Diversity Fellow Project, Kira Knight

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Cultural Competence for Healthcare Professionals

Cultural Competence is by nature and definition complex. After a year-long process of examining the historical and current literature, we developed an online cultural competence curriculum for healthcare professionals. To enhance our curriculum, the second year of the diversity fellowship was spent in the field. To really understand the full complexity of cultural competence, we diverged from the research to examine what students were learning in their everyday practice.

Cross-Cultural Communication Module [download]

Cultural Competence for Healthcare Professionals: Small Group Discussion [download]

Family-Centered Care Module [download]

meet Kira Knight >

Project Narrative

1. Please describe your activities during your Fellowship experience. Describe your final capstone project(s).
As a second year AUCD Diversity Fellow, I continued my work on developing a cultural competence curriculum that would enable our healthcare professionals to respond effectively to the multicultural and diverse needs of our culturally-rich Miami-Dade community. The overall goal of the University of Miami’s UCEDD Diversity Fellowship was to train future healthcare professionals with specific knowledge, attitudes and skills that enabled them to work effectively in cross-cultural, high-risk environments – environments where cultural competence is not simply an enhancement to care but a necessity to achieving best service standards available.

Cultural competence is by nature and definition complex. After a year-long process of examining the historical and current literature, I developed an online cultural competence series for healthcare professionals. Numerous steps were taken to enhance our emerging curriculum; the second year of the Diversity Fellowship began with the evaluation of the online content. With the recruitment of leadership faculty, community members, and other staff, the online module was extensively examined and revised.

Throughout this process, I continued to research best practices surrounding the topics of cultural competence, health disparities, and intersectionality. For a cultural competence curriculum to be effectively put in place in a healthcare setting, the Association of American Medical Colleges (AAMC) noted, “Cultural competence in health care combines the tenets of patient/family-centered care with an understanding of the social and cultural influences that affect the quality of medical services and treatment.” Guided by the AAMC recommendations and also working in a pediatric environment, this necessitated an extensive revamping of our parallel module, Family- Centered Care.

A key focus of the Diversity Fellowship was to build awareness on health disparities at the intersection of disability and minority status. Family-centered care and cultural competence are essential approaches to addressing the multiple strengths, needs, and preferences of diverse families, especially those who have children with special healthcare needs. Therefore, it was of paramount importance that we educated healthcare professionals on broadening their scope of understanding cultural competence beyond race and ethnicity, to include not just the lesbian, gay, bisexual, and transgender (LGBT) and disability communities, but the fundamental entity that is “the family.”

Lastly, the most critical component of the second year of my diversity fellowship was to examine cultural competence in the clinical setting. To really understand the full complexity of cultural competence, I had to diverge from the medical literature and examine what students and faculty were learning and teaching in their everyday practice. I recognized that much of what is learned about cultural competence was not necessarily learned in formal didactic sessions, but in the clinical setting. Students were learning “things” (knowledge, attitudes, and skills) that are quite different from those being presented in their required coursework. Hafferty and Franks called it the “hidden curriculum.” Using these educational pearls acquired during my clinical observations, I developed an interactive, high-energy workshop to share and disseminate practical advice amongst the participants as they continue on their path to cultural proficiency.

2. Who did your project inform, help, influence or impact? (UCEDD, individual, community, state) How?
This cultural competence curriculum targeted the healthcare professional – patient relationship. Understanding the central role of the healthcare professional as the patient advocate, we focused our training initiatives on the individual healthcare professional. Our goal was to build an innovative cultural competence curriculum that provides the knowledge, builds skills and creates diversity-valuing attitudes that transform our trainees to be diversity champions who seek to understand the various cultural dynamics that play into the healthcare professional–patient encounter.

We believe that by targeting this specific population (the entry-level healthcare professional), we can ingrain invaluable competencies early in their professional development. Thus, as they progress along their career paths, teaching others, they impact their communities. Therefore, evolving in a grassroots fashion, we set the foundation for a universal healthcare delivery system for all.
3. Why did you choose to work on that project(s)?
As noted in my year one project narrative, I was an international student who migrated to the United States to pursue my tertiary education. As an immigrant young woman, I quickly recognized the cultural differences between people and appreciated these differences as a valued asset and a learning tool. It was my international status that set the stage for me for my lifetime of service. There are ingrained challenges that come along with being “international” that taught me to appreciate the individuality of success. I was able to tie this concept to healthcare – understanding the effects that cultural, social and historical factors have on access and quality of care.

My second year diversity project was more aligned with my future goals of becoming a pediatrician. I chose to work on this project because it served as an opportunity to put all that I have learned during my first year as a diversity fellow into action. It allowed me to provide culturally competent care in a diverse outpatient pediatric clinic, discuss pediatric cases from a cultural standpoint and develop my clinical skills further.

4. What did you gain from being a Diversity Fellow?
Listening to a recent sermon the other day, the pastor noted, “I believe that God introduced you to people, who look like you would eventually look… and every time you are in the presence of a great person, God is giving you a snapshot of what you are going to look like (in the future).” These words completely sum up my AUCD Diversity Fellowship. I have crossed paths with so many great people, who have given me so much invaluable advice. I have learned from the best at my university, in my community, and nationally from the AUCD.

I have gained confidence as I continued my role as an educator at a prestigious academic institution. I developed the art of perspective-taking, and the ability to understand that there is always “more than what meets the eye.” I listen carefully; I listen not to respond, but to hear the unique stories of others.

5. How will this experience impact your education or career decisions?
My leadership training and practice has boosted my self-esteem and belief in my professional abilities. I have learned that I can have a positive impact on others and drive change. This fellowship has taught me to conquer my fears of public speaking and allowed me to develop a passion for teaching. It has been a pivoting point in my education and career path – shifting my mindset from a “student” to an “educator.”

This experience has also steered my direction as a medical doctor towards child advocacy and diversity leadership. Always with a keen interest in child and adolescent psychiatry, and developmental disabilities, I find myself better equipped to care for, coach, and mentor the multicultural population we serve. I am truly humbled and grateful for this experience.

6. What are your future goals? Where do you see yourself 5 years from now?
I continue on my path to becoming a board-certified Pediatrician. My experiences as a Diversity Fellow have giving me the confidence to trust in my abilities. I whole-heartedly believe that with the skills acquired throughout my fellowship, I can be a great pediatrician and provide the best care to children and families.

I was always aware of the naturally occurring injustice of one child’s life over another, but my fellowship has shown me that I can actually do something about this. It has infused an abiding, irrepressible desire in me to advocate for every child. This has become my life’s purpose.

7. What recommendations do you have for other Fellows?
"Ultimately, leadership is not about glorious crowning acts. It's about keeping your team focused on a goal and motivated to do their best to achieve it, especially when the stakes are high and the consequences really matter. It is about laying the groundwork for others' success, and then standing back and letting them shine - Chris Hadfield."

The AUCD Diversity Fellowship has enabled me to be a force for change. I have, and continue to go through a process of growth, self-awareness, and change. To the future Diversity Fellows, embrace this unique opportunity of growth and development. You will come across some of the most amazing people through this journey, learn from them. Stay humble and grateful every day. Embed the ideology of diversity in your day-to-day activities – create a vision of the reality you want, and seek to change the structure of society and the character of yourself and others that foster inclusion for everyone.

Above is my quoted response from my first year diversity narrative. I read it again and thought to myself, “Whoa! This is good!”. But if I had to amend this, I would add practice the art of saying no. It is an extremely important skill to have throughout your leadership career. We live in a world where all the demands of life sit in our back pocket on that smartphone of ours, and as much as we would like to save the world, the truth is, we are not going to save it if we spread ourselves too thin.

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