Critical theory and cultural competency in medical QI projects

Lessons from Pacific Islander communities

Bibliographic Data

ID21342821
AuthorsAdam Martorana (0009-0002-6117-3848, A.T. Still University, corresponding author), Sankalp Katta (A.T. Still University), Hanna Huynh (A.T. Still University), Ezgi Ulger (A.T. Still University), Jeffrey Andrion, Jeffrey John Andrion (University of Toronto)
Year2025
Volume57
Issue2
Pages257-262
Publication date2025-03-01
Open AccessYes
TypeARTICLE
VenueJournal of Biosocial Science (JOURNAL)
Journal identifiersISSN: 0021-9320 • E-ISSN: 1469-7599
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0021932025000100
PMID40012300
OpenAlexW4408004944
LanguageEN
Citations received1
References cited24

This reflection explores the transformative power of critical theory through a quality improvement (QI) project creating culturally relevant dietary resources for Pacific Islander communities in Washington State, USA. Food injustice and lack of food sovereignty are examined as manifestations of modern-day colonialism perpetuated by capitalist-driven social structures. The methodology employed critical reflection, defined as the process of examining assumptions and power relations that shape practice, central to critical theory. Iterative group discussions aimed to understand the impact of individual and collective assumptions, power dynamics, and oppression on the project’s conceptualization, implementation, and evaluation. Specific recommendations are integrated into the discussion to aid those replicating similar protocols, emphasizing actionable steps such as engaging with the community at all project stages. The research team, composed of osteopathic medical students and a critical theory expert, engaged in reflexivity to understand how social locations and lived experiences influenced perceptions. Despite the goal of fostering cultural inclusivity, limitations in engaging the Pacific Islander community throughout the project lifecycle highlighted the need for cultural humility and participatory action methodology. This study underscores the importance of understanding the history and socio-political context of marginalized communities to avoid perpetuating colonial practices and trauma. It emphasizes the necessity for medical schools to incorporate sociological theories into curricula to promote compassionate, culturally appropriate care and research. By critically examining positionality and engaging in transformative learning, the group advocates for systemic changes towards a more equitable global healthcare system. Through critical reflection, the group has come to understand how lived experiences have shaped perceptions of oppression, which are entrenched within and perpetuated by social institutions. Actionable items from these reflections are presented to help future practitioners and educators apply cultural humility, community empowerment, and critical theory in QI projects

Conceptualization · Cultural competence · Cultural humility · Ethnic group · Health care · Health equity · Oppression · Pacific islanders · Participatory action research · Pedagogy · Political science · Politics · Public relations · Reflexivity · Social science · Sociology · Transformative learning · Cultural Competency in Health Care · Dietetics, Nutrition, and Education · Law · Service-Learning and Community Engagement

Tools

Open DOIOpen Access