentations and relationships in the medical field. Gain insights into navigating linguistic and cultural capital for success in healthcare settings.
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Presentation Transcript
Date of presentation Culture and how it affects UK GP General Practice Anjla Sharman PD Equality in Training
Objectives Discuss the different dimensions of culture and identify key differences between the East and West Consider how culture impacts on relationships with patients and colleagues Discuss linguistic and cultural capital Tips for success www.hee.nhs.uk East Midlands Local Education and Training Board
Introductions What is your name? Who named you? Does your name have any meaning, if so what? www.hee.nhs.uk East Midlands Local Education and Training Board
Culture Collective programming of mind which distinguishes the members of one group of people from another and leads them to live their lives in ways that are shaped by unwritten social codes... Social codes are revealed in patterns of thinking, feeling and acting... (Hofstede 1991) www.hee.nhs.uk East Midlands Local Education and Training Board
Differences between East and West www.hee.nhs.uk East Midlands Local Education and Training Board
Dimensions of Culture An aspect of culture which can be measured relative to other cultures: Five dimensions: Authority v submission Individualism v collectivism Uncertainty v certainty Short-term v longterm Masculinity v femininity www.hee.nhs.uk East Midlands Local Education and Training Board
Dominant Cultural Themes East West Large power distance Collectivist Masculine Uncertainty avoiding Short-term orientation Small power distance Individual Feminine Uncertainty accepting Long-term orientation to future www.hee.nhs.uk East Midlands Local Education and Training Board
www.hee.nhs.uk East Midlands Local Education and Training Board
Cultural Dimensions patient presentations East Emotion can be shown Fear of ambiguous situations Resistance to innovation Structured environment with clear solutions Doctor must supply right solution promptly Belief in experts and specialization Few nurses, many doctors West Emotion not to be shown Comfortable with ambiguous situations Curiosity re innovations Open-ended situation with discussion Dr may say: I don t know Belief in generalists Many nurses, few doctors www.hee.nhs.uk East Midlands Local Education and Training Board
www.hee.nhs.uk East Midlands Local Education and Training Board
Cultural Dimensions doctor presentations West East Patient expected to have an opinion Doctors use intuition and strive for consensus Task prevails over relationship Effectiveness measured over longer term Direct confrontation tolerated Concern with maintaining professional relationship Doctors are gurus and take initiative Leaders should be assertive and decisive Relationships prevail Effectiveness measured in short-term fast results Direct confrontation avoided Concern with maintaining personal face www.hee.nhs.uk East Midlands Local Education and Training Board
www.hee.nhs.uk East Midlands Local Education and Training Board
Cultural Dimensions educational presentations Eastern students Competitive with peers Western Educators Value co-operation and team- work Enjoy students who question and debate Seek student participation shared learning Expect students to undertake self directed learning Educators are wise parents tendency to subservience Historically used to passive learning - may struggle with self directed learning Maybe uncertain re their progress compared with peers. Fear of losing face Learning from mistakes www.hee.nhs.uk East Midlands Local Education and Training Board
www.hee.nhs.uk East Midlands Local Education and Training Board
Language and Communication Different aspects to consider, including: Language (colloquialisms, pronunciation, accent) Style of language Language use eg humour, irony, understatement Non verbal behaviour Paralinguistic features eg emphasis, tone, pace... Conversation structure eg silence, taking turns... Manners cultural rules eg greetings, politeness, expressing emotions, saying no... www.hee.nhs.uk East Midlands Local Education and Training Board
www.hee.nhs.uk East Midlands Local Education and Training Board
Linguistic and cultural capital Linguistic capital mastery of language and non verbal communication Social capital personal resources based on group membership, relationships, support Cultural capital knowledge , skills, education www.hee.nhs.uk East Midlands Local Education and Training Board
Implications Stress affects your ability to use linguistic capital With less linguistic capital, trainees may over-model (formulaic phrases) May affect ability to demonstrate empathy and sensitivity www.hee.nhs.uk East Midlands Local Education and Training Board
General solutions Recognise issues at an early stage and recognise need to be pro-active re solutions Language - listening to UK tv and radio, read English papers Speak English at home, with peers Culture join social groups eg book clubs, sports teams... Get involved in informal aspects of life eg practice and scheme social events www.hee.nhs.uk East Midlands Local Education and Training Board
In the practice Communication skills Give trainers permission to discuss English language/style Joint surgeries Increased use of videos/COTS Tutorials on ethics, professionalism, sensitive areas such as sex, death Be curious about patient s lives Practice ways to explain conditions www.hee.nhs.uk East Midlands Local Education and Training Board
Summary Culture is a factor in the way in which learning and subsequent work is approached Behaviours are influenced by culture and relate to differing ways of perceiving situations Be aware of importance of linguistic and cultural capital and actively work to improve both www.hee.nhs.uk East Midlands Local Education and Training Board
