Abstract
Background
Midwives have a central role in closing the gap in health inequalities between Australias’
First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander
Health Curriculum Framework (The Framework) identifies five core cultural capabilities
(respect, communication, safety and quality, reflection and advocacy) to foster culturally
safe health care.
Aim
To use a decolonising, First Peoples-led approach to develop and validate a tool to
measure the development students’ cultural capabilities.
Method
A pre- post intervention design was used. Development of the Cultural Capability Measurement
Tool followed a staged process which centred on First Peoples’ knowledges. This process
included: item generation, expert review; a pilot, test-retest; and psychometric testing
(reliability, factor analysis and construct validity). All third year midwifery students
(n = 49) enrolled in a discrete First Peoples health course were invited to complete the
survey pre and post course.
Findings
A response rate of 77.5% (n = 38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated
good internal reliability (Cronbach alpha = .89–.91). Principal component analysis with varimax rotation produced a five-factor
solution. A paired samples t-test revealed a significant increase from pre-course
(mean 93.13, SD 11.84) to post-course scores (mean = 100.53, SD 7.54) (t (14) = −2.79, p = .014).
Conclusion
A First Peoples approach was critical to tool development and conceptual validity.
The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities
of The Framework. The draft tool appears suitable for use with midwifery students.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women and BirthAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. Cat. no. IHW 147.AIHW, Canberra2015
- Culturally competent maternity care for aboriginal and torres strait women report.Maternity Services Inter-Jurisdictional Committee for the Australian Health Ministers’ Advisory Council, Brisbane2012
- National Aboriginal and Torres Strait Islander Health Plan 2013–2023.Department of Health, Canberra2013
- Clinical practice guidelines: antenatal care.Australian Government Department of Health and Ageing, Canberra2012
- Predictors of negative attitudes toward Indigenous Australians and a unit of study among undergraduate nursing students: a mixed-methods study.Nurse Educ Pract. 2016; 17: 200-207
- National competency standards for the midwife.2006 (Available from: http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx. [Cited 28 September 2016])
- National midwifery education standards.ANMAC, Canberra, Australia2014
- Developing Aboriginal and Torres Strait Islander cultural capabilities in entry to practice health graduates: a review of the literature.Department of Health, Canberra2014
- An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition.Aust N Z J Public Health. 2013; 37: 250-256
- Cultural responsiveness and school education with particular focus on Australia’s first peoples: a review & synthesis of the literature.Menzies School of Health Research, Cenre for Child Development and Education, Darwin2012
- Quality in learning: a capability approach in higher education.Kogan Page, London1992
- Educational leadership: key challenges and ethical tensions.Cambridge University Press, Cambridge2007
- The handbook for teaching leadership: knowing, doing, and being.Sage, Thousand Oaks2011
- Aboriginal and Torres Strait Islander health curriculum framework.Commonwealth of Australia, Canberra2014
- The value of community-focused interprofessional care in Peru for developing cultural competency in health professions students.Int J Nurs Educ Scholarsh. 2013; 10: 153-162
- Online cultural competency education for millennial dental students.J Dent Educ. 2014; 78: 867-875
- A web-based cultural competency training for medical students: a randomized trial.Am J Med Sci. 2015; 349: 442-446
- Measuring the cross-cultural adaptability of a graduate student team from a global immersion experience.J Cult Divers. 2015; 22
- Utilizing the Intercultural Development Inventory® to develop intercultural competence.SpringerPlus. 2014; 3: 1
- The knowledge, efficacy, and practices instrument for oral health providers: a validity study with dental students.J Allied Health. 2013; 77: 998-1005
- Effectiveness of a developmental curricular design to graduate culturally competent health practitioners.J Allied Health. 2012; 41: 140-146
- Impact of cultural contact on intercultural competency of occupational therapy students and international graduate students.J Allied Health. 2007; 36 (30-E-46-E)
- Nursing students’ perspectives of the health and healthcare issues of Australian Indigenous people.Nurs Educ Today. 2015; 35: 461-467
- Exploring undergraduate midwifery students’ readiness to deliver culturally secure care for pregnant and birthing Aboriginal women.BMC Med Educ. 2015; 15: 1
- Making a difference: the early impact of an Aboriginal health undergraduate medical curriculum.Med J Aust. 2006; 184: 522
- Integrated undergraduate Aboriginal health curricula: validating a program evaluation survey tool.FoHPE. 2011; 12: 34
- Theory to social action: a university-based strategy targeting prejudice against Aboriginal Australians.Aust Psychol. 2008; 43: 148-159
- Confronting uncomfortable truths: receptivity and resistance to Aboriginal content in midwifery education.Contemp Nurse. 2013; 46: 113-122
- Turning the corner assessment: a key strategy to engagement and understanding in Indigenous health.FoHPE. 2011; 13: 52
- Psychometrics and psychology.Academic Press, London, UK1979
- Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis.PPMR. 2009; 12: 131-146
- Scale development: theory and applications.3rd ed. Sage, Thousand Oaks, CA2012
- Decolonizing methodologies: research and indigenous peoples.2nd ed. Zed Books, London2012
- Scale development: theory and applications.4th ed. Sage Publications, Thousand Oaks2016
- Indigenous research methodologies.Sage Publications, Thousand Oaks, CA2011
- Research.2016 (Available from: http://www.lowitja.org.au/research. [Cited 20 September 2016])
- Yarning about yarning as a legitimate method in indigenous research.IJCIS. 2010; 3: 37-51
- Is the CVI an acceptable indicator of content validity? Appraisal and recommendations.Res Nurs Health. 2007; 30: 459-467
- Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research.Commonwealth of Australia, Canberra2003
- Development and psychometric testing of the scales for measuring maternal satisfaction in normal and caesarean birth.Midwifery. 2012; 28: 348-357
- QLD Health Introductory Aboriginal and Torres Strait Islander cultural practice online program.2013 (Available from: https://ilearnexternal.health.qld.gov.au/course/52/qld-health-introductory-aboriginal-and-torres-strait-islander-cultural-practice-online-programS. [Cited September 2016])
- Beginning the journey: first peoples health and practice online training portal.2015 (Available from: http://www.cultureawarenessporthealth.com.au/ [Cited 21 September 2016])
- An index of factorial simplicity.Psychometrika. 1974; 39: 31-36
- A note on the multiplying factors for various χ2 approximations.J R Stat Soc Ser B Stat Methodol. 1954; 29: 6-8
- Statistical power for the behavioral sciences.Lawrence Erlbaum Associates, Hillsdale1988
- Young Aboriginal women’s voices on pregnancy care: factors encouraging antenatal engagement.Women Birth. 2015; 28: 47-53
- Reducing racism in Aboriginal health care in Australia: where does cultural education fit?.Aust N Z J Public Health. 2010; 34: S87-S92
- National best practice framework for indigenous cultural competency in Australian universities.Universities Australia, Canberra2011
- ‘Closing the Gap’: how maternity services can contribute to reducing poor maternal infant health outcomes for Aboriginal and Torres Strait Islander women.Rural Remote Health. 2010; 10
- Antenatal care for Aboriginal and Torres Strait Islander women.Aust Fam Phys. 2014; 43: 20
- Working as a culturally competent mental health practioner.in: Purdie N. Dudgeon P. Walker R. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. Department of Health and Ageing, Australia2010
- The rights and blights of the politics in Indigenous higher education.Anthropol Forum. 2013; 2013: 289-303
- A model for large-scale, interprofessional, compulsory cross-cultural education with an indigenous focus.J Allied Health. 2014; 43: 38-44
- Using reflection to enhance the teaching and learning of midwifery students.Br J Midwifery. 2014; 22
- Dudgeon P. Milroy H. Walker R. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. Commonwealth of Australia, Barton2014
- Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on the Social Determinants of Health.World Health Organisation, Geneva2008
Article info
Publication history
Published online: February 07, 2017
Accepted:
January 5,
2017
Received in revised form:
December 22,
2016
Received:
November 10,
2016
Identification
Copyright
© 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
