RUNNING HEAD: FIELDWORK & DIVERSITY IN PRACTICE SETTINGS

Mentorship Reflection Paper 5: Fieldwork and Diversity in the Practice Setting

Friday March 6, 2020

University of Toronto

1000487430
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Fieldwork and Diversity in Practice Settings
Toronto is a multicultural city filled with citizens from various races, ethnicities, sexual
orientations and culture. Growing up in Scarborough, diversity was my norm. Individuals who
would be considered as “minority” populations in other areas of Toronto filled my classrooms,
church, and grocery stores, making up the “majority” of the people I saw. I believed that my
experiences with diversity growing up prepared to practice OT in a way that was racially and
culturally sensitive.
In my second placement at Toronto Rehabilitation Institute in the Outpatient Stroke
Program, I had the pleasure of working with a Mandarin-speaking senior citizen. Throughout our
first few sessions, I ensured that I constantly thought about both the cross-cultural and
intergenerational factors coming to play in our therapeutic relationship. For instance, while
conducting the Chedoke with her, I noticed she had difficulty tracing the figure 8 with her arm
and wondered if this had something to do with how “8” was written in Mandarin. However, on
one particular busy day when I had seen all of my preceptor’s clients, I had a lapse in my
reflexivity. I had decided to do a functional scanning activity with my client, in which she was to
find various rooms and items throughout the building. However, in my error, as we were going
through the activity, I realized how culturally insensitive the site-developed activity was. For
example, a few items inquired: “What room is the Occupational Therapy Assessment Room in?”
and “What is the name of room 140?”. The activity presupposed that clients could read and
speak English. Consequently, I could tell my client was uncomfortable, but she coped with it by
joking around with me. Upon reflection, I realized that in my busy-ness, I had failed to consider
the cultural/language factors that were required to complete this assessment. In the future,
whenever I feel overwhelmed or busy, I must ensure that I take a moment to pause and reflect, so
as to avoid errors like this. I may have other clients who would take offense if I had attempted to
do an activity with them that was not designed to be conducted their first language.
After this session with my client, I approached my preceptor with the situation. She
mentioned that unfortunately we did not have a similar activity offered in various languages,
including Mandarin. I asked why that was and she mentioned that there were no resources or
time to create the activity in another language. I remember thinking that if we as healthcare
professionals did not take the time to create a more culturally sensitive activity, then how are we
providing equitable care to our clients? Additionally, my client will not be the only client who
would need to undergo this activity. Provision of culturally sensitive resources is especially
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Fieldwork and Diversity in Practice Settings
pertinent in Toronto, where there are so many patients with different ethnicities, races, and
cultures needing healthcare services. However, I did not inquire further because I was fearful to
offend my preceptor due to the power differentials that existed between us, as well as the
intercultural differences. I was an Asian woman and she was a white woman, who has previously
taken some of my questions, as well as other team members’ comments, personally in the past.
At the time, I did not know how to articulate my thoughts that did not come off as insinuating a
lack of cultural consideration in creating activities for diverse clients. However, providing
feedback and negotiating a culturally diverse setting with diverse, equitable resources is
something that I vow to work on in order to better advocate for my future clients.
In conclusion, OT practice in Toronto requires a great deal of continuous reflexivity and
sensitivity to the various personalities, values, cultures, races, ethnicities and sexual orientations
that our clients will have. As a profession that values equity of services for all our clients, it is
imperative that individual OTs learn to negotiate for culturally diverse settings and resources.
One important way that I can think of to ameliorate cultural sensitivity is hiring staff of various
cultures and ethnicities, in order to get a wider range of voices and experiences to help inform
client care. Having a diverse range of backgrounds on healthcare teams will inform the
development of culturally safe and sensitive practice with clients to promote equity and diversity.