Page 117 - Cultural Competence in Health Education

A Spiritually Grounded and Culturally Responsive Approach 95

I later did another study on the ways medical educators are teaching about
spirituality and complementary and alternative medicine (CAM), finding that many

schools are negotiating this addition to the traditional curriculum. Educators ’ success in
this is due in part to the general public ’ s growing interest in these topics and the
subsequent attention of grant funders. All the study participants were careful to
distinguish between religion and spirituality, noting that attention to spirituality allows
consideration of all the many factors that are at play in the therapeutic relationship and
that contribute to healing by complementing medical intervention. The participants also

specified that spirituality is separate from CAM, although CAM providers are more
likely to consider it in their care. These educators are expanding the boundaries of what
counts as knowledge and what constitutes healing (Tisdell, 2004). In the course of that
study I also discovered the works of medical anthropologists (Baer, 2001) and aca-
demic physicians (Astrow, Puchalski, & Sulmasy, 2001; Puchalski, 2004), who have
been heavily involved in dealing with spirituality in medical education. These sources
remain useful in developing my education practice.
What I was trying to do in facilitating the workshop at the refugee women ’ s
health conference is what I also try to do in my doctoral - level classes that deal with
culture: to draw on multiple ways that learners construct knowledge and to draw on
both their culture and activities that may touch on the spiritual to facilitate learning
and to facilitate healing. Obviously, doctoral students are required to read some
sophisticated material and write papers that draw on theoretical concepts in educa-
tional practice, whereas those who show up at a voluntary health conference are not.
But I tend to begin my courses by asking learners to explore their personal connec-
tion to the topic of the course and also their cultural connection, because most of my
courses in some way deal with culture. As the educator, I also discuss my personal
connection to the course and my experience of the phenomenon under study in my
earlier life growing up. In so doing I am trying to make my own positionality and
culture visible in order to get participants to think about what their own assump-
tions — growing out of the way they grew up — might be about people of a different
race, culture, sexual orientation, national origin, social class, or religion. I am trying
to help them look at these issues from a personal perspective. I am also trying to get
them to think about this on the systemic level, to explore how these social systems of
race, culture, and religion affect the education system and the knowledge production
system, and to consider why certain forms of knowledge are more valued than others,
particularly when they represent the interests of the dominant culture. In a variety of

exercises I draw on the Hays (2001) counseling model, which codifies dominant cul-
ture in the United States according to power (white, male, moneyed, heterosexual,
fully able, Euro - American born, of Christian background). Further, I try to help par-
ticipants examine issues of internalized oppression — the fact that every person will
have to some degree internalized the values of the dominant culture, even if he is not
a member of the dominant culture and it is not in his best interest to internalize those
values. At the immigrant women ’ s health conference, even though it was not an aca-
demic setting, I did talk about the phenomenon of internalized oppression, and how
the women might heal from it.

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