{"id":10010,"date":"2022-02-07T06:00:36","date_gmt":"2022-02-07T05:00:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10010"},"modified":"2022-01-31T19:00:32","modified_gmt":"2022-01-31T18:00:32","slug":"starting-a-consult-with-cultural-safety-adopting-a-tikanga-maori-inspired-approach-to-practice","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2022\/02\/07\/starting-a-consult-with-cultural-safety-adopting-a-tikanga-maori-inspired-approach-to-practice\/","title":{"rendered":"Starting a consult with cultural safety: Adopting a Tikanga M\u0101ori inspired approach to practice"},"content":{"rendered":"<p><em>How a quick and easy greeting can be used to enhance cultural safety in clinical practice. Part of the BJSM&#8217;s &#8216;Young clinician blog series&#8217;.<\/em><\/p>\n<p>\u201cKia ora. Just before beginning, I would like to introduce myself if that\u2019s okay? My name is Callum Law and I&#8217;m 25 years old, P\u0101keh\u0101 (white), and currently studying towards my Master\u2019s in Physiotherapy. I was born in Plymouth, England, but was raised by my two parents in Wellington, New Zealand, alongside my older sister. I\u2019m hoping to return to Wellington next year with my girlfriend and squeeze in all of the kayaking, surf, and sports that the windy city allows. I\u2019m sharing this with you as I\u2019m continually trying to develop awareness of how my privilege, biases, and culture, may influence my interactions with clients, and their health outcomes. Please feel free to share anything about yourself if you would like?\u201d<\/p>\n<p>Above, reflects a similar introduction as to how I begin consults; by sharing information that depicts a part of my culture and giving others the platform to do so also. This approach is something that I\u2019ve adapted from Tikanga M\u0101ori (M\u0101ori culture) as a practical means to aid my culturally safe practice, and I intend to share why.<\/p>\n<p><u>Cultural safety in Aotearoa New Zealand<\/u><\/p>\n<p>Globally, health inequities remain prevalent amongst indigenous and minority groups<sup>3<\/sup>. Within New Zealand, M\u0101ori have the worst health status of any ethnic group, even when adjusting for socioeconomic discrepancies.<sup>4<\/sup> In part, this is consequential to the power imbalance between client and clinician, often fuelled by the clinician\u2019s unconscious bias<sup>4<\/sup>. Health inequities are further exacerbated by poor communication, a lack of shared decision-making, a lack of respect, and a lack of trust between parties<sup>4<\/sup>. Culturally safe practice aims to rectify health inequities by reflecting and acknowledging the barriers to effective health care that stem from inherent power imbalance between client and clinician<sup>5<\/sup>. Additionally, cultural safety involves the acknowledgement of one\u2019s own culture, whilst recognising and respecting the cultural identity of others<sup>6<\/sup>. Therefore, cultural safety should be central to all health providers practice as a means of promoting high-quality, patient-centred care, and health equity.<\/p>\n<p>Developing culturally safe practices with M\u0101ori is essential for health professionals within Aoteroa New Zealand. One method that may be considered to improve cultural safety is learning one\u2019s Mihimihi. In Tikanga M\u0101ori, a Mihimihi is an introductory greeting or speech which often involves sharing one\u2019s Whakapapa (genealogy) and specific geological features pertaining to their identity<sup>7<\/sup>. A Mihimihi can be used to establish ties between individuals by sharing culturally significant aspects of themselves. It is becoming better recognised that health practitioners should not solely focus on learning other\u2019s cultural practices but aim to acknowledge their own cultures and how these may influence interactions. Therefore, even though learning one\u2019s Mihimihi could be a productive step towards promoting M\u0101ori culture, we don\u2019t necessarily have to emulate this cultural practice to ensure cultural safety, but rather acknowledge and learn from it. One way of doing this may be adapting the Mihimihi for universal clinical use by adopting the concept of sharing cultural identity as a way of greeting clients.<\/p>\n<p><u>Applying a Mihimihi inspired greeting in clinical practice<\/u><\/p>\n<p>If you\u2019re wondering where to begin in sharing your cultural identity, <em>Te Taura Whiri<\/em>\u00a0I te Reo M\u0101ori (The M\u0101ori Language Commission) has recently been encouraging people to learn their Mihimihi under the social media hashtag #MyMihi<sup>7<\/sup>, which is one place to start. Image 2 provides a framework on which you may wish to base your approach. The format I used in the first paragraph is one of many examples. What you consider sharing with your clients might be something very different, something verbal, visual, or physical, that represents yourself much better. There are many approaches you may take towards sharing a part of your cultural background with clients. Regardless of the approach, sharing something personal will take a step towards acknowledging your cultural influences and help to create a culturally safe environment for consultation. Sharing personal information is also exposing and demonstrates a vulnerability similar to that experienced by clients when sharing information with a health professional. Consequently, this may help in dismantling the power imbalance between clinician and client, and with it, its negative influence upon health outcomes.<\/p>\n<figure id=\"attachment_10011\" aria-describedby=\"caption-attachment-10011\" style=\"width: 702px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-10011\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2022\/01\/MyMihi.png\" alt=\"\" width=\"702\" height=\"324\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2022\/01\/MyMihi.png 1057w, https:\/\/blogs.bmj.com\/bjsm\/files\/2022\/01\/MyMihi-300x139.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2022\/01\/MyMihi-768x355.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2022\/01\/MyMihi-640x295.png 640w\" sizes=\"auto, (max-width: 702px) 100vw, 702px\" \/><figcaption id=\"caption-attachment-10011\" class=\"wp-caption-text\"><em>Source: PSA.org.nz https:\/\/www.psa.org.nz\/quick-menu\/working-life\/psa-working-life-journal\/my-mihi-challenge\/<\/em><\/figcaption><\/figure>\n<p>Since first utilising this approach, I perceive that can develop a stronger and more trusting partnership with clients. Providing each other with cultural background has helped to establish links, acknowledge differences, and develop new ways to collaborate across cultures. In some cases, individuals have used the safe environment to open up about their comfort with exposing body parts, physical touch, belief\u2019s surrounding their presentation, and expectations from treatment. Learning about client\u2019s families, friends, upbringings, religions, and experiences, whilst considering my own, aids my culturally safe approach to treatment every day.<\/p>\n<p><u>Concluding thoughts<\/u><\/p>\n<p>The M\u0101ori customary practice of a Mihimihi provides an effective framework for sharing a part of one\u2019s cultural identity. Universally, we can learn from this practice by embracing our own culture whilst acknowledging other\u2019s to facilitate a culturally safe environment. By itself, adopting this approach does not assure cultural safe practice. However, it does provide an efficient method to greet clients that may improve partnerships across cultures.<\/p>\n<p>Ng\u0101 mihi nui,Callum Law<\/p>\n<p><strong>Author and Affiliations:<\/strong><\/p>\n<p>Callum is a Physiotherapist from Wellington, although has spent most of 2021 working out of Dunedin whilst working and studying towards his Master\u2019s in Physiotherapy at the University of Otago, Aotearoa New Zealand. Callum&#8217;s post-graduate studies challenged him to explore novel and innovative approaches to practice, providing Callum with the platform to explore his\u00a0own believes surrounding the importance of building a strong client-clinician relationship, of which he considers cultural safety to form the crux of.<\/p>\n<p><a href=\"mailto:callum.e.law@gmail.com\">callum.e.law@gmail.com<\/a><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>How a quick and easy greeting can be used to enhance cultural safety in clinical practice. Part of the BJSM&#8217;s &#8216;Young clinician blog series&#8217;. \u201cKia ora. Just before beginning, I would like to introduce myself if that\u2019s okay? My name is Callum Law and I&#8217;m 25 years old, P\u0101keh\u0101 (white), and currently studying towards my [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2022\/02\/07\/starting-a-consult-with-cultural-safety-adopting-a-tikanga-maori-inspired-approach-to-practice\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":404,"featured_media":10011,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068],"class_list":["post-10010","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-featured"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Starting a consult with cultural safety: Adopting a Tikanga M\u0101ori inspired approach to practice - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/?p=10010\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Starting a consult with cultural safety: Adopting a Tikanga M\u0101ori inspired approach to practice - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"How a quick and easy greeting can be used to enhance cultural safety in clinical practice. Part of the BJSM&#8217;s &#8216;Young clinician blog series&#8217;. \u201cKia ora. Just before beginning, I would like to introduce myself if that\u2019s okay? 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