As an Occupational Therapist, during this Doctoral program, I wanted to establish diverse cultural aspects in many other countries. This way, I can be adaptable, able to build good relationships with clients who have different types of cultural backgrounds.
In AOTA, Cultural Competency Tool Kits explain the importance of multicultural competency and networking diverse identity to understand specific values for individuals who are from a different cultural backgrounds.
More information: OT multicultural practice
I wanted to focus on improving my knowledge to support and grow the profession as an Occupational Therapy and engage globally as a health profession. I planned to experience and explore the culture of Mexico and the Philippines and focuses on the environment in health care as an Occupational Therapist.
I chose the Philippines and Mexico because the countries have different cultural beliefs system compare to the US and my current hospital setting have many patients who are originally from the Philippines and Mexico. This experience was important for me as an Occupational Therapist to learn about their culture and imply my knowledge into the practice.
Throughout this journey, not only working by myself, but I learned how to engage with other disciplinary teams such as physicians, doctors, dentists, and podiatrists. There were some challenging moments where we had different opinions for patient care, but we learned how to communicate, understand each other and provide the best care possible with limited equipment and environment. This trip was an unforgettable moment and I was more than happy to serve as an Occupational Therapist.
- Finding culture; Mexico [ Global Program at NYU] March 10, 2018 – March 18, 2018
The image was taken in Mexico City, Mexico, in March 2018 by Yun Chung
Started with a group of Graduate students at NYU, experiencing a full of history in Mexico. (At Museo Nacional de Antropología)
The image was taken in Puebla, Mexico, in March 2018 by Yun Chung
The culture in Mexico was unique, TheThe country has a complex history that immerses with Spanish and immigrant cultures. They have been ruled by the Spanish for ~300 years and influenced Europe, Africa, and Asia. They enjoy music and arts and love to dance.
The image was taken in Puebla, Mexico, in March 2018 by Yun Chung and Teresa Buster
Visiting UPAEP (Universidad Popular Autónoma del Estado de Puebla) to learn about the culture and health care in Mexico. The picture with Professor in food culture (left) and students in health care (right)
Mexico carries private healthcare where many doctors and physicians are certified in both Mexico and the US and the hospitals are mostly accredited by both the Joint Commission International and the General Health Council of Mexico where it presents high-quality standards.
Occupational Therapy in Mexico
Due to cultural differences compared to the US, people in Mexico have different types of belief systems in disabilities which underrepresent the profession in OT. Currently, Mexico has limited providing services to local communities and due to belief systems and values, the overall growth of the OT profession is limited. There are some studies where to enhance Occupational Therapy as a global partnership and facilitate meaningful partnership and provide new trends in the study of occupational therapy.
2. Medical Missionary Trip to the Philippines as an Occupational Therapist on October 25, 2018 – November 2, 2018
As an Occupational therapist, I wanted to grow more in-depth culturally and learn different types of patients and imply into my goal. I decide to go on the Philippine medical missionary trip.
The image was taken in Tacloban, Philippines, in October 2018 by Soojin Kim
My main duty was to triage patients, assessing clients for needs. I was able to recommend intervention for patients with stroke and provided them quick MMT (Manual Muscle Testing) for clients.
The image was taken in Tacloban, Philippines, in October 2018 by Yun Chung
It was a great adventure, where we took a boat and arrived on small islands to see patients. I was able to experience different types of cultures and populations during this trip.
The image was taken in Tacloban, Philippines, in October 2018 by Yun Chung
The stroke rehabilitation and my goal 1 fit into my trips because I was able to work with clients with stroke in the Philippines and provide professional knowledge to healthcare students in Mexico. During this trip, I was able to assess Berg Balance Assessment, Manual Muscle Testing, AROM/PROM, and informal Visual Field test. During this trip, I provided training to the staff, including teachers, instructors, doctors, and administration.
In this trip, I have had the opportunity to engage with clients with different cultural backgrounds, evaluating and improving client and student engagement. With each session and treatment, I felt more comfortable speaking to clients with stroke, I received detailed feedback from the clients and students, and I enjoyed the opportunity to share my knowledge about Occupational Therapy.
Cultural diversity played an important role during this trip. I had to understand client’s perspectives on stroke and their expectation well enough to explain their symptoms. I spent many hours reading the cultural backgrounds and history in the Philippines and Mexico and trying to understand their values and knowledge. After reviewing, I realized that understanding their thoughts and building a rapport was effective. While looking at other’s communications, gestures, and I was able to understand clients with different cultural backgrounds. Going through this experience taught me one of many valuable lessons about myself: I need to understand other’s perspectives and values and communicate well to build a good rapport.
During this trip, the group set up a simulation in which two staff members participated, one at a time. The remaining staff were in the audience and watched the simulation. We asked the participant to read a paragraph about the definition of stroke. While the participant was reading, I provided Muscle Manual Testing (MMT). I demonstrated how to quickly assess the MMT due to limited time with clients with stroke. For further assessment, I provided a quick questionnaire on how to assess cognition level. For example, we simulated how to ask name, location, situation, and birthdate. The participant was then asked questions about the situation. Following the simulation practice, I asked the participants to ask any questions or concerns about their experiences. Later, I interviewed them to gain deeper insight into their experiences in Occupational Therapy. The participants first were confused, did not know why they are asked these questions. With a translator, I explained the definition of Occupational Therapy, the importance of therapy post Stroke, and was able to provide quick assessments to provide their strengths on bilateral upper extremities. During this experience, I was able to increase my knowledge on how to connect with clients with different cultural backgrounds, how to answer unexpected questions and build a rapport in such a short time period. Mixing a joke, proper gestures, and simplifying the sentences helped them understand the concept of stroke. Throughout this trip, my concept of cultural disparities has been changed. I wanted to interact with people more, and understand their struggles and their values.
My advanced knowledge of cultural diversity is demonstrated not only by clinical outcomes but also through understanding the current issues in the US. After this trip, I had an opportunity to learn about health disparities. Health disparity defines as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage (Carter-Pokras & Baquet, 2002). Social determinants like race or ethnicity, sex, sexual identity, age, education, and socioeconomic status can impact health outcomes in specific risk populations (Braveman, 2006). I learned more about current issues in the health care and stroke rehabilitation system, where due to health disparity, people with stroke are not receiving a fair assessment or treatment. During my time as an Occupational Therapist, I realized that there are limitation among each client with stroke, and would want to improve my skill as an Occupational Therapist. I realized that learning to be a competent OT requires guidance and feedback. After this trip, I was eager to engage more with other disciplinary teams, requesting their feedback on each client with a stroke.
Through these experiences, I learned about putting myself in the shoes of clients with a different culture to remember that I did not always know the things I know now. I tried to keep this empathy in mind as I worked toward each of my goals to acquire my OTD. I learned to communicate with others when I need help. I will continue to learn, grow, and improve along with the clients I work with. My confidence, empathy, and commitment to the clients have changed me throughout this experience and I look forward to using these experiences to enhance my skills in Occupational Therapy and ability to share information with the multidisciplinary team in the hospital.
Reference
Braveman, P. (2006). HEALTH DISPARITIES AND HEALTH EQUITY: Concepts and Measurement. Annual Review of Public Health, 27(1), 167–194. https://doi.org/10.1146/annurev.publhealth.27.021405.102103
Carter-Pokras, O., & Baquet, C. (2002). What is a “health disparity”? Public Health Reports, 117(5), 426–434. https://doi.org/10.1016/s0033-3549(04)50182-6