title: General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients - is cultural competence adequately considered?
abstract: BACKGROUND
  General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care.
  
  
  METHODS
  A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision.
  
  
  RESULTS
  Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar's generic communication and consultation skills, only 72% referred to culture or to the patient's Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified.
  
  
  CONCLUSIONS
  The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the disadvantage faced by vulnerable populations.
authors.affiliation: School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia. p.abbott@uws.edu.au.
authors.forename: Penelope
authors.initials: P
authors.lastname: Abbott
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reath
authors.forename: Elaine
authors.initials: E
authors.lastname: Gordon
authors.forename: Darshana
authors.initials: D
authors.lastname: Dave
authors.forename: Chris
authors.initials: C
authors.lastname: Harnden
authors.forename: Wendy
authors.initials: W
authors.lastname: Hu
authors.forename: Emma
authors.initials: E
authors.lastname: Kozianski
authors.forename: Cris
authors.initials: C
authors.lastname: Carriage
mesh_terms: D001315:Australia; D002983:Clinical Competence / Q000592:standards; D054521:Cultural Competency / Q000193:education; D004493:Education; D005246:Feedback; D058005:General Practitioners / Q000193:education / Q000592:standards*; D006801:Humans; D020380:Needs Assessment; D013663:Teaching / Q000379:methods