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Cultural safety and humility: laying the groundwork with education and moving forward with a Standard of Practice

The following is a feature story published in the 2022 CMTBC Annual Report.

Supporting Indigenous cultural safety and humility in health care is an important commitment for BC health regulatory colleges, including CMTBC. Each health regulator has determined a way to move forward with that commitment. CMTBC has chosen to begin by following a path  grounded in education and an understanding of history, which is now leading to the development of a Standard of Practice.

In November 2020, the BC Ministry of Health commissioned a review of Indigenous-specific racism in the provincial health care system. The review resulted in the release of a report entitled In Plain Sight: Addressing Indigenous-Specific Racism and Discrimination in B.C. Health Care, which outlined 24 recommendations. “The In Plain Sight report made it clear that there were significant issues with Indigenous-specific racism and disparate treatment of Indigenous peoples in health care generally,” says Eric Wredenhagen, CMTBC Registrar and CEO.

There were previous landmarks addressing Indigenous-specific racism in Canada. In 2019, the BC Government passed the Declaration on the Rights of Indigenous Peoples Act. In 2015, the Truth and Reconciliation Commission of Canada was established to document the legacy of the Indian residential school system. The Commission’s final report includes 94 calls to action aimed at reconciliation.

In this provincial and federal context, the CMTBC Board and staff members have deeply examined how the College can address Indigenous-specific racism in health care. It began with education. In February 2022, CMTBC Board and staff members, along with guests from other regulatory colleges, attended a presentation — “Full Circle: A History of Indigenous and Non-Indigenous Relations in Canada” — delivered by Max Faille and Aaron Christoff, partners in Gowling WLG’s Indigenous Law Group.

In September 2022, Board and staff members of CMTBC and the Registered Massage Therapists Association of BC (RMTBC) attended a one-day training session: “Working Effectively with Indigenous Peoples.” The main presenter was Bob Joseph, author, founder and President of Indigenous Corporate Training and member of the Gayaxala (Thunderbird) clan and Gwawaenuk First Nation. Rob Everson — Hereditary Chief of the Gigal’ga̱m ‘Walas Kwagu’ł and member of the K’omoks First Nation — also contributed to the session, which included time for discussion among the participants and was well-received by all who attended.

Jointly participating in the training with RMTBC was unprecedented and noteworthy. “We have a common objective and a common interest in making massage therapy more accessible and safer for Indigenous peoples,” says Mr. Wredenhagen.

Also in September 2022, CMTBC launched a new Cultural Safety & Humility section of the College’s website as a resource for registrants to support meaningful engagement and learning with respect to Indigenous anti-racism and cultural safety and humility. The resource includes:

  • An Introduction and Commitment to action, which includes a commitment to action from the CMTBC Board on addressing the consequences of intergenerational abuse and trauma of Indigenous peoples.
  • A Timeline that provides a history of institutional and systemic racism directed at Indigenous Peoples.
  • An Applications to Practice page that provides RMTs with guidance on how principles of cultural safety and humility can be applied to massage therapy practice.
  • Selected Resources for learning more about cultural safety and humility.

The Timeline and Applications to Practice pages were created in partnership with a cultural safety consultant, along with elders and artists of the Syilx/Okanagan Nation.

CMTBC developed and launched the website resource before developing a Standard of Practice because “we felt that everyone needed to start with the same foundational understanding of history,” says Kate Parisotto, CMTBC Deputy Registrar/Director, Inquiry, Discipline and Quality Assurance. “We wanted to start from the perspective of education and providing a useful practice resource as opposed to starting from the creation of a standard,” adds Mr. Wredenhagen.

Designing the resource with visual elements in the Timeline and Applications to Practice pages, along with the distinctive orange colour that’s a meaningful symbol of National Day for Truth and Reconciliation, has helped make the information accessible. “We wanted people of different learning styles to be able to absorb the key information without an undue amount of effort,” says Mr. Wredenhagen.

Feedback from RMTs about the resource has been very supportive. “RMTs have said that they really appreciate it,” says Alison Esser, CMTBC Manager of Practice Development & Support. “RMTs have expressed that while they’ve learned a lot about Indigenous cultural safety and humility, they realize that they still need to learn more, and they’re interested to know what more they can do.”

The Indigenous training participated in by CMTBC Board and staff members, and the website resource introduced by the College, lay the groundwork for developing a Cultural Safety & Humility Standard of Practice, a process that began in 2022. This new standard will follow the ground-breaking work done by the College of Physicians and Surgeons of BC and the BC College of Nurses and Midwives.

There are other ways CMTBC is meeting its commitment to Indigenous cultural safety and humility. In the previous Quality Assurance cycle, Cycle 13, the College approved nine courses focused on Indigenous cultural safety and humility that were eligible for continuing education credits (CECs).

“We will keep building on the work that has been done,” says Mr. Wredenhagen. “There is much more work to do in ensuring the principles of cultural safety and humility and Indigenous-specific anti-racism find their place in every part of the health care system, including regulation.”

Gordon MacDonald (Executive Director, RMTBC), Bob Joseph (author, and founder and President, Indigenous Corporate Training), and Eric Wredenhagen (Registrar & CEO, CMTBC).

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