Are we making a difference? What impact does cultural awareness curriculum have on student's attitudes? Initial results from a longitudinal study

Introduction: There is general consensus that to improve the health status of Aboriginal and Torres StraitIslander Australians all health professionals should be educated in how to work in a culturally safe way.Despite the many initiatives to teach cross-cultural education to health professionals as part of the usualcurriculum for health professionals, there is little evidence that any of these programs have a long-termimpact on the cultural safety of the students’ practice once graduated. In fact, recent research indicates thattraining programs have been largely ineffective in improving doctors’ cultural skills, their behaviour or healthoutcomes, and that some approaches to cross-cultural education are having the reverse effect and creatinghostility and racism.
Methods: Since 2012 Bond University has been conducting a significant cultural awareness and Aboriginaland Torres Strait Islander Health program with its medical students. We have also been conducting a fiveyearlongitudinal study to measure the impact of these cultural awareness activities on students’ attitudesand behaviours using a validated cultural awareness and cultural competence scale survey. The survey isadministered pre- and post-immersion at Year 1, in Year 3 and Year 5.
Results: Initial findings of the cultural awareness study (n=280) revealed positive shifts in various dimensionsof cultural awareness among first year undergraduate medical students. The most notable differencesoccurred within knowledge acquisition, retention and dissemination (items 18_20, p<0.001). The remainingstatement (item 21) in this component was significant at the 95 per cent confidence interval (p<0.05), whichinfers that students positioned themselves as making more effort to learn about how cultural factors affectedhealth theory, delivery and behaviour following the cultural immersion. Institutional and curricular influencesalso showed positive directions after the immersion.
Conclusion: Cultural immersion has a great potential to elicit positive shifts in attitudinal and knowledgerelatedaspects of cultural awareness in the early stages of a medical curricula. Sharing this initialinformation will assist others who are teaching into these programs.