Category | Frequency | Interview data (RTP A & B) |
---|---|---|
General teaching points | ||
Communication and consultation skills | 100% identified this as an area requiring improvement, and all gave at least one specific detail to be addressed in feedback session | ‘Less didactic, paternalistic approach’ (A3) |
‘Respectfulness – meet the patient on the same level as a participant on the same journey’ (A4) | ||
‘Locus of control remained with doctor – no likelihood of improved management or self care’ (A6) | ||
‘Criticising patient too much’ (B25) | ||
‘Listen- patient agenda not GP agenda’ (A15) | ||
‘Not patient- centred’ (A16) | ||
‘Bad basic consultation skills for any patient’ (A10) | ||
‘Doctor needs to check patient understanding before going on to other issues’ (B36) | ||
‘No open ended questions to allow her to discuss her concerns’ (B41) | ||
Cultural awareness and understanding | 72% (48/64) identified a need for the registrar to better consider the patient’s culture or Aboriginality within the consultation | ‘Understanding of Aboriginal culture & awareness’ (A4) |
‘Lacks exploration of patient’s many social and cultural factors and needs’ (B37) | ||
‘Cultural respect and safety’ (B45) | ||
‘Once you identified the patient as Aboriginal what other cultural issues did you need to address?’ (A9) | ||
66% (42/64) gave at least one specific detail related to the Aboriginal context or Aboriginal health to be addressed in registrar feedback (see below) | ||
Specific teaching points relevant to culture or Aboriginal health | ||
Cultural issues impacting on the consultation | 42% (27/64) - Cross cultural communication/consultation | ‘Explore ways in which he may alter his management style to be more culturally appropriate’ (A3) |
28% (18/64) - Identification of and terminology around Aboriginality | ‘Made judgement about Aunt’s Aboriginality without asking. “Part Aboriginal” doesn’t exist’ (A5) | |
‘Understanding of the meaning of Aboriginality’ (A10) | ||
27% (17/64) - The significance of Elders and family, and how to manage in a consultation | ‘Didn’t acknowledge or thank the Aunty’s presence, support and contribution’ (B29) | |
17% (11/64) - Ensure lifestyle advice is culturally appropriate | ‘Do you think an Aboriginal lady, short of money…plays tennis?’ (A1) | |
‘Assumption of appropriateness and usefulness of handouts’ (B9) | ||
14% (9/64)- Sorry business (bereavement) | ‘Acknowledgment of the ‘Sorry’ event that had affected her life’ (B33) | |
‘Acknowledge demands of Sorry business’ (A6) | ||
Health | 9% (6/64) - Health issues of particular importance in Aboriginal people | ‘Awareness Aboriginal higher risk of having cardiac disease’ (B14) |
Supports to assist patient to manage heath needs | 14% (9/64) - Access Aboriginal healthcare providers and services | ‘Try to involve Aboriginal health worker and support.’ (B15) |
‘Referral to Aboriginal services/dietitian who have better understanding of Aboriginal culture.’ (B17) | ||
‘Referred to allied health - didn’t check re transport issues’ (A5) | ||
8% (5/64)- Identified the relevance of government funded initiatives to support health care costs and support needs (Closing the Gap program) | ‘Failure to appreciate money – costs of meds. CTG could be used.’ (B41) | |
Supporting ongoing learning in Aboriginal health | ||
Response to question ‘What educational resources may be helpful?’ | 20% (13/64) - cultural awareness learning resources (including specific reference to workshops, written and visual materials) | ‘Aboriginal awareness training’ (A4) |
A day at Aboriginal health centre. Reading material. Video.’ (A3) | ||
16% (10/64) - accessing cultural advice and mentorship from Aboriginal people | ‘Discussion with Aboriginal Health Worker. Sitting in on consultation with mentor.’ (A5) | |
8% (5/64) - recommended Registrar needed improved knowledge of Aboriginal history | ‘History of Aboriginal self-determination. Many GPs weren’t born or educated in Australia – are unaware of the stolen generation, referendum Aboriginal vote’ (B16) |