42 / 60
Communication and connection: Valuing Aboriginal and Torres Strait Islander perspectives
40
JCPSLP
Volume 19, Number 1 2017
Journal of Clinical Practice in Speech-Language Pathology
Anne E. Hill
(top) and
Alison Nelson
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
CULTURAL
RESPONSIVE
NESS
INDIGENOUS
INTER
PROFESSIONAL
STUDENT
CLINICS
and Ageing, 2013; Indigenous Allied Health Australia [IAHA],
2015; Universities Australia, 2011). Clinical placements
are an obvious vehicle for learning these skills and are an
integral part of the undergraduate degree programs of most
allied health professions (Howells et al., 2016).
Interprofessional student clinics can improve client
outcomes, foster teamwork, and improve understanding of
health professional roles (Reeves, Perrier, Goldman, Freeth, &
Zwarenstein, 2013). Important features of interprofessional
clinical experiences may include face-to-face meetings for
therapy planning, joint goal-setting, and structured
reflection on the interprofessional process (Copley et al.,
2007). Interprofessional clinics have been identified as a
culturally responsive way of providing services for Aboriginal
and Torres Strait Islander peoples as service delivery is
holistic and integrated, there is less burden on families to
attend multiple appointments, and knowledge can be readily
shared, resulting in a more contextualised approach to the
family’s needs (Nelson, McLaren, Lewis, & Iwama, in press).
Initial learnings from student interprofessional clinics in
Indigenous contexts have included the importance of
long-term partnerships and removing structural barriers to
services, such as locating children’s therapy services in a
school, which enables the development of effective
partnerships with teachers and support staff (Davidson, Hill,
& Nelson, 2013; Nelson, 2014).
In order to further develop these clinical placement
opportunities, there is a need to clearly identify the factors
and approaches which support sustainable and culturally
responsive service delivery for Indigenous Australians.
Therefore, this study sought to answer the following
question: What factors and approaches support student
learning in Indigenous contexts and facilitate positive
outcomes for clients?
Method
This study involved a mixed methods approach and took
place in two contexts in which interprofessional student
placement models were in place. In both contexts, students
worked together in occupational therapy (OT) and speech-
language pathology (SLP) teams of two or more students
and were supervised by an interprofessional team of one
OT and one SLP.
Clinical contexts
Context 1: Aboriginal and Torres Strait Islander
Independent School (Murri School)
The therapy service began in 1997 in response to a need
identified by the principal and school board. The school is a
Previous research has indicated that
interprofessional student clinics provide
culturally responsive access to health care
for Indigenous Australians. The aim of this
study was to determine the factors and
approaches which support student learning in
Indigenous contexts and facilitate positive
outcomes for clients. Students (n = 36) and
their clinical educators (n = 4) in two clinical
contexts were participants. All students
completed a survey about their placement
experience and all clinical educators and
students in one context participated in
semi-structured interviews. Survey data
revealed that 94% of students in context 1
and 78.5% of students in context 2 felt they
were more skilled in working with Indigenous
people following their placement. Interview
data was analysed qualitatively and four main
themes emerged: 1) structures and processes
supporting placements; 2) the importance of
relationships; 3) client-centred practice; and
4) interprofessional leadership. These factors
should be considered in development of
student clinics in Indigenous contexts in order
to maximise outcomes for clients and students.
A
chieving health and well-being equity for Indigenous
Australians requires culturally responsive and
accessible health care, and necessitates a
workforce well equipped to partner with local services to
improve health outcomes (Anderson, Ewen, & Knoche,
2009; Australian Department of Health and Ageing,
2013). Addressing this gap requires concerted action
across multiple layers of health service provision, including
government services, community controlled organisations,
and universities (Thomson, 2005).
Universities have a responsibility to ensure that their
graduates acquire the necessary skills, knowledge
and attitudes that will enable them to deliver culturally
responsive care (Howells, Barton, & Westerveld, 2016). This
includes providing experiences that support students to
develop knowledge and practical skills to meet the needs
of Indigenous Australians (Australian Department of Health
Development of student
clinics in Indigenous
contexts
What works?
Anne E. Hill, Alison Nelson, Jodie Copley, Teresa Quinlan, and Rebekah White