title: Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people.
abstract: BACKGROUND
  Indigenous people are the most disadvantaged population within Australia with living conditions comparable to developing countries. The Bachelor of Nursing programme at the University of Western Sydney has embedded Indigenous health into the undergraduate teaching programme, with an expectation that students develop an awareness of Indigenous health and healthcare issues.
  
  
  OBJECTIVE
  To gain insight into students' perceptions of Indigenous people and whether the course learning and teaching strategies implemented improved students' learning outcomes and attitude towards Indigenous people and Indigenous health in Australia.
  
  
  METHODS
  A mixed methods prospective survey design was chosen.
  
  
  METHODS
  Students enrolled in the Indigenous health subject in 2013 were invited to complete pre- and post-subject surveys that contained closed- and open-ended questions. Students' socio-demographic data was collected at baseline, but the 'Attitude Toward Indigenous Australians' (ATIA) scale, and the 3-item Knowledge, Interest and Confidence to nursing Australian Indigenous peoples scale were administered at both pre- and post-subject surveys.
  
  
  RESULTS
  502 students completed the baseline survey and 249 students completed the follow-up survey. There was a statistically significant attitudinal change towards Indigenous Australians, measured by the ATIA scale, and participants' knowledge, intent to work with Indigenous Australians and confidence in caring for them increased significantly at follow-up. Based on the participants' responses to open-ended questions, four key themes emerged: a) understanding Indigenous history, culture and healthcare; b) development of cultural competence; c) enhanced respect for Indigenous Australians' culture and traditional practices; and d) enhanced awareness of the inherent disadvantages for Indigenous Australians in education and healthcare. There were no statistically significant socio-demographic group differences among those who commented on key themes.
  
  
  CONCLUSIONS
  Addressing health inequalities for Indigenous Australians is paramount. Nurses need cultural awareness and sensitivity to deliver culturally appropriate healthcare in Australia.
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: l.hunt@uws.edu.au.
authors.forename: Leanne
authors.initials: L
authors.lastname: Hunt
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: l.ramjan@uws.edu.au.
authors.forename: Lucie
authors.initials: L
authors.lastname: Ramjan
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: g.e.mcdonald@uws.edu.au.
authors.forename: Glenda
authors.initials: G
authors.lastname: McDonald
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: j.koch@uws.edu.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Koch
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: d.baird@uws.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Baird
authors.affiliation: University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia. Electronic address: y.salamonson@uws.edu.au.
authors.forename: Yenna
authors.initials: Y
authors.lastname: Salamonson
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D054521:Cultural Competency; D005260:Female; D006303:Health Services, Indigenous; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013338:Students, Nursing / Q000523:psychology*; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Cultural competence; Indigenous Australians; Indigenous health; Nursing students; Undergraduate nurse education