Observed and Reported Outcomes Following Experiential Cultural Capability and Clinical Yarning Training for Clinicians Treating Aboriginal and Torres Strait Islander People with Persistent Pain

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which was completed by 67 patients during a period pre- and post-training delivered to the clinicians. Using conversation analysis methods and focusing on clinicians recorded both pre- and post-training, analysis of video recordings identified observable differences in communication practices that were consistent with learning opportunities in the training. Statistical analysis of the CSS survey focused on subsamples of data from 20 patients who consulted clinicians who attended training. A comparison of pre- and post-training data and found no difference in the overall score of the CSS (p=0.594). The study identified differences in social practices following training but did not find changes to patient experiences of care. These findings demonstrate the feasibility of changing clinical communication in relation to culture, while also highlighting the importance of examining practices used in social interaction to determine whether and how training is applied by learners.