Cultural Safety

Outcomes

Cultural Safety

Outcomes

The Aboriginal and Torres Strait Islander Cultural and Health Training Framework > Cultural safety > Outcomes

RACGP has a strong Cultural Safety and Governance Strategy.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
Designed and implemented RACGP Cultural Safety and Governance strategy.	Engage with peak and jurisdictional Aboriginal and Torres Strait Islander health organisations to consult on cultural safety governance. Establish a Cultural Advisory Committee to provide cultural stewardship, governance and advice.	Cultural Safety and Governance strategy is established and in practice. Mechanisms are in place to incorporate feedback from Aboriginal and Torres Strait Islander Peoples and communities, and demonstrate success of the cultural safety and governance strategy.	RACGP RACGP Education RACGP Training National Faculty of Aboriginal and Torres Strait Islander Health Reconciliation Action Plan (RAP)

An ongoing and integrated process of cultural safety training and mentorship is systematically embedded, resourced and implemented across all segments of training.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
High-quality cultural safety training is integrated as business as usual across all areas of training and education.	Complete implementation of the Aboriginal and Torres Strait Islander Cultural and Health Training Framework. Establish a dedicated team for the implementation and monitoring of the Aboriginal and Torres Strait Islander Cultural and Health Training Framework. Develop and implement a Cultural Safety and Governance strategy to support implementation of Aboriginal and Torres Strait Islander Cultural and Health Training Framework. Cultural safety training program aligns with the RACGP innovative Reconciliation Action Plan. Cultural safety training program aligns with the RACGP Training Standards. Cultural safety training program meets the AMC accreditation standards. Cultural safety training program aligns with the GP Training Outcomes Framework Cultural safety training program meets the Commission on safety and Quality in Health Care National safety and quality health service standards. Record and evaluate uptake and measures across various business units.	A resourced implementation team is established, adequately resourced and operational. Evidence that the Aboriginal and Torres Strait Islander Cultural and Health Training Framework has been implemented across different areas of operations. Cultural Safety and Governance strategy has been developed and implemented. Cultural Advisory Committee has been established. Mechanisms are in place to incorporate feedback from Aboriginal and Torres Strait Islander peoples and communities, and demonstrate success of the cultural safety and governance strategy.	RACGP RACGP Education RACGP Training National Faculty of Aboriginal and Torres Strait Islander Health RACGP Evaluation Reconciliation Action Plan (RAP)

A dedicated formal and high-quality cultural safety curriculum and syllabus is developed and implemented.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
A national cultural safety curriculum for registrars is developed and can be tailored locally to ensure local contextual appropriateness and relevance.	Cultural safety curriculum and syllabus is developed, reviewed and/ or enhanced. Explore and develop an evidence base for cultural safety competencies and skills development indicators. Incorporation of cultural knowledge, worldviews, practices, methodologies and traditions into program resources and outputs e.g. Indigenous pedagogy. Aboriginal and Torres Strait Islander Cultural Educators and Medical Educators are involved with and lead this work. Immersion activities and face-to-face small group teaching sessions are a key component of cultural safety training and should be prioritised over large group lectures and online activities. A suite of resources is developed to support the curriculum and syllabus delivery-both for face-to-face, online activities and other educational modalities and modules. Local cultural education teams are supported to implement the curriculum and syllabus.	Updated national cultural safety curriculum and syllabus is published and in use. Cultural Safety curriculum and syllabus has been updated and matched to evidence-based competencies. Educational resources are being developed to support this curriculum and syllabus. Local cultural education teams are resourced to deliver the cultural safety training program. Feedback from internal RACGP evaluations demonstrate the impact and success of the national cultural safety curriculum.	RACGP RACGP Education RACGP Assessment RACGP Training National Faculty of Aboriginal and Torres Strait Islander Health RACGP Evaluation team Joint Colleges Training Services

All GP registrars complete comprehensive cultural safety training program as part of their training.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
All registrars complete the minimum requirements and assessments in a progressive cultural safety training program.	Establish minimum requirements for cultural safety training. Map cultural safety training and assessment across the whole training journey, which is a continuum of cultural safety training, building on cultural safety competencies over time. Design and implement appropriate evidence-based assessment for progress towards cultural competencies. Establish a process to identify trainees who need additional support with cultural safety skills development. Tailored program activities for Aboriginal and Torres Strait Islander registrars to assist them managing and coping with cultural safety issues. All trainees have access to a Cultural Educator and/or Cultural Mentor, and/or Aboriginal Medical Educator.	All registrars meet the minimum requirements. Review and record progress of registrars through the cultural safety training program. Cultural Educators and Cultural Mentors are a readily available and accessible resource to all registrars. Increased capacity of trainees to work competently, with a sound understanding of health issues and determinants of Aboriginal and Torres Strait Islander peoples’ health.	RACGP Training RACGP Education Joint Colleges Training Services Cultural Educator/ Cultural Mentor Aboriginal and Torres Strait Islander Health Medical Educators
Registrars undertaking Aboriginal and Torres Strait Islander health training placements have additional enriched cultural safety learning opportunities.	Registrars undertaking Aboriginal and Torres Strait Islander health training placements are provided with additional optional cultural safety training to strengthen their skills. A suite of resources developed that supports cultural safety enhanced skills development. Dedicated training time with a Cultural Mentor as part of practice placement. Establish mechanisms for a community of practice and collegiate support networks for registrars working in Aboriginal and Torres Strait Islander health.	Increased uptake of registrars doing additional cultural safety training activities. Increased interest in Aboriginal and Torres Strait Islander health training because of the increased supports and training opportunities. Cultural Mentors are a readily available and accessible resource for registrars on Aboriginal and Torres Strait Islander placements.	RACGP Training RACGP Education Joint Colleges Training Services Cultural Educator/ Cultural Mentor Aboriginal and Torres Strait Islander Medical Educators
Registrars finish the training program with enhanced self- reflective skills and improved cultural competencies.	Design and develop a process to evaluate the effectiveness of cultural safety training within the program and behavioural change. Evaluation should include feedback from Aboriginal and Torres Strait Islander People including patients, medical educators, Cultural Educators, Cultural Mentors practice staff and other colleagues. Evaluation should include self-reflective assessment from the registrars themselves using evidence based behavioural change methodologies. Establish mechanisms that are appropriate and safe to measure and collect feedback from Aboriginal and Torres Strait Islander People and communities on the degree to which they have felt culturally safe.	Evaluation of the cultural safety training program. Increase from baseline - Tracking assessment of cultural safety of registrars over time. Mechanisms in place to measure and collect feedback from Aboriginal and Torres Strait Islander people and communities demonstrate positive impact of cultural safety and cultural competency training.	RACGP Training Joint Colleges Training Services Cultural Educator/ Cultural Mentor Aboriginal and Torres Strait Islander MEs RACGP Evaluation Team

Cultural safety training enables critically reflexive practice as an integral part of lifelong continuous professional development as a GP.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
All GPs continue with cultural safety training throughout their career.	Cultural safety is considered a core skill of GPs and is part of the capability profile of a GP. Cultural safety training is a required element of CPD. GPs have ongoing access to cultural safety training options and cultural mentors. A suite of cultural safety training options is developed for GPs professional development that meets various levels of need and contextual relevance.	Increase in annual number of Fellowed GPs undertaking cultural safety training. Cultural safety training is reflected in Continual Professional Development (CPD) statements. A suite of cultural safety training options is available for use and easily accessible.	RACGP Education RACGP Continuing Professional Development (CPD) RACGP National Faculty of Aboriginal and Torres Strait Islander Health

Cultural safety training enables critically reflexive practice as an integral part of lifelong continuous professional development as a GP.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
There are adequate and culturally safe supervision models.	Develop a culturally safe supervision model and appropriate guidance documents. Culturally safe supervision models are supported by relevant evidence. Aboriginal and Torres Strait Islander GPs in training have access to culturally safe supervisors, practice staff, medical educators, examiners and other training and education staff.	Increased rates of individuals involved in GP training (including medical educators, examiners, supervisors and practice staff) completing cultural safety training. A culturally safe supervision model and appropriate guidance documents exist and are implemented. Aboriginal and Torres Strait Islander GPs in training feel culturally safe and valued. Aboriginal and Torres Strait Islander GPs in training report fewer incidents of experienced or witnessed, discrimination and racism.	RACGP Training RACGP Supervisors RACGP Accreditation RACGP Continuing Professional Development (CPD)
Supervisors have cultural safety capabilities and are competent in registrar support	All supervisors complete core cultural safety training. Supervisor cultural safety training is a key part of supervisor accreditation requirements. Supervisors are provided with ongoing professional development in cultural safety. Supervisors complete in person or immersive cultural safety training on an ongoing basis. Supervisors are up to date with their professional development. Supervisors have access to Cultural Mentors and Cultural Educators. Supervisors working in Aboriginal and Torres Strait Islander Health have opportunities to connect and create a community of supervision practice within this setting. Supervisors keen to specifically supervise Aboriginal and Torres Strait Islander GP registrars are supported and mentored to enhance their cultural competency skills for this purpose. Connection between in-practice and out-of-practice education to support cultural safety training. Supervisor can receive CPD points if they complete cultural safety training (face-to-face or online modules). Supervisors encouraged to attend/participate in Aboriginal and Torres Strait Islander significant national and local community cultural events.	Mechanisms to measure and collect feedback from Aboriginal and Torres Strait Islander People and communities. Pilot evaluation shows connection between in practice and out of practice education to support cultural safety training. New or revised administrative and clinical orientation, staff training and materials regarding Aboriginal and Torres Strait Islander cultural safety. Increased number of supervisors with recent (within last 18mths) cultural competency training. Increased supervisor presence at significant national and local community cultural events for Aboriginal and Torres Strait Islander peoples and communities.	RACGP Training RACGP Supervisors RACGP Accreditation RACGP Continuing Professional Development (CPD)
Medical Educators (MEs) have cultural safety capabilities and are competent in registrar support	All MEs receive cultural awareness orientation as part of their employment. All MEs complete core cultural safety training. ME cultural safety training is a key part of ME professional development and they are provided with ongoing professional development in cultural safety. MEs complete in person or immersive cultural safety training on an ongoing basis. ME cultural safety professional development is linked to workplace performance checks. MEs are up-to-date with their professional development. MEs have access to Cultural Educators and Cultural Mentors. MEs working in Aboriginal and Torres Strait Islander Health and training have opportunities to connect and create a community of practice within this setting. MEs who have trainees in Aboriginal and Torres Strait Islander health placements have clear access to cultural support person such as an Aboriginal and Torres Strait Islander Medical Educator. MEs keen to specifically support Aboriginal and Torres Strait Islander GP registrars are supported and mentored to enhance their cultural competency skills for this purpose. MEs can receive CPD points if they complete cultural safety training (face to face or online modules) MEs are encouraged to attend and participate in Aboriginal and Torres Strait Islander significant national and local community cultural events.	Mechanisms to measure and collect feedback from Aboriginal and Torres Strait Islander People and communities. New or revised administrative and clinical orientation, staff training and materials regarding Aboriginal and Torres Strait Islander cultural safety. Pilot evaluation shows positive impact and reinforcement of cultural competencies across all education engagement. Increased number of MEs and training staff with recent (within the last 18 months) cultural safety training. Increased ME presence at significant national and local community cultural events for Aboriginal and Torres Strait Islander peoples and communities.	RACGP Training RACGP Continuing Professional Development (CPD) Joint Colleges Training Services
Regional Operations Managers (ROMs), Training Coordinators (TCs) and other training staff have cultural safety capabilities and are competent in registrar support.	All training staff receive cultural awareness orientation as part of their employment. All training coordinators and other training staff complete core cultural safety training. Cultural safety training is a key part of professional development, and they are provided with ongoing professional development in cultural safety. Cultural safety professional development is linked to workplace performance checks. TCs have access to Cultural Educators and Cultural Mentors. TCs who have trainees in Aboriginal and Torres Strait Islander health placements have clear access to cultural support person such as an Aboriginal and Torres Strait Islander Medical Educator. TCs keen to specifically support Aboriginal and Torres Strait Islander GP registrars are supported and mentored to enhance their cultural competency skills for this purpose. TCs and other staff are encouraged to attend/ participate in Aboriginal and Torres Strait Islander significant national and local community cultural events. Dedicated and appropriately trained training coordinators to support Aboriginal and Torres Strait Islander registrars. Dedicated and appropriately trained training coordinators to support registrars in Aboriginal and Torres Strait Islander training placements. Dedicated and appropriately trained training coordinators to support Aboriginal and Torres Strait Islander training placements and practices.	All Regional Operations Managers (ROMs), Training coordinators (TCs) and other training staff have had cultural safety training. All Regional Operations Managers (ROMs), Training Coordinators (TCs) and other training staff are knowledgeable about the support systems and structures for Aboriginal and Torres Strait Islander trainees. Mechanisms in place to measure and collect feedback from Aboriginal and Torres Strait Islander peoples and communities.	RACGP Training Regional and local training teams RACGP Communications
Practices and training placements are culturally safe, clinical and training environments.	Practices should demonstrate how they are culturally safe for Aboriginal and Torres Strait Islander patients, communities and registrars as part of their accreditation process. Practice staff cultural safety training is a requirement of training site accreditation. In and out of practice cultural safety training is provided for practices and their staff. Practices keen to specifically help train Aboriginal and Torres Strait Islander GP registrars are supported and mentored to enhance their cultural competency skills for this purpose. Practices are encouraged to attend/participate in Aboriginal and Torres Strait Islander significant national and local community cultural events. Practices are encouraged and supported to develop Reconciliation Action Plans (RAPs). Practices create culturally appropriate and welcoming spaces according to local cultural protocols, such as Acknowledgement of Country signs, resources in local languages, local artwork, employ Aboriginal and Torres Strait Islander staff	Practice accreditation standards include items pertaining to cultural safety training that are assessed during accreditation proceedings. Increased number of practices with RAPs. Mechanisms in place to measure and collect feedback from Aboriginal and Torres Strait Islander peoples and communities.	RACGP Training RACGP Accreditation RACGP Faculty of Aboriginal and Torres Strait Islander Health

Assessment of cultural safety competencies and responsiveness is aligned to the best evidence.

OUTCOME	STRATEGIES	INDICATORS	RESPONSIBILITY
Cultural safety competencies are developed and mapped against the best available evidence.	Identify and collate current evidence available for the assessment of cultural safety competencies in Aboriginal and Torres Strait Islander health and other First Nations health education programs. Structure assessments and competencies to align with the evidence.	Existing evidence base is incorporated into the design of the development of assessments for cultural safety competencies and responsiveness. An evidence-based competency framework is designed, implemented and evaluated.	RACGP Training RACGP Education RACGP Assessment RACGP National Faculty of Aboriginal and Torres Strait Islander Health Aboriginal and Torres Strait Islander Medical Educators Cultural Educators Joint Colleges Training Services (JCTS)
Contribute to the evidence base for cultural safety competencies by conducting appropriate evaluation and research.	Identify any gaps in evidence for cultural safety competencies. Evaluate education, assessment processes and competencies developed and implemented by the RACGP. Develop evaluation or research which is focused on enhanced health and safety outcomes for Aboriginal and Torres Strait Islander communities and Peoples. Aboriginal and Torres Strait Islander People and health consumers can give feedback on what is culturally safe to them.	Key learnings and recommendations are identified and can be used for continual improvement for the cultural competency and responsiveness framework and strategy. Publications of evaluations and research that supports the evidencebased cultural competency framework.	RACGP Training RACGP Education RACGP Assessment RACGP National Faculty of Aboriginal and Torres Strait Islander Health Aboriginal and Torres Strait Islander Medical Educators Cultural Educators Joint Colleges Training Services (JCTS)
All College staff, registrars, supervisors and practices can clearly identify what racism, discrimination, bullying and harassment is and their effects on social, emotional and physical wellbeing.	Privilege, bias, discrimination and racism are key components of the cultural safety training program. Clear definitions and training models on racism, discrimination, bullying and harassment. Comprehensive training program is developed and implemented. Resources developed to support training including face-to-face and online modules.	Cultural safety training program is developed and launched. Number of people that have participated in specific “what is racism” training.	RACGP RACGP Training RACGP Education RACGP Policy RACGP Legal RACGP People and Capability National Faculty Aboriginal and Torres Strait Islander Health
Safe environment created to support reporting of racism, discrimination, bullying and harassment in training and the RACGP.	The RACGP has zero tolerance for racism, discrimination, bullying and harassment which is clearly articulated and visible to staff, registrars, supervisors and practices. Media and position statements articulate the commitment and advocacy of RACGP on zero tolerance for racism, discrimination, bullying and harassment. Strong policies and procedures to support reporting of racism, discrimination, bullying and harassment in training at RACGP. There is Aboriginal and Torres Strait Islander leadership and governance on racism policy and decision-making processes. Clearly defined and accessible process to identify and report racism, discrimination, bullying and harassment at the RACGP. Reporting of racism, discrimination, bullying and harassment does not negatively impact the reporter in any way. There is a fair and equitable approach to managing reports of racism, discrimination, bullying and harassment. There are clear repercussions and consequences for perpetrators of racism, discrimination, bullying and harassment. The RACGP adopts the Ahpra and National Boards Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 202-2025.	Visibility of the RACGP’s commitment to a zero tolerance for racism, discrimination, bullying and harassment. Racism policy and associated processes and procedures established and reviewed. RACGP has position statements on zero tolerance for racism, discrimination, bullying and harassment. Shift in workplace survey racism results. A decrease in reported experiences of racism in the Medical Training Service survey (Medical Board of Australia).	RACGP RACGP Policy National Faculty of Aboriginal & Torres Strait Islander Health Censor – Aboriginal & Torres Strait Islander health RACGP Training Joint Colleges Training Services

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