Fresh and focused

Third-year student’s perspective on cultural competence in midwifery lands her in journal. 

Koby Elliott, a third-year midwifery student at the University of Technology, Sydney, has been published in the journal Contemporary Nurse.

Her paper, Providing Culturally Competent Learning Experiences for Aboriginal Students: An undergraduate midwife’s perspective, revolves around the discussion of cultural competence in healthcare programs in higher education and improvements that could be made.

Elliott first began studying midwifery to help improve Aboriginal maternal and infant health outcomes and to provide Aboriginal and Torres Strait Islander women and their families with an Aboriginal midwife. She was encouraged by UTS lecturer Dr Tamara Power to adapt the paper from an essay she had submitted for an undergraduate midwifery subject assessment.

“I am the first person in my family to go to university, so to also have a paper published in a peer-reviewed journal as an undergraduate is an incredible achievement,” Elliott says.

She says it was an overwhelming feeling being accepted for publication. “It was hard work, but very rewarding,” she says. “I felt proud of my work and was overjoyed when I received news that it was accepted for publication.”

Nursing Review spoke to Elliott about the focus of her paper, the process of being published, and her plans for the future.

NR: Why did you decide to look into the area of learning experiences for Aboriginal students?

KE: Dr Tamara Power was a guest editor for the journal Contemporary Nurse and contacted me to see if I would be interested in turning my essay into an article for a special edition they were publishing on Indigenous health. The original piece of work was written as an assignment for a subject called Indigenous Health: Women and Babies, which is a core subject of the bachelor of midwifery degree at UTS. The essay was about developing culturally competent midwifery practice. However, clinical practice for student midwives most often occurs in mainstream health facilities. Despite numerous policies governing cultural safety in public hospitals, my own experiences as an Aboriginal midwifery student have shown that mainstream health facilities can be culturally unsafe places.

What were the main points you raised within the paper?

In the paper, I defined cultural competence for individuals and institutions and discussed what it means to be a culturally safe practitioner. I then outlined specific programs in Australia that are culturally appropriate and empowering for undergraduate Indigenous health practitioners. However, these programs are often run in rural and remote areas with the local communities. One of the main points raised in my paper was the lack of similar opportunities for urban students and the lack of Indigenous mentorship available in mainstream facilities. In a personal reflection, I shared several experiences of culturally unsafe incidents that left me feeling vulnerable and marginalised. The paper concluded with the recommendation that wherever possible, Indigenous students who desire to work with Indigenous people should be given clinical placements in Indigenous organisations; and where this is not possible workplaces should be prepared to ensure culturally safe working conditions.

What should be taken from the paper? What needs to be done to ensure there are culturally competent learning experiences for Aboriginal students?

I would like to see Aboriginal health students provided with the opportunity to do their clinical experience in facilities that cater primarily for Aboriginal and Torres Strait Islander peoples. If this is not available, I would like to see students supported in spending as much time as they can within services that cater to Aboriginal and Torres Strait Islander peoples. For mainstream services to ensure there are culturally competent learning experiences for Aboriginal health students, they need to provide Aboriginal facilitators/mentors and find out what each student needs to feel comfortable. Students are not going to learn and thrive in the clinical field if they feel threatened or judged in a service that is not culturally safe or culturally supportive. Since this paper went to press, I have continued to be exposed to culturally unsafe and at times overtly racist behaviour, which makes me realise how important it is to keep drawing attention to this issue. By publishing this paper, I hope to raise awareness of the issues Indigenous students face when studying mainstream health degrees.

What was the process of getting a paper published like? What did it involve?

It was a long process. It involved changing my original assignment essay into a piece of work that was suitable to be published. During this process, I worked closely with Power. The piece was then submitted to the journal, for blind review by two people. The paper was returned to me and I was notified that it was accepted for publication pending some minor changes. It was a long process, but it was extremely rewarding.

How can other follows in your footsteps? Do you have any advice for those who are looking to be published?

For students looking to be published, I think having faith in their own abilities and passion for what they are doing is a good place to start. I would not have had the opportunity to be published if I was not supported by Power, so I think it is important for lecturers to provide opportunities, encourage and support aspiring students with the process.

What will your focus be as you move into the workforce? Would you like to work in the area of research or academic?

My focus as I move into the workforce is in Aboriginal maternal and infant health. I would like to work within an Aboriginal maternal and infant health service part-time to keep my clinical skills up to date and provide Aboriginal and Torres Strait Islander women and their families with an Aboriginal midwife. In addition to my studies, I also work part time on several research grants as a research assistant. In the future, I aim to undertake higher degree research so that I can continue to contribute at a high level to the health and wellbeing of Indigenous people.

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