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An Indigenous cultural competence model for dentistry education

British Dental Journal volume 228, pages 719–725 (2020)Cite this article

Abstract

Reorientation of education for health professionals is necessary to support future health workforce in meeting population needs. Dental graduates must be competent to effectively communicate with patients, their families and other health professionals involved in their care, regardless of social or cultural background. Indigenous people in Australia experience significant oral health disparities compared to non-Indigenous Australians. Cultural competence has evolved as the leading model to equip future clinicians to deliver culturally safe care. A case study conducted at the University of Sydney School of Dentistry examined the integration of Indigenous cultural competence into dental curricula using four data sources: a systematic review identifying intervention strategies to improve cultural competence; an online survey to provide a baseline analysis of Indigenous curricula practices; and two in-depth interview studies with academics and students to determine barriers and enablers to increasing Indigenous cultural competence among dental students. As a result, an Indigenous cultural model was developed for dentistry education, recognising three major constituents being critical to achieving cultural competence among dental students. Indigenous cultural competence in dentistry education requires stringent governance, adequate faculty resources and effective educational strategies, in order to increase students' knowledge, understanding and skills to achieve a minimum cultural competence standard upon graduation.

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References

  1. Balasubramanian M, Davda L, Short S D, Gallagher J E. Moving from advocacy to activism? The fourth WHO global forum on human resources for health and implications for dentistry. Br Dent J 2018; 225: 119-122.

  2. Hanks S, Marples C, Wall E. Reflections on learning and enhancing communication skills through community engagement: a student perspective. Br Dent J 2016; 221: 81-85.

  3. Forsyth C J, Irving M J, Tennant M, Short S D, Gilroy J A. Teaching cultural competence in dental education: a systematic review and exploration of implications for Indigenous populations in Australia. J Dent Educ 2017; 81: 956-968.

  4. Forsyth C J, Irving M J, Tennant M, Short S D, Gilroy J A. Indigenous Cultural Competence: A Dental Faculty Curriculum Review. Europe J Dent Educ 2018; DOI: 10.1111/eje.12320.

  5. Forsyth C J, Irving M J, Short S D, Tennant M, Gilroy J A. Strengthening Indigenous cultural competence in dentistry and oral health education: Academic perspectives Europe J Dent Educ 2019; DOI: 10.1111/eje.12398.

  6. Forsyth C J, Irving M J, Short S D, Tennant M, Gilroy J A. Students Don't Know What They Don't Know: Dental and Oral Health Students' Perspectives on Developing Cultural Competence Regarding Indigenous Peoples. J Dent Educ 2019; 83: 679-686.

  7. Ferguson H, Sherrell H. Overseas students in Australian higher education: a quick guide. 2019. Available online at https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Quick_Guides/OverseasStudents (accessed January 2020).

  8. Universities Australia. Australia tipped to overtake the UK as a magnet for international students. 2018. Available at https://www.universitiesaustralia.edu.au/media-item/australia-tipped-to-overtake-the-uk-as-a-magnet-for-international-students/ (accessed March 2020).

  9. Smith L T. Decolonizing Methodologies: Research and Indigenous Peoples. 2nd ed. London: Zed Books, 2012.

  10. Martin K. Ways of knowing, ways of being and ways of doing: a theoretical framework and methods for Indigenous research and Indigenist research. J Aust Stud 2003; 76: 203-214.

  11. Yin R K. Case Study Research: Design and Methods. 5th ed. Thousand Oaks, California: Sage Publications, 2014.

  12. Stake R E. The Art of Case Study Research. Thousand Oaks, California: Sage Publications, 1995.

  13. A Guide to Infusing Cultural & Linguistic Competence. Available at https://nccc.georgetown.edu/video-infusing-clc/continuum.pdf (accessed April 2020).

  14. Palmer G R, Short S D. Health Care and Public Policy: An Australian Analysis. 5th ed. Melbourne: Palgrave Macmillan, 2014.

  15. Australian Dental Council. Professional competencies of the newly qualified dentist. 2016. Available at https://www.adc.org.au/sites/default/files/Media_Libraries/PDF/Accreditation/Professional%20Competencies%20of%20the%20Newly%20Qualified%20Dentist_rebrand.pdf (accessed March 2017).

  16. Australian Government. Healthy Mouths Healthy Lives: Australia's National Oral Health Plan 2015-2024. Available at https://www.mah.se/PageFiles/1541119092/Australias-National-Oral-Health-Plan-2015-2024_uploaded-170216.pdf (accessed November 2017).

  17. Department of Health, Australian Government. National Aboriginal and Torres Strait Islander Health Plan 2013-2023. Available online at http://www.health.gov.au/natsihp (accessed August 2017).

  18. Australian Health Practitioner Regulation Agency. Aboriginal and Torres Strait Islander cultural safety training. 2018. Available at https://www.ahpra.gov.au/News/2018-09-03-cultural-safety.aspx (accessed August 2018).

  19. Universities Australia. National Best Practice Framework for Indigenous Cultural Competency in Australian Universities. 2011. Available at https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/National-Best-Practice-Framework-for-Indigenous-Cultural-Competency-in-Australian-Universities.pdf (accessed March 2020).

  20. Universities Australia. Guiding Principles for Developing Indigenous Cultural Competence in Australian Universities. 2011. Available at https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/Guiding-Principles-for-Developing-Indigenous-Cultural-Competency-in-Australian-Universities.pdf (accessed March 2020).

  21. James Cook University Australia. University Plan 2018-2022. Available at https://www.jcu.edu.au/__data/assets/pdf_file/0012/589764/JCU-University-Plan.pdf (accessed August 2018).

  22. The University of Queensland. Strategic Plan 2018-2021. Available at https://www.uq.edu.au/about/docs/strategicplan/UQStrategicPlan2018-2021.pdf (accessed August 2018).

  23. The University of Western Australia Strategic Plan 2014-2020 Available at https://www.web.uwa.edu.au/__data/assets/pdf_file/0010/2538343/114085-VICCHA-StrategicPlan-v3.pdf (accessed March 2020).

  24. The University of Sydney. Wingara Mura - Bunga Barrabugu: The University of Sydney Aboriginal and Torres Strait Islander Integrated Strategy. 2012. Available at https://www.sydney.edu.au/content/dam/corporate/documents/about-us/values-and-visions/wingara-mura-bunga-barrabugu.pdf (accessed June 2012).

  25. Goerke V, Kickett M. Working towards the assurance of graduate attributes for Indigenous cultural competency: The case for alignment between policy, professional development and curriculum processes. Int Educ J Compar Persp 2013; 12: 61-81.

  26. The University of Melbourne. The Melbourne Graduate. Available at https://provost.unimelb.edu.au/student-life/the-melbourne-graduate (accessed January 2019).

  27. Griffith University. The Griffith Graduate. Available at https://policies.griffith.edu.au/pdf/The%20Griffith%20Graduate.pdf (accessed January 2019).

  28. The University of Adelaide. Graduate Attributes. https://www.adelaide.edu.au/learning/strategy/gradattributes/ (accessed January 2019).

  29. Charles Sturt University. Graduate Attributes Policy. Available at https://policy.csu.edu.au/view.current.php?id=00257 (accessed January 2019).

  30. The University of Sydney. 2016-20 Strategic Plan: If you change nothing, nothing will change. 2016. Available at https://www.sydney.edu.au/dam/intranet/documents/strategy-and-planning/strategic-plan-2016-20.pdf (accessed August 2018).

  31. Bainbridge R, McCallum J, Clifford A, Tsey K. Cultural competency in the delivery of health services for Indigenous people. Produced for the Closing the Gap Clearinghouse. July 2015.

  32. The University of Sydney. The University of Sydney School of Dentistry: Overarching Strategic Goals and Objectives 2018-22. 2018. Available at https://www.sydney.edu.au/content/dam/corporate/documents/faculty-of-medicine-and-health/dentistry/sydney-dental-school-strategic-plan.pdf (accessed August 2018).

  33. Clifford A, McCalman J, Bainbridge R, Tsey K. Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review. Int J Qual Health Care 2015; 27: 89-98.

  34. Flavell H, Thackrah R, Hoffman J. Developing Indigenous Australian cultural competence: A model for implementing Indigenous content into curricula. J Teach Learn Grad Employabil 2013; 4: 39-63.

  35. Australian Government. Aboriginal and Torres Strait Islander: Health Curriculum Framework. 2016. Available at https://www1.health.gov.au/internet/main/publishing.nsf/Content/aboriginal-torres-strait-islander-health-curriculum-framework (accessed April 2018).

  36. The University of Sydney. Wingara Mura - Bunga Barrabugu Strategy https://www.sydney.edu.au/content/dam/corporate/documents/about-us/values-and-visions/wingara-mura-bunga-barrabugu.pdf (accessed April 2020).

  37. Sherwood J, Russell-Mundine G. How We Do Business: Setting the Agenda for Cultural Competence at the University of Sydney. In Frawley J, Larkin S, Smith J A (eds) Indigenous Pathways, Transitions and Particiption in Higher Education. pp 133-150. Singapore: Springer, 2017.

  38. Blyton G. Reflections, Memories, and Sources: Healthier Times?: Revisiting Indigenous Australian Health History. Health Hist 2009; 11: 116-135.

  39. Durey A, Thompson S. Reducing the health disparities of Indigenous Australians: time to change focus. BMC Health Serv Res 2012; 12: 151.

  40. Universities Australia. Universities Australia Indigenous Strategy First Annual Report. 2019. Available at https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/20190304-Final-Indigenous-Strategy-Report-v2-2.pdf (accessed January 2020).

  41. Universities Australia. Indigenous Strategy 2017-2020. 2019. Available at https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/Indigenous-Strategy-v16-1.pdf (accessed August 2018).

  42. Minniecon D, Kong K. Healthy Futures: Defining best practice in the recruitment and retention of Indigenous medical students. 2005. Available at https://www.aida.org.au/wp-content/uploads/2018/03/AIDA-Healthy-Futures-Report.pdf (accessed March 2020).

  43. Curtis E, Wikaire E, Stokes K, Reid P. Addressing indigenous health workforce inequities: A literature review exploring 'best' practice for recruitment into tertiary health programmes. Int J Equity Health 2012; 11: 13.

  44. Betancourt J R, Green A R, Carrillo J E, Park E R. Cultural Competence and Health Care Disparities: Key Perspectives and Trends. Health Aff 2005; 24: 499-505.

  45. Behar-Horenstein L S, Warren R C, Catalanotto F A. Addressing Oral Health Disparities Via Educational Foci in Cultural Competence. Am J Public Health 2017; DOI: 10.2105/AJPH.2017.303721.

  46. Thackrah R D, Hall M, Fitzgerald K, Thompson S C. Up close and real: living and learning in a remote community builds students' cultural capabilities and understanding of health disparities. Int J Equity Health 2017; 16: 119.

  47. Kurtz D, Janke R, Vinek J, Wells T, Hutchinson P, Froste A. Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review. Int J Med Educ 2018; 9: 271-285.

  48. Clifford A, Mc Calman J, Jongen C, Bainbridge R. Cultural Competency Training and Education in the University-Based Professional Training of Health Professionals: Characteristics, Quality and Outcomes of Evaluations. Divers Equal Health Care 2017; 14: 136-147.

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Acknowledgements

We thank members of the Cultural Competence Curriculum Review Reference Group, for their invaluable advice and support: Linda Lewis - Aboriginal Otitis Media Coordinator, Western Sydney Local Health District; Boe Rambaldini - Aboriginal Oral Health Coordinator, NSW Centre Oral Health Strategy; Jacinda Stamenkovic - Aboriginal Graduate of the Bachelor Oral Health and current Clinical Educator in the Bachelor Oral Health and Doctor of Dental Medicine programs; Dr Nigel Rock - Doctor of Dental Medicine Clinical Educator, The University of Sydney; and Prof Heiko Spallek - Head of School and Dean, The University of Sydney School of Dentistry. Furthermore, we thank Bettina Fulham, Research Support Administrative Assistant, for her dedicated work, Sasha Cohen, for his graphic design expertise in the development of this model, and our academic colleagues who generously responded to our request to be interviewed.

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Authors and Affiliations

  1. School of Dentistry, Faculty of Medicine and Health, University of Sydney, Australia

    Cathryn Forsyth & Michelle Irving

  2. School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia

    Stephanie Short & John Gilroy

  3. International Research Collaborative, Oral Health and Equity, University of Western Australia, Australia

    Marc Tennant

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  1. Cathryn Forsyth
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Correspondence to Cathryn Forsyth.

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Forsyth, C., Short, S., Gilroy, J. et al. An Indigenous cultural competence model for dentistry education. Br Dent J 228, 719–725 (2020). https://doi.org/10.1038/s41415-020-1480-3

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