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Indiana University School of Medicine
Indiana University School of Medicine
Internal Medicine

Sustainable Engagement

Rightful Presence - Cultural Humility - Authenticity and Self-Care - Recognition and Joy

Rightful Presence

Rightful presence is a teaching and learning framework offered by Calabrese Barton and Tan (2019) that emphasizes justice and allows educators to acknowledge the political hierarchies that exist in education environments. To adopt rightful presence means to embrace the socio-historical insights that individuals bring with them to the educational space. Overall, to embrace rightful presence is to know that an individual’s right to be in an environment begins with their presence.

  1. Calabrese Barton, A., and E. Tan. “Designing for Rightful Presence in STEM: The Role of Making Present Practices.” Journal of the Learning Sciences, vol. 28, no. 4–5, 2019, pp. 616–658. https://doi.org/10.1080/10508406.2019.1591411.
  2. “Disrupting Power and Reimagining Support: Six Actions for Centering Students' Humanity in Education.” Makeeba Consulting, https://makeebaconsulting.com/blog.
  3. Gyles, Symone A., and Heather F. Clark. “(Re)Defining Expert in Science Instruction: A Community-Based Science Approach to Teaching.” Cultural Studies of Science Education, vol. 19, no. 1, 2024, pp. 117–140. doi:10.1007/s11422-023-10202-2.
  4. Sharp, S., Clarke, A. H., and O. P. Okoruwa. “Why Do I Need to Belong? Black Women and Latinas Navigate Medical Education beyond Belonging toward Rightful Presence.” BMC Medical Education, vol. 25, 2025, p. 1205. https://doi.org/10.1186/s12909-025-07781-9.

Cultural Humility

Cultural humility is a practice and commitment designed to consistently evaluate and critique actions for the purpose of reducing power imbalances. Cultural humility involves reflecting on the various socio-historical backgrounds that exist in the environment to explore how those backgrounds may impact said environment. Organizations and individuals engaging in cultural humility have the desire to fix power imbalances and develop partnerships with groups who lack necessary resources.

 

Image Source: The cultural awareness-cultural safety spectrum, featured on ClinicalLeader.com

Graphic shows the cultural awareness-cultural safety spectrum Companies, teams, and individuals start their journey at the awareness level and progress through learning, understanding, and self-reflection to cultural humility

  1. Blue, B., A. Pierre, and J. Mikhael. “Culturally Responsive Care Delivery in Oncology: The Example of Multiple Myeloma.” Clinical Lymphoma, Myeloma & Leukemia, vol. 23, no. 9, Sept. 2023, pp. 651-659. doi:10.1016/j.clml.2023.05.005.
  2. Cultural Sensitivity – A Pocket Guide for Health Care Professionals. Joint Commission Resources Mission, 2012. https://ogg.osu.edu/media/healthliteracy/pdfs/Cultural_Sensitivity.pdf.
  3. “How Psychological and Cultural Safety Can Accelerate Diverse Patient Recruitment and Retention.” By Valerie Schaeffer, The DOT Connector, LLC, 2022. https://www.clinicalleader.com/doc/how-psychological-and-cultural-safety-can-accelerate-diverse-patient-recruitment-and-retention-0001.
  4. “What Is Culturally Sensitive Trauma-Informed Care?” HealthCare Toolbox, https://www.healthcaretoolbox.org/culturally-sensitive-trauma-informed-care.

Authenticity and Self-care

Authenticity and self-care mean acting in alignment with core values and being genuine while also maintaining professional boundaries for purposes of self-preservation. Authenticity and self-care involve multifaceted and purposeful engagement in strategies that promote healthy functioning. Being and promoting authenticity and self-care can lead to psychologically safe work environments and can help eliminate bias.

  1. Finucane, Adair, Mickey Sperlich, and Whitney Mendel. “Weaving in Wellness: Infographics for Self-Care.” Journal of Human Services: Training, Research, and Practice, vol. 6, no. 1, 2020, Article 5. https://scholarworks.sfasu.edu/jhstrp/vol6/iss1/5.
  2. “How to Bring Your Authentic Self to Work.” Harvard Business Review, Dec. 2023, https://hbr.org/2023/12/how-to-bring-your-authentic-self-to-work.
  3. Kazmierczak, M., A. Albahri, and C. Mull. “A Call to Restore Your Calling: Self-Care of the Emergency Physician in the Face of Life-Changing Stress.” Pediatric Emergency Care, vol. 36, no. 5, 2020, pp. 257-261. doi:10.1097/PEC.0000000000002098.
  4. Micklitz, K., G. Wong, and J. Howick. “Mindfulness-Based Programs to Reduce Stress and Enhance Well-Being at Work: A Realist Review.” BMJ Open, vol. 11, no. 3, 19 Mar 2021, e043525. doi:10.1136/bmjopen-2020-043525.
  5. Mull, C., and W. Bowman. “A Call to Restore Your Calling: Self-Care of the Emergency Physician in the Face of Life-Changing Stress.” Pediatric Emergency Care, vol. 36, no. 1, 2020, pp. e25-e29. doi:10.1097/PEC.0000000000002025.
  6. Perkins, Kathy Miller. Authenticity at Work: How to Balance Transparency with Professionalism. Forbes, 25 Mar. 2024.
  7. Rimmer, A. “How Can I Say No?” BMJ, 2 Sept. 2024, vol. 386, q1711. doi:10.1136/bmj.q1711.
  8. Staying in Bounds: A Framework for Setting Workplace Boundaries to Promote Physician Wellness.” Journal of Hospital Medicine, 2023, vol. 18, pp. -43. doi:10.1002/jhm.13102.
  9. Turman, N. T. “Authentic Leadership: Centering Context to Critically Examine Authenticity.” New Directions for Student Leadership, vol. 2023, no. 180, Dec. 2023, pp. 85-95. doi:10.1002/yd.20583.

Recognition and Joy

Recognition and joy can be taken separately or together. Both are active processes that must be promoted and pursued. Recognition is to show public appreciation, which can cultivate feelings of joy, by fulfilling the human need for acknowledgement and validation. Engaging in activities that promote recognition and joy can decrease workplace burnout and promote a strong and healthy organizational culture.

  1. “AMA Joy in Medicine Health Systems Recognition Program.” American Medical Association, https://www.ama-assn.org/practice-management/physician-health/joy-medicine-health-system-recognition-program.
  2. Jalilianhasanpour, R., S. Asadollahi, and D. M. Yousem. “Creating Joy in the Workplace.” European Journal of Radiology, vol. 145, Dec. 2021, 110019. doi:10.1016/j.ejrad.2021.110019. https://libkey.io/libraries/100/pmid/34798537.
  3. “Recognition at Work: Key Statistics & Solutions [Infographic].” Altrum Recognition Solutions, https://www.altrum.com/resources/recognition/recognition-at-work-key-statistics-solutions-infographic/.
  4. Sexton, J. B., and K. C. Adair. “Forty-Five Good Things: A Prospective Pilot Study of the Three Good Things Well-Being Intervention in the USA for Healthcare Worker Emotional Exhaustion, Depression, Work-Life Balance and Happiness.” BMJ Open, vol. 9, no. 3, 20 Mar. 2019, e022695. doi:10.1136/bmjopen-2018-022695.
  5. “Ways to Find Joy at Work.” Everyday Gyaan, https://www.everydaygyaan.com/find-joy-at-work/.