Reflective Cycle Interactive Tool

Introduction
Cultural Safety involves a process of constant self-reflection and a commitment to transformative action, informed by the perspectives of patients, whānau and communities. Such critical consciousness development requires healthcare practitioners to actively work towards normalising and embedding practices and systems that contribute to culturally safe environments, and to health equity. 

This Reflective Cycle is designed for individual health professionals to aid the process of embedding and habitualising self-reflective and reflexive practice. 

Reflective practice involves thinking about past experiences to inform future actions. Reflexive practice goes deeper - examining how your own position, beliefs, and actions influence situations and outcomes. For example;

Reflective = considering how a patient interaction went

Reflexive = examining how your own cultural background and assumptions influenced that interaction, and considering whether a change in approach is needed

This Reflective Cycle is designed to complement the Self-reflective Tool and the Transformative Action Tool by; providing real-time application of self-reflection principles, creating structured learning from each interaction, building habits of continuous improvement, and documenting growth over time.

It forms part of the suite of tools in the Council of Medical Colleges Cultural Safety Toolkit[1], providing resources to operationalise the Cultural Safety Training Plan for Vocational Medicine in Aotearoa 2023[2].

[1] See the Council of Medical Colleges website for other Cultural Safety Tools.  Similar tools drawn on to inform the development of this Reflective Cycle Tool include:  Gibbs Reflective Cycle, Kolb’s Reflective Cycle, ERA reflective cycle.
[2] Simmonds et al 2023

Author: Shirley Simmonds, peer review: Mataroria Lyndon
Graphics: Krishni Manek – Neo Design thisisneo.co.nz

Healthcare professionals have an important role as navigator and ‘border worker’ at the interface between patients, whānau and communities, and the wider healthcare ecosystem.  Those who work at this ‘border’ are required to recognise ideas or idealogical codes in the community that they serve, and have an advocacy role and influence in the health system. This role also requires knowledge and awareness of the different organisations, services, and providers in the healthcare ecosystem, knowledge of the activities and influence of each, and one’s own locus of power within the ecosystem.  Culturally safe practice requires that the needs, aspirations, experiences and perspectives of patients, whānau and communities are always centred.

The diagram below provides a visual representation of the role of the healthcare worker, the healthcare ecosystem, and the wider socio-political context, with patients, whānau and communities at the centre.

Graphic design credit, Krishni Manek – Neo Design, thisisneo.co.nz

Consider an experience, task, or interaction you encounter as part of your healthcare role.  In readiness before the interaction, enter the cycle below at the ‘Plan and Prepare’ stage in order to plan in advance. Consider the questions, making notes if needed, and undertaking any research or background work required. Then follow through the cycle to ‘Experience’, ‘Reflect’, and ‘Transform’.

While it is ideal to enter the cycle at the ‘Plan and Prepare’ stage, in practice it can be entered at any stage – for example, following an interaction that has already happened, the cycle can be entered at the ‘Reflection’ stage. The tool is designed largely for interactions between healthcare professionals and patients, whānau and communities, however it can also be applied to interactions within the workforce and interactions with the organisation you work for or other organisations in the healthcare ecosystem. This tool can be incorporated as part of a continuing professional development plan. 

Reflective Cycle

Contact data is collected to allow a summary of your responses to be emailed to you for your records. All responses are deleted from the system after 30 days.

• Ensure I remain alert to the impact of unanticipated biases and privileges.
• Find ways to relinquish and leverage my own power to foster shared decision making and informed consent.
• Clarify my sphere of influence in the healthcare ecosystem if needed, including what I can and cannot do.
• Look for opportunities to advocate for patient, whānau and communities in the healthcare ecosystem, including identifying and influencing barriers and solutions.
• Continue to incorporate patient, whānau and community feedback and perspectives into healthcare planning and decision-making.

• Partake in educational opportunities or undertake further research on implicit bias, privilege, racism, critical consciousness development, power dynamics, communication skills.
• Further investigate own background, history and positionality.
• Initiate and strengthen relationships with other providers and organisations in the healthcare ecosystem.
• Initiate and strengthen community relationships.
• Explore different ways to seek and incorporate patient, whānau and community perspectives.