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The Clinical Competencies for the CCE

Competencies

11. Aboriginal and Torres Strait Islander health

Last revised: 19 Mar 2024

AH 1.1.1 Communicate effectively, develop social and cultural competency with Aboriginal and Torres Strait Islander peoples
AH 1.1.2 Develop effective therapeutic relationships with Aboriginal and Torres Strait Islander peoples
AH 2.1.1 Optimise health outcomes by early identification and effective management of all health conditions
AH 2.2.1 Identify and address the social and cultural determinants of health in the local community
AH 3.1.1 Promote the health and wellbeing of Aboriginal and Torres Strait Islander communities
AH 4.1.1 Support Aboriginal and Torres Strait Islander health research and education
AH 5.1.1 Identify and implement effective models of primary healthcare delivery
AH 5.2.1 Implement appropriate policies and initiatives regarding Aboriginal and Torres Strait Islander health to optimise outcomes

This section contextualises all the core competency skills and how they are applied to culturally appropriate, safe, effective and holistic Aboriginal and Torres Strait Islander health care delivery as defined by Aboriginal and Torres Strait Islander peoples. This includes demonstrating cultural understanding, having a culturally respectful, non-judgmental and safe communication approach, acknowledging the impact of colonisation, historical and contemporary events and policies, awareness of intergenerational trauma, systemic barriers to health equity and optimising health outcomes. It specifically requires self-reflectiveness and self-awareness to avoid harmful biases, assumptions, stereotyping and rote learned responses that do not consider the individual patient context and value diversity within cultures.

Criteria  

  1. Uses a range of methods to facilitate culturally safe communication with Aboriginal and Torres Strait Islander peoples
  2. Integrates cultural perspectives on, and beliefs about, the health and wellbeing of Aboriginal and Torres Strait Islander peoples into holistic clinical practice
  3. Appraises and addresses barriers to development of effective therapeutic relationships with Aboriginal and Torres Strait Islander peoples
  4. Identifies and addresses obstacles to optimising the management of complex health presentations in Aboriginal and Torres Strait Islander peoples
  5. Demonstrates effective diagnostic and management strategies that enhance health outcomes for Aboriginal and Torres Strait Islander patients
  6. Collaborates effectively with multidisciplinary teams to develop meaningful and holistic management plans
  7. Identifies and uses professional resources to assist with delivery of best-practice care to Aboriginal and Torres Strait Islander patients
  8. Identifies and incorporates social and cultural determinants of health into management plans
  9. Uses evidence-based preventive and population health approaches to reduce health inequalities in Aboriginal and Torres Strait Islander communities
  10. Identifies health-delivery strategies to reduce inequities and enhance self determination
  11. Uses specific Medicare and Pharmaceutical Benefits Scheme programs to improve health outcomes
  12. Appraises the capacity of the primary health care model to comprehensively meet the needs of the community
  13. Develops strategies to promote a culturally safe practice environment
  14. Appropriately uses Medicare programs in the delivery of healthcare for Aboriginal and Torres Strait Islander patients
  15. Integrates knowledge of history of government policies and consequent health impacts into delivery of care
  16. Advocates for, and uses policies and initiatives, that promote equity in healthcare

For the trainee

You should develop knowledge and understanding of Aboriginal and Torres Strait Islander health and culture and how this applies to the management of health outcomes for Aboriginal and Torres Strait Islander patients and communities. You should understand screening and health assessment tools, preventative health and health promotion programs and tools, referral methods and Aboriginal and Torres Strait Islander health information sources. You should be aware of the primary health care models utilised by Aboriginal community-controlled health services to support patients, their families, and the community and the role of multidisciplinary teams to optimise care including appropriate collaboration with Aboriginal and Torres Strait Islander Health Practitioners.

Resources such as Closing the Gap and other culturally appropriate/specific resources eg PBS, MBS, Access to Allied Psychological Services (ATARS) program, medical outreach programs, Care Coordination and Supplementary Services (CCSS) program and Aboriginal and Torres Strait Islander community based programs are particularly worth learning about and accessing.

Other areas where you should concentrate include:

Role of social and cultural determinants of health, evidence-based preventive activities and management of prevalent conditions

Skills

  • Diagnostic
  • Managing significant illnesses and complex comorbidity
  • Use of tools in management (ie health assessment, GP Management Plan, Closing the Gap)
  • Clinical decision making.
  • Strategies to facilitate selfcare
  • Cultural competence and use of competence models in communication (ie Arnold’s ‘Ask-Tell-Ask’ model)
  • Organisational change to improve patient health journey
  • Collaboration with Aboriginal and Torres Strait Islander Health Practitioners and other health professionals, , Aboriginal hospital liaison officers and other cultural brokers
  • Involvement of family, community and cultural supports in management
  • Advocacy for patients

Attitudes

  • Self awareness and understanding of one’s own cultural attitudes, beliefs, biases and behaviours
  • Openness to cultural immersion experiences
  • Value for the perspective of health that incorporates whole family and community wellbeing
  • Value for holistic approach to healthcare that incorporates social, emotional, cultural aspects including connectedness to country, land and sea
  • Understanding of the importance of developing trust and building relationships with Aboriginal and Torres Strait Islander patients and communities and the time that this takes
  • Respect and willingness to learn from Cultural Educators, Cultural Mentors and other advisors
  • Commitment to ongoing learning in regard to developing cultural understanding, and culturally safe and responsive health care delivery practices
This event attracts CPD points and can be self recorded

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