Decolonisation for health: A lifelong process of unlearning for Australian white nurse educators.

Indigenous nurse scholars across nations colonised by Europeans articulate the need for accomplices (as opposed to mere performative allies) to work alongside them and support their ongoing struggle for health equity and respect and to prioritise and promote culturally safe healthcare. Although cultural safety is now being mandated in nursing codes of practice as a strategy to address racism in healthcare, it is important that white nurse educators have a comprehensive understanding about cultural safety and the pedagogical skills needed to teach it to undergraduate nurses. We open this article with stories of our journeys as two white nurses in becoming accomplices and working alongside Indigenous Peoples, as patients and colleagues. Our lived experience of the inertia of healthcare and education organisations to address systemic and institutional resistance to the practice of cultural safety underpins the intention of this article. We understand that delivering this challenging and complex topic effectively and respectfully is best achieved when Indigenous and white educators work together at the cultural interface. Doing so requires commitment from white nurses and power holders within universities and healthcare institutions. A decolonising approach to nurse education at individual and institutional levels is fundamental to support and grow the work that needs to be done to reduce health inequity and increase cultural safety. White nurse accomplices can play an important role in teaching future nurses the importance of critical reflection and aiming to reduce power imbalances and racism within healthcare environments. Reducing power imbalances in healthcare environments and decolonising nursing practice is the strength of a cultural safety framework.

"Teaching in Circle" with student nurses contributes to experiential understanding of Cultural Safety.

Background: Cultural safety is mandated for Australian nursing practice and education. Cultural safety privileges the knowledge of the client, who determines whether healthcare is culturally safe. Understanding and learning cultural safety requires critical self-reflection to expose clinicians' assumptions, unconscious biases, beliefs and actions, and their impact on clients. More research is required on best-practice strategies on how students learn about cultural safety in nursing education. Experiential pedagogical methods may be one such strategy to promote understanding of principles that underpin safe environments.Objectives: To explore the influence of "Teaching in Circle" to enhance students' understanding of cultural safety within the classroom environment.Methods: Students in first-year undergraduate Bachelor of nursing units participated. Teachers facilitated tutorials using a respectful adaptation of "Teaching in Circle" methodology; it was underpinned by the principles of Yarning, an Aboriginal and Torres Strait Islander Peoples way of learning and communicating in groups. Students developed principles to guide the facilitation of a more culturally safe classroom, providing written feedback on the environment and their participation in the circle.Results: Student feedback was reflected in three themes: "Journey through unfamiliar territory"; "More personable way of learning and sharing" and "Relational engagement creates safety". Student perspectives resonated strongly with the principles of cultural safety or lack of within healthcare settings. The method disrupted normative classroom/learning environments and supported experiential learning about the principles of cultural safety.Conclusions: "Teaching in circle" provided an experiential means of enhancing first-year nursing students' understanding of the principles of cultural safety. This learning should be embedded in the nursing curriculum and on-going education to prepare nurses to provide culturally safer care to Aboriginal and Torres Strait Islander Peoples. The study supports similar research calling for innovative learner-focused, experiential methods for the development of the practice of cultural safety in Australian nursing education.Impact statement: Exploratory research project, "Teaching in Circle" with student nurses contributes to experiential understanding of cultural safety principles.

Cultural Safety: teachers' engagement with an Indigenous pedagogical method in undergraduate nursing education.

Background: Given the continued disparity between the health of Indigenous Australian people's health and that of the broader Australian population, cultural safety is mandated as a component of undergraduate education as a strategy to improve health care. Evidence suggests that academics are not confident to teach cultural safety to undergraduate nursing students.Objectives: To explore the efficacy of an Indigenous teaching method (Teaching in Circle) to create culturally safe classrooms and to build the capacity and confidence of teachers to teach about cultural safety.Design: An Indigenous pedagogy was adapted for use in tutorials by teachers, with mentorship provided by an Indigenous knowledge expert. Teaching in Circle (TiC) methodology was implemented by teachers in tutorials.Methods: All nurse academics teaching in the Bachelor of Nursing program at a small regional Australian university were eligible to participate. Information about the project was provided in team meetings, with invitations to participate. Teachers provided a written reflection on the method and participated in regular on-line mentored support meetings throughout the teaching session. Data were analysed, using a reflective, inductive systematic process.Results: Final themes were "Sticking with initial disconcertment and discomfort"; "A renewed enjoyment of teaching"; "Learning and adapting", "The influence of the method on safety" and "Shifts in classroom dynamics".Impact Statement: 'Teaching in Circle', underpinned by respectful practice, positively influences culturally safe teaching and learning environments. The method enhances academics' confidence to teach cultural safety to undergraduate nursing students and supports an understanding of the essential components of culturally safe health care.Conclusions: Evidence suggests the method built capacity to teach and foster experiential learning of safety, and thus what is required to create a culturally safe teaching and learning space.

Exploring cultural safety with Nurse Academics. Research findings suggest time to "step up".

Background: As the largest professional group employed within the health care system, the capacity for nurses to contribute to improving the health of Australian Indigenous people is substantial. Cultural safety has recently been incorporated into the national codes of conduct for nurses. Nurse academics have a key role in ensuring graduates are culturally safe practitioners. Staff capacity is a crucial consideration if cultural safety is to be embedded effectively within nursing curriculum. Aims: The aim of this study was to explore capability in relation to cultural safety with Nurse Academics at a regional university in New South Wales, Australia. Design: Mixed methods approach incorporating a survey and individual interviews. Methods: Casual and permanent nurse academics involved in teaching the undergraduate nursing program were eligible to participate. Results: Fifteen staff completed the survey and eight participated in an interview. Although the importance of cultural safety was recognised, there was a lack of comprehensive understanding and lack of confidence to teach the philosophy and practices of cultural safety. There was strong support cultural safety and anti-racism professional development. Impact statement: Building staff capacity is a crucial consideration if cultural safety is to be embedded within nursing curriculum. Conclusions: Cultural safety professional development is a starting point for nurses to develop their skills in providing culturally safe care and an essential step towards shifting the institutional and professional culture of the nursing profession. Research findings are clear it is time for Nurse Academics to "Step up" to effectively embed cultural safety in undergraduate nursing curriculum.