Aboriginal and Torres Strait Islander health workers: the skills recognition and upskilling project

Introduction: Throughout 2014 and 2015 a series of three, two-week residential blocks were conducted by Tropical North Queensland TAFE in collaboration with James Cook University to deliver essential content to help with skills recognition and upskilling of Aboriginal and Torres Strait Islander Health Workers in Queensland. The project goal was to assist eligible Aboriginal and Torres Strait Islander Health Workers to qualify for a Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care Practice and be able to apply for registration with the Australian Health Practitioner Regulation Agency (AHPRA). Purpose: This presentation will share what was achieved throughout this project and some of the challenges faced by the educational institutions in delivering the program. Furthermore, challenges faced by students will also be explored, along with strategies that were implemented to help overcome them. Issues for exploration or ideas for discussion: i.Criteria used for student selection to program –how successful was it? ii. The importance of clearly communicated training goals. iii. Working collaboratively to provide successful cross institutional education. Results: The first cohort of students were less satisfied with the training experience than the second and third cohorts of students. The results also showed that that the third cohort had the most students to complete all five units of the training package. Discussion: Reasons why the first cohort's experience was not as satisfying as the subsequent groups will be explored and discussed. Lesson learned and recommendations will be shared

Enhancing clinical education for Aboriginal and Torres Strait Islander health workers: a university/vocational education and training (VET) sector collaboration

Introduction: Throughout 2014 and 2015 a series of three, two-week residential blocks were conducted by TAFE North Cairns in collaboration with James Cook University to deliver upskilling training, including simulation education, for Aboriginal and Torres Strait Islander health workers in north Queensland. Aim of the project: The project goal was to assist eligible Aboriginal and Torres Strait Islander Health Workers to qualify for a Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care Practice and be able to apply for registration with the Aboriginal and Torres Strait Islander Health Practice Board of Australia. Methods used to bring about change: Strategies developed for delivering quality clinical education in a collaborative environment include: - Shared resources – simulation equipment, teaching staff (knowledge and expertise), lesson plans and other equipment and resources - Regular meetings to explore innovative teaching strategies and enhance simulation opportunities - A commitment to providing quality clinical education Outcomes: As the partnership strengthened so did student satisfaction and learning outcomes/pass rates. Students consistently reported the simulation training was the highlight. Conclusion: Lessons Learnt/Recommendations for wider application: - Importance of promoting collaboration and cooperation between health and higher education providers: It is recommended for future training that time spent by higher education (University/VET sector) building relationships with health industry is a solid investment in positive training outcomes and health industry (health worker and employer) satisfaction - Language Literacy Numeracy (LLN) support needs: It is recommended that LLN assessment be conducted prior to students attending residential training in order for learning support staff to develop and implement individualised learning support plans

A qualitative exploration of priorities for quality improvement amongst Aboriginal and Torres Strait Islander primary health care services

Background: Achieving quality improvement in primary care is a challenge worldwide, with substantial gaps between best practice and actual practice. Within the context of Australia, Aboriginal and Torres Strait Primary Health Care (PHC) services have great variation across settings, structures and context. Research has highlighted how these contextual differences can critically influence the success of Quality Improvement (QI) interventions and outcomes. Less understood is the interaction between local context and other factors, which may impact the implementation of QI interventions. This paper aims to explore the strengths and challenges in QI for Aboriginal and Torres Strait Islander PHC services and their priorities for improvement. Methods: A multiple case study design was adopted, working with eight Aboriginal and Torres Strait Islander PHC services in Northern Territory, Queensland and Western Australia. Data were collected via a health service survey, semi-structured interviews with health service staff and service users and researcher observations, to explore QI and perceptions of care quality at the service level. Data reported here were analysed using an iterative thematic technique, within-case and across-case. Results: A total of 135 interviews were conducted with health service staff, service users and community members. Participants emphasised the centrality of resilient community, committed workforce and valued Aboriginal and Torres Strait Islander team members in delivering care. A shared purpose around improving the health of community was a significant driver. Key challenges included staff turnover and shortages, a complex and overwhelming acute and chronic care workload, building relationships and trust between health services and the community. Service-suggested priority areas for improvement were categorised into five themes: i) cultural safety (community driving health and planning for culturally safe services); ii) community engagement (through clinical activities in the community); iii) shared ownership and a team approach around QI; iv) strengthening systems and consistent ways of doing things in the health service; and v) strengthening local workforce (and resources for a culturally safe workforce). Conclusions: These findings advance understandings of relational, community and cultural factors which are identified priorities for the delivery of quality care in Aboriginal and Torres Strait Islander PHC services across varied contexts

Birthing on country: an elusive ideal?

The concept of birthing on country for Aboriginal people means having babies born on traditional lands, and more recently the term is used to indicate the desire of Aboriginal communities to have our babies born in our communities. Being born on country connects an Aboriginal person to the land and community in a deeply cultural way and affords life-long privileges such as hunting and fishing rights, as well as life-long responsibilities for looking after country, both land and people. For Aboriginal women, birthing has moved from the personal to the political, as governments provide policies about what is 'best' for Aboriginal women and their babies

Remote dwelling Aboriginal Australian women and birthing: a critical review of literature

Objective: The aim of this literature review is to critically analyse the policy documents informing maternity services policy and scholarly literature on the birthing experiences (including the provision of maternity services) of Aboriginal Australian women from remote communities from an Indigenous standpoint. Method: Policy documents and scholarly literature were critically analysed to identify who the authors were, their background, approaches and perspectives; and emergent themes. A further analysis of the literature drew on Fairclough's ideas on discourse, power and hegemony. Findings: A critical discourse analysis of this literature exposed how these texts are ideologically shaped to give voice (and power) to the medical fraternity, maternity care services practitioners and policy makers (whose knowledge is valued) while simultaneously silencing the voices of Aboriginal Australians that pose a challenge to that power. Conclusion: This critical review of current literature highlights the importance of ongoing critique of maternity services policy and practice discourse necessary to combat western medical hegemony that maintains the disenfranchisement of Aboriginal Australians

Indigenous health: can occupational therapy respond to the challenge to 'Close the Gap'?

[Extract] The health of Indigenous Australians continues to be a national embarrassment. Life expectancy at birth remains some 20 years less (Thomson et al., 2010) and Indigenous Australians continue to bear a disproportionate burden of disease, mainly from chronic diseases (Australian Bureau of Statistics, Australian Institute of Health and Welfare, 2008). Ominously, Indigenous communities are also at the frontline of re-emerging tropical infectious disease in the Torres Strait and northern Queensland.\ud \ud Attempts by the government in previous decades to redress the poor status of Indigenous health have had little success (Aboriginal and Torres Strait Islander Social Justice Commissioner, 2005). This failure prompted a call in 2005 by the then Social Justice Commissioner, Tom Calma, for the governments of Australia to commit to achieving equality for Indigenous people in the areas of health and life expectancy within 25 years (Aboriginal and Torres Strait Islander Social Justice Commissioner).\ud \ud The government responded with the 'Closing the Gap' strategy that aims to reduce Indigenous disadvantage with respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes by 2030 (Aboriginal and Torres Strait Islander Social Justice Commissioner, 2005)

U-Connect: a tool for engaging and supporting Aboriginal and Torres Strait Islander students at university

Background:In an effort to improve the retention of Aboriginal & Torres Strait Islander students, Academic and Support Staff within the Health disciplines of James Cook University have identified the need to build foundations for engaging Aboriginal and Torres Strait Islander students and develop strategies to support them to stay connected, motivated and improve academic outcomes. \ud \ud Aims of Study: UConnect was initiated to identify Aboriginal and Torres Strait Islander Nursing and Midwifery students who are at risk, particularly those from rural and remote communities and to inform improvements in the provision of social, cultural and academic support services for our students.\ud \ud Methods: UConnect comprised of i) Interview Script and Assessment Tool, and ii) an Individual Student Support Plan, to provide important baseline data to academic and support staff to ensure appropriate monitoring, referrals and follow-ups. \ud \ud Results:UConnect has provided new learnings about the specific needs and cultural obligations of Aboriginal and Torres Strait Islander students, informing the cultural and structural change necessary for improving the academic success and personal wellbeing of Aboriginal & Torres Strait Islander students. \ud \ud Conclusions/Recommendations: UConnect has been developed to ensure Aboriginal and Torres Strait Islander students maintain their cultural identity, improve their academic performance and have a positive and supported university experience

Indigenous Lifescripts: A tool for modifying lifestyle risk factors for chronic disease.

BACKGROUND: A national chronic disease strategy has been described focusing on health promotion and lifestyle change, screening and evidence based disease management. The Lifescripts resources complement this strategy by focusing on health promotion and lifestyle change. OBJECTIVE: To provide an overview of the role of the recently developed indigenous Lifescripts resources as a tool for health checks and chronic disease prevention and management. DISCUSSION: Effective indigenous health promotion requires appropriate tools for behavioural modification and community engagement. This involves a greater emphasis on the social determinants of health to reduce the barriers to healthy behaviours. The indigenous Lifescripts provide a flexible tool for health care providers in the indigenous health sector to deliver lifestyle related brief interventions that accommodate local community resources and support structures. However, to maximise their potential, a systematic approach to incorporating these tools into practice must be adopted

Aboriginal and Torres Strait Islander health workers: the skills recognition and upskilling project

Introduction: Throughout 2014 and 2015 a series of three, two-week residential blocks were conducted by Tropical North Queensland TAFE in collaboration with James Cook University to deliver essential content to help with skills recognition and upskilling of Aboriginal and Torres Strait Islander Health Workers in Queensland. The project goal was to assist eligible Aboriginal and Torres Strait Islander Health Workers to qualify for a Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care Practice and be able to apply for registration with the Australian Health Practitioner Regulation Agency (AHPRA). Purpose: This presentation will share what was achieved throughout this project and some of the challenges faced by the educational institutions in delivering the program. Furthermore, challenges faced by students will also be explored, along with strategies that were implemented to help overcome them. Issues for exploration or ideas for discussion: i.Criteria used for student selection to program –how successful was it? ii. The importance of clearly communicated training goals. iii. Working collaboratively to provide successful cross institutional education. Results: The first cohort of students were less satisfied with the training experience than the second and third cohorts of students. The results also showed that that the third cohort had the most students to complete all five units of the training package. Discussion: Reasons why the first cohort's experience was not as satisfying as the subsequent groups will be explored and discussed. Lesson learned and recommendations will be shared