CULTURAL REFLECTION

Cultural reflection: Critically reflect on how one’s own culture, life experiences and world view as well as dominant cultural paradigms, influence perceptions of and interactions with Aboriginal and or Torres Strait Islander Peoples.

This module is about REFLECTION of your cultural self and healthcare, racism and white privilege. You will continue your lifelong journey towards cultural capability by examining and reflecting on how one’s own culture and dominant cultural paradigm, influences perceptions of and interaction with Aboriginal and Torres Strait Islander peoples.

Within the Cultural Reflection capability module you will cover the following:

  • Descriptor 1: Cultural Self and Healthcare;
  • Descriptor 2: Racism;
  • Descriptor 3: White Privilege
  • Descriptor 4: Self-reflexivity

Descriptor 1: Cultural Self and Healthcare

Introduction

This topic develops students’ ability to recognise and describe their own cultural and professional identity and how this influences professional practice.

Learning Outcome

Upon the completion of this topic you should be able to explore the limitations of one's own perspective and identify the implications this may have on delivering culturally safe health care service to Australia’s First Peoples.

Content

On our journey to be culturally safe, we must become self-reflexive practitioners. In order to do this we must first understand our cultural self, our cultural self in health care, how to practice reflection and more importantly, how to practise critical reflection.

Cultural Self in Healthcare

Not everyone shares the same views about health and what it means to be healthy. Yet – our individual practice is influenced by our philosophy, our worldview, our framework – about how we think about health.

'Our healthcare systems often privileges a certain way of thinking and doing at the expense of others’ ways of thinking and doing, and therefore, their health and wellbeing (Taylor & Guerin, 2014). First People may view health differently and have a worldview that is largely different to the biomedical model of health that forms the basis of Australia’s healthcare system today. Understanding of this difference is fundamental to providing culturally safe healthcare for First Peoples.

Cultural Self

A crucial part of being culturally capable, is being able to define our own culture to know how our own cultural identity influences and shapes our worldview (Smith, 2016).
Worldview: The paradigms that guide and determine the ways in which people see the world. Worldviews influence how people make sense of the world through systems of knowledge (Best & Fredericks, 2014).

What influences your worldview? Think about your beliefs, values and attitudes – where do these come from?

Descriptor 2: Racism

Introduction

This descriptor introduces students to stereotypes and different forms of racism, and how these impact Australia’s First Peoples. The topic develops students’ ability to reflect critically on how racism and stereotypes impact health outcomes.

Read the following essay White Privilege: Unpacking the Invisible Knapsack (excerpt from Working Paper 189. "White Privilege and Male Privilege: A Personal Account
of Coming To See Correspondences through Work in Women's Studies" (1988) McIntosh).

Learning Outcome

Upon the completion of this topic you should be able to identify different forms of racism and prevailing stereotypes about Australia’s First Peoples and observe how they impact equitable health services access and health outcomes.

Content

What is racism?

  • Racism is the inequitable distribution of opportunity, benefit or resources across ethnic/racial groups;
  • Racism is expressed through attitudes, beliefs, behaviours, norms and practices and may be either intentional or unintentional; and
  • Racism is about power.

Racism can be both individual and institutionalised. Institutionalised or systemic racism describes the systemic disadvantage of racial minorities through systems and institutions (Taylor & Guerin, 2014).

Racism reflects, and is perpetuated by deeply rooted historical, social, cultural and power inequities in society. Racism is oppressive because it involves the systematic use of power or authority to treat others unjustly (Australian Psychological Society definition of racism, as cited in Ranzijn et al., 2009).

Most non-indigenous Australians are completely unaware of the persistent everyday racism experienced by First Peoples. Watch this short video from Beyond Blue about the ‘everyday’ racism experienced by First Peoples.

Descriptor 3: White Privilege

Introduction

This topic introduces students to the concept of white privilege and how this impacts health outcomes and health care for First Peoples.

Learning Outcome

Upon the completion of this topic you should be able to define the concept of White Privilege and other social privileges and observe how this affects health care and health outcomes for Australia’s First Peoples.

Content

What is White Privilege?

The concept of ‘whiteness’ examines how people with fair skin are dominant in society and have privileges that are unacknowledged (Taylor & Guerin, 2014). Although Australia has a culturally diverse population, non-Indigenous ‘white’ populations are the majority. This predominantly white ‘Western’ worldview has informed healthcare services and institutions and as a social norm is the basis of power (McDonald, 2007).

Watch this short video which demonstrates the concept of white privilege:

The purpose of examining the concept of ‘whiteness’ is to make the history and practices of white superiority in institutions and social life visible (McDonald, 2007). It is a way to confront cultural norms and expectations and that encourages health professionals to practise with multiple worldviews (Martin-McDonald & McCarthy, 2008).

A pivotal essay about White Privilege, was written in 1988, by Academic and Feminist, Peggy McIntosh (McIntosh, 1988), who identified some of the daily effects of privilege in her life, as a white person living in the United States.

Read her essay:

White Privilege And Male Privilege: A Personal Account Of Coming To See Correspondences Through Work In Women’s Studies

Implicit Association Test (IAT)

Project Implicit is a non-profit organisation and international collaboration between researchers who are interested in implicit social cognition - thoughts and feelings outside of conscious awareness and control. The goal of the organisation is to educate the public about hidden biases and to provide a “virtual laboratory” for collecting data on the Internet.

The Implicit Association Test (IAT) for social attitudes has been developed as a tool for exploring the unconscious roots of thinking and feeling, and allows individuals to gain greater awareness about their own unconscious preferences and beliefs.

It is not part of the assessment but you are encouraged to complete the IAT test on race hosted on the Harvard University website using the following link:

Implicit Association Test

Descriptor 4: Self-Reflexivity

Introduction

This descriptor introduces students to the concept of ongoing self-reflexivity and its crucial role in facilitating culturally safe health service delivery.

Learning Outcome

Upon the completion of this descriptor you should be able to critically analyse one's own cultural values and privileges. Develop humility and respectful person-centered health care practices allowing you to understand one's own worldview for delivering culturally safe health care services to Australia’s First Peoples.

Content

How we make sense of our values and beliefs about health care comes from various different frameworks of health. Different models of health have informed the way in which medicine and healthcare has evolved.

Self Reflexivity

A key outcome of cultural capability is being able to engage in self-reflexivity. Self-reflexivity is being critically reflective in the moment. It is having an ongoing conversation with one’s whole self about what one is experiencing as one is experiencing it.

To be self-reflexive is to engage in feeling and thought while being in the moment, it is an advanced form of self-knowledge. It is the ability to make the quality of our relationships better at the time in that encounter, without having to wait for our next interaction.

Self Reflection

Reflection is looking back on an experience or a situation with the intention of drawing insight that may inform future practice in positive ways (Taylor & Guerin, 2014).

Self Critical Reflection

Critical reflection is an extension of simple self-reflection. Critical reflection is paying critical attention to the values, norms and conventions that inform practice and action, so as to engage in the process of continuous learning (Dudgeon et al., 2014).

In order to be culturally safe health practitioner, you must be able to be critically reflective. Critical reflection requires you to understand your cultural self, as well as how your cultural self is situated in the broader healthcare system and how this may influence your practice.

Why do you think this would be important when working with First Peoples?

Health care services that make up the healthcare system in Australia are dominated by tertiary hospitals that largely treat patients at the end stages of disease using principles of Western medicine. What may be the implications of treating patients who share different views of health than the dominant biomedical model?

NOW TAKE THE QUIZ FOR REFLECTION...

References

Taylor K, Guerin P. (2014) Health care and Indigenous Australians: cultural safety in practice

Best, O. Fredericks, BL. (2014) Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care

Moreton Robinson, A. (2009) Talkin’ up to the White Woman

Durey A. (2015) Antonio Gramsci and Pierre Bourdieu: ‘Whiteness’ and Indigenous Healthcare

Martin-McDonald K. McCarthy A. (2008) ‘Marking’ the white terrain in indigenous health research: literature review

Dudgeon P et al, (2014) Effective strategies to strengthen the mental health and wellbeing of Aboriginal and Torres Strait Islander People https://www.aihw.gov.au/getmedia/6d50a4d2-d4da-4c53-8aeb-9ec22b856dc5/ctgc-ip12-4nov2014.pdf.aspx?inline=true

McIntosh P. (1988) WHITE PRIVILEGE AND MALE PRIVILEGE: A Personal Account of Coming to See Correspondences Through Work in Women's Studies.