Skip to main content
SpringerLink
Log in

Cultural Safety and Critical Race Theory: Education Frameworks to Promote Reflective Nursing Practice

  • Chapter
  • First Online:
Forms of Practitioner Reflexivity

Abstract

As a nurse educator with 30 years of clinical experience, I have observed myself and other nurses to ignorantly cause distress to clients and patients due to failure to understand and act outside our own cultural biases. Nurse educators through their students have the potential to impact the future health and illness outcomes of whole communities for generations to come. Teaching the evolving concepts of Cultural Safety and including concepts of Critical Race Theory holds promise for educating nurses to be mindful of power differentials that must be shifted to provide patient-centered, family-centered care. It is intended that this chapter will inspire nurse educators to examine the potential of adapting and teaching Cultural Safety concepts to their students who can potentially reduce health disparities, as well as avoid iatrogenic emotional and physical travesties resulting from cultural blindness and institutional racism as they provide nursing care in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Association of Birth Centers (AABC). (2014, April). Birth center accreditation. Retrieved from American Association of Birth Centers: http://www.birthcenters.org/about-aabc/history

  • American Association of Colleges of Nursing (AACN). (2011, March). AACN tool kit for cultural competence in master’s and doctoral nursing education. Retrieved April 17, 2011, from American Association of Colleges of Nursing: http://www.aacn.nche.edu/

  • Anderson, J., Perry, J., Blue, C., Browne, A., Henderson, A., Khan, K. B., et al. (2003). Rewriting cultural safety within the postcolonial and postnational feminist project toward new epistemologies of healing. Advances in Nursing Science, 26(3), 196–214.

    Article  Google Scholar 

  • Arieli, D., Friedman, V., & Hirschfield, M. (2012). Challenges on the path to cultural safety in nursing education. International Nursing Review, 59(2), 187–193. doi:10.1111/j.1466-7657.2012.00982.x.

    Article  Google Scholar 

  • Benner, P. (1984). From novice to expert, excellence and power in clincial nursing practice. Upper Saddle River, NJ: Prentice Hall Health.

    Google Scholar 

  • Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. Jossey-Bass.

    Google Scholar 

  • Bennett, M. J. (2000). A development model of intercultural sensitivity. Retrieved July 29, 2011, from University of Wisconsin: http://www.library.wisc.edu/EDVRC/docs/public/pdfs/SEEDReadings/intCulSens.pdf

  • Bobo, L. (2004). Inequalities that endure? Racial ideology, american politics, and the peculiar role of the social sciences. In M. Krysan & A. Lewis (Eds.), The changing terain of race and ethnicity (pp. 13–42). New York: Russell Sage Foundation.

    Google Scholar 

  • Brookfield, S. D. (1995). Becoming a critically reflective teacher. San Francisco: Jossey-Bass, Inc..

    Google Scholar 

  • Calin, M. (1996). From RN to BSN: Seeing familiar situations in different ways. Mezirow’s theory of perspective transformation. Journal of Continuing Education in Nursing.

    Google Scholar 

  • Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 181–184.

    Google Scholar 

  • Capra, F. (1989). Uncommon wisdom: Conversations with remarkable people. London: Fontana Paperbacks.

    Google Scholar 

  • Clingerman, E. (2011). Social Justice: A framework for culturally competent care. Journal of Transcultural Nursing, 334–341. doi:10.1177/1043659611414185.

    Google Scholar 

  • Cochran-Smith, M. (2000). Blind vision: Unlearning racism in teacher education. Harvard Educational Review, 70(2), 157–189.

    Article  Google Scholar 

  • Commission for the Accreditation of Birth Centers. (2014, April). Retrieved from https://www.birthcenteraccreditation.org/

  • Cross, T. (1988). Cultural competence continuum. Retrieved September 10, 2010, from nysccc.org: http://nysccc.org/family-supports/transracial-transcultural/voices-of-professionals/cultural-competence-continuum/

  • Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, Volume l. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

    Google Scholar 

  • Dekker, L. (1996a). A child is born. Unpublished poem. Fairfax, CA.

    Google Scholar 

  • Dekker, L. (1996b). Left of faith. Unpublished. Personal collection, Fairfax, CA.

    Google Scholar 

  • Dekker, L. (1997). Woman’s work. Personal collection.

    Google Scholar 

  • Dekker, L. (2014). Informing nursing education: The meaning and experience of cultural safety as expressed by nurses in the Pacific Northwest. Pullman, Washington: Washington State University.

    Google Scholar 

  • Dekker, L. (2015). Cultural safety and social justice in global society. WSU Angel course.

    Google Scholar 

  • Dewey, J. (1916). Democracy and education. New York, NY: The Macmillan Company.

    Google Scholar 

  • Diekelmann, N. (2001). Narrative pedagogy: Heideggerian hermeneutical analyses of lived experiences of students, teachers, and clinicians. Advances in Nursing Science, 23, 53–71.

    Article  Google Scholar 

  • Doutrich, D., Arcus, K., Dekker, L., Spuck, J., & Pollock-Robinson, C. (2012). Cultural safety in New Zealand and the US: Looking at a way forward together. Journal of Transcultural Nursing, 23, 143–150. doi:10.1177/1043659611433873.

    Article  Google Scholar 

  • Doutrich, D., Dekker, L., Spuck, J., & Hoeksel, R. (2014). Identity, ethics and cultural safety: Strategies for change. Whitireia Nursing & Health Journal, 21, 15–21.

    Google Scholar 

  • Duke, J., Connor, M., & McEldowney, R. (2009). Becoming a culturally competent health practitioner in the delivery of culturally safe care: A process oriented approach. Journal of Cultural Diversity, 16, 40–49.

    Google Scholar 

  • Flemmer, N. (2014). Retrieved from The We Belong Project: http://thewebelongproject.com/

  • Flemmer, N., Dekker, L., & Doutrich, D. (2014). Empathetic partnership: An interdisciplinary framework for primary care practice. Submitted.

    Google Scholar 

  • Flemmer, N., Doutrich, D., Dekker, L., & Rondeau, D. (2012). Creating a safe and caring health care context for women who have sex with women. The Journal for Nurse Practitioners, 8(6), 464–481.

    Article  Google Scholar 

  • Ford, C. L., & Airhihenbuwa, C. O. (2010). Critical race theory, race equity, and public health: Toward antiracism praxis. American Journal of Public Health, 100(S1), S30–S35.

    Article  Google Scholar 

  • Freire, P. (1970). Pedagogy of the oppressed. New York: Continuum.

    Google Scholar 

  • Gibbs, K. (2005). Teaching student nurses to be culturally safe. Journal of Transcultural Nursing, 16(4), 356–360.

    Article  Google Scholar 

  • Giroux, H. (1992). Border crossings: Cultural workers and the politics of education. New York: Routledge, Chapman and Hall.

    Google Scholar 

  • Greene, M. (1991). Teaching: The question of personal reality. In A. Lieberman & L. Miller (Eds.), Staff development for education in the ’90s (pp. 3–13). New York: Teachers College.

    Google Scholar 

  • Greenwood, D. A. (2009). Place, survivance, and white remembrance: A decolonizing challenge to rural education in mobile modernity. Journal of Research in Rural Education, 24(10), 1–6.

    Google Scholar 

  • Group, C. S. (2006). Opening our eyes-shifting our thinking. The process of teaching and learning about reflection in cultural safety education and practice: An evaluative study. Wellington, New Zealand: Whitireia Community Polytechnic and Victoria University of Wellington.

    Google Scholar 

  • Harry, B. (1992). Developing cultural self-awareness: The first step in values clarification for early interventionists. Topics in Early Childhood Special Education, 333–352.

    Google Scholar 

  • Hooks, B. (1994). Teaching to transgress: Education as the practice of freedom. London: Routledge.

    Google Scholar 

  • Institute of Medicine. (1999). To err is human: Building a safer healthcare system. Retrieved from National Academy of Sciences: http://www.iom.edu/Reports/1999/To-Err-is-Human-Building-A-Safer-Health-System.aspx

  • Institute of Medicine (IOM). (2003). Institute of Medicine findings and recommendations on health disparities. Retrieved April 17, 2011, from American Medical Association: http://www.ama-assn.org/ama1/pub/upload/mm/433/iom.pdf

  • Institute of Medicine (2004). In the nations’s compelling interest: Ensuring diversity in the health care workforce. Washington, DC: National Academy Press.

    Google Scholar 

  • Ironside, P. M. (2001, March). Creating a research base for nursing education: An interpretive review of conventional, critical, feminist, postmodern, and phenomenologic pedagogies. Advances in Nursing Science, 23(3), 72–87. PMID: 1122505.

    Google Scholar 

  • Jeffs, L. (2001). Teaching cultural safety the culturally safe way. Nursing Praxis in New Zealand, 17(3), 41–50.

    Google Scholar 

  • Johnstone, M., & Kanitsaki, O. (2007). An exploration of the notion and nature of the construct of cultural safety and its applicability to the Australian health care context. Journal of Transcultural Nursing, 18(3), 247–256. doi:10.1177/1043659607301304.

    Article  Google Scholar 

  • Joint Commision Standards on Patient Safety. (2010). Retrieved September 10, 2010, from Joint Commission.org: http://www.jointcommission.org/PatientSafety/HLC/HLC_Joint_Commission_Standards.htm

  • Josewski, V. (2012). Analyzing ‘cultural safety’ in mental health policy reform: Lessons from British Columbia, Canada. Critical Public Health, 22(2), 223–234.

    Article  Google Scholar 

  • Kaiser Family Foundation. (2005, July 14). Cultural competency: a critical component to address reacial and ethnic health disparities for women. Retrieved March 3, 2006, from kaisernetwork.org

  • Kinsella, E. (2009). Professional knowledge and the epistomology of reflective practice. Nursing Philosophy, 3–14.

    Google Scholar 

  • Koro-Ljungberg, M., Yendel-Hoppey, D., Smith, J. J., & Hayes, S. B. (2009). (E)pistemological awareness, instantiation of methods, and uninformed methodological amibiguity in qualitative research projects. Educational Researcher, 38(9), 687–699. doi:10.3.102/0013189X09351980.

    Article  Google Scholar 

  • Kuiper, R. A., & Pesut, D. J. (2004). Promoting cognitive and metacognitive refelctive reasoning skills in nursing practice: Self-regulated learning theory. Journal of Advanced Nursing, 381–391.

    Google Scholar 

  • Lytle, S. L., & Cochran-Smith, M. (1992). Teacher research as a way of knowing. Harvard Educational Review, 62(4), 447–474.

    Article  Google Scholar 

  • Mkandawire-Valhmu, L., & Doering, J. (2012). Study abroad as a tool for promoting cultural safety in nursing education. Journal of Transcultural Nursing, 23(1), 82–89. doi:10.1177/1043659611423831.

    Google Scholar 

  • Moceri, J. (2014). Hispanic nurses experiences of bias in the workplace. Journal of Transcultural Nursing, 25(15), 15–22. doi:10.1177/1043659613504109.

    Article  Google Scholar 

  • Mortensen, A. (2010). Cultural safety: Does the theory work in practice for culturally and linguistically diverse groups? Nursing Praxis in New Zealand, 26(3), 6–16.

    Google Scholar 

  • National Aboriginal Health Organization (NAHO). (2009, April). Cultural competency and safety in First Nations, Inuit and Metis health care. Retrieved December 2012, from http://www.naho.ca/documents/naho/english/factSheets/culturalCompetency.pdf

  • National Center for Cultural Competence. (2004). Curricula enhancement module series, National Center for Cultural Competence. Retrieved March 18, 2014, from Georgetown University Center for Child and Human Development http://www.nccccurricula.info/culturalcompetence.html

  • Nicoll, H., & Higgins, A. (2004). Reflection in preregistration nursing curricula. Journal of Advanced Nursing, 46(6), 578–585.

    Article  Google Scholar 

  • Nursing Council of New Zealand. (2011). Guidelines for Cultural Safety, the Treaty of Waitangi, and Maori Health in nursing education and practice. Retrieved March 17, 2014, from Nursing Council of New Zealand: http://www.nursingcouncil.org.nz/Publications/Standards-and-guidelines-for-nurses

  • Papps, E., & Ramsden, I. (1996). Cultural safety in nursing: The New Zealand experience. International Jouranl for Quality in Health Care, 8(5), 491–497. doi:10.1093/intqhc/8.5.491.

    Article  Google Scholar 

  • Ramsden, I. (2003). Cultural Safety Kawa Whakaruruhau. Retrieved September 10, 2010, from Massey University: http://culturalsafety.massey.ac.nz/

  • ReimerKirkham, S., Baumbusch, J., Schultz, A., & Anderson, J. (2007). Knowledge development and evidence-based practice, insights from a postcolonial feminist perspective for transformative nursing practice. Advances in Nursing Science, 30(1), 26–40.

    Article  Google Scholar 

  • Richardson, F., & Carryer, J. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 201–208.

    Google Scholar 

  • Richardson, S. (2004). Aoteaorora/New Zealand nursing: From eugenics to cultural safety. Nursing Inquiry, 11(1), 35–42.

    Article  Google Scholar 

  • Rolfe, G., & Gardner, L. (2006). Do not ask who I am…: Confession, emancipation and (self)-management through reflection. Journal of Nursing Management, 593–600.

    Google Scholar 

  • Ruth-Sahd, L. (2003). Reflective practice: A critical analysis of data-based studies and implications for nursing education. Journal of Nursing Education, 488–497.

    Google Scholar 

  • Schön, D. A. (1983). The reflective practitioner. New York: Basic Books, Inc.

    Google Scholar 

  • Schunk, D. H. (2012). Learning theories an educational perspective (6th ed.). Boston: Pearson.

    Google Scholar 

  • Seaton, L. (2010). Cultural care in nursing: A critical analysis. Sydney: University of Technology. Retrieved Jan 2013

    Google Scholar 

  • Shank, G., & Villella, O. (2004). Building on new foundations: Core principles and new directions for qualitative research. The Journal of Educational Research, 98(1), 46–54.

    Article  Google Scholar 

  • Srivastava, R. (2007). The health care provider’s guide to clinical cultural competence. Toronto: Elsevier.

    Google Scholar 

  • Tatum, B. D. (2009). Teaching white students about racism. In E. Taylor, D. Gillborn, & G. Ladson-Billings (Eds.), Foundations of critical race teory in education (pp. 275–288). New York: Routledge.

    Google Scholar 

  • Taylor, E. (2009). Foundations of critical race theory in education: An introduction. In E. Taylor, D. Gillborn, & G. Ladson-Billings (Eds.), Foundations of critical race theory in education (pp. 1–13). New York and London: Routledge.

    Google Scholar 

  • Teekman, B. (2000). Exploring reflective thinking in nursing practice. Journal of Advanced Nursing, 31(5), 1125–1135.

    Article  Google Scholar 

  • Thorpe, K. (2004). Reflective learning journals: From concept to practice. Reflective Practice, 5(3), 327–343.

    Article  Google Scholar 

  • Trinh T, M.-h. (1995). No master territories. In B. Ashcroft, G. Griffins, & H. Tifin, The post-colonial studies reader (pp. 215–218). London: Routledge.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2014). Healthy people 2020. Retrieved from Healthy People.gov: http://www.healthypeople.gov/2020/default.aspx

  • Villarruel, A. (2004). Introduction: Eliminating health disparities among racial and ethnic minorities in the United States. Annual Review of Nrusing Research, 22, 1–6.

    Google Scholar 

  • Williams, R. (1999). Cultural safety-what does it mean for our work practice? Australian and NewZealand Journal of Public Health, 23(2), 213–214.

    Article  Google Scholar 

  • de Witt, L., & Ploeg, J. (2006). Critical appraisal of rigour in interpretive phenomenological nursing research. Methodological Issues in Nursing Research, 215–229. doi:10.1111/j.1365-2648.2006.03898.x.

    Google Scholar 

  • Woods, M. (2010). Cultural safety and the socioethical nurse. Nursing Ethics, 17(6), 715–725.

    Article  Google Scholar 

  • Yurkovich, E., Hopkins-Lattergrass, Z., & Rieke, S. (2011). “Chaotic soup of politics:” A native American Indian mental health perspective. Mental Health, Religion & Culture, 14(10). doi:10.1080/13674676.2010.547986.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Washington State University Vancouver, Vancouver, WA, USA

    Lida Dekker

Authors
  1. Lida Dekker
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Brock University, St. Catharines, Ontario, Canada

    Hilary Brown

  2. Washington State University, Portland, Oregon, USA

    Richard D. Sawyer

  3. Brock University, St. Catharines, Ontario, Canada

    Joe Norris

Copyright information

© 2016 The Author(s)

About this chapter

Cite this chapter

Dekker, L. (2016). Cultural Safety and Critical Race Theory: Education Frameworks to Promote Reflective Nursing Practice. In: Brown, H., Sawyer, R., Norris, J. (eds) Forms of Practitioner Reflexivity. Palgrave Macmillan, New York. https://doi.org/10.1057/978-1-137-52712-7_5

Download citation

  • DOI: https://doi.org/10.1057/978-1-137-52712-7_5

  • Published:

  • Publisher Name: Palgrave Macmillan, New York

  • Print ISBN: 978-1-137-52711-0

  • Online ISBN: 978-1-137-52712-7

  • eBook Packages: EducationEducation (R0)

Publish with us

Policies and ethics

Search

Navigation