Exploring Veteran cultural competency in Canadian health care services

Introduction: Thousands of Canadian Armed Forces (CAF) Veterans leave service and transition to civilian life each year. This involves leaving the military health care system and transitioning to civilian provincial or territorial health care systems. Emerging research has shown that increased awareness of military culture - the culture from which Veterans are coming - among health care providers positively impacts the quality of health care delivery. The objective of this study was to identify Veteran cultural competencies to enhance and support the transition to civilian health care services. Methods: In this qualitative study, critical incident technique (CIT) was used to conduct individual interviews. Purposive sampling was used to recruit Regular Force Veterans and health care professionals who worked with Veterans. Data analysis was conducted using framework analysis. Results: Eight interviews were completed, including five Veterans, two physicians, and one occupational therapist. Identified competencies resulted in a framework representing four cultural competency domains: awareness (5 competencies), sensitivity (5 competencies), knowledge (8 competencies), and skills (10 competencies). Discussion: The study identified military cultural competencies specific to the health care experiences for Canada's Veterans and validated existing cultural competency domains. Themes identified can be used to inform the development of clinical reference guides, including advice for health care providers to build knowledge when working with Veterans. In addition, resources can be created to support Veterans as they prepare to leave military service and begin accessing the civilian health care system.