Teaching cultural safety principles: optometry student perceptions

ABSTRACT

Clinical relevance

Providing optometry learners with cultural safety training can improve patient safety and health outcomes among Indigenous Peoples.

Background

Healthcare practitioners require cultural safety training to provide safe eye care to Indigenous Peoples in Canada. Culturally safe care requires optometrists to critically reflect upon their unconscious biases and power differences that impact patient care. Informed by the cultural safety literature and working directly with learners, revisions were made to first and second-year optometry clinic experience courses in a Canadian Doctor of Optometry program. This descriptive study examined student feedback on curricular changes, focused on enhancing cultural safety.

Methods

An 8-item, anonymous, online survey was offered to all learners (n = 178) enrolled in clinic experience courses at in fall 2021 and winter 2022. The survey addressed student understanding of cultural safety, comfort with self-reflective activities, and course effectiveness in teaching patient-centred care. Six items used a 5-point Likert response scale. Descriptive statistics were analyzed (Wilcoxon and Wilcoxon-Pratt). Two open-ended items were analysed using content analysis for themes.

Results

Thirty-three surveys were completed. Overall respondents found the clinic experience courses provided effective training in cultural safety and were of professional value. Comfort engaging in self-reflective activities increased (before: mean response 4.0; after: 4.4), and students made connections with societal problems (overall mean 3.5) and with bias/power differential (overall mean 4.0). Suggested changes to support the learning objectives included increased clinic observation, scaffolding these topics in additional courses, and adding relevant literature (e.g. anti-racism) and guest speakers with Indigenous knowledge and experience.

Conclusion

Optometry learners were favourable about the inclusion of cultural safety concepts in their clinic experience courses. Their feedback points to areas for improvement including deepening course content, and collaborating with Indigenous Peoples in content, course design, and cross-curricular scaffolding.

KEYWORDS:

• Cultural safety
• Indigenous Peoples
• optometry curricula
• patient-centred care
• self-reflection

Acknowledgments

This paper is authored by faculty members and students at the University of Waterloo, School of Optometry and Vision Science in Ontario, Canada. Our work takes place on the traditional territory of the Attawandaron, Anishinaabeg and Haudenosaunee Peoples. Our main campus is situated on the Haldimand Tract, the land granted to the Six Nations that includes six miles on each side of the Grand River.

Disclosure statement

No potential conflict of interest was reported by the author(s).