Introduction
As I work towards culturally safe public health as a medical student, reflective thinking and critical self-reflection are crucial. Acquiring the necessary reflexivity skills for cultural humility, as well as an understanding of one’s own cultural identity and role in healthcare, is essential to delivering adequate treatment to Australia’s First Peoples. I will be able to critically reflect on my views, values, prejudices, preconceived ideas, and assumptions about culturally safe public health practises with Aboriginal and Torres Strait Islander communities in this reflective essay using the Adapted Cultural Iceberg Model.
Understanding Cultural Self in Healthcare
Worldviews, standpoints, and philosophy shape healthcare. Our healthcare system frequently prioritises one viewpoint over another, which may be prejudicial to the needs of indigenous people. The worldviews of Aboriginal and Torres Strait Islander people can diverge significantly from the biomedical model1. These disparities must be acknowledged for healthcare to be accepted in different cultures. To be culturally competent, I must first define my culture and comprehend how it affects my perspective. My attitudes, values, and beliefs shape my worldview. Examining these values and beliefs is necessary.
Self-reflexivity and Self-reflection
The capacity to use self-talk to analyse events as they arise critically is known as self-reflexivity. Enhancing self-awareness can lead to better relationships in the present. 3. When engaging with patients or communities, I must focus on my attitudes and ideas. Examining the past to enhance present and future practices is called reflection. Looking back at previous exchanges and figuring out how to improve requires work. Critical reflection differs from self-reflection. The beliefs, customs, and norms that shape behaviours are evaluated critically3. To practise medicine in a culturally safe manner, I need to consider critically how my cultural identity functions within the healthcare system and how it influences my work.
Importance of Working with the Natives
Working with Aboriginal and Torres Strait Islander society might be complex due to Western biomedical concepts dominating Australian healthcare4. These groups often disagree on health and well-being. Ineffective healthcare delivery and health inequities might emerge from not understanding and respecting these perspectives.
Critical Self-Reflection Using the Adapted Cultural Iceberg Model
The Cultural Iceberg Model portrays the concept symbolically. It was created to show that while some components of culture are prominent, many more are hidden5. The members of the culture include visible elements and invisible elements.
Observation (What do I see occurring here?): As a medical student, I have not interacted directly with Aboriginal and Torres Strait Islander people. Lectures and workshops have taught me about the community healthcare needs and culture.
Internal Reflection (Notice what is happening with self): I realise my expertise is confined to academia. I need to reflect critically and self-reflect on how to apply it in real-world healthcare.
Existential Reflection (Shifting one’s belief system): Academic knowledge alone cannot provide culturally safe medical treatment, so I must adjust my perspective. Actively seek Aboriginal and Torres Strait Islander participation.
Systematic Reflection (Shifting the frame of perception): I must critically assess healthcare structural biases and power dynamics that may harm First Peoples’ care. Addressing racism and privilege is included. I must actively seek significant cultural exchange encounters with Aboriginal and Torres Strait Islander communities to reconcile academic understanding and practical, cultural humility in healthcare practice.
Conclusion
Self-reflection and critical self-reflection help public health professionals achieve cultural humility. Using the Adapted Cultural Iceberg Model, I realised my limited knowledge and that I must actively interact with Aboriginal and Torres Strait Islander people to deliver culturally safe healthcare. Self-reflection has shown me that I must constantly examine my views, values, biases, and assumptions to better assist Indigenous people in Australia. Cultural safety will influence my public health career, helping me confront interpersonal, organisational, and systemic biases in healthcare policies and practices that harm Aboriginal and Torres Strait Islander communities.
Bibliography
Australian Government. The new National Aboriginal and Torres Strait Islander Health Plan 2021–2031. Australian Government Department of Health and Aged Care. Published December 10, 2020. https://www.health.gov.au/topics/aboriginal-and-torres-strait-islander-health/how-we-support-health/health-plan#a-new-approach-to-aboriginal-and-torres-strait-islander-health-and-wellbeing
2.Nolan-Isles D, Macniven R, Hunter K, et al. Enablers and barriers to accessing healthcare services for Aboriginal people in New South Wales, Australia. International Journal of Environmental Research and Public Health. 2021;18(6). doi: https://doi.org/10.3390/ijerph18063014
Kross E, Ong M, Ayduk O. Self-Reflection at Work: Why It Matters and How to Harness Its Potential and Avoid Its Pitfalls. Annual Review of Organizational Psychology and Organizational Behavior. 2023;10(1):441-464. doi: https://doi.org/10.1146/annurev-orgpsych-031921-024406
Mitchell A, Wade V, Haynes E, Katzenellenbogen J, Bessarab D. “The world is so white”: improving cultural safety in healthcare systems for Australian Indigenous people with rheumatic heart disease. Australian and New Zealand Journal of Public Health. 2022;46(5). doi: https://doi.org/10.1111/1753-6405.13219
Kishore K. The Iceberg Model Of Culture And Behavior. Harappa. Published September 2, 2020. Accessed September 8, 2023. https://harappa.education/harappa-diaries/iceberg-model-of-culture-and-behavior/#:~:text=One%20of%20the%20most%20important,from%20their%20culture%20and%20community.
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