The KAIROS Blanket Exercise: Engaging Indigenous ways of knowing to foster critical consciousness in medical education

Reflexive Practice as an Approach to Improve Healthcare Delivery for Indigenous Peoples: A Systematic Critical Synthesis and Exploration of the Cultural Safety Education Literature

“…A total of 46 documents were analysed, describing 43 different educational interventions. The majority ( n = 35) of documents described university-based educational interventions [ 16 , 18 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 38 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 66 , 68 , 69 , 70 , 73 , 80 , 81 , 83 , 84 ], with one set of documents describing a short vocational training course [ 85 , 86 , 87 ], and the remainder ( n = 8) describing continuing professional education (CPE) courses for practicing health professionals [ 17 , 19 , 20 , 36 , 69 , 73 , 88 , 89 ]. Just over half of the documents analysed ( n = 28) were from Australia [ 17 , 18 , 20 , 22 …”

“…One of these documents referred to practicing cultural safety skills learned in a previous topic via structured simulation workshops [ 28 ], but the cultural safety skills are not outlined so it is unclear whether this includes reflexivity. An additional eight documents included in the analysis did not include reflexivity in the definition or conceptualisation of cultural safety but did include reflexivity as part of the educational intervention described [ 23 , 32 , 33 , 56 , 57 , 64 , 67 , 68 ].…”

“…Ten documents specifically referred to a process of ‘reflexivity’, either as part of the cultural safety definition [ 17 , 18 , 25 , 26 , 29 , 30 , 31 , 84 ] or as part of the educational intervention [ 23 , 38 ]. The remaining 30 documents used variations of the following terms: (self) awareness [ 20 , 54 , 57 , 58 , 59 , 63 , 64 , 69 , 80 , 91 ]; (critical and/or self) reflection [ 21 , 22 , 32 , 33 , 36 , 55 , 56 , 57 , 58 , 63 , 64 , 66 , 67 , 68 , 73 , 80 , 81 , 83 , 84 , 85 , 86 , 87 , 91 ]; (self) examination [ 16 , 61 , 65 , 71 , 72 , 75 ]. None of the documents analysed used the term reflexivity as a standalone concept; the ten documents that used the term reflexivity did so interchangeably with the other terms listed above.…”

“…Where documents described the process of reflexivity, a variety of terms was used. The most common descriptors included ‘reflect on’ [ 21 , 22 , 23 , 27 , 30 , 31 , 32 , 33 , 36 , 56 , 64 , 66 , 67 , 68 , 73 , 80 , 90 ]; ‘examine’ [ 16 , 17 , 25 , 61 , 71 , 72 ]; ‘become aware of’ [ 17 , 18 , 36 , 63 , 68 , 75 , 88 ]; ‘explore’ [ 17 , 18 , 36 , 63 , 68 , 75 , 88 ]; ‘consider’ [ 29 , 56 , 67 , 68 ]; ‘understanding’ [ 36 , 58 , 87 ]; and ‘identify’ [ 21 , 64 , 67 , 72 , 89 ]. What is notable about these descriptors is that most—including all the most commonly used—describe a passive process of identification, observation, and awareness.…”

“…While there is a growing body of literature on cultural safety education, at present, there is little guidance on the best approach to teach or assess reflexivity in the context of cultural safety. Currently, most cultural safety education literature falls into three broad categories: qualitative explorations of student learning experiences [ 18 , 22 , 30 , 54 , 55 , 56 , 57 , 58 ], evaluations of student learning outcomes [ 17 , 19 , 23 , 26 , 29 , 32 , 33 , 50 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ], and descriptions of curricula development and delivery [ 16 , 20 , 21 , 25 , 28 , 31 , 38 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ]. In evaluations of curricula and learning outcomes, student reflective journals are a common source of data.…”