Activity 1.1 Read: Coffin, J. (2007). Rising to the challenge in Aboriginal health by creating cultural security. Aboriginal and Islander Health Worker Journal, 31(3), 22-24. After reading the Coffin article, complete the following activities. The continuum below asks you to rate yourself (from 1-6) on the Cultural Security Scale with regards to your knowledge of what is meant by ‘cultural security’? You may have no idea where to place yourself on this scale, that is fine but if you feel that you have a level of understanding, simply record the appropriate number and word. For example, 4 - Protocol. This continuum will be reviewed in class at the beginning of next week’s workshop. See below for meaning of each scale p.4 Mark on the scale, or record below the scale, where you think you are in terms of your cultural sensitivity. Cultural Security Scale (Coffin, 2007) I believe I am at the Awareness point on the Cultural Security Scale. At the end of the unit, in Week 12, we will revisit this scale and you will once again determine where you fit along the scale. This scale might go up or might go down as you begin to learn the concepts and culture of Aboriginal and Torres Strait Islander peoples, while reflecting on your own knowledge and understandings. That old chestnut of ‘the more you know, the more you realise we don’t know’. Think back to the Coffin article and answer the following questions: What are the three key concepts being discussed? In Coffin’s article, the concept of culture security is explained to be highly important as Indigenous culture is seldom catered to in a healthcare setting. The key concept of Cultural security is about the creation of processes that adhere to the culture of indigenous individuals, and that can be immediately applied in any given situation. This idea, however, can only be reached when certain criteria is met, which includes cultural awareness and cultural safety. Cultural awareness is considered the first stage towards achieving cultural security and is defined as a basic understanding of a cultural issue. Cultural safety is a small action or gesture that supports an indigenous person, however, is not standardised procedure. For cultural security to be attained cultural awareness and cultural safety must be achieved first. Can you name some of the ill-effects felt by Aboriginal and Torres Strait Islander peoples in a healthcare environment? An indigenous pregnant woman may feel that healthcare workers are not supporting them as in indigenous culture, it is older ladies who speak on behalf of them. If a healthcare worker did not know this, they may create an uneasy environment for the pregnant indigenous woman. In order to achieve cultural security, what foundations need to be attained? A foundation of a definite and standardised language that can demystify confusion and allow people to plot themselves or their health service along a continuum and move forward to achieve the same level of cultural security is needed Review the Cultural Security Scale below and identify the steps that lead to cultural security. Cultural Awareness Involves understanding Aboriginal and Torres Strait Islander peoples by learning about cultural beliefs, values, practices and experiences. It’s about obtaining cultural knowledge. Brokerage Understanding successful and safe practice. It involves two way communication where both health practitioner and Aboriginal clients are equally informed and equally important in the discussion. Communication and respect are of the utmost importance, values and ideas are not pushed but considerations from both sides are equally regarded. It involves selfawareness. It’s about listening and ‘yarning’. Cultural Safety Focuses on the subjective experience of the Aboriginal person who uses the health services, whereby experiencing an environment that does not challenge, assault or deny the individual’s cultural identity. It’s about the Aboriginal and Torres Strait Islander person feeling safe. Protocols Strategy that can take a culturally safe practice to a culturally secure one. Protocols formalise the fact that in an Aboriginal context, health care delivery and programs need to be done in consultation with the Elders and key stakeholders within the particular community (or context). Cultural Security All health care providers, doctors, speech pathologists, social workers, school nurses, dentists, etc. need to provide this no matter the role played in the provision of health care. It’s about intercultural teams working together to provide culturally secure services. Sustainability Maintenance of culturally secure environments. There is a need to evaluate a systems-level intervention that combines bestevidence strategies to reduce disparities in healthcare delivery to Aboriginal and Torres Strait Islander Australians. It’s about the consistent delivery of high quality care for Aboriginal and Torres Strait Islander people. It’s about developing culturally tailored interventions to improve the quality of care. Adapted from Coffin (2007) The relationships between health professionals and Aboriginal and Torres Strait Islander peoples have been identified as one of the many factors that can have a positive or negative influence on Aboriginal health and wellbeing and therefore the ‘Gap’ that exits between Aboriginal and Torres Strait Islander peoples and non-Indigenous populations. An understanding of the role that individual professional’s and interprofessional collaboration plays in the creation and maintenance of culturally secure environments for Indigenous peoples offers students a starting point from which to develop the skills required to progress along the cultural continuum (Bainbridge et al., 2015; Hole et al., 2015; Coffin, 2007).
