This signifies a growing awareness, building foundational knowledge and skills, and recognising power imbalances and the need for transformative change. It highlights understanding one's cultural positioning and biases, and the influence of these on professional and personal interactions.

It indicates an awareness of one’s cultural positioning and biases and how they shape professional and personal interactions.

Developing understanding and initiating transformative action

This signifies a growing awareness, building foundational knowledge and skills, and recognising power imbalances and the need for transformative change. It highlights understanding one's cultural positioning and biases, and the influence of these on professional and personal interactions.

It indicates an awareness of one’s cultural positioning and biases and how they shape professional and personal interactions. This signifies deeper understanding and the beginning of transformative action, putting into practice behaviours and actions that support and promote cultural safety.

This marks the beginning of cultural safety awareness. It requires acting on insights gained through reflection, taking deliberate steps to shift behaviours, challenge biases, and engage in culturally safe practices. This initiates the shift from unconscious behaviour to intentional reflection and responsibility
This signifies ongoing practices that promote cultural safety, and that these practices have become embedded.

It does not signal an ‘end point’ but indicates the continuing pursuit of advancement and growth, and habitualised self-reflective practices.

Embedding practices and continued reflection

This signifies ongoing practices that promote cultural safety, and that these practices have become embedded.

It does not signal an ‘end point’ but indicates the continuing pursuit of advancement and growth, and habitualised self-reflective practices.

I have some awareness and knowledge of my own cultural heritage, values and history, and recognise it would be beneficial to learn and explore more

I am aware of my own positionality (ethnicity, gender, sexual orientation, age, social class, religion etc) and how each contributes to my identity and interactions as a medical professional

I have an awareness of my roles in life (e.g. parent, sibling, child, friend, scholar etc) and how these impact my identity and interactions as a medical professional

Developing understanding and initiating transformative action

I have a good awareness and knowledge of my own cultural heritage, values and history and have spent some time learning and exploring this.

I have deepened my knowledge on my own positionality, and life roles and continue to explore these aspects of my identity.

I often reflect on how my own culture impacts interactions with others as a medical professional, and I change my behaviours accordingly when I recognise practices that do not contribute to a culturally safe environment.

Embedding practices and continued reflection

I have an excellent awareness and knowledge of my own cultural heritage, values and history, and have committed a lot of time to learning and exploring this, consistently reflecting on how they shape my interactions and behaviours and my practice of medicine.

I often reflect on how my culture, positionality and roles in life impact interactions with others as a medical professional.

I have a deeper understanding of my cultural heritage and values, consistently reflecting on how they shape my interactions and behaviours.

I understand my own identities, culture and dimensions of power/privilege, and how these potentially impact my practice of medicine.

I have implemented many culturally safe practices that are now part of my regular practice, and I continue to reflect on my interactions to identify further areas of change.

I have some awareness of how biases, attitudes, assumptions, stereotypes and prejudices can affect interactions with others

I am aware of some of my own biases and recognise the need to address these

I recognise there is bias in medical practice at all levels: personal, horizontal (within workforce), vertical (in the workplace and wider healthcare ecosystem).  This includes teaching, management, workforce, research, collection & use of data, and in the delivery of care

Developing understanding and initiating transformative action

I am aware of a lot of my own biases and have a deeper understanding of how they can affect my interactions as a medical professional

I actively work to address and mitigate these biases and have changed my thinking and practice to ensure they contribute to culturally safe environments

I actively work to identify, address and mitigate biases in my workplace and the wider healthcare ecosystem, across the different dimensions in medicine

Embedding practices and continued reflection

I have an excellent awareness of bias in medical practice at all levels and how biases, attitudes, assumptions, stereotypes  and prejudices can affect interactions with others and medical practice

I have an excellent awareness of my own biases, and have changed my thinking and practice in many respects in order to contribute to culturally safe environments

I consistently reflect on how biases affect my medical practice. I have integrated ongoing self-assessment into my professional development

I consistently identify and work towards addressing biases amongst colleagues in my workplace and the wider healthcare ecosystem.

Occasionally I engage in self-reflection and self-awareness of my own conduct to identify oppressive practices in my medical practice and interactions with others.

I recognise the need to address some oppressive practices in my conduct and interactions with others.

I am aware I need to be open to receiving feedback and to making transformative changes.

I recognise that oppression and marginalisation (at all levels) can impact patient and whānau experience, health outcomes, and progress towards equity.

Developing understanding and initiating transformative action

I actively engage in self-reflection and self-awareness of my own conduct to identify oppressive practices in my medical practice and interactions with others.

I have identified and addressed some oppressive practices in my conduct and interactions with others.

I am open to receiving feedback and to making transformative changes.

I have identified and addressed some oppressive and marginalising practices (at different levels in the healthcare ecosystem). 

Embedding practices and continued reflection

I regularly engage in self-reflection and self-awareness of my own conduct to identify oppressive practices in my medical practice and interactions.

I have identified and addressed several oppressive practices and undertaken transformative change that contributes to culturally safe environments.

I have embedded several practices that encourage ongoing self-reflection and anti-oppressive practice.

I continue to be alert to further oppressive and marginalising practices (at all levels of the healthcare ecosystem) in order to identify other areas of change

Occasionally I engage in self- reflection and self-awareness of my own conduct to identify oppressive practices with colleagues in the workplace.

I am aware I need to implement further practices to encourage ongoing self- reflection.

I am aware I need to be open to receiving feedback from colleagues and supervisors, and to making transformative changes.

I recognise the need to address some oppressive practices.

I am sometimes alert to oppressive practices such as bullying, microaggressions, silencing behaviours and aversive body language by colleagues in the workplace.

Developing understanding and initiating transformative action

I often engage in self- reflection and self-awareness of my own conduct to identify oppressive practices with colleagues in the workforce.

I have implemented some practices in my regular routine that encourage ongoing self-reflection on interactions with colleagues in the workforce.

I have identified and addressed some oppressive practices, making changes that contribute to culturally safe environments.

I have identified and respectfully addressed some oppressive practices by colleagues in the workplace, and am alert to workplace hierarchies and dynamics.

Embedding practices and continued reflection

I regularly engage in self- reflection and self-awareness of my own conduct to identify oppressive practices with colleagues in the workforce.

I have normalised several practices in my regular routine that encourage ongoing self-reflection of interactions with colleagues in the workforce.

I have identified and addressed several oppressive practices, making changes that contribute to culturally safe environments, and I actively foster an inclusive and respectful environment.

I continue to look out for further oppressive practices in my own practice, and in the practice of colleagues order to identify other areas of change.

Developing understanding and initiating transformative action

I have demonstrated some commitment to transformative change and normalising practices that contribute to equity and ongoing advancement towards optimal health, particularly for Māori and other groups that experience inequitable health outcomes.

I regularly reflect on my practice, through activities such as; keeping a self- reflection journal, peer group sharing of solutions and alternative practice, receiving feedback from colleagues, supervisors, patients, whānau and communities and others in the wider healthcare ecosystem.

Embedding practices and continued reflection

I have demonstrated a high level of commitment to transformative change and normalising practices that contribute to equity and ongoing advancement towards optimal health, such as; keeping a self-reflection journal, peer-sharing of solutions and alternative practices, positive feedback from colleagues and/or patients, whānau and communities, supervisors, and others in the wider healthcare ecosystem.

I have integrated transformative change practices into my medical practice.

I support, mentor, lead, or teach others to engage in transformative change that contributes to equity.

I have a strong focus on continuing to advance strategies to maintain meaningful change in the workplace and wider healthcare ecosystem, promote culturally safe environments and progress towards equity.