Creating cultural empathy and challenging attitudes through Indigenous narratives

The poorer health status of Indigenous Australians has been largely attributed to social disadvantage and their marginalisation within mainstream society (Marmot, 2011). This includes access to health care, as well as proximity to health services, availability and cultural appropriateness of health services, transport availability, health insurance, the affordability of health services and patient proficiency in English (AIHW, 2011). The interpersonal attitudes and behaviours of non-Indigenous health providers, both conscious and unconscious, are also known to contribute to disparities in treatment, impairment of communication between health providers and patients, and consequently, patients’ mistrust of the health system due to negative past experiences (Geiger, 2001). This project collected stories from Indigenous people about their experiences with health care services. Their stories serve to enhance relationships and understanding between diverse peoples, and give Indigenous Australians a voice in health curricula across Australian universities and in agencies delivering health services

Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: A methodological perspective

Background: Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients’ experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians’ experiences with health care in Western Australia. The purpose of these narratives is to provide health students and professionals with an opportunity to ‘walk-in the shoes’ of Aboriginal people where face-to-face interaction is not feasible. Methods: With the incorporation of Indigenous peoples’ voices being an important link in cultural safety, the project was led by an Indigenous Reference group, who encouraged active participation of Aboriginal people in all areas of the project. Using a phenomenological approach and guided by the Indigenous Reference group, yarning data collection was implemented to collect stories focusing on Aboriginal people’s experiences with health care services. An open-access, on-line website was established to host education resources developed from these “yarns”. Results: Yarning provided a rich source of information on personal experiences and encouraged the story provider to recognise their facilitative role in the research process. While the methodology used in this project was lengthy and labour-intensive it afforded a respectful manner for story collection and highlighted several innate flaws when Western methods are applied to an Indigenous context. Conclusion: Engagement of an Indigenous Reference Group was pivotal to designing an appropriate methodology that incorporated the voices of Aboriginal people in a multimedia resource of Aboriginal narratives. However further research is warranted to understand how the resources are being used and integrated into curricula, and their impact on students and health care outcomes

Creating Cultural Empathy and Challenging Attitudes Through Indigenous Narrative Project

The gap in life expectancy between Indigenous and non-Indigenous Australians is too large to ignore. This has been attributed to social and economic disadvantage, access to health care and lack of cultural appropriateness of health services and providers. Creating culturally secure healthcare requires that we explore new ways for health professionals to relate to Aboriginal people. This article describes the development, implementation and early results from the Creating cultural empathy and challenging attitudes though Indigenous narrative project. The purpose of the project is to collect and trial narrative resources to engage students in stories of Indigenous people’s perceptions and experience of healthcare. Storytelling has a long tradition within Indigenous culture and narrative approaches can be successful in engaging students changing attitudes. These stories are intended to trigger classroom discussions to encourage students to reflect on their own assumptions and values and to enhance empathy, thereby enabling future health providers to improve their management of Indigenous patients. Key to this project has been working collaboratively with Indigenous people as active participants in the project with roles as project leads, team members, Indigenous Reference Group members, external evaluators and providers of the narratives

Improving health professional\u27s knowledge of hepatitis B using cartoon based learning tools: a retrospective analysis of pre and post tests

Background: Hepatitis B serology is complex and a lack of knowledge in interpretation contributes to the inadequate levels of screening and referral for highly effective hepatitis antiviral treatments. This knowledge gap needs to be addressed so that current and future healthcare professionals are more confident in the detection and assessment of hepatitis B to improve the uptake of treatment and reduce long-term complications from the disease. Cartoons have been used effectively as a teaching tool in other settings and were considered as a potentially useful teaching aid in explaining hepatitis B serology. This study examines the impact of cartoons in improving healthcare professionals’ knowledge. Methods: A cartoon based learning tool designed to simplify the complexities of hepatitis B serology was developed as part of an online learning program for medical practitioners, nurses and students in these professions. A retrospective analysis was carried out of pre and post online test results. Results: An average improvement of 96% of correct answers to case study questions in hepatitis B serology was found across all ten questions following the use of an online cartoon based learning tool. Conclusion: The data indicates a significant improvement of participants’ knowledge of hepatitis B serology from pre-test to post-test immediately following an online cartoon based learning tool. However, further research is required to measure its long term impact

Cartoons for e-health informatics

Not only is Hepatitis B serology often misunderstood because of its complex serological implications, but advances in medical science have revolutionised screening and treatment of hepatitis B. To maximise such evolution however, this new information must be relayed effectively and efficiently to current and future medical professionals. Cartoons have been well regarded as a teaching tool in a variety of different settings as is the use of web based technology. Therefore the delivery of a cartoon based learning tool, accessed via on-line learning modules was considered a novel and potentially effective way of disseminating new knowledge. To increase health professionals’ understanding of hepatitis B serology and skill in interpreting the tests that indicate the appropriate treatment, a cartoon series was developed. The cartoons are located on an online educational website and include characters that represent the different antibodies and antigens associated with hepatitis B. The cartoon characters are involved in a series of adventures that represent the various phases of hepatitis B infection, and the paper describes their development. Subsequent research demonstrated that exposure to the online cartoon based learning tool indicates that they are a fun and useful way to increase knowledge

Influencing Behaviour Change in General Practice: Part 2-Motivational Interviewing Approaches

Behaviour change toward achieving a healthy lifestyle is important for all Australians, and general practitioners have a key role to play in assisting patients to make these changes. This is the second of two articles on influencing behaviour change in general practice. This article deals with the \u27how to\u27 of motivational interviewing in the general practice setting. Motivational interviewing can help build motivation, commitment and confidence to change. General practitioners can use motivational interviewing to help their patients achieve their health goals. Motivational interviewing is not about a set of techniques and questions; it is about creating a climate that facilitates change; it is more about listening than telling, evoking rather than instilling. Motivational interviewing can be done in the brief periods available in consultations over time

Influencing Behaviour Change in General Practice (Part 1): Brief Intervention and Motivational Interviewing

Background: Behaviour change toward achieving a healthy lifestyle is important for all Australians, and general practitioners have a key role to play in assisting patients to make these changes. Objective: This is the first of a two part series which provides the background to approaches to influencing behaviour change in general practice, from brief interventions to motivational interviewing (MI). The second part of the series will explore motivational interviewing in more detail. Discussion: General practitioners have a key role in changing their patients\u27 health behaviours. There are a range of tools GPs can use to help enhance their patients\u27 motivation to achieve their health goals