EPA 8 - Overview
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EPA 8: Recognizes knowledge, power, and wisdom from people in the community. |
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Brief explanation: Recognizing power, knowledge and wisdom from the community includes both an attitude and an action. Includes: honoring sources of wisdom and knowing outside of usual Western European hierarchies, honoring ways of partnering with communities, learn how to respectfully ask for help for a particular community. |
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Key Functions |
Skills Progression |
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Collaborate to address the effects of systemic oppression on health for Indigenous populations and other historically marginalized groups |
Can define decolonization and decolonization practices; Can discuss historical events and US power structures that have oppressed indigenous people and others; Can discuss lasting impact and intergenerational trauma these events and structures have caused; Understands the road to healing includes decolonization practices |
Can discuss the interrelated concepts of colonization, slavery, white supremacy and identify how these show up in the health system and other U.S. structures in present day. Recognizes when cultural factors may be influencing patient/family health and is able to respectfully engage in dialogue with patients about these factors using a trauma informed approach. |
Approaches clinical care and health systems improvement/projects with a decolonizing lens that includes true community engagement. Engages in partnership with communities at a local level (or broader) to dismantle systems of oppression, always seeking to understand context, honor community wisdom and lived experience before doing/acting |
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Humbly asks for help and advice in a way that the community deems appropriate and respectful. |
Understands there are sources of wisdom and knowing outside of existing hierarchies |
Honors ways of partnering with communities by learning how to respectfully ask for help for a particular community |
Co-creates rich, trusting patient and community partnerships through humility and deep listening that elevate and revolve around community knowledge, power, and wisdom |
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Engages with new ways of knowing, being, and doing |
Demonstrates flexibility/openness to new ideas; Demonstrates self-awareness of the historic and structural factors that influence their natural or go-to ways of operating (knowing/being/doing) |
Demonstrates ability to course correct when bias, background, and normative structures influence attitudes and actions in harmful ways. |
Incorporates new ways of knowing, being, and doing into policies and programs to foster health and strengthen communities |
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Instructional Strategies |
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Didactics |
Concepts on colonizing and decolonizing History of colonization/oppression of Indigenous people |
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Workshops |
Power/privilege/intersectionality and identity
Two hour workshop First hour - Review the following resources:
Second hour - Discussion questions 1. What does Dr. Rodgers mean by “epigenetic” effects of slavery and racism? 2. Describe the three levels of racism described by Dr. Jones and provide examples of each (you can broaden this to the three levels of oppression [e.g. sexism]). 3. How has power and privilege shown up in your life, particularly in the medical profession? 4. Can you provide an example of a time you became aware of your own unconscious bias? |
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Community Projects |
Relational meetings with community/tribal members |
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Reflection and Coaching |
Empathy experiences Goal: Resident will have an experiential opportunity to gain an understanding of the difficulties navigating social service or legal systems in the community and will bring this awareness to their interactions with patients in clinic and hospital settings. Tasks: You will need to use public transportation to do some of the following activities.
Discussion/Reflection following empathy activity
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Assessment Methods and Tools |
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OSCE Journaling Portfolio review Video review Discussion with a coach Community feedback |