Contemporary Nurse最新文献

BackgroundCultural safety has been a constituent in nursing education for more than two decades. As evidence of racism and interpersonal violence in the health care system is mounting there is speculation on the meaning of cultural safety for nurses working in the field and with Indigenous peoples regarding the clarity of its intent. Objectives: Discussion Paper to revisit the foundation of Ramsden's work and articulate the rationale for specific antiracist language. Conclusions: Antiracist practice is a necessity for cultural safety to be successful. Impact Statement: Nurse educators must clarify the intention of cultural safety to explicitly include antiracist language, skills-based training, and pedagogy building on critical race theory.

Background: This article provides the findings of a research project which explored the experiences of participants in a mentoring programme designed to support Aboriginal and Torres Strait Islander nurses and midwives in a rural health district.Aims: It seeks to understand how a mentoring programme achieved its aims and anticipated outcomes that would ultimately inform future Aboriginal and Torres Strait Islander workforce support programmes.Design: The research project used a hermeneutic phenomenological philosophical framework to conduct Aboriginal and Torres Strait Islander people's methods of yarning, which engaged in conversation around key topics with participants, followed by the research team's analysis of yarns.Methods: A qualitative study utilising purposive sampling to select participants. Participants were drawn from those who had undertaken the cultural mentoring programme and could have been either mentors or mentees. Interviews were conducted once the 12-month mentoring programme had ceased.Results: The five main themes that were drawn from the data were cultural safety, motivations, relationships, learning and support.Conclusion: Participant experiences indicate that mentoring can be an avenue for providing appropriate clinical and cultural support and a safe space for Aboriginal and Torres Strait Islander nurses and midwives. They also show that identified support roles and Aboriginal-led projects can have larger impacts; fostering organisational connections and broader feelings of cultural respect amongst Aboriginal and Torres Strait Islander staff beyond programme participation.

Background: Cultural Safety is a mandatory training requirement for the 16 regulated health practitioners in Australia. Tools measuring outcomes need to be appropriate for different education and training contexts.Aim: To test refinements to the 25 item Cultural Capability Measurement Tool (CCMT).Methods: Framed by decolonising and relational ways of knowing, being, and doing in the tool development process. New items of the CCMT were generated through engagement with key knowledge holders. New items were piloted with expert reviewers and modified accordingly to produce a 41-item scale. Two online surveys conducted with 875 students and then 276 health professionals were collected for analysis. Exploratory factor analysis and a parallel analysis were conducted.Results: The newly named Ganngaleh nga Yagaleh (GY) tool contained 28 items loaded on 3 factors accounting for 47.95% of variance. Factor 1 (Commitment to Culturally Safe Practice; α = .89) comprised 12 items, Factor 2 (Understanding of History and Power; α = .86) contained 9 items, and Factor 3 (Attitudes, Values, and Beliefs; α = .52) contained 7. Total scale reliability was good (α = .87).Impact statement and conclusion: The GY Scale can be used in education and practice settings. Challenges remain about how educational providers and health services approach cultural safety as a life-long learning journey, and how education and clinical practice embed cultural safety standards. Future directions for use of the GY tool include expanding it for use in other contexts and more explicit separation of what is emerging as a separate scale the 'Keeping Culture Strong' scale which evaluates the unique learning experiences of First Peoples.

Background: To improve health equity, especially for American Indian/Alaska Native peoples, cultural safety must be included in the nursing education curricula. Cultural safety requires self-reflection with an examination of one's own culture and an ongoing analysis of biases and power imbalances.

Methods: Using a case study approach, a description and discussion of an ongoing Baccalaureate nursing clinical immersion experience on an American Indian Reservation is presented. With travel to the Pine Ridge Reservation, nursing students offer health promotion at community events and partner sites, with a focus on prevention of heart disease, diabetes, and unintentional injury. Transformative Learning Theory provides the foundation for the nursing clinical immersion experience at the Pine Ridge Reservation. Nursing students reflect throughout and after the Pine Ridge clinical experience via blogging.

Results: Cultural safety themes identified in nursing student reflections include critical consciousness; providing a safe place; seeking to understand historical trauma; and acknowledging power imbalances. Satisfaction surveys are completed by Lakota screening participants, and results provide further evidence of emerging cultural safety.

Impact statement: A clinical immersion experience at an American Indian Reservation can foster cultural safety while also encouraging transformative learning.

Conclusions: Nursing educators should consider clinical experiences focused on American Indian/Alaska populations. With a service component, the clinical immersion at the Pine Ridge Reservation requires that participants reflect on their experiences. A transformative change in perspective, required for cultural safety, is often the end result for nursing student participants.

Background: Australian Nursing and Midwifery Accreditation Council prescribes midwifery accreditation standards that support students' development in Aboriginal and Torres Strait Islander Health and cultural safety to be deemed practice ready. However, the impact of training programmes are not widely explored.Aim: This study aimed to assess the impact of a mandatory 8-week online subject focussed on the development of culturally safe practices among midwifery students.Methods: The Ganngaleh nga Yagaleh cultural safety assessment tool was used to collect online quantitative data from post graduate midwifery students at the commencement and completion of an online subject.Results: Through a purposive sample (n = 10) participant perceptions of culturally safe practices remained relatively unchanged, except for three items of the Ganngaleh nga Yagaleh cultural safety assessment tool.Discussion: Findings demonstrate that when post graduate midwifery students are exposed to Aboriginal and Torres Strait Islander perspectives of Australia's colonial history it impacts their sense of optimism, personal values and beliefs about the healthcare they will provide to Aboriginal and Torres Strait Islander peoples. However, midwifery students who self-identified as Aboriginal and/or Torres Strait Islander people, reported a decline in optimism when imagining a healthcare system free of racism.Conclusion: The subject did not impact on cultural safety scores. This may be due to prior learning of student midwives. Educators should consider building on prior knowledge in post graduate midwifery to ensure the content is contextualised to midwifery.

Background: In Australia, undertaking cultural safety education often evokes strong emotional responses by health students. Despite the potential for emotion to drive transformative learning in this space, measures of emotion are uncommon.

Aim: To review existing tools that intend to measure emotional components of learning in relation to cultural safety education.

Methods: Articles published in English from January 2005 to January 2020; reported studies from Australia, New Zealand, Canada and United States of America; and measured an emotional construct/s after an education intervention offered to university students enrolled in a health programme were included. Studies were assessed for quality according to the Critical Appraisals Skills Programme criteria.

Results: Eight articles were reviewed; five conducted in the United States of America, and three in Australia. Intervention type, measures, methodological rigour and outcomes varied. Studies predominately measured empathy, guilt and/or fear.

Conclusions: Although students' emotional responses were measured, processes for students to reflect upon these reactions were not incorporated in the classroom. The review has implications for future research and curricula through developments in measuring and acting upon emotion in cultural safety education for nursing students in Australia.