Unit rationale, description and aim
Being a health professional, it is a requirement that you are able to perform person-centred care in a culturally competent manner. This requirement exists because all people deserve to be treated with respect and dignity regardless of their beliefs, values or attitudes. Students are required to undertake this unit as it provides the foundation for culturally competent practice through the lens of Indigenous Australian culture to ensure graduates enter the workforce as culturally competent practitioners.
The social-historical-political context, cultural knowledges, and related health issues of Indigenous peoples of Australia and across the world will be the focus of this unit. The concept of globalisation will be introduced and explored with reference to the health of Indigenous peoples. Students will then examine the historical context of Aboriginal and Torres Strait Islander peoples’ health, contemporary issues in healthcare provision, and Aboriginal and Torres Strait Islander peoples’ ways of knowing, being and doing. The impact of current strategies to close the gap in Aboriginal and Torres Strait Islander health care will be examined, along with ways that the health care system can respond to the health needs of this population. The notion of culturally competent care will be introduced, and students will start to develop knowledge and skills needed to provide culturally competent care to people from diverse cultural backgrounds. Aligned with cultural competence are principles of community engagement – in this unit, students will be introduced to the principles that would enable safe and effective community engagement and explore how these principles can be applied within their practice.
The aim of this unit is to provide health students with a solid foundation on which to build cultural competency across their undergraduate program – knowledge and skills that they will need to apply to their future health care practice.
Learning outcomes
To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.
Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.
Explore the graduate capabilities.
Describe the implications and health consequences ...
Learning Outcome 01
Critically evaluate how social, cultural and cross...
Learning Outcome 02
Apply the principles of cultural safety to enable ...
Learning Outcome 03
Content
Topics will include:
The health consequences of globalisation with particular reference to
- Social determinants of health
- Inequalities in health status
- Global Indigenous health
Aboriginal and Torres Strait Islander health
- Indigenous Australian ways of knowing, being and doing
- Traditional ways of healing
- History and health consequences of colonisation
- Acute and chronic conditions, co-morbidity and disability amongst Aboriginal and Torres Strait Islander people
- Racism and the impact on Aboriginal and Torres Strait Islander people
- Effect of government policy on health and social wellbeing
Aboriginal and Torres Strait Islander health care provision
- Policy and community initiatives in health care, including the Closing the Gap strategy
- Primary healthcare approach
- Aboriginal and Torres Strait Islander health care workers
- Self-determination and Aboriginal controlled healthcare organisations
- Reconciliation
Cultural competence in health care
- Definitions and debates around cultural competence
- Knowledge and skills in the provision of culturally competent care
- Using a strengths-based approach
- Providing culturally appropriately care
- Community engagement
- Interprofessional and multi-sectorial healthcare
Introduction to community engagement in health
- Principles of working collaboratively with communities, capacity building, reciprocity, and transformative learning
Assessment strategy and rationale
A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the Unit Learning Outcomes and attain the Graduate Attributes. These assessments are required to build student knowledge and skills which, by the conclusion of this program, will enable the student to graduate as a safe and effective health care professional.
The oral assessment supports the development of sound communication skills which are required for all interactions as a health care professional; it assesses an understanding of issues specific to Aboriginal and Torres Strait Islander peoples. The quiz and cultural project examine cultural competence and associated knowledge which will direct future practice as a health care professional. These assessments are required to build student knowledge which, by the conclusion of this program, will allow the student to graduate as a health care professional who can behave with cultural competence. This requirement exists because all people deserve to be treated with respect and dignity regardless of their beliefs, values or attitudes.
Intensive and multi-mode assessment of this unit will be transparently equitable with on campus mode offerings as endorsed by the relevant Course Implementation Committee.
Overview of assessments
Assessment Task 1: Oral Presentation Enables stu...
Assessment Task 1: Oral Presentation
Enables students to practice culturally safe communication, and gain understanding of Aboriginal and/or Torres Strait Islander people and their impact from a strengths-based perspective.
25%
Assessment Task 2: Quiz Enables students to arti...
Assessment Task 2: Quiz
Enables students to articulate an understanding of the socio-historical-political context, cross-cultural communication, and cultural safety.
30%
Assessment Task 3: Project Enables students to a...
Assessment Task 3: Project
Enables students to apply their understanding of the socio-historical-political context, cross-cultural communication, and cultural safety to a cultural scenario.
45%
Learning and teaching strategy and rationale
This unit requires students to undertake 150 hours of focused learning to achieve the unit learning outcomes. It has two delivery patterns: a standard full semester delivery pattern which is scheduled nationally; and an intensive delivery pattern which is scheduled off-shore. Modes of delivery in this unit for both full semester and intensive delivery patterns include lectures, tutorials, online activities and self-directed study. In addition, this unit fosters student-centred active learning and accommodates diverse student needs. It includes a combination of self-paced, online learning and real-time classes. Early and additional feedback on learning, and tailored support, are provided to facilitate students’ transition to university. Consistent with adult learning principles, the teaching and learning approaches used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional practice for healthcare professionals. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers. The social-historical-political context, cultural knowledges, and related health issues of Indigenous peoples across the world and related concepts will be delivered as lectures and online content. Explanation, exploration and application of these concepts to health care practice will be undertaken in the tutorial classes and embedded in the assessment activities.
This unit may also be offered on or off campus in intensive mode or multi-mode for sponsored / special cohorts, with the learning and teaching strategies being equivalent with on campus mode offerings as endorsed by the School Course Implementation Committee.
National Safety and Quality Health Service Standards (Second Edition)
In connection to the learning outcomes, the Australian Commission on Safety and Quality in Health Care Standards developed in this unit are:
Relating to
Clinical Governance Standard
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Identifies the diversity of the consumers using its services
b. Identifies groups of patients using its services who are at higher risk of harm
c. Incorporates information on the diversity of its consumers and higher risk groups into the planning and delivery of care
Relevant Learning OutcomeLO1, LO2, LO3
Nursing and Midwifery Board of Australia Midwife Standards for Practice
In connection to the learning outcomes, these Midwife standards for practice provide a framework for midwifery practice in all contexts. They also inform women, and others including consumers, those who regulate, educate, collaborate with and manage midwives on what to expect from a midwife’s practice.
Relating to
Promotes health and wellbeing through evidence-based midwifery practice
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Identifies what is important to women as the foundation for using evidence to promote informed decision-making, participation in care, and self-determination
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Undertakes ongoing processes of reflection to ensure professional judgements acknowledge how personal culture impacts on practice
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Engages in professional relationships and respectful partnerships
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Supports the choices of the woman, with respect for families and communities in relation to maternity care
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Partners with women to strengthen women’s capabilities and confidence to care for themselves and their families
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Practises ethically, with respect for dignity, privacy, confidentiality, equity and justice
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Practises without the discrimination that may be associated with race, age, disability, sexuality, gender identity, relationship status, power relations and/or social disadvantage
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Practises cultural safety that is holistic, free of bias and exposes racism
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Practises in a way that respects that family and community underpin the health of Aboriginal and/or Torres Strait Islander Peoples
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Demonstrates the capability and accountability for midwifery practice
Relevant Learning OutcomeLO2
Relating to
Contributes to a culture that supports learning, teaching, knowledge transfer and critical reflection
Relevant Learning OutcomeLO2
Nursing and Midwifery Board of Australia Registered Nurse Standards for Practice
In connection to the learning outcomes, these are the national Registered nurse standards for practice for all RNs. Together with NMBA standards, codes and guidelines, these Registered nurse standards for practice should be evident in current practice, and inform the development of the scopes of practice and aspirations of RNs.
Relating toThinks critically and analyses nursing practice
Relevant Learning OutcomeLO1, LO2, LO3
Relating toAccesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice
Relevant Learning OutcomeLO1, LO2, LO3
Relating toDevelops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice
Relevant Learning OutcomeLO1, LO2, LO3
Relating toRespects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures
Relevant Learning OutcomeLO1, LO2, LO3
Relating toComplies with legislation, regulations, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions
Relevant Learning OutcomeLO1, LO2, LO3
Relating toUses ethical frameworks when making decisions
Relevant Learning OutcomeLO1, LO2, LO3
Relating toEngages in therapeutic and professional relationships
Relevant Learning OutcomeLO3
Relating toEstablishes, sustains and concludes relationships in a way that differentiates the boundaries between professional and personal relationships
Relevant Learning OutcomeLO3
Relating toCommunicates effectively, and is respectful of a person’s dignity, culture, values, beliefs and rights
Relevant Learning OutcomeLO3
Relating toRecognises that people are the experts in the experience of their life
Relevant Learning OutcomeLO3
Relating toProvides support and directs people to resources to optimise health-related decisions
Relevant Learning OutcomeLO3
Relating toAdvocates on behalf of people in a manner that respects the person’s autonomy and legal capacity
Relevant Learning OutcomeLO3
Relating toActively fosters a culture of safety and learning that includes engaging with health professionals and others, to share knowledge and practice that supports person-centred care
Relevant Learning OutcomeLO3
Relating toMaintains the capability for practice
Relevant Learning OutcomeLO3
Relating toProvides the information and education required to enhance people’s control over health
Relevant Learning OutcomeLO3
Relating toUses a lifelong learning approach for continuing professional development of self and others
Relevant Learning OutcomeLO3
Relating toIdentifies and promotes the integral role of nursing practice and the profession in influencing better health outcomes for people.
Relevant Learning OutcomeLO3
Paramedicine Board of Australia Professional Capabilities for Registered Paramedics
The Paramedicine Board of Australia is responsible for assessing, consulting on and setting the standards for paramedics practicing in Australia. These standards and relevant domains are articulated in the Professional Capabilities for a Registered Paramedic document. The learning outcomes of this unit are matched to the relevant capabilities, in order to align your development with the requirements of a paramedic.
Relating to
The professional and ethical practitioner
This domain covers paramedics’ responsibility to be professional and ethical, and to practise with professional autonomy and accountability within the current medico-legal framework. It also addresses their responsibility for ensuring that patient confidentiality and privacy is always maintained, while recognising the potential role as a patient advocate.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Practise ethically and professionally, consistent with relevant legislation and regulatory requirements
- Demonstrate understanding of: reporting obligations, legal responsibilities, legal requirements, ethical and professional responsibilities, and the legal and ethical boundaries of paramedicine practice.
- Manage personal, mental and physical health to ensure fitness to practice.
- Follow mandatory and voluntary reporting obligations. • Apply the Paramedicine Board of Australia’s Code of conduct to their practice.
- Provide relevant information to a patient and demonstrate appropriate methods to obtain informed consent.
- Demonstrate knowledge of Australia’s healthcare systems, their standards and requirements.
- Demonstrate understanding of the basic principles underpinning bio- ethics in paramedicine practice.
- Demonstrate culturally safe practice when providing healthcare services for Aboriginal and Torres Strait Islander Peoples.
- Exercise appropriate levels of autonomy and professional judgement in a variety of practice settings.
- Operate within the current legislation applicable to paramedicine practice.
- Practise in accordance with the applicable legislation governing the safe use of scheduled medicines by paramedics in the jurisdiction of practice.
Legal responsibilities may include an understanding of responsibilities contained in relevant Commonwealth, state and territory legislation and regulations, specific responsibilities to maintain confidentiality, confirm informed consent and exercising duty of care.
Informed consent is a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved.
Principles underpinning bio-ethics must include: respect the rights of the individual, respect the autonomy of the individual, cause no harm, and advance the common good.
Relevant aspects of the Australian health care systems may include knowledge of service provision arrangements, the structure of the health system, points of access and the range of roles that paramedics may play within that structure.
Key elements of fitness to practise must include competence, professionalism, including a sense of responsibility and accountability, self-awareness and professional values, sound mental health and the capacity to maintain health and wellbeing for practice.
Reporting obligations must include making a notification about the health (impairment), conduct or performance of a registered health practitioner that may be placing the public at risk; as well as of their own impairments to practice.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Provide each patient with an appropriate level of dignity and care
- Demonstrate understanding of the influence of socio-cultural factors on patient attitudes and behaviour.
- Display appropriate professional behaviour in patient interactions.
- Provide culturally safe care for all patients.
- Identify and respect appropriate boundaries between patients and health professionals.
- Assess each situation, determine the nature and severity of the problem and apply the required knowledge and experience to provide a response that is in the best interest of the patient/s.
- Facilitating advance care planning where appropriate.
Socio-cultural factors may include those related to cultural and linguistic diversity, age, gender, disability, socio-economic, geographic locations; and identifying as Aboriginal and Torres Strait Islander Peoples.
Appropriate professional behaviour must include behaviour that:
- is culturally safe for Aboriginal and Torres Strait Islander patients to access safe and responsive healthcare, free of racism
- respects socio-cultural difference, is empathetic and non-discriminatory, regardless of individuals’ or groups’ race, culture, religion, age, gender identity, sexuality, physical or mental state, and
- respects, and so far as possible, upholds the rights, dignity, values and autonomy of every patient. This includes their role in the diagnostic and therapeutic process and in maintaining health and well being.
Cultural Safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities. Culturally safe practise is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practicing behaviours and power differentials in delivering safe, accessible and responsive healthcare free from racism.
- To ensure culturally safe and respectful practice, health practitioners must:
- acknowledge colonisation and systemic racism, social, cultural, behavioural and economic factors which affect individual and community health
- acknowledge and address individual racism, their own biases, assumptions, stereotypes and prejudices and provide care that is holistic, free of bias and racism
- recognise the importance of self-determined decision- making, partnership and collaboration in healthcare which is driven by the individual, family and community, and
- foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander People and colleagues.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Advocate on behalf of the patient, when appropriate in the context of the practitioner’s practice as a paramedic
- Demonstrate understanding of the principles of patient advocacy and their application to paramedicine practice.
- Recognise when it may be appropriate to intervene on the patient’s behalf.
Principles of advocacy may include supporting and promoting the rights and interests of individuals, helping individuals to achieve or maintain their rights and representing their needs.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The communicator and the collaborator
This domain covers paramedics’ responsibility to use appropriate, clear and effective communication. It also addresses their responsibility to ensure that they always function effectively with other healthcare team members.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Communicate clearly, sensitively and effectively with the patient and other relevant people
- Establish a rapport with the patient to gain understanding of their issues and perspectives, and to encourage their active participation and partnership in care and/or treatment.
- Communicate with the patient and/or other relevant people to collect and convey information and reach an agreement about the purpose of any care and treatment.
- Convey knowledge and procedural information in ways that engender trust and confidence, and respects patient confidentiality, privacy and dignity.
- Respond appropriately to patient queries or issues.
- Use appropriate communication skills to effectively manage avoidance, confusion and confrontation particularly with those who cannot communicate verbally or physically.
- Identify and effectively manage communication barriers, including anxiety and stress, specific to individual patients and/or carers.
- Make appropriate adjustments to communication style to suit the needs of the patient including those from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander Peoples.
- Make provisions to engage third parties, including interpreters, to facilitate effective communication with patients whose first language is not English, whenever possible.
Communication needs may be influenced by English language skills, health literacy, age, health status and culture.
Appropriate adjustments may include the paramedic demonstrating an awareness of the ways that their own culture and experience affect their interpersonal style and having an awareness of strategies to ensure this does not present an impediment.
Communication techniques must include active listening, use of appropriate language and detail, use of appropriate verbal and non-verbal cues and language, written skills and confirming that the other person has understood.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The evidence-based practitioner
This domain covers paramedics’ responsibility to engage in evidence-based practice and to critically monitor their actions through a range of reflective processes. It also addresses their responsibility for identifying, planning and implementing their ongoing professional learning and development needs.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Make informed and reasonable decisions
- Operate within a framework of making informed, evidence-based, reasonable and professional judgements about their practice, with acting in the best interests of their patients as their primary concern.
- Make sensible, practical, and culturally safe decisions about their practice, taking account of all relevant information and the best interests of the people who use, or are affected by, the service being provided.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The safety and risk management practitioner
This domain covers paramedics’ responsibility to protect patients and others from harm by managing and responding to the risks inherent in paramedicine practice. It also addresses their responsibility to ensure high-quality professional services are provided for the benefit of patients and others.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Participate in the mentoring, teaching and development of others
- Participate in guiding the learning of others.
- Share knowledge with colleagues.
- Support healthcare students to meet their learning objectives.
- Share knowledge and experience relating to individual/group/unit problems with colleagues.
- Contribute to orientation and ongoing education programs.
- Demonstrates a commitment to participating in and contributing to the research process.
- Display leadership and role modelling of culturally safe practice as members of the healthcare team.
- Participate, where possible, in coaching and mentoring to help and develop colleagues.
- Participate, where appropriate, in teaching others including paramedic students, those of other health and emergency services, disciplines and developing less experienced paramedics.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The paramedicine practitioner
This domain covers profession-specific knowledge, skills and capabilities required for practice as a registered paramedic
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Assess and monitor the patient capacity to receive care
- Identify factors or conditions that may affect the patient behaviour and/or capacity to undergo the procedure.
- Identify patients who are vulnerable or otherwise most at risk including those with mental health issues particularly Aboriginal and Torres Strait Islander Peoples.
- Identify contraindications and limitations arising from the patient capacity to consent or refuse to receive care; determine appropriate adjustments to procedures; and, where appropriate, communicate these to the patient.
- Perform patient assessment and interventions in accordance with legislation, registration standards, codes and guidelines, including gaining informed consent.
- Identify and respond to a patient deteriorating condition, or inability to undergo a procedure or treatment, consistent with duty of care and statutory requirements.
Patient capacity or behaviour may include pre-existing medical and/or physical and physiological conditions and other factors that may affect their capacity to receive care which includes culturally safe care.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Understand the key concepts of the bodies of knowledge which are specifically relevant to paramedicine practice
- Understand the structure, function and pathophysiology of the human body, relevant to their practice, together with knowledge of health, human growth and development, disease, disorder and dysfunction.
- Understand the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process.
- Understand the theoretical basis of and the variety of approaches to assessment and intervention.
- Demonstrate an applied knowledge of human anatomy and physiology sufficient to understand the nature and effects of injury or illness and to conduct assessment and observation in order to establish patient management strategies.
- Understand psychological and social factors, including intergenerational trauma that impact and influence an individual in health and illness.
- Understand the clinical sciences underpinning paramedic practice, including physiological, pharmacological, behavioural and functional.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Conduct appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely
- Maintain the safety of self, patients and those involved in their care.
- Practice safely and effectively across the full range of patient presentations and circumstances.
- Arrive at a reasonable working diagnosis.
- Position for safe and effective interventions.
- Demonstrate an applied knowledge of the indications and contra-indications of using specific paramedic interventions including their modifications.
- Modify and adapt practice appropriate and inclusive of a culturally safe practice environment.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Formulate specific and appropriate patient care and treatment actions
- Adapt practice to meet the needs of different groups distinguished by, for example, physical, psychological, environmental, cultural or socio-economic factors within their authorised scope of practice.
- Demonstrate sensitivity to the factors which shape lifestyle that may impact on the individual’s health and affect the interaction between the patient and registered paramedic.
- Utilise knowledge, reasoning and problem-solving skills to determine appropriate judgements and actions.
- Prioritise the care provided to optimise safety and health outcomes for the patient and demonstrate a logical and systematic approach to problem-solving in a culturally safe framework.
Relevant Learning OutcomeLO1, LO2, LO3
Representative texts and references
Recommended references:
Biles, B., & Biles, J. (Eds.). (2020) Aboriginal and Torres Strait Islander peoples' health and wellbeing. Oxford University Press.
Best, O., & Fredericks, B. (2018). Yatdjuligin: Aboriginal and Torres Strait Islander nursing and midwifery care (3rd ed.). Cambridge University Press.
Eckermann, A-K., Dowd, T., Chong, E., Nixon, L., Gray, R., & Johnson, S. (2010). Binan Goonj: Bridging cultures in Aboriginal health (3rd ed.). Churchill Livingstone/Elsevier. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012598825902352
Germov, J. (Ed.) (2019). Second opinion: an introduction to health sociology (6th ed). Oxford University Press. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5611991 .
Guzys, D., Brown, R., Halcomb, E. & Whitehead, D. (2020) An introduction to community and primary health care. (3rd ed.). Cambridge University Press.
Hampton, R., & Toombs, M. (Eds.). (2013). Indigenous Australians and health: The wombat in the room. Oxford University Press. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991012619256002352
Labonte, R. & Ruckert, A. (2019). Health inequities in a globalizing era: past challenges, future prospects. Oxford University Press.
Smith, J. (2020). Australia’s rural, remote and Indigenous health (3rd ed.). Elsevier. https://www.clinicalkey.com.au/nursing/#!/content/book/3-s2.0-B9780729542418000159 .
Taylor, K., & Guerin, P. (2019). Health care and Indigenous Australians: Cultural safety in practice (2nd ed.). Palgrave Macmillan.