Delivery+of+Cultural+Competence

=WA11BP03 Delivery of Introductory Cultural Learning= = =

Background
WA Health employs 32,000 staff from all over the world, working in 150 hospital and health sites across WA, providing services to many Aboriginal patients and families. North Metropolitan and WA Country Area Health Services formed a partnership to engage Aboriginal staff and stakeholders to design, test and promote cultural awareness e-learning modules. From this, an introductory e-learning Aboriginal Cultural Awareness resource has been developed for use at staff induction.

Through this e-learning resource we will be better able to 'Close the Gap' in health outcomes between Aboriginal and non-Aboriginal Australians as staff will be able to deliver more culturally appropriate health services in more 'culturally safe' places for Aboriginal clients. The e-learning resource is part of a developing **framework** of cultural initiatives within WA Health. Area Health Service will continue to develop modules addressing specific work group needs (eg medical, admin or support services) or location-specific area needs.

Link to [|WA Health]website, [|WA Country Area Health Service] and [|North Metropolitan Area HealthService]

=What was done:=
 * [[image:CA_John_Ward.jpg width="293" height="225" align="left" caption="John Ward, NMAHS"]]Partnership**: North Metropolitan Area Health Service (NMAHS) (as the RTO) formed a partnership with WA Country Area Health Service (WACHS) (which has many Aboriginal clients)[[image:007.JPG width="266" height="192" align="right" caption="Rosalie Miles, WACHS"]]
 * Communication**: Emails to Executives and Regional Directors sought endorsement and support, and called for nominations of Aboriginal staff to act as as local project leaders.
 * Governance**: A Steering committee, project working party and regional Reference Groups were formed.
 * Engagement**: 50 Regional Aboriginal staff and stakeholders participated on local Reference Groups, to prioritise course content appropriate to their cultural groups, to test the e-learning material and to promote it to local staff. This provided a professional development opportunity for Aboriginal staff to learn about the education process.
 * Testing**:Blended learning sessions were conducted across the state, to test the draft e-learning modules, using instructor-led, online learning, in computer classrooms across the metropolitan area and country regions.
 * Piloting**: Educators and Aboriginal staff were encouraged to pilot the modules once the subsequent draft was loaded on the internal WA Health intranet sites. During the 2 week pilot process 70 staff provided feedback.

What was done
Aboriginal people were involved in all phases of the project and gained an awareness of on-line learning formats and educational design processes.

** **Phase 1:** ** Topic identification involved consulting with as many Aboriginal people across WACHS and NMAHS as possible to identify the key content topics for inclusion in an introductory Aboriginal cultural resource. We needed to complete these consultations by early December 2010. The next two-three months was spent identifying suitable content from nearly 60 reference sources (other cultural packages, policies, government reports, journal articles, books and DVDs). This material was used to populate the content of the resource into over 300 slides (including graphics, interactions and quizzes). Our intention was to develop a package that would engage participants rather than being a passive exercise.



** **Phase 2:** ** Content Review involved regional Learning & Development Coordinators and Aboriginal Health Improvement Unit staff meeting with focus groups of Aboriginal people to advise us the assembled draft content. This included advice on reducing the overall duration to 1-1.5 hours, in order to be suitable for inclusion in induction programs). Based on this feedback we then spent a number of weeks revising and condensing content. This reduced the number of slides to 120.

A bank of 50 Quiz question were developed. A number were spread throughout the resource and a random selection of ten were selected for completion by the learner at the end of the package. A certificate was generated after completion of the questions, with an 80% pass rate required.

The Director General, Health, Mr Kim Snowball provided a welcome and introduction to the e-learning package through a video clip. This endorsement adds value to the resource and will assist with future implementation.

** **Phase 3:** ** Evaluation of the package was conducted by about 70 staff from around WA Health and was very positive. 86 per cent of participants indicating that it contributed to their knowledge of Aboriginal culture while 89 per cent indicated that it could be applied in their workplace. One quarter of the respondents were using e-learning for the first time yet 82% of respondents said they would be willing to work through another e-learning resource in future.

A series of medium term evaluations, Phase 4, is proposed for 2012 to identify if there has been a shift towards increased cultural security in WA Health workplaces.

**Benefits for WA Health**
- The introductory Aboriginal culture e-learning resource will become a mandatory training component of the induction program for staff at WA Country Health Service and North Metropolitan HealthServices from July 1 2011. The aim is to increase awareness of everyone's individual responsibility to build a culturally safe workplace, which in turn will increase retention of Aboriginal employees. - By being available on the Intranet, the resource will also be available to existing staff 'anywhere, any time'. - The opportunities offered during the development of the resource have increased the confidence of metropolitan and regional educators in the delivery of blended learning.

Lessons learnt
The development of a cultural awareness e-learning resource was a much larger, more complex and more time-consuming task than anticipated. Everything takes twice as long as expected. This is doubly true when a six-month period includes Christmas and Easter when staff availability is compromised. There are so many technologies available, selecting what would work best and be most appropriate was both difficult and time-consuming. The time and effort need to develop a level of expertise in the chosen technologies Reference groups needed clear guidance to differentiate discussion points from decision making items.

**Reflections and suggestions**
It is important to get executive support initially, so that when asked, staff feel able to contribnute. Having endorsement from the highest level possible; in our case the Director General; will assist greatly. WA is vast, and to embed anything into large organisations required acknowledgement of internal diversity of needs and approaches. Patience and persistence is required as complexity is added by both technology and people. External stakeholders will be interested even if not directly affected.

Framework connection
The national training system’s e-learning strategy, the Australian Flexible Learning Framework (Framework [1] ) funds and supports [|E-learning Innovations] projects which aim to embed e-learning into the national training system by supporting and enabling innovation in training design and delivery, at the state and territory level.

This project will embed e-learning by developing reference Group Guidelines for clients and staff to participate in the design of e-learning materials. The project will also produce e-learning modules to inform staff of cultural differences between Aboriginal groups across WA. The partnership will be strengthened and will continue with other projects in the future.

In engaging in this E-learning Innovations project, the following Framework products and resources were used… LORN modules and E-Learning Toolkit

media type="file" key="ELearningSpeak_2.flv" width="360" height="270"

Acknowledgement
This is a Western Australian [|E-learning Innovations] project output, developed by North Metropolitan Area Health Service (RTO) and WA Country Area Health Service, with seed funding from the Framework.

For more information
John Ward, Manager, Learning & Development Centre Cultural Awareness Project Phone: (08) 9346 4101 Email: John.Ward@health.wa.gov.au
 * For more information on North Metro Area Health Service RTO:**

Phone: (07) 3307 4700 Email: enquiries@flexiblelearning.net.au Website: www.flexiblelearning.net.au
 * For more information on the Australian Flexible Learning Framework:**