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Increasing Cultural Capability in
private practice Physiotherapists: A professional development program



To implement an educational
professional development program that will assist physiotherapists within a
private practice with developing and maintaining a high level of cultural capability
within the workplace. The ultimate goal will be to increase client satisfaction
and retention of Aboriginal and Torres Strait Islander peoples ….. improved
health outcomes for.



Discrepancies in the health of Aboriginal
and Torres Strait Islander peoples and other Australians are well recognized and
are currently a major interest of researchers (Bennet, 2013; Clifford,
McCalman, Bainbridge & Tsey, 2015; McCalman, Jongen & Bainbridge, 2017;
O’Shaughnessy & Tilki, 2007; Paul, Hill & Ewen, 2012; West et al.,
2017). These continuing health disparities have been proposed to be a likely
consequence of problems with quality of care and limitations in access to health
services (Paul et al., 2012). Recent studies have suggested that institutional
racism and health professionals lack of knowledge about history and culture are
among the reasons First Peoples receive poorer quality of care and decide not
to access services (Clifford et al., 2015; Paul et al., 2012; State of
Queensland, 2010). In Australia, many frameworks have been developed in an
attempt to increase the cultural capability of health professionals as a step
towards closing the health gap and providing more culturally safe and
appropriate health services (Australian Government, 2015; Department of Health,
2014; State of Queensland, 2010). Cultural capability involves gaining and maintaining
knowledge, skills and attitudes that assist in the delivery of culturally safe
and respectful health care (Australian Government, 2015; Bennet, 2013;
Department of Health, 2014; McCalman et al., 2017; O’Shaughnessy & Tilki,
2007; State of Queensland, 2010; Truong, Paradies & Priest, 2014; West et
al., 2017).  

While there are currently First Peoples
health programs aimed at developing cultural capability in health students,
cultural capability is an ongoing learning process; therefore, we must have
programs in place for future advancement (Department of Health, 2014; State of
Queensland, 2010). Physiotherapists are first contact practitioners; therefore,
it is essential that they possess the skills necessary to provide the highest
quality of care to people from all cultural backgrounds. Physiotherapists
working for Queensland Health undertake a mandatory cultural capability program
for staff to gain fundamental skills, knowledge and attitudes to provide
quality health care to all First Peoples (State of Queensland, 2010).

Physiotherapists working in the private sector, however, may not receive sufficient
ongoing cultural capability training specific to First Peoples. The Australian
Physiotherapy Association (APA) Practice Standards state that a practice must
to educate staff on culturally appropriate care, relating to all cultural
groups. The professional development program suggested in this paper will be
aimed at the advancement of cultural capabilities of Physiotherapists within a
private practice, specific to Aboriginal and Torres Strait Islander peoples. The
program will include the five essential elements of cultural capability
outlined in the Aboriginal and Torres Strait Islander curriculum framework;
respect, communication, safety and quality, reflection and advocacy (Department
of Health, 2014).



The program will provide staff working
in the private practice with the opportunity to expand on their knowledge of
the history, values, traditions and culture of Australia’s First Peoples. Professionals
who partake in the program will gain an understanding of how these factors will
impact on the structure of and the interactions within a session. If
successful, the program will provide Physiotherapists within the practice with
the skills, knowledge and attitudes required to successfully deliver a culturally
safe and respectful service to all First Peoples. The program will provide
Physiotherapists with skills in self-reflection and self-reflexivity which may
benefit their professional practice as a whole and with patients from all

Individuals will benefit from
increasing cultural capability in the private practice as First Peoples in the region
will have additional options for Physiotherapy treatment. Although not a lot of
solid evidence has been established to date, authors have suggested that
educational programs such as the one proposed in this paper lead to enhancements
in the quality of health care, increased satisfaction of patients and improved health
outcomes (Clifford et al., 2015; McCalman, 2017). A systematic review by Truong
and colleagues on interventions to improve cultural competence found increases
in the utilisation of health services and improved health outcomes after
providers developed their knowledge, skills and attitudes.

After staff of the private practice expand
their learning and development of skills in cultural capability, the practice may
become known within the community as a practice that provides safe and respectful
treatment. The practice may gain the opportunity to work with Aboriginal and
Torres Strait Islander health workers and build connections with other First
Peoples health services in the area.



–       Staff to gain the
essential knowledge, skills and attitudes that will assist in building a
culturally capable workplace and providing a safe and respectful service to all
First Peoples.  This will be measured via
self-reported questionnaires with sections on knowledge, skills and attitudes
with regards to First Peoples health.

–       Increases in the
utilisation of the Physiotherapy practice by First Peoples. The number of First
Peoples that utilise the service will be recorded using patient questionnaires.

–       Increases in the rates
of retention of First Peoples. Data will be analysed to assess each patients’
statistics regarding culture, number of sessions etc.

–       Increases in First
Peoples patient satisfaction. Patients will be asked to fill out questionnaires
to assess how satisfied they are with the treatment. These questionnaires will
be implemented before the educational program to allow for a before and after comparison.

–       Improved health outcomes
for First Peoples. Data from before the educational program will be compared with
data from after the program  



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