Abstract:
Introduction: There is general consensus that to improve the health status of Aboriginal and Torres Strait Islander Australians all health professionals should be educated in how to work in a culturally safe way. Despite the many initiatives to teach cross-cultural education to health professionals as part of the usual curriculum for health professionals, there is little evidence that any of these programs have a long-term impact on the cultural safety of the students’ practice once graduated. In fact, recent research indicates that training programs have been largely ineffective in improving doctors’ cultural skills, their behaviour or health outcomes, and that some approaches to cross-cultural education are having the reverse effect and creating hostility and racism.
Methods: Since 2012 Bond University has been conducting a significant cultural awareness and Aboriginal and Torres Strait Islander Health program with its medical students. We have also been conducting a five year longitudinal study to measure the impact of these cultural awareness activities on students’ attitudes and behaviours using a validated cultural awareness and cultural competence scale survey. The survey is administered pre- and post-immersion at Year 1, in Year 3 and Year 5.
Results: Initial findings of the cultural awareness study (n=280) revealed positive shifts in various dimensions of cultural awareness among first year undergraduate medical students. The most notable differences occurred within knowledge acquisition, retention and dissemination (items 18_20, p<0.001). The remaining statement (item 21) in this component was significant at the 95 per cent confidence interval (p<0.05), which infers that students positioned themselves as making more effort to learn about how cultural factors affected health theory, delivery and behaviour following the cultural immersion. Institutional and curricular influences also showed positive directions after the immersion.
Conclusion: Cultural immersion has a great potential to elicit positive shifts in attitudinal and knowledge related aspects of cultural awareness in the early stages of a medical curricula. Sharing this initial information will assist others who are teaching into these programs.