dr della yarnold indigenous transitions pathways director, nt medical school, flinders university

NT Medical Program

Dr Della YarnoldNT Indigenous Transition Pathways Director

This is me

Overview

• Approach to Indigenous health curriculum• Local context curriculum• Where does health literacy fit?• Integrated approaches• Benefits to patients• Indigenous Entry Stream

The Numbers

Pop. 227,025 (approx. 32.5% Indigenous)1,349,129 square kilometres (520,902 sq mi),

People

The School

Approach to Indigenous Curriculum

• CDAMS Framework• Three key areas• Communication• Applied knowledge• Holistic health

Communication

• Recognition of health literacy issues• Effective listening• Language used• Concepts explained• Resources available

The Ideal

Confusing Messages

Applied Knowledge

• Experiential learning• Team work / Multidisciplinary approaches• Recognition of system issues• Holistic health• Epidemiological knowledge• Local context

Living Stats

Holistic Health

• Not in name only• Practical applications (travel, medications

etc...)• Family, AHW, ALO, DMO, Interpreters• Mind, body, spirit• Traditional practices

Local Context Curriculum

• Cultural Educators (Matthew, Colleen & Bilawara)

• Indigenous reference group• Community placements providing

experiential learning• Service providers• Interpreters, AHW & ALO

Health Literacy Approach

• Not just literacy• Understanding health systems in the

dominant culture• Two way communication• Not appropriate to test for literacy• Must be aware of the potential impact• Mediated by holistic health approaches

Health Literacy Elements

Onus on practitioner to ensure it happensAwareness of literacy, numeracy and the

culture specific interpretation of health information

An interaction which empowers an individualSystem and the culture in which it sits

Health Literacy Awareness

• Newest Vital Sign• Teach Back• Ask Me Three• Health Promotion• Communication skills• Holistic health plans• Awareness of a different worldview

Outcomes

• Appropriate two-way communication of health information - responsive

• Understand & be able to apply the information to decisions made about health

• Options for self empowerment and self management

Integrated Approaches

• Applied knowledge increases awareness• Communication facilitates assessment• Holistic health assists with addressing

health literacy• Skills transferrable to all patients

Benefits to Patients

• Responsive doctors• Improved options for increasing health

knowledge• Self management options increased• Appropriate management plans• Especially relevant to chronic disease

What might stop us?

Barriers

• System• Cultural Awareness/Safety/Competency• Modelling of behaviours• Medical/Health Culture• HALT

Indigenous Entry Stream

• Indigenous doctors • Combining cultural knowledge with clinical

skills• Increased recognition of health literacy

issues, incorporation of traditional healing practices, awareness of holistic health domains

Questions??