I would suggest that being culturally aware in practice is very important, it helps us understand equality legislation and the policies relating to diversity, equality and inclusion (DEI or EDI) we have in practice that we must follow.
I like to think of this as welcoming people (colleagues and patients) from all backgrounds and celebrating their differences.
The UK is a multicultural society. As an optical advisor, being culturally aware will help communication and allow trust and rapport to be built more effectively with patients.
Showing respect for one’s culture and acknowledging the tension between clinical practice demands versus patients’ beliefs is important.
Optical advisors are often front of house and invariably spend more time with patients. That’s why all optical advisors will benefit from understanding the following.
1. What is cultural awareness and why is it important?
I feel it is the understanding of the differences between ourselves and people from other countries or other backgrounds, especially differences in attitudes and values. In the practice, an awareness of religious festivals feels like it should be a minimum, acknowledging and sharing in religious festivals is even better.
A practice may have Christmas and Easter decorations but your community may feel more included if we also had basic decorations at the relevant times for the major festivals of the major religions present in your community. It is a great opportunity to share cultures and try new foods.
This should be across all communities, for example, a Muslim owned practice getting involved in celebrating Christmas.
The major religious festivals of the major religions present in the UK2 are:
- Buddhist: Wesak (Buddha Day)
- Christian: Good Friday, Easter Sunday, Christmas Day, Epiphany
- Hindu: Krishna Janmashtami, Diwali (Divali, Deepavali)
- Jewish: Pesach – Passover (first 2 days), Pesach – Passover (final 2 days), Shavuot (Pentecost Festival of weeks), Rosh Hashanah, Yom Kippur (Day of Atonement), Sukkot (Tabernacles), Shemini Atzeret, Simchat Torah, Chanukah
- Muslim: Ramadan month, Eid-ul-Fitr, Eid-ul-Adha, Ashura, Muharram
- Sikh: Guru Gobind Singh’s birthday, Vaisakhi/Baisakhi, Martyrdom of Guru Arjan Dev, Bhandi Chor Divas, Birthday of Guru Nanak, Martyrdom of Guru Tegh Bahadar, Holla Mohala.
Other secular UK festivals important to some of your staff and patients include: Burns’ Night, Chinese New Year, Valentine’s Day, Mother’s Day, Beltane, King’s Offical Birthday, Father’s Day, Summer Solstice, Eisteddfod, Notting Hill Carnival, Halloween, Bonfire Night, Remembrance Day and the Winter Solstice.
I have found it slightly strange that big companies describe the holidays at Christmas as the festive break, do you know who gets most annoyed at that? In my experience, its colleagues from the Hindu or Muslim community who I have worked with. Who have often said in frustration: ‘Why don’t they just call it Christmas holidays?’
How does the above bring people together? People need to think they belong. Being in a healthcare setting, it is really important that all parts of our communities feel that they are welcome into any practice.
The ability to talk to people from a different background to you, just makes life more pleasant. We all openly talk about the weather, parking in town or going on holiday but a willingness to learn about different cultures is more important now than ever.
We have lots of immigrants, migrants, refugees, we are becoming a more diverse population. According to the 2021 census, 18% of the population of England and Wales belong to black, Asian, mixed or other ethnic groups that do not identify as white British.
However, many areas are much more ethnically diverse. According to DiversityUK, the top 10 cities by percentage ethnic minority are:
- Westminster, 72%
- Leicester, 67%
- City of London, 67%
- Birmingham, 57%
- Manchester, 51%
- Cambridge, 47%
- Oxford, 47%
- Wolverhampton, 45%
- Coventry, 45%
- Bradford, 43%
Is it difficult to co-exist with people you do not understand?
I have a personal example where admittedly I was a little naive. My daughter plays football, and I often take her and her friend to matches.
We had some wine gums in the car, my daughter had one and I offered her friend one, but she refused. It was my own daughter that explained that wine gums contain porcine gelatin and as a Muslim she does not eat pork. Other sweets contain bovine gelatin and cannot be eaten by Hindus.
After that slightly awkward situation, I felt that I had learned something that I could remember for the future.
In another example, an ex-colleague of mine told me about the Indian caste system, which basically goes off your surname to how you used to be viewed in society.
The Four Varna System: The early caste system is said to have been based on the ‘Varna’ model described in ancient Hindu texts, such as the Rigveda. The four broad divisions are:
Brahmins: Priests, scholars and religious teachers; considered the highest caste.
Kshatriyas: Warriors and rulers; responsible for protection and governance.
Vaishyas: Merchants, farmers and traders; involved in commerce and agriculture.
Shudras: Laborers and service providers; responsible for serving the higher castes.
These four categories are independent of religious background and were often portrayed as corresponding to different functions in society, with the Brahmins occupying the highest, and the Shudras, the lowest status.
This to me was very intriguing because I have not heard about it before. I remember thinking hopefully this is not used today, it does not seem fair, in my opinion, to be judged by your surname, surely it is how you as an individual live your life and your surname should not hold you back.
Since then, I had discovered from a research paper written by the UK Government Equalities Office that discrimination based on caste is still present in the UK but is illegal and contrary to the Equality Act 2010.1
Again, I felt that I had learned something, that I could remember and be aware of for the future.
2. What do you feel is key to professionalism and cultural awareness for us in optical practice?
Being aware of people’s beliefs and views such as race/religion and not discriminating anyone for this. Not judging someone for their differences and beliefs and supporting your colleagues to learn about and celebrate those differences.
In some cultures, certain eye conditions might be more prevalent, or there might be traditional practices or beliefs about vision care. Being culturally aware means being open to integrating these practices where possible and ensuring treatments are respectful of their culture.
3. How important is cultural awareness to the patient relationship and why might this be particularly important for optical assistants to learn?
You see a range of patients day in, day out, and you need to be mindful of different patients’ views and opinions. It is about having that mutual respect for one another.
Showing respect for people’s culture and acknowledging that some people will have different beliefs to you is important skill to have in a clinical practice.
People need to think they belong, to feel welcome. Being able to talk to people from a different background will really help make this happen.
4. Why is it good practice to run a session on professionalism and cultural awareness for learners starting a career in optics?
We have standards of practice, which are rules/guidance that we need to understand. They include the legalities in relation to equality, diversity and inclusion.
How does our own attitude impact on customers and colleagues? Whether positive or negative, the way we approach others can shape their experiences, engagement and feelings of respect and inclusion.
5. How is professionalism linked to cultural awareness and why it is important in practice?
Professionalism is a common platform that makes people feel welcome within the workplace, supporting them by not exposing them to prejudice or beliefs from people who do not support this and discriminate against them just because of something such as age or gender. These rules are important as they help run a business day to day smoothly without causing upset for anyone.
When I am marking set tasks of my optical assistant apprentices, I always like to hear examples of cultural awareness from their practices.
One recent example provided was: ‘We offer access to a separate staff area during Ramadan at lunch times for those not eating during day light hours, instead of having to sit next to those who are. We stagger the optometrists break times, so that there is room available.’
While I was thinking about what cultural awareness means to me, I realised that everyone is unique, what we have lived through has given us a unique perspective of the world that has been formed from our own experiences and culture.
Working in an optical practice, we need to be aware of cultural differences and be sensitive to them. The Equality Act 2010 should be your guide.
We need to treat all our patients as unique individuals with their own distinctive view of the world.
To me, being professional and culturally aware in a healthcare setting can be about empathy, listening to our patients’ frustration and showing understanding of their feelings.
This reminds me of the ‘be kind’ message during the pandemic, you do not know what others have been through.
It is important to consider any understanding of a patient’s life gained during a practice visit is only a window of information, we still only know a small amount about a person.
What is a key takeaway you have gained on professionalism and cultural awareness?
For cultural awareness, I think the main thing is to be respectful and considerate of the patient you are treating.
Everyone deserves quality eye care, so if we can make the experience comfortable and pleasant, then I think people will be more inclined to have regular eye tests to maintain the health of their eyes.
I feel healthcare can be a deeply personal part of people’s lives, so the way in which we communicate with patients and approach learning about their health and lifestyle can also affect the greater context of their lives.
We can learn about frames and lenses and all things optical but to be really effective in your job, you need to understand people.
Cultural awareness is great for society but there are laws as well that enforce how we conduct ourselves towards others.
Key legislation – Equality Act 2010
Do your eye care services embrace the Equality Act and are you doing everything to ensure people with disabilities have full access to them?
The Equality Act 2010 states that no individual should be discriminated against because they have, be perceived to have, or are connected to someone with a physical or mental disability.
Basically, no one should receive substantially different treatment, either in employment or in the provision of goods and services, because of their differences or disability.
The Equality Act (2010) replaces previous legislation (such as the Race Relations Act 1976 and the Disability Discrimination Act 1995). The Equality Act (2010) covers:
Age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership, pregnancy and maternity.
These are called ‘protected characteristics’. The Act extends some protections to characteristics that were not previously covered and also strengthens particular aspects of equality law.
ABDO guidance
ABDO recommends, as best practice, that employers introduce an equality and diversity policy, which includes a copy of the Equality Act 2010, along with your company’s statement on equality and diversity and expectations in relation to staff behaviour.
Your practice policy statement should include objectives and processes to ensure that all staff are treated equally and with respect, in relation to their individual characteristics, in all interactions, and should include protection from discrimination from patients too.
Processes should include how to raise a concern and the responsible staff member and who will manage the process.
An example of the wording that could be used in a company equality statement could include:
‘At [insert practice name] all staff have the right to be free from bullying, harassment, unwanted behaviour and discrimination in relation to the Equality Act 2010. We commit to providing all staff with a safe working environment that provides an equal chance to develop and achieve their potential. We ask that all staff make themselves aware of the company’s policy on equality and follow protocols in place to raise any concerns.’
Summary of cultural awareness
Every culture, every nationality, and every single person sees the world in a different way. Similarly, every culture, nationality and person has different knowledge, perspectives and points of view.
When all of these different views are shared and considered together it enables better understanding and respect for each other’s differences, in life as well as the workplace.
Understanding cultural awareness is about how well the contributions, presence and perspectives of different groups of people are valued and used in practice.
All employers should be aware, and make their employees aware, of the Equality Act 2010 and understand their responsibilities in providing equal opportunities to their staff and potential staff.
Manager perspectives
‘On the back of this class, we held a training session in
practice, to talk all about our practice colleagues’
backgrounds. I feel it brought us all closer together.’
Optical assistant perspectives
‘This topic is something I did not expect to be part of on
an optical course, but I now know how important
it is to be culturally aware.’
- Tony Douglass currently works part-time at UCLan as a lecturer in ophthalmic dispensing and part-time as a tutor on Training 2000 level 3 Optical Assistant apprenticeship.
- Douglass designed, developed, and managed the level 3 Optical Assistant Apprenticeship course at Training 2000, and was involved in the development and delivery of the benchmark Btec level 4 certificate in optical dispensing, which started hundreds of students’ careers in optics with around 70% of students going onto further study as a dispensing optician. Douglass is also an experienced author and presenter of CPD lectures and discussion workshops with audiences of up to 500. He also previously worked as a part-time lecturer in ophthalmic dispensing at Anglia Ruskin University.
References
- https://assets.publishing.service.gov.uk/media/5a79eb82ed915d042206bff2/caste-discrimination-summary.pdf
- https://www.aston.ac.uk/about/mission/inclusive-aston/religious-festival-calendar
