Respecting the Difference: An Aboriginal Cultural Training ... · Respecting the Difference: An...

Respecting the Difference: An Aboriginal Cultural Training Framework for NSW Health

Summary The Aboriginal Cultural Training Framework: Respecting the Difference (the Framework)will assist increasing cultural competencies and therefore promote greater understandingof the processes and protocols for delivering health services to Aboriginal people.

To significantly improve the health status of Aboriginal people and reverse the impact ofracism, there is an immediate need for organisations to provide more respectful,responsive and culturally sensitive services. Its everyones responsibility to get involved inchanging organisational culture.

Document type Policy Directive

Document number PD2011_069

Publication date 01 November 2011

Author branch Workforce Planning and Development

Branch contact 9424 5745

Review date 30 June 2018

Policy manual Not applicable

File number 03/83654-5

Previous reference N/A

Status Review

Functional group Personnel/Workforce - Learning and Development

Applies to Local Health Districts, Specialty Network Governed Statutory Health Corporations, BoardGoverned Statutory Health Corporations, Chief Executive Governed Statutory HealthCorporations, Affiliated Health Organisations, Public Health System Support Division,Community Health Centres, Dental Schools and Clinics, NSW Ambulance Service, Ministryof Health, Public Health Units, Public Hospitals

Distributed to Public Health System, Health Associations Unions, NSW Ambulance Service, Ministry ofHealth, Tertiary Education Institutes

Audience All NSW Health staff

Policy Directive

Secretary, NSW HealthThis Policy Directive may be varied, withdrawn or replaced at any time. Compliance with this directive is mandatoryfor NSW Health and is a condition of subsidy for public health organisations.

POLICY STATEMENT

PD2011_069 Issue date: November 2011 Page 1 of 3

PROVISION OF RESPECTING THE DIFFERENCE – AN ABORIGINAL CULTURAL TRAINING FRAMEWORK FOR NSW HEALTH

PURPOSE This Policy Directive sets out the cultural training requirements for the NSW Ministry of Health (MoH), Local Health Districts (LHDs) and other NSW Health Organisations to ensure that all staff are culturally competent and empowered to deliver more respectful, responsive and culturally sensitive services for Aboriginal people, their families and communities.

MANDATORY REQUIREMENTS Gaining an understanding of and respect for Aboriginal people will enable NSW Health staff to develop meaningful and respectful professional relationships, culminating in improved health care outcomes for Aboriginal people, their families and communities. NSW Health is committed to mandatory Aboriginal Cultural Training for all health staff. Understanding the disparities in health status and outcomes of Aboriginal people is essential for creating positive change. Changing the platform of service delivery requires engagement and participation through knowledge acquisition and cultural education. Senior Executive, Governing Boards, Program and Service Managers and all staff are responsible for ensuring their services consider the needs of Aboriginal individuals and communities when working to achieve the closure of gaps between Aboriginal and non-Aboriginal health outcomes and improving the overall health of Aboriginal people within a decade. Provision of Aboriginal cultural training programs is required within health services to facilitate organisational/workplace cultural change and overcome institutional racism. Staff will be provided with the necessary knowledge and skills to interact positively with Aboriginal people and communities and improve engagement and communication methods required to improve work practices. Improving appreciation, understanding and knowledge of Aboriginal culture, customs, heritage and protocols is of paramount importance in ensuring improved Aboriginal health outcomes.

IMPLEMENTATION Implementation of this Policy Directive will be guided by Respecting the Difference –An Aboriginal Cultural Training Framework for NSW Health (“The Framework”). The Framework outlines the target audience, aims, training requirements, learning outcomes, and responsibilities in providing Aboriginal Cultural Training.

POLICY STATEMENT

Training Requirement Target Group E-Learning Generic Subject Content

and Local Content/Face to Face

Leadership Groups 2 hrs 4hrs (nominal) Program and Service Managers

2 hrs 6hrs (nominal)

Frontline, Administrative, Clinical and staff that provide direct care to Aboriginal people

2hrs 6hrs (nominal)

All other staff, other Corporate, Administrative & Support staff

2hrs 6hrs (nominal)

NSW Health Learning and Development Units have the responsibility to ensure that sustainable cultural training programs specific to Aboriginal people are incorporated into training systems and have the task of overseeing their implementation via a working group or committee established for the health service. This will be supported by Aboriginal Health Management Teams/Units and Managers, Aboriginal Workforce Development, providing advice regarding the content of the programs, especially local community protocols and information. The Framework outlines the minimum training requirements for all staff working in NSW Health. Some services may choose to provide more training than the minimum requirements.

There are three components to the delivery of Respecting the Difference training:

• E-learning (online) • Generic Subject Content (face-to-face) • Local Content (face-to-face)

Resources to support E-learning have been developed and are available to complement the local cultural training programs of Local Health Districts and other NSW Health organisations. All staff can access generic modules online that will provide general knowledge and strategies for working with Aboriginal people. NSW Health will implement appropriate reporting procedures to assist Local Health Districts and other NSW Health organisations. Monitoring and review of cultural training programs will be undertaken as part of the ongoing coordination of programs to ensure they are relevant and meet the needs of staff. Local Health Districts and other NSW Health organisations will be required to report progress annually.

POLICY STATEMENT

REVISION HISTORY Version Approved by Amendment notes November 2011 (PD2011_069)

Deputy Director-General Health System Support

Corrects some information in original policy. Replaces PD2011_053

August 2011 (PD2011_053)

Deputy Director-General Health System Support

New policy

ASSOCIATED DOCUMENTS 1. Respecting the Difference – An Aboriginal Cultural Training Framework for

NSW Health

Respecting the DifferenceAn Aboriginal Cultural Training

Framework for NSW Health

The disparity between health outcomes of Aboriginal people and those of the non-Aboriginal population has been identified by the NSW Government as a priority issue. Associated State and National health strategies have identified the urgent need to address these health inequalities.

To significantly improve the health status of Aboriginal people and reverse the impacts of racism, there is an immediate need for organisations to provide more respectful, responsive and culturally sensitive services. It’s everyone’s responsibility to get involved in changing organisational culture.

Understanding the disparities in health status and outcomes experienced by Aboriginal people is essential for creating positive change. Changing the platform of service delivery requires engagement and participation through knowledge acquisition and education.

The Aboriginal Cultural Training Framework: Respecting the Difference (“The Framework”) will assist with increasing cultural competencies and therefore promote greater understanding of the processes and protocols for delivering health services to Aboriginal people.

Gaining an understanding of and respect for Aboriginal people will enable NSW Health staff to develop meaningful and respectful professional relationships, culminating in improved healthcare outcomes. NSW Health is committed to the Aboriginal Cultural Training Framework,incorporating it into the mandatory training requirements for all health staff.

The purpose of this training is to motivate NSW Health staff to build positive and meaningful relationships with Aboriginal people who may be clients, visitors or Aboriginal staff, and to improve their confidence in establishing appropriate and sustainable connections.

The first step toward improving relationships is to identify and acknowledge the different healthcare access issues and inequalities that have been endured by Aboriginal people for many years. So that better relationships with Aboriginal people will result, training has been designed to provide all NSW Health staff with an insight into why many Aboriginal people do not comfortably engage with healthcare providers.

A NSW Aboriginal Workforce Steering Committee (AWSC) will be established to oversee the implementation of the ‘Framework’ and will consist of representatives of the NSW Ministry of Health, Local Health Districts and other NSW Health organisations.

Regular data gathering and analysis will be undertaken by the Aboriginal Workforce Development Unit (AWDU) to monitor the Framework’s implementation and progress and to provide an annual, summary report to the AWSC.

NSW Ministry of Health, Local Health Districts and other NSW Health organisations will be required to provide six-monthly data against the key performance indicators to the AWSC.

Introduction

Governance and Monitoring

Training CommitmentE-Learning [2 hours]

History and Culture• Graphical timeline/chronology of Aboriginal

Australia.

• Historical impact of invasion.

• Removal of cultural practices, denial of access to traditional lands.

• Stolen Generation.

• Traditional Aboriginal Culture.

• Evolving cultural context of Aboriginal Culture.

• Historical context and Aboriginal view point of health.

• Gender based issues and roles: ‘Men’s and Women’s Business’.

• Elders, community leadership, representation and ambassadors.

Identity• The Dreaming.

• Land, connectedness, relationships and spirituality.

• Totems, traditional lands and country.

• Custodianship, language and heritage.

• Deceased persons and passing away; ‘Sorry Business’.

• Stereotypes.

• Significant events and notable dates on the Aboriginal calendar.

Aboriginal Health• Health statistics (improved data collection).

• Government commitments and strategies – ‘Closing the Gap’, ‘Statement of Intent’, ‘Making it Our Business’, etc.

• Aboriginal Community Controlled Health Sector.

• Understanding the need for Aboriginal-specific health services.

• Historical relationships, community and family experiences and local protocols.

• Needs and wants from health services provisions: ‘An Aboriginal Perspective’.

Communication• Protocols, community terminology and

processes.

• Community representation, Elders and kinship.

• Consultation, partnerships and negotiation

• Community-based organisations.

• First language, Aboriginal English and local content and context.

Existing barriers for access to health services• Racism, prejudice and discrimination.

• Language, education, socioeconomic circumstances and employment.

• Geographic isolation, transport, living costs.

• Past personal, family and community experiences.

• Significance and importance of family and community connectedness (i.e. not wanting to leave family/community to access health services).

E-learning component – is an online and blended learning program that allows for the greatest number of staff to access consistent training and information. A set of web-based resources will increase participation and access to information across NSW.

The following will be addressed in the e-learning component:

NSW MINISTRY OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. (02) 9391 9000 Fax. (02) 9391 9101 TTY. (02) 9391 9900 www.health.nsw.gov.au

This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the NSW Ministry of Health.

PD2011_069 SHPN (WDI) 110029

Further copies of this document can be downloaded from the NSW Health website www.health.nsw.gov.au

This document and other related resources may contain images of Aboriginal people who may be deceased.

October 2011 © NSW Ministry of Health

The Artist Bronwyn Bancroft is a descendant of the Djanbun clan of the Bundjalung Nation and is the creator of all artwork for the

‘Respecting the Difference’ project.

Respecting the DifferenceThis artwork represents the holistic approach to creating better health outcomes for Aboriginal people. The outer circle symbolises Mother Earth, the binding of the land to health and the nourishment of the spirit through this connection.

The second blue circle represents fresh water – the cleansing qualities it brings to our lives, and a source of life and food replenishment.

The weaving shape over the fresh water represents salt water and the people who come from saltwater areas.

The next circle represents both Aboriginal and non-Aboriginal community members who will work together to achieve better health outcomes and support the individual to overcome fear of the unknown, especially in relation to non-Aboriginal health methods.

‘Respecting The Difference’ ‘Men and Women’

Evaluating the implementation of the NSW Aboriginal Cultural Training Framework will be fundamental to its ongoing success.

Evaluation can be assessed in three key areas:

Ê Evaluation of the development and implementation of the training: Was the training adequately planned and implemented across all NSW Health organisations?

Ë Assessment of the learning outcomes and training: Were the learning outcomes of the training appropriate and comprehensive?

Ì Effectiveness: Has the training achieved its objectives with regard to service provision, health improvement and community empowerment?

Evaluation

‘Water Life Replenishment’

Introduction

Australia.

• Stereotypes.

processes.

PD2011_069 SHPN (WDI) 110029

Evaluation

Respecting the Difference – An Aboriginal Cultural Training Framework for NSW HealthLearning Outcomes E-Learning [2 hours]

• Recognise the need to improve Aboriginal health and understand how healthcare workers can contribute to ‘Closing the Gap’.

• Recognise the positive influence that greater appreciation for cultural values, beliefs and practices can have upon healthcare provision and health outcomes for Aboriginal people.

• Understand that past interactions influence an Aboriginal person’s willingness to access healthcare services.

• Develop an awareness of Aboriginal concepts of health and wellbeing.

• Recognise that NSW Health’s Aboriginal staff bring a unique set of skills to the workforce that can assist in improving Aboriginal health outcomes.

• Appreciate the impact that racism and discrimination has upon Aboriginal people’s experience of healthcare.

• Understand and overcome the potential causes for miscommunication.

Goals Training DeliveryThe Framework will assist in ensuring that all health staff are empowered to deliver more respectful, responsive and culturally sensitive services to Aboriginal people, their families and communities.

Improving appreciation, understanding and knowledge of Aboriginal culture, customs, heritage and protocols in Aboriginal families and communities is of paramount importance in ensuring improved Aboriginal health outcomes. Training will improve staff knowledge and understanding of the diverse culture, customs and protocols of Aboriginal communities in NSW.

Staff will be given the necessary knowledge and skills to interact positively with Aboriginal people and communities and to improve engagement and communication methods to improve work practices.

The goals of the Respecting the Difference Framework are: • Motivate staff to question their current

attitudes, behaviours and actions in delivering health services to Aboriginal people.

• Recognise how healthcare outcomes for Aboriginal people can be improved through greater awareness of Aboriginal culture.

• Challenge preconceived perceptions or beliefs about working with and providing health services to Aboriginal communities and, in particular, dismantle the stereotyping of Aboriginal people.

• Understand how Aboriginal people may view healthcare and the barriers that can prevent individuals or groups from accessing services.

The Framework outlines the nominal training requirements for all staff working in NSW Health. Locally; organisations may choose to provide more training than the nominal requirements.

There are three components to the delivery of ‘Respecting the Difference’ training:

• E-learning (online)

• Generic Subject Content (face-to-face)

• Local Content (face-to-face)

The e-learning program content will encompass a variety of activities and teaching methodologies to cater for differing learning styles.

Face-to-face generic subject components will support and complement the online program. The local content training component is specific to particular local Aboriginal communities and is provided by face-to-face workshops.

All components of the training are connected and ideally should be completed close together or within six months.

Should staff move locations, it is recommended that they undertake the local content training for the new area.

Local Health Districts and other NSW Health organisations will determine their individual Aboriginal Cultural Training Programs (ACTP) with consideration of the information provided in this Framework.

Key Performance Indicators

Desired outcomes of Respecting the Difference: Cultural Training

Generic Subject and Local Content ComponentsObjectives:

• Understand and demonstrate sensitivity to contemporary Aboriginal culture and issues.

• Describe local Aboriginal community demographics, including health status.

• Recognise the need for equity, sensitivity and accessibility of healthcare services to the Aboriginal community.

• Comprehensively understand local Aboriginal health programs and staff.

• Comprehensively understand local Aboriginal Community Services (health and other).

• Appreciate the role and wisdom of local Elders.

• Understand responsibilities in relation to relevant Aboriginal health policies and procedures.*

‘Land - Home’

Objectives:

This Framework outlines the target audience, aims, training requirements, learning outcomes and responsibilities in providing Aboriginal Cultural Training.

Staff will gain information to improve their knowledge and understanding of the diverse culture, customs and protocols of Aboriginal communities in NSW.

Participants will also learn how to interact positively with Aboriginal people by implementing engagement and communication strategies that will improve the way they work.

Target Audience Aim Training Requirements Responsibility To Provide Learning Outcomes

1. Leadership Groups

Senior Executive and Governing Boards of Local Health Districts, Ministry of Health and other NSW Health organisations.

Lead the change

E-Learning 2 hours

Leadership Group; Specific face-to-face content Nominal 4 hours face-to-face

Director-General • Demonstrate and lead the commitment to changing Aboriginal health outcomes.

• Absorb national/state/local Aboriginal health policies and ‘priority areas’ into core business.

• Embed Aboriginal health outcomes and Aboriginal cultural understanding in strategic planning processes.

• Lead NSW Health organisations to address Aboriginal health priority areas and cultural understanding.

• Develop and maintain effective partnerships with the Aboriginal Community Controlled Health Sector (ACCHS).

For leaders of frontline health services:• Understanding of local Aboriginal culture,

communities, demographics and services.

• Establishment of local governance and support structures to implement Aboriginal health priority areas and cultural understanding.

2. Program and Service Managers

All managers of Local Health Districts, Ministry of Health and other NSW Health organisations.

Plan the change

E-Learning 2 hours

Generic Subject Content Nominal 2 hours face-to-face

Local Content Nominal 4 hours face-to-face

Deputy Director-General

Chief Executives

• Understand and apply the cultural training framework.

• Develop and implement programs to meet national/state/local Aboriginal health priority areas.

• Understand how health services can be more responsive to the needs of the Aboriginal community in terms of access and cultural appropriateness.

• Encourage involvement of local Aboriginal communities and organisations in the development of services.

• Develop strong community partnerships with the Aboriginal community to encourage effective collaboration.

• Develop and implement Aboriginal health plans that are effective and culturally appropriate.

• Manage and support Aboriginal staff.

• Demonstrate culturally appropriate and effective consultative and negotiation skills.

3. Frontline Staff

Administrative and clinical staff who provide direct care to Aboriginal people.

Make the change

E-Learning 2 hours

Chief Executives

• Understand local Aboriginal health and other related programs such as ‘Closing the Gap’.

• Understand and deliver positive interactions with Aboriginal people.

• Identify the barriers that Aboriginal people face in accessing local health services.

• Communicate and interact with local Aboriginal people/communities.

4. All other staff

Other corporate, administrative and support staff.

Make and support the change

E-Learning 2 hours

Chief Executives• Understand and demonstrate sensitivity

to contemporary Aboriginal culture and issues.

*Code of Conduct, Bullying – Prevention and Management of Workplace Bullying: Guidelines for NSW Health [GL2007_011], NSW Health Aboriginal Workforce Strategic Framework 2010 – 2015, Aboriginal Health Impact Statement and Guidelines, Anti-Discrimination Act 1977.

‘Many Stories, within Bigger Story’

‘Respect’

The Framework will be monitored and evaluated through the collection of short-term and long-term KPIs and should be incorporated into the development, implementation and evaluation of local Aboriginal Cultural Training Programs.

Evaluation of the development and implementation of trainingKPI-1 Leadership commitment to implementing the training framework in each NSW Health organisation.

KPI-2 Programs for each target audience established in the NSW Health organisation.

KPI-3 All staff provided access to training programs.

KPI-4 Appropriate involvement of Aboriginal community groups in implementing training programs.

Assessment of the learning outcomes and trainingKPI-5 Percentage of staff undertaking online learning annually.

KPI-6 Each NSW Health organisation submits a plan outlining strategies, targets and timeline for participation of all staff and targeted audience groups to attend face-to-face workshops and that targets for year 1 are achieved.

KPI-7 Evaluation of learning outcomes indicate learning outcomes are achieved (target of 80%).

Effectiveness KPI-8 Training evaluation reports indicate ‘Respecting the Difference’ Aboriginal Cultural training has provided staff with the tools to provide better services to Aboriginal individuals and communities.

KPI-9 ‘Respecting the Difference’ Aboriginal Cultural training is visible both in the health service and community and has high priority and is valued.

KPI-10 ‘Respecting the Difference’ Aboriginal Cultural training is visibly linked to recruitment and retention strategies providing appropriate services for Aboriginal people and performance outcomes for Aboriginal health.

Target Audience Leadership Group• Demonstrated leadership regarding

Aboriginal health issues.

• Clearly identified priorities for Aboriginal health in policies and strategies.

• Demonstrated consultation, collaboration and partnership with Aboriginal community groups and stakeholders.

• Demonstrated inclusion of Aboriginal-specific indicators in staff performance agreements and knowledge of and commitment to the Ministry’s Aboriginal health strategies and policies.

• Demonstrated representation of Aboriginal people at all levels of governance within the organisation.

Program and Service Managers• Demonstrated application of the NSW

Health Aboriginal Health Impact Statement and Guidelines into policies and strategies.

• Demonstrated consultation, collaboration and partnerships with Aboriginal community groups and stakeholders.

• Demonstrated inclusion of Aboriginal-specific indicators in staff performance agreements and knowledge of and commitment to the Ministry’s Aboriginal Health strategies and policies.

• Increased recruitment and retention of Aboriginal staff across all health professions in NSW Health.

Frontline Staff• Increased appropriateness of service

delivery to Aboriginal patients/clients.

• Priority enhanced commitment in addressing Aboriginal health issues.

• Increased awareness of issues impacting on Aboriginal staff and colleagues.

All Other Staff• Completion of E-learning generic subject

and local face-to-face content.

Organisational Short Term• Increased knowledge and awareness

regarding Aboriginal health and other issues.

• All NSW Health personnel complete training requirements from E-learning generic subject and local content face-to-face training.

Long Term• Demonstrated improvement of

Aboriginal health data in routinely collected and reported data sets (e.g. identification).

• Demonstrated improvement in Aboriginal health outcomes based on evaluations of NSW Health programs.

‘Land - Home’

Objectives:

Lead the change

E-Learning 2 hours

Plan the change

E-Learning 2 hours

Chief Executives

3. Frontline Staff

Make the change

E-Learning 2 hours

Chief Executives

4. All other staff

E-Learning 2 hours

‘Respect’

‘Land - Home’

Objectives:

Lead the change

E-Learning 2 hours

Plan the change

E-Learning 2 hours

Chief Executives

3. Frontline Staff

Make the change

E-Learning 2 hours

Chief Executives

4. All other staff

E-Learning 2 hours

‘Respect’

‘Land - Home’

Objectives:

Lead the change

E-Learning 2 hours

Plan the change

E-Learning 2 hours

Chief Executives

3. Frontline Staff

Make the change

E-Learning 2 hours

Chief Executives

4. All other staff

E-Learning 2 hours

‘Respect’

Introduction

Australia.

• Stereotypes.

processes.

PD2011_069 SHPN (WDI) 110029

Evaluation

Introduction

Australia.

• Stereotypes.

processes.

PD2011_069 SHPN (WDI) 110029

Evaluation

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