Indigenous Cultural Awareness and Rural Health

rural Cultural awareness training

Where can health students and staff access training in rural areas, and how is it changing attitudes and cultural literacy?

Being culturally aware when working with Aboriginal and Torres Strait Islander people in health care can only aid in improving health outcomes for the community.

NSQHS Standards now also require health services to improve the cultural competency of staff, to develop a safe and respectful organisation and enable Aboriginal and Torres Strait Islander patients to feel more comfortable to engage with and receive care (see this standard here).

But what training is available, especially in rural areas, and what are health staff and students getting out of it? And what proportion of students have undertaken cultural training prior to working directly with clients on clinical placement?

University-Based Cultural Training for Health Disciplines

Many university courses are now providing an Indigenous cultural component, though some are still in their infancy. Structure of this varies from a stand-alone unit, to embedding cultural considerations into all aspects of learning. Preliminary findings from a University of Melbourne survey of health practitioner perceptions of Aboriginal and Torres Strait Islander Health suggested a disconnect between health practitioner knowledge of major health issues and key health systems issues and the published evidence of disease burden, determinants of health and well-functioning health systems. This finding further suggests that pre-service exposure to basic population health science and to well-functioning health systems theory should be embedded into the curricula of all genres of health practitioner undergraduate training in Australia.

Statistics - Student Training

Going Rural Health, and other UDRH departments, survey students at the completion of rural placements and gather information about the placements and the students completing them. 

The survey asks students about whether they received cultural training. From Going Rural Health data:

  • 40% of students had received no cultural training before, during or after their placement.
  • 50% of students had received cultural training prior to their placement
  • 10% of students received cultural training during their placement.
Students: Perceived Utility of Cultural Awareness Training

Students were also asked about their perceptions of the utility of cultural training they received.

Of those who received cultural training:

  • 81% thought their training was adequate.
  • 15% didn’t have an opinion either way, and
  • 4% thought their training was inadequate.

There is no indication from this whether their university provided the training or it was provided by private individuals from local Aboriginal communities.

Rural Cultural Awareness Training

Training provided by Going Rural Health

Local traditional owners facilitate training in Ballarat, Maryborough, Shepparton, Mooroopna and Wangaratta.  Feedback from participants following each training has been excellent. Specifically, with regard to the Cultural Insight Experience conducted in Ballarat, a survey of a sample of twenty-three participants indicated that most reported being significantly more likely to engage with Aboriginal and Torres Strait Islander people after the training (median value 64/100) than before (median value 34/100). Further, all respondents indicated that, for health practitioners from all disciplines, experiencing insight into Aboriginal and Torres Strait Islander culture was ‘highly important’ (median value 98/100).

Find scheduled Going Rural Health workshops and book via this link: https://goingruralhealth.com.au/events/

 

Training provided by RWAV

Cultural Safety Training: multiple sites over the course of the year, in collaboration with VACCHO. Find the schedule of workshops and book via this link: https://www.rwav.com.au/vicoutreach/cultural-safety-training/

Research - Effectiveness of Training

A 2015 Australian Institute of Health and Welfare Closing the Gap Issues Paper on cultural competency in the delivery of health services for Indigenous peoples identified four studies of moderate methodological strength specifically addressing the training and education of health discipline students. These studies were conducted between 2006-2011, with no other significant study identified in subsequent years. One of these studies (Paul et al., 2006), suggested that the inclusion of an integrated cultural awareness training program into undergraduate medicine curricula significantly increased medical students’ cultural knowledge, attitudes, skills and competence in Indigenous Australian settings. This was specifically so when Indigenous Australians had contributed to the development of the training program curriculum. The study also suggested that cultural competence training specifically increased medical students’ preparedness to work with Indigenous people, play an advocacy role, and take responsibility for prompting change in Indigenous health.

At the healthcare practitioner level, the Issues Paper identified six studies that showed healthcare outcomes at the level of practitioners’ knowledge, attitudes and practice (Braun et al. 2005; Hearn et al. 2011; Ka‘opua 2003; McCabe et al. 2006; McRae et al. 2008; Mooney et al. 2005). However, the Mooney et al study concluded that, even though a significant increase in understanding of Indigenous Australian health issues and in forging better friendships and working relationships with Indigenous people was noted among half-day workshop participants, these workshops failed to bring about change in participants’ beliefs and attitudes.

Our experiences with this training, using multiple facilitators and at multiple locations, have been very positive. Direct verbal feedback from attendees has been excellent; they are often surprised just how much they get out of it. 

So keep an eye on our website (and RWAV’s) for cultural training scheduled across rural Victoria.