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反思性实践作为改善原住民医疗服务的方法:对文化安全教育文献的系统批判性综合与探索。

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

机构信息

School of Psychology, University of Adelaide, Adelaide, SA 5000, Australia.

Poche SA+NT, Flinders University, Bedford Park, SA 5042, Australia.

出版信息

Int J Environ Res Public Health. 2022 May 30;19(11):6691. doi: 10.3390/ijerph19116691.

Abstract

Cultural safety is increasingly being taught in tertiary programmes of study for health professionals. Reflexivity is a key skill required to engage in culturally safe practice, however, there is currently limited literature examining how reflexivity is taught or assessed within cultural safety curricula. A systematic review of the literature up until November 2021 was conducted, examining educational interventions which aimed to produce culturally safe learners. Studies were limited to those with a focus on Indigenous health and delivered in Australia, Aotearoa New Zealand, Canada, and the United States. A total of 46 documents describing 43 different educational interventions were identified. We found that definitions and conceptualisations of reflexivity varied considerably, resulting in a lack of conceptual clarity. Reflexive catalysts were the primary pedagogical approaches used, where objects, people, or Indigenous pedagogies provided a counterpoint to learners' knowledges and experiences. Information regarding assessment methods was limited but indicates that the focus of existing programmes has been on changes in learner knowledge and attitudes rather than the ability to engage in reflexivity. The results demonstrate a need for greater conceptual clarity regarding reflexivity as it relates to cultural safety, and to develop methods of assessment that focus on process rather than outcomes.

摘要

文化安全越来越多地被教授给健康专业人员的高等教育课程。反思能力是进行文化安全实践所需的关键技能,然而,目前关于文化安全课程中如何教授或评估反思能力的文献有限。我们对截至 2021 年 11 月的文献进行了系统回顾,研究了旨在培养文化安全学习者的教育干预措施。研究仅限于以原住民健康为重点并在澳大利亚、新西兰、加拿大和美国开展的研究。共确定了 46 份描述 43 种不同教育干预措施的文件。我们发现,反思的定义和概念化差异很大,导致概念不清晰。反思催化剂是主要的教学方法,其中对象、人员或原住民教学法为学习者的知识和经验提供了对比。关于评估方法的信息有限,但表明现有课程的重点是学习者知识和态度的变化,而不是进行反思的能力。结果表明,需要在与文化安全相关的反思方面提高概念清晰度,并开发注重过程而非结果的评估方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c09/9180854/9db3dde97400/ijerph-19-06691-g001.jpg

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