A consistent definition of cultural safety within Australian health professional education: a scoping review

Abstract

This scoping review aims to explore how cultural safety is defined in the Australian literature with health professional learners in clinical interactions. It maps how the components of the Australian Health Practitioner Regulation Agency definition of cultural safety align with this evidence. Databases were systematically searched for original, peer-reviewed research that included Australian Aboriginal and Torres Strait Islander peoples, health professional learners who were eligible for registration in Australia, teaching and assessment. Many elements of cultural safety lacked Indigenous input and had no patient involvement. General consultation and communications skills were key components of culturally safe interactions. The Australian Health Practitioner Regulation Agency consensus statement on cultural safety provides a consistent definition for teaching and learning cultural safety within health professions in Australia. The findings suggest that developing an approach for cultural safety requires incorporation of Indigenous voices, patient-centred care metrics, patient feedback, learner self-assessment and attitude measures.

The Human Library and the development of cultural awareness and sensitivity in occupational therapy students: a mixed methods study

“…In the context of culturally safe care this is an important aspect of the Human Library activities. Cultural safety builds on awareness and sensitivity and requires a continual process of reflection on practice with the health professional reflecting on their own cultural identity and privilege ( 4 , 40 , 41 ). Reflective tasks are therefore built into the educational element of the Human Library as mandatory submitted pass/fail tasks, but were not part of the research analysis.…”

Seeking a voice: the inadequacy of the “four principles” and the need for care ethics in the provision of health care to vulnerable populations

“…Questions are rightly asked about whether cultural competency training and assessment are performed from the perspective of an empowered care provider interacting with an othered client. A scoping review found many elements of cultural safety programs “lacked Indigenous input and had no patient involvement” 19 and this creates numerous mechanisms for potential inadvertent harm, 20 as the scenario demonstrates. Consequently, although there are now some formal mechanisms by which the collective voices of Indigenous patients are being presented, we still lack evidence that health care systems are actually responding to these voices: only four of the 17 Closing the Gap targets are on track, 21 the AIHW reports mixed trends in health system performance, 11 and there is a paucity of data to support a conclusion that “culturally competent” medical professionals are associated with positive health outcomes for Indigenous patients 22 …”

Walking backwards into the future of health professional practice

“…Australian initiatives to address Indigenous healthcare are gaining political momentum , with regulatory mandates for cultural safety within health professional training (Brumpton et al, 2022). Indigenous worldviews raise questions about traditional power dynamics within healthcare, where clinicians have been considered as "experts" and patients as "passive recipients" (McWhinney, 1984).…”