While professional education in medicine and nursing in Australia has been implementing strategies to increase accessibility for Indigenous Australians, allied health professions remain underdeveloped in this area. Failure to improve the engagement of allied health professions with Indigenous Australians, and failure to increase the numbers of Indigenous staff and students risks perpetuating health inequities, intergenerational disadvantage, and threatens the integrity of professions who have publically committed to achieving cultural safety and health equity between Indigenous and non-Indigenous people. Knowing this, leaders in the allied health professions are asking “What needs to change?” This paper presents a critical reflection on experiences of a university-based Indigenous Health Unit leading the embedding of Indigenous perspectives in allied health curriculum, informed by Indigenous community connections, literature reviews, and research in the context of an emerging community of practice on Indigenous health education. Key themes from reflections are presented in this paper, identifying barriers as well as enablers for change, which include Indigenous community relationship building, education of staff and students, and collaborative research and teaching on Indigenous Peoples’ allied health needs and models of care. These enablers are inherently anti-racism strategies that redress negative stereotypes perpetuated about Indigenous Australians and encourage the promotion of valuable Indigenous knowledges, principles, and practices as strategies that may also help meet the health needs of the general community.
Cultural safety is a keystone reform concept intended to improve First Nations Peoples’ health and wellbeing. Are definitions of cultural safety, in themselves, culturally safe? A purposive search of diverse sources in Australian identified 42 definitions of cultural safety. Structuration theory informed the analytical framework and was applied through an Indigenist methodology. Ten themes emerged from this analysis, indicating that cultural risk is embedded in cultural safety definitions that diminish (meddlesome modifications and discombobulating discourse), demean (developmentally dubious and validation vacillations), and disempower (professional prose, redundant reflexivity, and scholarly shenanigans) the cultural identity (problematic provenance and ostracised ontology) of First Nations Australians. We offer four guidelines for future definitional construction processes, and methodology and taxonomy for building consensus based of definitions of cultural safety. Using this approach could reduce cultural risk and contribute to improved workforce ability to respond to the cultural strengths of First Nations Australians.
BACKGROUND Indigenous peoples live across all continents, representing approximately 90 nations and cultures and 476 million people. There have long been clear statements about the rights of Indigenous peoples to self-determine services, policies, and resource allocations that affect our lives, particularly via the United Nations Declaration on the Rights of Indigenous Peoples. An area for urgent improvement is curricula that train the predominantly non-Indigenous health workforce about their responsibilities and that offer practical strategies to use when engaging with Indigenous peoples and issues. OBJECTIVE The Bunya Project is designed to advance Indigenous community-led teaching and evaluation of the embeddedness of strategies to achieve an Indigenous Graduate Attribute in Australia. The project centers the relationships with Aboriginal community services to lead education design relating to Indigenous peoples. The project aims to articulate community recommendations for university education in allied health in the usable format of digital stories to create culturally informed andragogy, curriculum, and assessment measures for use in teaching. It also aims to understand the impact of this work on student attitudes and knowledge about Indigenous peoples’ allied health needs. METHODS Multilayered project governance was established, along with a 2-stage process using mixed methods participatory action research and critical reflection, using the reflective cycle by Gibbs. The first stage, <i>preparing the soil</i>, used community engagement, drew on lived experience, encouraged critical self-reflection, embodied reciprocity, and demanded working collectively. The second stage, <i>planting the seed</i>, requires more critical self-reflection, the development of community data through interviews and focus group discussions, the development of resources with an academic working group and community participants, the implementation of those resources with student feedback, the analysis of the feedback from students and community members, and reflection. RESULTS The protocol for the first stage, <i>preparing the soil</i>, is complete. The results of the first stage are the relationships built and the trust earned and gained, and it has resulted in the development of the <i>planting the seed protocol</i>. As of February 2023, we have recruited 24 participants. We will analyze data shortly and expect to publish the results in 2024. CONCLUSIONS The readiness of non-Indigenous staff to engage with Indigenous communities has not been ascertained by Universities Australia, nor can it be assured. Staff preparation and skills to support the curriculum, create a safe learning environment, and develop teaching and learning strategies to guide academics to recognize that how students learn is as important as the content students learn. This learning has broad implications and benefits for staff and students within their professional practice and for lifelong learning. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/39864
Background Indigenous peoples live across all continents, representing approximately 90 nations and cultures and 476 million people. There have long been clear statements about the rights of Indigenous peoples to self-determine services, policies, and resource allocations that affect our lives, particularly via the United Nations Declaration on the Rights of Indigenous Peoples. An area for urgent improvement is curricula that train the predominantly non-Indigenous health workforce about their responsibilities and that offer practical strategies to use when engaging with Indigenous peoples and issues. Objective The Bunya Project is designed to advance Indigenous community-led teaching and evaluation of the embeddedness of strategies to achieve an Indigenous Graduate Attribute in Australia. The project centers the relationships with Aboriginal community services to lead education design relating to Indigenous peoples. The project aims to articulate community recommendations for university education in allied health in the usable format of digital stories to create culturally informed andragogy, curriculum, and assessment measures for use in teaching. It also aims to understand the impact of this work on student attitudes and knowledge about Indigenous peoples’ allied health needs. Methods Multilayered project governance was established, along with a 2-stage process using mixed methods participatory action research and critical reflection, using the reflective cycle by Gibbs. The first stage, preparing the soil, used community engagement, drew on lived experience, encouraged critical self-reflection, embodied reciprocity, and demanded working collectively. The second stage, planting the seed, requires more critical self-reflection, the development of community data through interviews and focus group discussions, the development of resources with an academic working group and community participants, the implementation of those resources with student feedback, the analysis of the feedback from students and community members, and reflection. Results The protocol for the first stage, preparing the soil, is complete. The results of the first stage are the relationships built and the trust earned and gained, and it has resulted in the development of the planting the seed protocol. As of February 2023, we have recruited 24 participants. We will analyze data shortly and expect to publish the results in 2024. Conclusions The readiness of non-Indigenous staff to engage with Indigenous communities has not been ascertained by Universities Australia, nor can it be assured. Staff preparation and skills to support the curriculum, create a safe learning environment, and develop teaching and learning strategies to guide academics to recognize that how students learn is as important as the content students learn. This learning has broad implications and benefits for staff and students within their professional practice and for lifelong learning. International Registered Report Identifier (IRRID) DERR1-10.2196/39864
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