Translating Cultural Safety to the UK.

Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The 'Black Lives Matter' movement has exposed structural racism's contribution to these health inequities. 'Cultural Safety', an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.This paper explores what it means to be 'culturally safe'. The ways in which New Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the 'nuts and bolts' of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation.

Early career midwives' perception of their teamwork skills following a specifically designed, whole-of-degree educational strategy utilising groupwork assessments.

OBJECTIVE: The aim of this study was to investigate whether a specifically designed whole-ofdegree strategy utilising groupwork assessments was effective in facilitating the development of early career midwives' teamwork skills. DESIGN AND METHODS: A qualitative study using in-depth, semi-structured interviews was undertaken with early career midwives who had graduated within the previous two years. This study is the final cycle of a larger participatory action research project. Qualitative data was analysed using thematic analysis. PARTICIPANTS: Nineteen early career midwives from one Australian university participated. Their preregistration education was via a Bachelor of Midwifery. Their education included a whole-of-degree educational strategy to facilitate the development of teamwork skills. FINDINGS: One overarching theme "Becoming an Effective Team Member' and three sub-themes: 'Learning and developing Teamwork Skills'; 'More secure and confident' and 'Self-Assurance in interprofessional interactions' were identified in the interview data. Despite their junior status, the midwives demonstrated the knowledge, skills, and attitudes of an effective team member. Their social and emotional skills appeared well developed and they felt confident interacting with other health care workers in a professional manner. KEY CONCLUSIONS: Early career midwives who were taught and practiced teamwork skills throughout their degree, appear to have developed the social and emotional competencies required for effective teamwork. IMPLICATIONS FOR PRACTICE: The capacity for effective teamwork of this small group of early career midwives has the potential to improve the quality and safety of their care for childbearing women. Learning teamwork skills in the educational setting appears to have generated skills focused on conflict resolution, emotional self-regulation and social and emotional competency in these new midwives. These are favourable skills in the emotionallycharged environment of maternity care, where inter-collegial bullying is present and where new midwives can experience poor psychological wellbeing. Health care employers want new graduate health professionals to be work ready and to have the skills necessary to be effective team members. The program undertaken by these new graduates may be of assistance in developing these capabilities in other health students. THE KNOWN: Teamwork skills are an intrinsic part of the day-to-day activities of maternity services, influencing the workplace culture, retention of midwives and the quality and safety of care. Poor teamwork is associated with clinical errors, bullying and high turnover of staff. THE NEW: Early career midwives who were taught teamwork skills and practice these skills using their groupwork assignments throughout their undergraduate degree appear to demonstrate the social and emotional competencies required for effective teamwork. THE IMPLICATIONS: Implementing a whole-of-degree program to develop teamwork skills in undergraduate midwifery students may improve early career midwives' social and emotional competencies and interactions with other health professionals. Learning teamwork skills in the educational setting may generate skills in the new midwife that focus on conflict resolution, emotional self-regulation, and social and emotional competency. These are favourable skills in the emotionally charged environment of maternity care, where inter-collegial bullying is present and where new midwives can experience poor psychological wellbeing.

'TeamUP': An approach to developing teamwork skills in undergraduate midwifery students.

OBJECTIVE: to develop an effective model to enable educators to teach, develop and assess the development of midwifery students' teamwork skills DESIGN: an action research project involving participant interviews and academic feedback. SETTING: a regional university PARTICIPANTS: midwifery students (n = 21) and new graduate midwives (n = 20) INTERVENTIONS: a whole of course program using a rubric, with five teamwork domains and behavioural descriptors, to provide a framework for teaching and assessment. Students self and peer assess. Lectures, tutorials and eight different groupwork assignments of increasing difficulty, spread over the three years of the undergraduate degree are incorporated into the TeamUP model. FINDINGS: the assignments provide students with the opportunity to practice and develop their teamwork skills in a safe, supported environment. KEY CONCLUSIONS: the social, emotional and practical behaviours required for effective teamwork can be taught and developed in undergraduate health students. IMPLICATIONS FOR PRACTICE: students require a clear overview of the TeamUP model at the beginning of the degree. They need to be informed of the skills and behaviours that the TeamUP model is designed to help develop and why they are important. The success of the model depends upon the educator's commitment to supporting students to learn teamwork skills.