Discipline of Podiatry, University of Newcastle, Ourimbah, NSW, 2258, Australia.
Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, 3086, Australia.
J Foot Ankle Res. 2021 Jan 26;14(1):9. doi: 10.1186/s13047-021-00450-2.
For university-based podiatry education there are little data available documenting the delivery method and impact of Aboriginal and Torres Strait Islander health curricula or the use of, and outcomes from, immersive clinical placements generally or specific to podiatry practice. Therefore, the primary aim of this study was to evaluate the effect of undertaking clinical placement in a culturally safe podiatry service for Aboriginal and Torres Strait Islander Peoples on podiatry students' understanding of, and confidence with, providing culturally safe podiatry care.
Final year University of Newcastle undergraduate podiatry students attending a culturally safe Aboriginal and Torres Strait Islander student clinic at a local hospital were purposively recruited to participate. Students completed a custom-made and pilot-tested cultural awareness and capability survey before and after placement. Survey domains were determined from a principle component analysis. The Wilcoxon Signed Rank test was used to compare pre-placement scores on each domain of the survey to the post-placements scores. Effect sizes were calculated and interpreted as small (0.1-0.29), medium (0.3-0.49), and large (≥0.5).
This study recruited 58 final year University of Newcastle podiatry students to complete baseline and follow-up surveys. For survey domain 1 (level of understanding of power relationships), domain 2 (level of understanding of the interrelationship between culture and self-perceived health), domain 3 (level of understanding of the importance of culture in clinical practice and access to health care), and domain 4 (level of confidence with providing culturally safe care) a statistically significant (p < 0.05) increase in scores was recorded post-placement. The effect sizes were medium to large.
This study demonstrated that an immersive student placement at a culturally safe podiatry clinic significantly improved students' understanding of, and confidence with, providing culturally appropriate care to Aboriginal and Torres Strait Islander Peoples. This study provides foundation evidence of the role that such placements have on developing students' cultural capability in a tertiary health care setting, and will help inform future curricula development at both educational institutions and health services, as well as form the basis for ongoing research.
对于大学的足病医学教育，很少有数据记录关于原住民和托雷斯海峡岛民健康课程的教学方法和影响，也很少有数据记录沉浸式临床实习的使用情况和结果，更不用说这些临床实习对一般足病医学实践或特定足病医学实践的影响了。因此，本研究的主要目的是评估在一个对原住民和托雷斯海峡岛民友好的足病医学服务中进行临床实习对足病医学学生理解和自信地提供文化上安全的足病护理的影响。
我们有目的地招募了在当地医院的一个文化上安全的原住民和托雷斯海峡岛民学生诊所实习的纽卡斯尔大学的最后一年本科足病医学学生参与本研究。学生在实习前后完成了一份定制的和经过试点测试的文化意识和能力调查。调查领域是从主成分分析中确定的。采用 Wilcoxon 符号秩检验比较调查每个领域的实习前得分和实习后得分。计算效应大小并解释为小（0.1-0.29）、中（0.3-0.49）和大（≥0.5）。
本研究招募了 58 名最后一年的纽卡斯尔大学足病医学学生完成基线和随访调查。对于调查领域 1（对权力关系的理解程度）、领域 2（对文化与自我感知健康之间的相互关系的理解程度）、领域 3（对文化在临床实践和获得医疗保健中的重要性的理解程度）和领域 4（提供文化上安全护理的信心水平），记录到实习后得分显著增加（p<0.05）。效应大小为中到大。
本研究表明，在一个文化上安全的足病医学诊所进行沉浸式学生实习显著提高了学生对为原住民和托雷斯海峡岛民提供适当护理的理解和信心。本研究为这种实习在培养学生在高等医疗保健环境中的文化能力方面的作用提供了基础证据，并将有助于指导教育机构和卫生服务机构未来的课程发展，也为进一步的研究奠定了基础。
