Student placements in First Nations practice contexts should always be based on the principle that they are ‘a privilege and not a right’ (Whitford, Taylor & Thomas, 2013, p.340).
Pre-placement: Supervisor reflection
Many allied health professionals have extensive experience as student supervisors but have limited experience providing care for First Nations people. Prior to offering a placement in a First Nations health setting or with First Nations people, supervisors should consider their responses to the following questions, and seek to enhance their professional development to ensure they provide appropriate support for First Nations students or when working with First Nations people:
- What is my understanding of the complex history of Australia’s First Nations peoples?
- What is my attitude towards First Nations people and my understanding of First Nations culture?
- How will my views affect my working relationship with this student?
- What learning and training do I have in supporting First Nations students? What additional support and learning do I need?
- What learning and training have I received that would help me provide guidance to non-Indigenous students in providing culturally safe and responsive care?
Useful resources:
Pre-placement: Planning
First Nations health issues are often complex and multi-layered. Supervisors should consider general factors when they have students entering a community or culture that is different from their own. Supervisors should also be aware that students may come to the placement with varying awareness of:
- The health inequity that exists and the historical reasons that have led to the inequity for First Nations people.
- The unconscious biases they (the student) possess, and how it may impact on the care they can deliver.
- The importance of drawing on local knowledge and the client’s connection to family, community, country, and culture as part of the care they deliver.
Placements in First Nations communities need flexibility, patience, a degree of informality and an essential respect for First Peoples. “If you’ve got a person with the right attitude, who’s non-judgemental, who’s open, willing to accept difference, then they will learn those cultural things as they go along” (Nelson, Allison & Copley, 2007, p.211).
Additional questions supervisors and students could consider when determining their professional development and/or placement needs include:
- Will the students need a 'cultural mentor' and are they available within the placement organisation?
- How can First Nations associations or networks support the student on placement?
- Are students connected with key First Nations and discipline specific First Peoples networks?
- How can I role-model what I can bring to the health service as a non-indigenous person and how can I ensure my First Nations colleagues are valued for their cultural knowledge and contribution in Western healthcare services?
It is important to reflect on these questions and discuss them with the student at the commencement of their placement. From the discussion, determine the appropriate strategies that facilitate a culturally safe environment for everyone.
Students often feel under-prepared for these types of placements. In the report, 'I Wish I Knew Then What I Know Now', students reflected on their placement experiences in First Nations settings, and provided practical suggestions on how they could be better prepared.
A student faced with the data and life experiences on the differences in health outcomes between First Nations people and other Australians might find the information confronting. Supervisors are recommended to facilitate students’ understanding of the historical, social, economic, political and cultural determinants that impact on health outcomes of First Nations peoples, particularly in relation to those that they are managing. Planning student placements in culturally diverse health settings provides some useful strategies for supervisors to start these conversations.
