Mandatory versus non-mandatory training in culturally safe practices for education staff at universities

The need for cultural safety training

Throughout history, Indigenous peoples have consistently been portrayed in a negative light through mainstream media outlets that misrepresent this population in conventional society (Riggs & Due, 2011). The use of terms such as problem and dysfunctional to characterise Indigenous communities has inevitably made them subject to a deficit discourse (W. Fogarty, Bulloch et al., 2018), which consequently has positioned them as the racial other (Riggs & Due, 2011). Stereotypes and inequalities have risen from this, which in turn predispose Indigenous peoples to negative public perceptions, thus limiting the ability of non-Indigenous peoples to make informed decisions and engage effectively with their Indigenous counterparts. As a downstream effect of this deficit discourse, Indigenous peoples sadly experience ongoing disadvantage. The constant internalisation of these negative portrayals of identity negatively impacts their health and well-being. In saying that, this is only one of the many social, cultural, and economic determinants of health which have put Aboriginal and Torres Strait Islander peoples at a disadvantage (Vickery et al., 2007).

In recent years, the urge to move away from a deficit narrative and towards a strengths-based approach has been increasingly recognised in Australia (Australian Institute of Aboriginal and Torres Strait Islander Studies, 2019). Furthermore, it has become more apparent that the success of this new approach to training and education is dependent on future input from Aboriginal and Torres Strait Islander communities (Australian Institute of Aboriginal and Torres Strait Islander Studies, 2019). Only after this can we start to address the systemic disadvantage experienced by Aboriginal and Torres Strait Islander peoples. By using a whole-of-system approach that highlights Indigenous ownership and partnerships, the assets of Aboriginal and Torres Strait Islander peoples such as strength and resilience can be embraced (W. Fogarty, Lovell et al., 2018). This, in turn, can help to improve education and engagement for this population and potentially bring us a step closer to improving health outcomes for this population.

Despite previous efforts to increase Indigenous content in curricula, a lack of Indigenous academics has resulted in deficit-based content framed by a colonialist lens that focuses on what people do not know or cannot do. In comparison, a strengths-based approach highlights the importance of knowledge and capacity (Grant & Cadell, 2009; Saint-Jacques et al., 2009; Scerra, 2012). By recognising the resilience of individuals, it focuses on aspects such as growth, learning and change. Furthermore, it recognises the potential benefit of community to provide immense resources, and thus acts as a foundation for collaborative relationships in the future (Grant & Cadell, 2009; Saint-Jacques et al., 2009; Scerra, 2012). Therefore, instead of being perceived as victims, this educational approach aims to portray Aboriginal and Torres Strait Islander peoples in a positive light, where they can be seen as “able, capable and having agency” (Hutchins et al., 2007, p. 35).

The relationship between resilience and a strengths-based approach can be described as that of theory and practice (Hunter, 2012), whereby resilience is a theory that identifies the importance of protective factors and competencies. On the other hand, practice can reinforce other theories and broader ideas like empowerment, healing and wellness, all of which are encompassed by a strengths-based approach (Dobia & O’Rourke, 2011; Hunter, 2012).

Recent attempts have been made to challenge the undermining perceptions of a deficit-based approach towards Aboriginal and Torres Strait Islander peoples through education of emerging researchers and practitioners, in which case there has been pressure for Universities to embed “Indigenous cultural competencies within and across the institution in sustainable ways which engender reconciliation and social justice” (Universities Australia, 2011, p. 8). Those competencies which “articulate with discipline-specific requirements” and use a strength-based approach to convey Indigenous content and perspectives are extremely important (Universities Australia, 2011, p. 62).

In general, the integration of Indigenous health content within curricula has been well received; however, there seems to be a consensus that cultural safety in the teaching and learning environment is lacking (Bond, 2016). Previous studies have reported incidents of Aboriginal and Torres Strait Islander students experiencing forms of discrimination and exclusionary practices, as well as negative attitudes of non-Indigenous students (Bailey, 2016; Currie et al., 2012). The inability to implement sufficient content within the University curriculum and insensitive teaching methods are the two main protagonists of this cultural safety issue (Cameron & Robinson, 2014). This aligns with findings by Garvey et al. (2009) and Stuart and Gorman (2015), who cited these factors as the major barriers to retention of Indigenous students and academics.

In a 2015 review of Australian Universities, it was found that Aboriginal and Torres Strait Islander students’ participation in higher education remains significantly low, compared to their non-Indigenous counterparts (Wilks & Wilson, 2015). Here, the number of Aboriginal and Torres Strait Islander students who completed a higher education programme only represented 0.5% of the total number of students (Wilks & Wilson, 2015). Despite previous initiatives over the years to address the underrepresentation of Aboriginal and Torres Strait Islander students in higher education, not much has changed (Taylor et al., 2019). There are several studies that focus on improving academic success rate and completion for Aboriginal and Torres Strait Islander students in their tertiary studies (Craven & Dillon, 2013; Devlin, 2009). Eason (2016) stated, “Understanding the ongoing impacts of colonialization in modern day classrooms is an integral part of developing authentic relationships that improve training and assessment outcomes for Indigenous learners” (p. 11). This is especially relevant for Aboriginal and Torres Strait Islander students in health-related degrees such as medicine, nursing and social work, where the prevalence of Aboriginal and Torres Strait Islander students in this area is growing. Therefore, the need for improved cultural safety training within these courses at University is evident and is essential for creating an environment in which Aboriginal and Torres Strait Islander students can feel safe and empowered to reach their full potential (Eason, 2016; Oliver et al., 2013). However, this necessitates educators who are equipped with the skills to create a transformative, yet culturally safe teaching and learning environment (Kickett et al., 2014).

Cultural safety

The phrase cultural safety training has often become interchangeable with the words cultural competence and diversity training, as is reflected in several studies. However, cultural safety has become the more common and appropriate term of use. Cultural safety was originally defined by Ramsden (2002) as “an outcome of. . . education that enables safe service to be defined by those who receive it” (p. 117). As a Māori nurse, she intended this to apply within a health care setting. However, cultural safety can also be defined more broadly as

an environment that is spiritually, socially and emotionally safe, as well as physically safe for people; where there is not assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning, living and working together with dignity and truly listening. (Australian Human Rights Commission, 2019)

Previous research has found that there is a distinct difference between the values of Aboriginal and Torres Strait Islander and non-Indigenous students who attend University (G. J. Fogarty & White, 1994). Aboriginal and Torres Strait Islander students are shown to place greater emphasis on values associated with tradition, conformity and security as seen in a collective (G. J. Fogarty & White, 1994). In comparison, non-Indigenous students are more likely to shift towards values of self-interest such as achievement, self-direction and stimulation (G. J. Fogarty & White, 1994), the effects of which could have played a major role in many Aboriginal and Torres Strait Islander students feeling discomfort and unsafe during their time at University. In saying that, more recent research has suggested that such views may be changing over time between these two populations. For young and upcoming generations, it has been shown that views of self-concept, motivation and academic engagement actually differ very little between Indigenous and non-Indigenous students (Mooney et al., 2016). However, this is not the same from a cultural perspective whereby values such as cultural diversity and identity are still considered higher value for Aboriginal students (Mooney et al., 2016). Given that both cultural and non-cultural perspectives can be positive predictors of academic engagement (Mooney et al., 2016), this highlights the importance of promoting a positive sense of culture in the classroom.

Therefore, the use of cultural safety training for educators at University has the potential to benefit Aboriginal and Torres Strait Islander students and their learning experiences. This is because educators will have the knowledge and skills needed to teach in a culturally appropriate manner and thus minimise the risk of such issues for Aboriginal and Torres Strait Islander students. In addition, there is a possibility that these effects can extend beyond the classroom to a broader context, such as those in health care provision (McCleland, 2011). This again speaks to the importance of increasing awareness and the use of cultural safety training.

The process of integrating cultural competency training into content-laden curricula and making sure that such educational experiences are valuable and target outcomes are achieved is a challenge for many educators. However, there is limited research to suggest that any significant actions have been taken to address the lack of cultural safety for Aboriginal and Torres Strait Islander students in tertiary education. Instead, there is a greater focus on cultural safety training for health care workers to better understand Indigenous culture and provide more sensitive care for their patients (Shah & Reeves, 2015; Vogel, 2018). Furthermore, despite the abundance of literature that highlights the importance of and calls for the implementation of cultural safety training for University education staff (Day & Nolde, 2009), there is a lack of studies that show the effectiveness of any such interventions.

The purpose of implementing cultural safety training in Universities is to build educators’ capacity to teach Aboriginal and Torres Strait Islander and non-Indigenous students in a way that provides a safe learning space for these students. However, there are various ways of implementing an intervention and thus determine how well it works. Whether or not the training has been mandated is one such determinant. In the past, non-mandatory training has been regarded with less importance than mandatory training (Sutha et al., 2016). It is only within the last few years that non-compulsory training has been regarded with the same level of importance as mandatory training (Sutha et al., 2016). In saying that, there are still mixed opinions as to which type of training is more effective. In addition, a large portion of research that is devoted to this argument is centred on cultural safety training within the health workplace (Machin & Treloar, 2004; Renaud et al., 2004). However, such findings may be applicable to the education sector.

Future perspectives and research

Given that there is still a lot of uncertainty surrounding the question of whether mandatory versus non-mandatory training is more effective, perhaps another question to ask could be what form of delivery may be better suited to achieve the desired outcome? Under the right circumstances, either mandatory or non-mandatory may prove to be effective. Most institutions or workplace settings have some form of cultural competency training, and the type of activities and assessments can vary widely (Crandall et al., 2003). For example, many medical or health degrees incorporate activities such as language training (Godkin et al., 2002), lectures, workshops and interactive sessions (Isaacs et al., 2016; Ranzijn et al., 2008), student clerkships (Godkin et al., 2002), immersion programmes (Crampton et al., 2003), month-long residency programmes for residents (Takayama et al., 2001) and cultural safety objective structured clinical examinations (Altshuler & Kachur, 2001). In other words, there are many ways to implement cultural safety training, irrespective of whether it is mandatory or non-mandatory. Moreover, while not all of these sources are related to Aboriginal and Torres Strait Islander people in particular, all of these learning experiences pay attention to the role of ethnic and cultural issues which can be generalizable. Therefore, in addition to using a mixed methods of training in Universities, there are potential advantages of looking at different modes of delivery and deciding which one may be most suitable for the given study population. Future research is warranted in this area and may be the focus of other interventions regarding cultural safety training.

Implications

The findings of this review have implications for not only Aboriginal and Torres Strait Islander students who wish to pursue future study, but they also serve relevant for helping to reduce the health gap between Indigenous Australians and their non-Indigenous counterparts. “Progress has been slow in improving health disparities between Aboriginal and Torres Strait Islander Australians and other Australians” (Durey et al., 2017, p. 12). As a secondary effect of improving cultural safety within the classroom, there is potential to improve Indigenous health outcomes. Overall, the issue of cultural safety in the classroom is an active and ongoing process and, thus, must be revisited over time and across multiple visits. Furthermore, we must understand that attitudinal change like that reported in the literature may not always correlate with behavioural change. This is troubling because at the end of the day, behavioural change is the main determinant of efficacy in cultural safety training.