Medical decision making using knowledge of patient identification as Aboriginal or Torres Strait Islander: what do medical students think?

Objective Best-practices guidelines require Australian health practitioners to ask all patients “are you [is the person] of Aboriginal and/or Torres Strait Islander origin?”. The present study investigated medical student attitudes regarding medical decisions made after asking this standard status question. Methods A hypothetical interaction between a doctor and an Aboriginal patient was presented in a pen-and-paper questionnaire in which: (1) the doctor considered (or did not consider) the patient’s Indigenous status relevant to make a medical diagnosis, and (2) the doctor registered (or did not register) the patient for the Closing the Gap PBS co-payment. Participants were first- and second-year medical students at the Australian National University who evaluated the doctor’s decisions against 20 attributes characterising professionalism and prejudice. Results Students evaluated the doctor more favourably when the doctor registered the patient for the co-payment and when the doctor did not consider Indigenous status relevant to making a medical diagnosis. Conclusions Encouragingly, medical students recognise that withholding registration for the co-payment is unprofessional. At the same time, medical students clearly do not think medical diagnoses should be made using the knowledge a patient identifies as Aboriginal. Implications With the continual development of policy and guidelines (and the prospect of diagnostic guidelines) to improve Aboriginal and Torres Strait Islander health, students and practitioners must understand how to use this knowledge of a patient’s status to benefit health outcomes

A multiple method investigation of serving and ex-serving defence members’ experiences with the PTSD Coach Australia app

Background: PTSD Coach Australia is an app for serving and ex-serving Defence members that was adapted for the Australian context in 2013 from PTSD Coach, which was created in the USA. Objective: The current study aimed to provide an evaluation of the app from the perspective of serving and ex-serving members of the Australian Defence Force. Methods: Qualitative data were collected in response to questions to participants in one of five workshops (n = 29), or in telephone interviews (n = 24). Results: Analysis of the qualitative data demonstrated mixed support for the app. While some people found it to be extremely useful, especially as an adjunct to therapy, others pointed to limitations and cautioned against the app potentially triggering symptoms in people with PTSD. This perceived risk was usually seen as arising from frustration with the app’s functionality rather than its content. Participants spoke about helpful and unhelpful aspects of the app and barriers for its use and made suggestions for improvement. Many participants encouraged its continued use and highlighted the need for it to be promoted more broadly, as many were not aware of it until invited to participate in this research. Conclusions: PTSD Coach Australia was seen in a positive light by some participants, but others suggested it was too text dense and had the potential to trigger a traumatic response in users with PTSD. A need to update the app was also a common comment as was the need to increase awareness of the apps existence

Clinicians' perceptions of PTSD Coach Australia

Introduction: Applications or “mobile apps” are a potentially important source of assistance for serving and ex-serving Defence members with mental health problems. PTSD Coach Australia is a modified version of an application developed by the US Department of Veteran Affairs. Clinician perceptions of mobile apps are important as they influence the dissemination and adoption of apps. This study aimed to explore the perceptions of PTSD Coach Australia by clinicians with experience in assisting Defence members with mental health problems. Method: The study involved two samples of participants who were asked about their perceptions of PTSD Coach Australia. The first involved 33 clinicians who participated in one of five focus groups. The second comprised 30 clinicians who were individually interviewed by telephone. Qualitative responses to questions regarding PTSD Coach Australia were analysed to identify representative themes. Participants in the focus group sample also rated the app on the user version of the Mobile Apps Rating Scale (uMARS). Results: On the uMARS, clinicians rated the mobile app's subjective quality as ‘average’ to ‘good’. Participants generally saw the app as a useful to help track symptoms, improve engagement and help implement strategies between sessions. However, they also expressed concerns with the app not being user-friendly (e.g. too wordy, poor layout/navigation) and having technical issues (freezing or crashing on Android devices). Discussion: PTSD Coach Australia is generally seen as being acceptable and useful by mental health clinicians. However, it is important to include their concerns in future developments of PTSD Coach Australia and similar mobile apps in order to maximize their utilisation in Defence members.</p