Richards Kieva, Reed Kirk, Parrish Ange
School of Allied Health, Human Services & Sport, La Trobe University, Bundoora, Australia.
School of Health and Social Development, Deakin University-Waterfront Campus, Geelong, Australia.
Aust Occup Ther J. 2025 Jun;72(3):e70019. doi: 10.1111/1440-1630.70019.
In Australia, poor health outcomes for Aboriginal and Torres Strait Islander peoples have been well-documented. This often results from colonising practices embedded in systemic, environmental, economic, and social factors leading to marginalisation. To address these injustices, directives to enshrine cultural safety in health-care education/training have been proposed to ensure the development of a culturally safe workforce. Several frameworks have been developed to support tertiary education providers to decolonise curricula. However, with little published about occupational therapy curricula, how and whether occupational therapy students and/or graduates are culturally safe is not known. The purpose of this study is to capture the experiences of students that attended an inaugural On-Country experience embedded within a first-year, undergraduate occupational therapy unit (subject).
This qualitative study used a reflexive thematic analysis method to recruit undergraduate students enrolled in a first-year occupational therapy unit, which incorporated an immersive On-Country learning experience. Data were collected from students via online blog posts, which prompted participants to describe their observations and reflections pre and post the On-Country experience. Data were analysed using Braun and Clarke's six stage thematic analysis process to generate themes.
This study was conducted and authored with input from two diverse Aboriginal and Torres Strait Islander people-the facilitator and a colleague of mixed heritage. The tailored On-Country experience was facilitated by the Wadawurrung Traditional Owners Corporation.
Analysis of the responses revealed three overarching themes: (1) Creation of a learning experience; (2) an awareness of embarking on a journey to being culturally safe practitioners and recognition of an emerging occupational therapy lens; and (3) engagement and connection to clinical practice.
Students expressed enhanced awareness and reflexivity in that they examined themselves, their history and recognised the influential value this had on health and wellbeing. This awareness can be used as a tool/opportunity to inform curriculum design and promote development of professional identity.
Aboriginal and Torres Strait Islander peoples often have worse health because the health-care system has treated them unfairly. To change this, we need a fair system and health workers who give safe and respectful care. Culturally safe care means health workers must think about what they know and how they act. Universities try to teach this, but there are problems. Some teachers and students feel unsure. There are not enough resources. Health courses mostly follow Western ideas. Strong leaders are needed to help change this. One way to improve learning is by, including Aboriginal and Torres Strait Islander knowledges. This study looked at what first-year occupational therapy students learned from an On-Country experience. Students shared their thoughts online. They said the experience helped them think in new ways and understand the struggles of Aboriginal and Torres Strait Islander peoples. They are not yet working as health professionals, but they know their role in making health-care fair and safe. Many said, they now see the world differently. But more learning and changes in universities are needed.
在澳大利亚,原住民和托雷斯海峡岛民健康状况不佳的情况有充分记录。这通常源于系统性、环境、经济和社会因素中根深蒂固的殖民做法,导致他们被边缘化。为解决这些不公正现象,有人提议在医疗保健教育/培训中确立文化安全的指导方针,以确保培养一支具有文化安全意识的劳动力队伍。已经制定了几个框架来支持高等教育机构对课程进行去殖民化改革。然而,关于职业治疗课程的公开资料很少,职业治疗专业的学生和/或毕业生是否具有文化安全意识以及如何具备这种意识尚不清楚。本研究的目的是了解参加本科一年级职业治疗单元(课程)中首次开展的实地体验活动的学生的经历。
本定性研究采用反思性主题分析法,招募了参加本科一年级职业治疗单元课程的学生,该课程包含沉浸式实地学习体验。通过在线博客文章收集学生的数据,促使参与者描述他们在实地体验前后的观察和反思。使用布劳恩和克拉克的六个阶段主题分析过程对数据进行分析以生成主题。
本研究在两名不同的原住民和托雷斯海峡岛民——活动主持人和一位具有混合血统的同事的参与下进行并撰写。量身定制的实地体验活动由瓦达武伦传统所有者公司提供协助。
对回复的分析揭示了三个总体主题:(1)创造学习体验;(2)意识到踏上成为具有文化安全意识的从业者的旅程,并认识到新兴的职业治疗视角;(3)参与并与临床实践建立联系。
学生们表达了更强的意识和反思能力,因为他们审视了自己、自己的历史,并认识到这对健康和幸福具有的重要价值。这种意识可以用作一种工具/机会,为课程设计提供信息并促进职业身份的发展。
原住民和托雷斯海峡岛民的健康状况往往较差,因为医疗保健系统对他们不公平。为改变这种情况,我们需要一个公平的系统和提供安全且尊重的护理的医护人员。具有文化安全意识的护理意味着医护人员必须思考自己的所知和所为。大学试图教授这一点,但存在问题。一些教师和学生感到不确定。资源不足。健康课程大多遵循西方观念。需要强有力的领导者来帮助改变这种状况。改进学习的一种方法是纳入原住民和托雷斯海峡岛民的知识。本研究考察了本科一年级职业治疗专业学生从实地体验中学到了什么。学生们在网上分享了他们的想法。他们表示,这次经历帮助他们以新的方式思考,并理解了原住民和托雷斯海峡岛民的艰难处境。他们尚未成为医疗专业人员,但他们知道自己在使医疗保健公平和安全方面的作用。许多人说,他们现在看待世界的方式不同了。但大学还需要更多的学习和变革。