Abstract
Background First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants.
Methods Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia’s Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick’s evaluation model.
Results Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences.
Conclusion The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.
| Original language | English |
|---|---|
| Article number | 119 |
| Pages (from-to) | 1-13 |
| Number of pages | 13 |
| Journal | BMC Health Services Research |
| Volume | 24 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2024 |
Bibliographical note
Funding Information:Vicki Kerrigan was supported by an Australian Government Research Training Program Scholarship and Improving Health Outcomes in the Tropical North: A multidisciplinary collaboration (HOT NORTH)’, (NHMRC GNT1131932). Stuart Yiwarr McGrath was supported by HOT NORTH Indigenous Development and Training Award (NHMRC GNT 113193). Anna P Ralph was supported by an NHMRC fellowship 1142011.
Funding Information:
The authors would like to thank the anonymous NT health staff who participated in the pilot and shared their feedback. We also thank Professor Alan Cass from Menzies School of Health Research, the NT Aboriginal Interpreter Service especially training facilitator Mandy AhMat and RDH Obstetrics and Gynaecology and Endocrinology department leads Dr Jeremy Chin and Dr Anna Wood for their support.
Publisher Copyright:
© 2024, The Author(s).
