Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-26T20:47:25.390Z Has data issue: false hasContentIssue false
  • English
  • Français

Addressing Uncomfortable Issues: Reflexivity as a Tool for Culturally Safe Practice in Aboriginal and Torres Strait Islander Health

Published online by Cambridge University Press:  10 November 2014

Annabelle Wilson
Annabelle Wilson*
Affiliation:
Poche Centre for Indigenous Health and Well-Being and Discipline of Public Health, Flinders University, Adelaide, South Australia, Australia
*
address for correspondence: Annabelle Wilson, Discipline of Public Health, Flinders University, GPO Box 2100, Adelaide SA 5001. Email: [email protected]
Get access

Abstract

It is well recognised that research with Aboriginal communities needs to be ethical, meaningful and useful, in a way that is defined by communities themselves. This article provides an example of how reflexivity, from a number of positions and paradigms, can be used to undertake such research. I used a reflexive journal to document and critically assess the challenges and discomfort I experienced while undertaking research with Aboriginal communities, including uncertainty and feeling in the minority. Reflexivity allowed me to experience a number of key learnings, including: the importance of relationships; the importance of time, transparency and trust in relationships; reciprocity; the importance of listening; a partnership approach; and the impact of Aboriginal culture and past experience. The way in which I redefined my success as a researcher is also explored. In using reflexivity I reached new levels of understanding about myself, which enabled me to alter my practice and therefore change the experiences of those I was working with, ideally towards experiences that were perceived as culturally safe. Using reflexivity also enabled me to identify my position as a White researcher and centralise the needs and perspectives of Aboriginal people in my research. The purpose of this article is to present my own journey, as well as start a dialogue and provide a framework for how others might use reflexivity to become a culturally safe health professional or researcher and centralise the needs and perspectives of Aboriginal people in research and practice.

Keywords

reflexivitycultural safetyAboriginal and Torres Strait Islander health
Type
Research Article
Information
The Australian Journal of Indigenous Education , Volume 43 , Issue 2 , December 2014 , pp. 218 - 230
Copyright
Copyright © The Author(s) 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allan, J. (2010). Engaging primary health care workers in drug and alcohol and mental health interventions: Challenges for service delivery in rural and remote Australia. Australian Journal of Primary Health, 16, 311–318.CrossRefGoogle ScholarPubMed
Anderson, C. (2009). Indigenous footprints on health curriculum. The Australian Journal of Indigenous Education, 38 (Suppl.), 40–45.CrossRefGoogle Scholar
Behar, R. (1996). The Vulnerable Observer: Anthropology that Breaks Your Heart. Boston: Beacon Press.Google Scholar
Behrendt, L., Larkin, S., Griew, R., & Kelly, P. (2012). Review of Higher Education Access and Outcomes for Aboriginal and Torres Strait Islander People Final Report. Canberra, Australia: Australian Government.Google Scholar
Bin-Sallik, M. (2003). Cultural safety: Let's name it! The Australian Journal of Indigenous Education, 32, 21–28.CrossRefGoogle Scholar
Bolak, H. (1997). Studying one's own in the Middle East: Negotiating gender and self-other dynamics in the field. In Hertz, R. (Ed.), Reflexivity & Voice Thousand Oaks, CA: Sage PublicationsGoogle Scholar
Bond, C.J., Sporling, G.K., & Askew, D.A. (2014). A different kind of treatment: Health professionals’ duty of care includes combating racism in society as well as in health care settings. Medical Journal of Australia, 201 (1), 10–11.CrossRefGoogle Scholar
Bond, C., & Brady, K. (2013). Locating Indigenous Australia within community development practice: clients, consumers or change makers? New Community, 11 (3), 33–43.Google Scholar
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77–101.CrossRefGoogle Scholar
Brimblecombe, J., Ferguson, M., Liberato, S., & O'Dea, K. (2013). Characteristics of the community-level diet of Aboriginal people in remote northern Australia. Medical Journal of Australia, 198 (7), 380–384.CrossRefGoogle ScholarPubMed
Brookfield, S. (2009). The concept of critical reflection: Promises and contradictions. European Journal of Social Work, 12 (3), 293–304.CrossRefGoogle Scholar
Brookfield, S. (1998). Critically reflective practice. The Journal of Continuing Education in the Health Professions, 18, 197–205.CrossRefGoogle Scholar
Dowling, M. (2006). Approaches to reflexivity in qualitative research. Nurse Researcher, 13 (3), 7–21.CrossRefGoogle ScholarPubMed
Durey, A., & Thompson, S. (2012). Reducing the health disparities of Indigenous Australians: Time to change focus. BMC Health Services Research, 12 (151), 1–11.CrossRefGoogle ScholarPubMed
Durey, A., Thompson, S., & Wood, M. (2011). Time to bring down the twin towers in poor Aboriginal hospital care: Addressing institutional racism and misunderstandings in communication. Internal Medicine Journal, 42 (1), 17–22.CrossRefGoogle Scholar
Durey, A., Wynaden, D., Thompson, S., Davidson, P., Bessarab, D., & Katzenellenbogen, J. (2012). Owning solutions: A collaborative model to improve quality in hospital care for Aboriginal Australians. Nursing Inquiry, 19 (2), 144–152.CrossRefGoogle ScholarPubMed
Eckermann, A., Dowd, T., Chong, E., Nixon, L., Gray, R., & Johnson, S. (2006). Binan Goonj: Bridging Cultures in Aboriginal Health. Sydney, Australia: Churchill Livingstone.Google Scholar
Etherington, K. (2004). Becoming a reflexive researcher: Using our selves in research. London: Jessica Kingsley Publishers.Google Scholar
Etherington, K. (2005). Researching trauma, the body and transformation: A situated account of creating safety in unsafe places. British Journal of Guidance & Counselling, 33 (3), 299–313.CrossRefGoogle Scholar
Etherington, K. (2007). Ethical research in reflexive relationships. Qualitative Inquiry, 13 (5), 599–616.CrossRefGoogle Scholar
Etherington, K., & Bridges, N. (2011). Narrative case study research: On endings and six session reviews. Counselling and Psychotherapy Research, 11 (1), 11–22.CrossRefGoogle Scholar
Frankenberg, R. (1993). White women, race matters: The social construction of Whiteness. Minneapolis, MN: University of Minnesota Press.CrossRefGoogle Scholar
Fredericks, B. (2006). Which way? Educating for nursing Aboriginal and Torres Strait Islander peoples. Contemporary Nurse, 23 (1), 87–99.CrossRefGoogle ScholarPubMed
Gair, S. (2007). Pursuing Indigenous-inclusive curriculum in social work tertiary education: Feeling my way as a non-Indigenous educator. The Australian Journal of Indigenous Education, 36, 49–55.CrossRefGoogle Scholar
Hayman, N., White, N.E., & Spurling, G.K. (2009). Improving Indigenous patients’ access to mainstream health services: The Inala experience. Medical Journal of Australia, 190 (10), 604–606.CrossRefGoogle ScholarPubMed
Helms, J.E. (1984). Toward a theoretical explanation of the effects of race on counseling: A black and white model. The Counseling Psychologist, 12 (4), 153–165. doi:10.1177/0011000084124013.CrossRefGoogle Scholar
Helms, J.E. (1995). An update of Helm's white and people of colour racial identity models. In Ponterotto, J.G., Casas, M.J., Suzuki, L.A., & Alexander, C.M. (Eds.), Handbook of multicultural counseling. Thousand Oaks, CA: Sage Publications.Google Scholar
Jackson, L., & Ward, J. (1999). Aboriginal health: Why is reconciliation necessary? Medical Journal of Australia, 170 (9), 437–440.CrossRefGoogle ScholarPubMed
Kowal, E. (2008). The politics of the gap: Indigenous Australians, liberal multiculturalism, and the end of the self-determinantion era. American Anthropologist, 110 (3), 338–348.CrossRefGoogle Scholar
Lee, A.J., Bonson, A.P., Yarmirr, D., O'Dea, K., & Mathews, J.D. (1995). Sustainability of a successful health and nutrition program in a remote Aboriginal community. Medical Journal of Australia, 162 (12), 632–635.CrossRefGoogle Scholar
Lloyd, J., Wise, M., & Weeramanthri, T. (2008). Changing shape: Workforce and the implementation of Aboriginal health policy. Australian Health Review, 32 (1), 174–185.CrossRefGoogle ScholarPubMed
Mackinlay, E. (2012). PEARL: A reflective story about decolonising pedagogy in Indigenous Australian studies. The Australian Journal of Indigenous Education, 41 (1), 67–74.CrossRefGoogle Scholar
Mauthner, N., & Doucet, A. (2003). What comes (just) after ‘post’? The case of ethnography. In Denzin, N. & Lincoln, Y. (Eds.), Handbook of qualitative research (pp. 563–574). London: Sage.Google Scholar
McDermott, D. (2012). Can we educate out of racism? Medical Journal of Australia, 197 (1), 15.CrossRefGoogle ScholarPubMed
McIntosh, P. (1986). White privilege and male privilege: A personal account of coming to see correspondences through work in women's studies. Virginia Women’s Studies Conference, Richmond, Virginia.Google Scholar
Minniecon, D., Franks, N., & Heffernan, M. (2007). Indigenous research: Three researchers reflect on their experiences at the interface. The Australian Journal of Indigenous Education, 36 (Suppl.), 23–31.CrossRefGoogle Scholar
Moreton-Robinson, A. (2000). Talkin’ up to the white woman. Brisbane, Australia: University of Queensland Press.Google Scholar
Naples, N. (2003). Feminism and method. New York: Routledge.Google Scholar
O'Dea, K. (1984). Marked improvement in carbohydrate and lipid metabolism in diabetic Australian Aborigines after temporary eversion to traditional lifestyle. Diabetes Care, 33, 596–603.CrossRefGoogle Scholar
O'Dea, K., Cunningham, J., Maple-Brown, L., Weeramanthri, T., Shaw, J., Dunbar, T., & Zimmet, P. (2008). Diabetes and cardiovascular risk factors in urban Indigenous adults: Results from the DRUID study. Diabetes Research and Clinical Practice, 80 (3), 483–489.CrossRefGoogle ScholarPubMed
Panaretto, K., Coutts, J., Leon, D., & Hayman, N. (2010). Evaluating performance of and organisational capacity to deliver brief interventions in Aboriginal and Torres Strait Islander medical service. Australian and New Zealand Journal of Public Health, 34 (1), 38–44.CrossRefGoogle Scholar
Pellatt, G. (2003). Ethnography and reflexivity: Emotions and feelings in fieldwork. Nurse Researcher, 10 (3), 28–37.CrossRefGoogle ScholarPubMed
Pillow, W. (2003). Confession, catharsis, or cure? Rethinking the uses of reflexivity as methodological power in qualitative research. International Journal of Qualitative Studies in Education, 16 (2), 175–196.CrossRefGoogle Scholar
Pitner, R.O., & Sakamoto, I. (2005). The role of critical consciousness in multicultural practice: Examining how its strength becomes its limitation. American Journal of Orthopsychiatry, 75 (4), 684–694. doi:10.1037/0002–9432.75.4.684.CrossRefGoogle ScholarPubMed
Ramsden, I. (2002). Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu (Unpublished PhD thesis). Victoria University of Wellington, New Zealand.Google Scholar
Rowley, K.G., Daniel, M., Skinner, K., Skinner, M., White, G.A., & O'Dea, K. (2000). Effectiveness of a community-directed ‘healthy lifestyle’ program in a remote Australian Aboriginal community. Australian and New Zealand Journal of Public Health, 24 (2), 136–144.CrossRefGoogle Scholar
Silverman, D. (2005). Doing qualitative research: A practical handbook. London: Sage.Google Scholar
Standing Committee on Family and Community Affairs. (2000). Health is life: Report on the Inquiry into Indigenous Health. Canberra, Australia: Author.Google Scholar
Taylor, K., & Guerin, P. (2010). Health Care and Indigenous Australians: Cultural safety in practice. Sydney, Australia: Palgrave Macmillan.Google Scholar
Vos, T., Barker, B., Stanley, L., & Lopez, A. (2007). The burden of disease and injury in Aboriginal and Torres Strait Islander peoples: Summary report. Brisbane, Australia: School of Population Health, The University of Queensland.Google Scholar
Wear, D., & Aultman, J. (2005). The limits of narrative: Medical student resistance to confronting inequality and oppression in literature and beyond. Medical Education, 39, 1056–1065.CrossRefGoogle ScholarPubMed