"There Is Much More to Learn Still": Embedding Culturally Safe Practice Education into Medical School Programs

The ability to provide culturally safe care is a core expectation of graduates from medical schools in Australia. Yet medical schools often struggle to meet this requirement. Recognising the need for curriculum redesign, this project created, delivered, and evaluated a program on providing culturally safe healthcare to First Nations peoples in the Northern Territory. The program was delivered to medical students enrolled in the Flinders University Northern Territory Medical Program over 9 weeks in 2022. To create the program, education theories including community of practice, constructivist principles, and transformative learning were drawn upon. The program also drew on training designed specifically for Northern Territory health staff, which used the podcast "Ask the Specialist: Larrakia, Tiwi and Yolngu stories to inspire better healthcare" to promote critical reflection on racism in healthcare. To evaluate the program, 177 surveys were collected weekly from students and seven students consented to pre- and post-program interviews. Written informed consent was obtained from these participants. Inductive narrative analysis, guided by critical theory and First Nations knowledges, was applied to data. Kirkpatrick's training evaluation model provided a framework to present results. On average, 81% of participants agreed or strongly agreed the program was valuable. Participants learnt to critically reflect on power dynamics and racism in healthcare and learnt skills regarding rapport building, communication and patient-centred care. The pilot demonstrated a successful framework for cultural safety education within medical school curricula which has potential for further adaptation and implementation.