Assessing Indigenous Cultural Safety Learning using Modified Reflexive Visual Arts

  • Jason Min Faculty of Pharmaceutical Sciences - University of British Columbia
  • Kimberley MacNeil University of British Columbia, Faculty of Pharmaceutical Sciences
  • Filip Zekic University of British Columbia, Faculty of Pharmaceutical Sciences
  • Larry Leung University of British Columbia, Faculty of Pharmaceutical Sciences
Keywords: cultural safety, cultural competency, qualitative assessment, Indigenous health, photovoice, assessment, pharmacy education


Objective: Assessing Indigenous cultural safety learning in pharmacy students using modified reflexive visual arts

Innovation: Traditional quantitative assessment methods are often ineffective and impractical for the evaluation of Indigenous cultural safety learning. Existing qualitative assessment methods have shown potential in small-class and experiential environments, but evidence to guide the scalability and use in a large lecture format is sparse. An innovative, visual arts-based qualitative assessment of cultural safety learning was developed and deployed to 223 first-year pharmacy students. The assessment was deployed in a pre- and post-term style in a foundational pharmacy module that included content on Indigenous health and cultural safety. The pre-term assessment included two activities for students: 1) a visual art self-reflection requiring students to use any visual art medium to depict what they think it means to practice as a pharmacist with cultural safety, accompanied by a brief written description and (2) an in-class session with a brief lecture component, small and large group sharing of reflections, debrief of experiences, and student peer review of the visual reflections. The post-term portion included a similar self-reflection activity and an in-class session that now asked students in their small groups to: 1) compare their pre/post reflections, and 2) collectively create a new summative visual that depicts the entire group’s thoughts. Surveys and a focus group were used as an additional source of data.

Critical Analysis: Survey responses (n=215) indicated that feedback for the assessment was highly positive, with 77% of students recommending the activity for future first-year pharmacy students. Students also validated the utility of the assessment, with 70% strongly or somewhat agreeing that the activity was valuable for their learning, 80% strongly or somewhat agreeing that the activity stimulated their thinking, and 81% strongly or somewhat agreeing the activity accurately reflected their true feelings on practicing cross-culturally.


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Received 2021-01-18
Accepted 2021-06-17
Published 2021-07-15