Transcultural Knowledge Sharing (TKS)

1. Transcultural Knowledge Sharing(TKS) Bringing Together Circles of Knowledge The MJOS Knowledge Brokering Approach

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3. MJOS Approachto Knowledge Sharing Learn By Who is Beside You

4. Learn by Who is Beside You… First Nation ways of learning… Learn by watching, by listening, by working together, by sharing, by example.. “Learn by Who is Beside You”. Learning takes place within an active relationship, and can be an ongoing process as relationships build toward the future, rather than just one learning opportunity. Learn by sharing stories about how we live our values personally and professionally and how we see the world, care for others and share in the human experience.

5. Learn by Who is Beside You… Beside You… Speaks about the coming together of two or more people that are focused on a common purpose or task at hand. The work requires active engagement from all, and the diversity of life experience that each person brings. Based on equality in supportive relationships where others are there with you, not in front of or behind you, but beside you, sharing in the learning experience.

6. Learn by Who is Beside You “…an acceptance of our way of life…for the doctors to have more acceptance of how we see things…the way we eat, certain foods, herbs, wild berries, moose meat.. we want to hear the doctors ask about our medicine …for ourselves and for our family..” • NPTC Elder

7. Learn by Who is Beside You “Western medicine does not deal with the whole person. When they see a patient, they see the wound, the kidney failure.” - First Nation Elder “Whereas, we as First Nations people, see the whole person, we deal with the physical, the emotional, the mental and the spiritual well-being of the person.” - First Nation Elder

8. Learn by Who is Beside You “One of the biggest challenges for realizing the goal of harmonizing traditional knowledge and western knowledge within the MJOS activities is to acknowledge and work with the wide differences in the values and worldview of the First Nations’ people, especially between traditional Elders and mainstream western culture, including the health care system.” • Lorraine Boucher, NPTC Health Director

9. Learn by Who is Beside You “…The biggest challenge between mainstream health care and First Nations ways of healing is respect for the place of the sacred.. God.. the spirit world.” “Because the health system is based on western empiricism.. what is “real” is what can be measured and experienced through the 5 senses…..that is very different in the First Nations world.” “In the world of empiricism there is no space for mystery and the sacred. The whole endeavour is to dispel mystery…, whereas in the First Nations world, mystery is something you embrace, and you worship, you ask for help from. That is where I see the biggest clash….” • Discovery Session Participant

10. Project Partners • North Peace Tribal Council • Northern Lights Health Region • Capital Health Region • First Nations Inuit Health Branch – Health Canada

11. Project Status • Project Approval and Funds Flowing – Nov. 2004 – Dec. 2004 and Mar. 2005 • Project Start-up – Jan. 2005 • Preparation, community discussions and Elder engagement, networking, partnership meetings and CHSRF events and site visit – Jan. to Jul. 2005 • Review of evaluation findings of the MJOS Health Integration Initiative (HII) to inform project philosophy, approach and planning – Jun. – Jul. 2005 • Discovery Session participant identification and planning – Jun. – Jul. 2005

12. Project Status (continued) • Discovery Session – Aug. 2005 • Evaluation instrument review – Aug. 2005 • Discovery Session transcript preparation and review – Sept.- October 2005 • Project staff and partners clarification of roles and responsibilities – Aug. – Sept. 2005 • Articulation of Emerging Working Principles and Challenges as guideposts for future action • Planning second workshop for Nov. 2005 and planning for Year 2 and 3

13. Identified Challenges • Creating the relational context – individuals engaged in developing new relationships need to feel safe and respected. • Surfacing Assumptions based on History – individuals may interpret an opportunity for sharing knowledge as unsafe based on personal or family historical experience. • Communication - transcultural communication requires awareness, knowledge, commitment and skills in cultural competence to move from “knowing to doing” effectively.

14. Identified Challenges (continued) • Using Pictures and Stories – we need ways to share what we see in our minds and hearts and use our stories to create context for learning. • Language and Lexicon – English is a second language for some of the participants and we use language as we have learned it. In order to develop relationships for the purposes of sharing knowledge, we need shared language and terminology. • Common Purpose - Developing a common understanding of the purpose of sharing knowledge.

15. Emerging Working Principles • First Nation Values, Principles & the Wisdom of the Elders are the foundation and starting point of the process. Relationships come first. Sacred space for sharing and honoring the spiritual aspects of the people and the process is essential for respectful sharing. • MJOS has a series of project streams, the results of which inform each other, influence each other and work together to create positive change in delivery of health care services to First Nation people.

16. Emerging Working Principles (continued) • Honor and respect for each participant from the four quadrants and what it takes to respond to the diversity within the quadrant and span the “realities” across groups, i.e. (Indigenous / First Nation Knowledge Keepers; Health Care Researchers and Academics; Interdisciplinary Practice Health Care Providers; Policy Makers/Managers).

17. Emerging Working Principles (continued) • Emergent Process is our method and designing of the “next step” must be based on the experience so far and a vision of the purpose of the project and the future of the relationships. • Comfort with “Breaking Trail” in recognizing that we are taking on new challenges and working our way through by investing in relationships, using our best ideas and focusing our good intentions.

18. Emerging Working Principles (continued) • Give and Take in teaching and learning is a complex process that involves back and forth within relationships. The reciprocity is based on mutual respect and “seeking to understand before being understood”.

19. Emerging Working Principles (continued) • Multiple definitions and understandings of knowledge, ways of knowing and “evidence” need to be bridged in order to find appropriate and shared “solid ground” for decisions that improve the quality of health for First Nation people. • Knowledge must be understood within the context from which it arises and appropriately translated if it is to be applied in a different context.

20. Emerging Working Principles (continued) • Welcoming each other to experience and understand “our world” begins with the First Nation world and moves around the circle through a series of “invitations”.

21. The Many Jurisdictions, One System (MJOS) Knowledge Brokering Demonstration Site is funded by the Canadian Health Services Research Foundation and Alberta Heritage Foundation for Medical Research