Cultural safety training for allied health students in Australia
DOI:
https://doi.org/10.1017/jie.2020.2Keywords:
Cultural safety, health, Indigenous Australians, students, workshopAbstract
AbstractCulturally safe health practitioners are essential for effective service provision to culturally diverse populations, including Indigenous Australians. Therefore, cultural safety education during training as a health care professional is an essential component in helping improve the health of Indigenous Australians. This study examined whether the implementation of an Indigenous cultural safety education workshop increased self-rated cultural safety knowledge and attitudes of allied health students. The study employed a quantitative before-and-after design using pre- and post-surveys to determine the level of attitudinal change in students who attended a day long workshop. The study sample consisted of 1st year (n = 347) and 4th year (n = 149) allied health students at a regional Australian university over the years 2007–2011. Whilst the results of this current study are varied in terms of achieving positive change across all of the taught items of knowledge and attitude, they provide some evidence around the value of this type of curriculum intervention in helping develop culturally safe practitioners. An important finding was around the student's becoming self-aware about their own values and cultural identity, combined with acknowledging the importance of this cultural identity to interactions with clients. This form of ‘cultural humility’ appears to be an important step to becoming a culturally safe practitioner. These types of interventions would be enhanced through embedding and scaffolding throughout the curricula.
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References
Aboriginal and Torres Strait Islander Health Workforce Working Group (ATSIHWWG) (2016) National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework (2016–2023). Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/work-pubs-natsihwsf (Accessed 19 June 2019).
Australia Co (2009) Social inclusion. Closing the gap for Indigenous Australians. Available at http://www.socialinclusion.gov.au/Initiatives/Pages/closingthegap.aspx (Accessed 20 June 2018).
Australian Health Practitioner Regulation Agency (AHPRA) (2019) What we do. Available at https://www.ahpra.gov.au/About-AHPRA/What-We-Do.aspx (Accessed 2 September 2019).
Australian Human Rights Commission (2019) Let's talk about race: a guide on how to conduct a conversation about racism. Available at https://www.humanrights.gov.au/our-work/publications (Accessed 2 September 2019).
Beach MC, Price EG, Gary TL, Robinson KA, Gozu A, Palacio A, Smarth CR, Jenckes MA, Feuerstein CA, Bass EA, Powe AN and Cooper LA (2005) Cultural competency: a systematic review of health care provider educational interventions. Medical Care 43, 356.10.1097/01.mlr.0000156861.58905.96
Beagan BL (2015) Approaches to culture and diversity: a critical synthesis of occupational therapy literature: Des approches en matière de culture et de diversité : une synthèse critique de la littérature en ergothérapie. Canadian Journal of Occupational Therapy 82, 272–282.
Bennett JM and Salonen R (2007) Intercultural communication and the new American campus. Change: The Magazine of Higher Learning 39, 46–50.
Betancourt JR, Green AR, Carrillo JE and Ananeh-Firepong O (2003) Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care 118, 293–302.
Bittle M, Duggleby W and Ellison P (2002) Implementation of the essential elements of service learning in three nursing courses. Journal of Nursing Education 41, 129–132.
Bonferroni CE (1936) Teoria statistica delle classi e calcolo delle probabilita. Seeber: Libreria Internazionale.
Brown AE, Middleton PF, Fereday JA and Pincombe JI (2016) Cultural safety and midwifery care for Aboriginal women – a phenomenological study. Women and Birth 29, 196–202.
Bullen J and Roberts L (2018) Transformative learning: a precursor to preparing health science students to work in Indigenous health settings? The Australian Journal of Indigenous Education 48, 1–12.
Carey M (2015) The limits of cultural competence: an Indigenous studies perspective. Higher Education Research and Development 34, 828–840.
Carter MM, Lewis EL, Sbrocco T, Tanenbaum R, Oswald JC, Sykora W, Williams P and Hill LD (2006) Cultural competency training for third-year clerkship students: effects of an interactive workshop on student attitudes. Journal of the National Medical Association 98, 1772.
Casey D and Murphy K (2008) Irish Nursing students’ experiences of service learning. Nursing & Health Sciences 10, 306–311.
Caffrey R Neander W Markle D Stewart B (2005) Improving the Cultural Competence of Nursing Students: Results of Integrating Cultural Content in the Curriculum and an International Immersion Experience. Journal of Nursing Education 44, 234–240.
Chapman R, Martin C and Smith T (2014) Evaluation of staff cultural awareness before and after attending cultural awareness training in an Australian emergency department. International Emergency Nursing 22, 179–184.10.1016/j.ienj.2013.11.001
Cheung Y, Shah S and Muncer S (2002) An exploratory investigation of undergraduate students’ perceptions of cultural awareness. The British Journal of Occupational Therapy 65, 543–550.
Dade Smith J (2007) Australia's Rural and Remote Health: A Social Justice Perspective. Croydon, Victoria: Tertiary Press.
Dean R (2001) The myth of cross-cultural competence. Families in Society 82, 623–630.
Department of the Prime Minister and Cabinet (DPMC) (2019) Closing the Gap Report 2019. Available at https://ctgreport.pmc.gov.au/sites/default/files/ctg-report-2019.pdf?a=1 (Accessed 18 August 2019).
Dillard M, Andonian L, Flores O, Lai L, MacRae A and Shakir M (1992) Culturally competent occupational therapy in a diversely populated mental health setting. American Journal of Occupational Therapy 46, 721–726.
Dogra N (2001) The development and evaluation of a programme to teach cultural diversity to medical undergraduate students. Medical Education 35, 232–241.
Durey A (2010) Reducing racism in Aboriginal health care in Australia: where does cultural education fit? Australian and New Zealand Journal of Public Health 34, S87–S92.
Fitzgerald MH, Mullavey-O'Byrne C and Clemson L (1997) Cultural Issues from Practice. Australian Occupational Therapy Journal 44, 1–21.10.1111/j.1440-1630.1997.tb00749.x
Foronda C, Baptiste D, Reinholdt MM and Ousman K (2016) Cultural humility: a concept analysis. Journal of Transcultural Nursing 27, 210–217. doi: 10.1177/1043659615592677
Forwell SJ, Whiteford G and Dyck I (2001) Cultural competence in New Zealand and Canada: occupational therapy students’ reflections on class and fieldwork curriculum. Canadian Journal of Occupational Therapy 68, 90–103.
Gair SM, Savage DD and Zuchowski I (2014) Racism unmasked: the experiences of Aboriginal and Torres Strait Islander students in social work field placements. Australian Social Work 68, 1–17.
Gallagher R and Polanin J (2015) A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students. Nurse Education Today 35, 333–340.
Gerlach AJ (2012) A critical reflection on the concept of cultural safety. Canadian Journal of Occupational Therapy 79, 151–158. doi: 10.2182/cjot.2012.79.3.4
Gerrish K and Papadopoulos I (1999) Transcultural competence: the challenge for nurse education. British Journal of Nursing 8, 1453–1457.
Gibbs A (1984) Cultural awareness training for New Zealand counsellors. International Journal for the Advancement of Counselling 7, 131–141.10.1007/BF00135815
Gray M and McPherson K (2005) Cultural safety and professional practice in occupational therapy: a New Zealand perspective. Australian Occupational Therapy Journal 52, 34–42.
Gruen RL, Bailie RS, d'Abbs PH, O'Rourke IC, O'Brien MM and Verma N (2001) Improving access to specialist care for remote Aboriginal communities: evaluation of a specialist outreach service. The Medical Journal of Australia 174, 507–511.
Hammell KW (2009) Sacred texts: a sceptical exploration of the assumptions underpinning theories of occupation. Canadian Journal of Occupational Therapy 76, 6–13. doi: 10.1177/000841740907600105
Hamner JB, Wilder B and Byrd L (2007) Lessons learned: integrating a service learning community-based partnership into the curriculum. Nursing Outlook 55, 106–110.
Hughes KH and Hood LJ (2007) Teaching methods and an outcome tool for measuring cultural sensitivity in undergraduate nursing students. Journal of Transcultural Nursing 18, 57–62.
Hunt RJ and Swiggum P (2007) Being in another world: transcultural student experiences using service learning with families who are homeless. Journal of Transcultural Nursing 18, 167–174.
Hutnik N and Gregory J (2008) Cultural sensitivity training: description and evaluation of a workshop. Nurse Education Today 28, 171–178.
Isaacson M (2014) Clarifying concepts: cultural humility or competency. Journal of Professional Nursing 30, 251–258.
Jungersen K (1992) Culture, Theory, and the Practice of Occupational Therapy in New Zealand/Aotearoa. American Journal of Occupational Therapy 46, 745–750.
Johnstone MJ and Kanitsaki O (2007) An exploration of the notion and nature of the construct of cultural safety and its applicability to the Australian health care context. Journal of Transcultural Nursing 18, 247–256.10.1177/1043659607301304
Kreuter MW, Lukwago SN, Bucholtz DC, Clark EM and Sanders-Thompson V (2003) Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches. Health Education & Behaviour 30, 133–146.10.1177/1090198102251021
Kruske S, Kildea S and Barclay L (2006) Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians. Women and Birth 19, 73–77.
Kutob RM, Bormanis JM, Crago MM, Harris JM, Senf JM and Shisslak CM (2013) Cultural competence education for practicing physicians: lessons in cultural humility, nonjudgmental behaviours, and health beliefs elicitation. Journal of Continuing Education in the Health Professions 33, 164–173.
Larson K and Bradshaw C (2017) Cultural competence and social desirability among practitioners: a systematic review of the literature. Children and Youth Services Review 76, 100–111.
Liaw ST, Hasan I, Wade V, Canalese R, Kelaher M, Lau P and Harris M (2015) Improving cultural respect to improve Aboriginal health in general practice: a multi-methods and multi-perspective pragmatic study. Australian Family Physician 44, 387–392.
Lipson JG and Desantis LA (2007) Current approaches to integrating elements of cultural competence in nursing education. Journal of Transcultural Nursing 18(suppl. 1), 10S–20S.10.1177/1043659606295498
Mackean T, Fisher M, Friel S and Baum F (2019) A framework to assess cultural safety in Australian public policy. Health Promotion International 22, 1–12.
Meydanlioglu A, Arikan F and Gozum S (2015) Cultural sensitivity levels of university students receiving education in health disciplines. Advances in Health Sciences Education 20, 1195–1204.
Minkler M and Wallerstein N (2012) Improving health through community organization and community building: perspectives from health education and social work. In Community Organizing and Community Building for Health and Welfare, 3rd Edn. New Brunswick, NJ: Rutgers University Press, pp. 37–58.
Nash R, Meiklejohn B and Sacre S (2006) The Yapunyah project: embedding Aboriginal and Torres Strait Islander perspectives in the nursing curriculum. Contemporary Nurse 22, 296–316.
National Aboriginal Health Strategy Working Party (1989) A National Aboriginal Health Strategy. Canberra: National Aboriginal Health Strategy Working Party.
National Aboriginal and Torres Strait Islander Health Council (2003) National Strategic Framework for Aboriginal and Torres Strait Islander Health. Canberra: NATSIHC. Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/12B50420F5E0006DCA257BF000199D6C/$File/nsfatsihcont.pdf (Accessed 29 August 2019).
Neander W and Markle D (2005) Improving the cultural competence of nursing students: results of integrating cultural content in the curriculum and an international immersion experience. Journal of Nursing Education 44, 234.
Nelson A, Gray M, Jensen H, Thomas Y, McIntosh K, Oke L and Paluch T (2011) Closing the gap: supporting occupational therapists to partner effectively with First Australians. Australian Occupational Therapy Journal 58, 17–24.
Papadopoulos I (2006) The Papadopoulos, Tilki and Taylor Model of Developing Cultural Competence in Transcultural Health and Social Care: Development of Culturally Competent Practitioners. Edinburgh: Churchill Livingstone/Elsevier, pp. 7–24.
Phillips G (2004) CDAMS Indigenous Health Curriculum Framework. Melbourne: VicHealth Koori Health Research and Community Development Unit.
Pope-Davis DB, Prieto LR, Whitaker CM and Pope-Davis SA (1993) Exploring multicultural competencies of occupational therapists: implications for education and training. American Journal of Occupational Therapy 47, 838–844.
Ramsden IM (1992) Kawa Whakaruruhau: Guidelines for Nursing and Midwifery Education. Wellington: Nursing Council of New Zealand.
Rasmussen TM, Lloyd C and Wielandt T (2005) Cultural awareness among Queensland undergraduate occupational therapy students. Australian Occupational Therapy Journal 52, 302–310.
Rigby W, Duffy E, Manners J, Latham H, Lyons L, Crawford L and Eldridge R (2011) Closing the gap: cultural safety in Indigenous health education. Contemporary Nurse 37, 21–30.
Sanner S and McAllister LE (2010) A longitudinal study of cultural competence among health science faculty. Journal of Cultural Diversity 17, 68.
Shepherd SM (2019) Cultural awareness workshops: limitations and practical consequences. BMC Medical Education 19, 1–10.
Stedman A and Thomas Y (2001) Reflecting on our effectiveness: occupational therapy interventions with Indigenous clients. Australian Occupational Therapy Journal 58, 43–49.
Steed R (2010) Attitudes and beliefs of occupational therapists participating in a cultural competency workshop. Occupational Therapy International 17, 142–151.10.1002/oti.299
Taylor K and Guerin P (2010) Health Care and Indigenous Australians: Cultural Safety in Practice, 1st Edn. South Yarra, Victoria: Palgrave Macmillan.
Trentham B, Cockburn L, Cameron D and Iwama M (2007) Diversity and inclusion within an occupational therapy curriculum. Australian Occupational Therapy 54, S49–S57.
Turale S and Miller M (2006) Improving the health of Indigenous Australians: reforms in nursing education. An opinion piece of international interest. International Nursing Review 53, 171–177.
University of Huston (2019) Privilege walk activity. Available at https://www.uh.edu/cdi/diversity_education/resources/activities/pdf/privilege-walk.pdf (Accessed 29 August 2019).
Valencia AA (1992) Multicultural education: contemporary perspectives and orientations for teachers and counsellors. Journal of Multicultural Counselling and Development 20, 132–142.
Williamson M and Harrison L (2010) Providing culturally appropriate care: a literature review. International Journal of Nursing Studies 47, 761–769.
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