Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Understanding practitioner professionalism in Aboriginal and Torres Strait Islander health: lessons from student and registrar placements at an urban Aboriginal and Torres Strait Islander primary healthcare service

Deborah A. Askew A B , Vivian J. Lyall A F , Shaun C. Ewen C , David Paul D and Melissa Wheeler E
+ Author Affiliations
- Author Affiliations

A Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Health, Qld 4077, Australia.

B Discipline of General Practice, University of Queensland, Qld 4029, Australia.

C Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Vic. 3010, Australia.

D Aboriginal Health, School of Medicine Fremantle, University of Notre Dame, WA 6959, Australia.

E Centre for Ethical Leadership, University of Melbourne, Vic. 3010, Australia.

F Corresponding author. Email: vivian.lyall@health.qld.gov.au

Australian Journal of Primary Health 23(5) 446-450 https://doi.org/10.1071/PY16145
Submitted: 11 November 2016  Accepted: 27 May 2017   Published: 15 August 2017

Abstract

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, four learning principles for medical professionalism were identified: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient–practitioner relational power imbalances; and knowledge, understanding and skills for providing patient-centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health care is an essential component of medical professionalism.

Additional keywords: Aboriginal health, medical education, practitioner bias.


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