Answer :

 Assessment Item 2

Research Methods:

One of the major strengths that the research method of the chosen paper is that it has approached 610 staffs, 200 from database of employee email addresses, 200 from the nursing list and 210 other health professionals from the Sydney Children’s Hospitals Network (SCHN) that means a large number of participants. Dependability and strengths of research findings depends largely on sample size as too smaller a sample size may lead to stronger and dependable outcomes (Bernard, 2011). However too large sample size may result in different issues such as data management, data strong followed by data collection and data assimilation (Mackey, Gass, & ., 2015) . Too large sample size may also cause researchers to spend huge amount and time in carrying out the research study (Neuman, 2013. ). Another strength of the particular research is its sampling technique that it has chosen. Simple random sampling technique is free from researcher’s bias and judgement as researcher do not select the samples of the study individually, based on any specific criteria but the sampling is conduced, randomly (Saunders, Lewis, & Thornhill, 2012).  

21 questions were developed for data collection which included closed-ended, Likert scale five-point and free-text boxes. All the questions were based on educating on delivery of care services Aboriginal people, information of Aboriginal health and services, approaches and behaviors towards Aboriginal patients and recommendations about way to care service delivery to Aboriginal health care users.  Therefore it can be analyzed, that the chosen key areas of study have very strong role in determining the effectiveness of health care delivery to Aboriginal people, hence, have been rightly selected. The key areas will demonstrate how effective the health care facilities have been designed in meeting the health needs of the Aboriginal patients. Since the paper has included statistical method of data analysis that is SPSS, the dependability and reliability of finding is high. The paper has included only quantitative method of data analysis, however the study findings could have been further strengthened with the inclusion of qualitative data analysis. In qualitative data analysis, health professionals could have shared their insights and experience on the areas of study (Saunders M. , 2011). The key areas such as Aboriginal culture training to clinical staffs, referral of Aboriginal patients to Aboriginal staffs, knowledge on aboriginal health care facilities and identification of Aboriginal patients could have been evaluated in greater details with the adoption qualitative research technique. Qualitative data is open ended process which allows participants share information and thoughts on the selected areas of study. However with the adoption of only quantitative method, the research relies on statistical data findings which could have been increased with the inclusion of qualitative data analysis technique (Taylor, Bogdan, & DeVault, 2015). 

Data findings: 

From the data findings and research results, it is evident that out of 286 respondents 238 were trained in Australia including non-medical staffs. However less than half of the respondents had received training based on Aboriginal health, amongst them about half of the nurses have reported to receive training in this area. Additionally one third of respondents were found to receive cultural competency training on Aboriginal service provision. Additionally, about half of the medical staffs have reported to receive no training at all on Aboriginal health care delivery. In contrast, only a quarter of health care professional had reported that their training had improved their competency in providing culturally designed services to Aboriginal care users. High number of respondents and high quality methods of data collection and data analysis have been determining the clinical significance of the study. 

One of the major weakness of the research is its response rate as 2980 email addresses were there inclusive of clinical and non-clinical staffs. 38 emails bounced back. 286 respondents have responded out of 572 staffs which is 50%. The respondents who have not responded could have showed different perspective to the given questions. However the health care staffs who have responded, demonstrated to have more interest in receiving cultural training to meet Aboriginal health needs and care facilities. They also were interested in referral to Aboriginal care providers. 

Clinical significance of the research outcome is high as the study has included different clinical as well as non-clinical staffs of Australian health care sector. The study further enables the researchers in identifying the comparison of cultural competency training among clinical staffs. The study shows that although both clinical and non-clinical staffs have been receiving clinical training, most of the clinical staffs have reported that they do not receive adequate culturally competent training that would help them in providing effective care service delivery to the Aboriginal patients.  

Most of the respondents unanimously have reported that Aboriginal population has higher prevalence of illness than non-Aboriginal people. Not even quarter of the all staffs who were included in the study have reported to possess sound knowledge about Federal Government Closing the Gap initiative, inclusive of both clinical and non-clinical staffs. Different health care services provided for Aboriginal population were poor due to inadequate knowledge about the health need and culturally competent services. In identifying Aboriginal patients, most of the respondents find that identifying Aboriginal patients were necessary to provide them with best possible healthcare provision. However one of five respondent have reported that asking patients whether they are Aboriginal care users could hurt their feelings. 

Most of the respondents have agreed to have dedicated Aboriginal staff rather than Aboriginal health workers and liaison officers. Moreover a large number of care professionals supported that cultural training is must for them. This research outcome is one of the key areas to focus by the health care institutions and Australian Government as culturally competent training has significant role in providing effective care provision to Aboriginal people (Kildea, Tracy, Sherwood, Magick‐Dennis, & Barclay, 2016). This research outcome has close association with the principle of health equality and a human rights approach. By providing cultural training, health care professional would gain adequate knowledge about how care provision plan must be developed so that those are aligned with the Aboriginal culture. Cultural training will facilitate the clinical and non-clinical staffs in health care settings promote health care facilities complied with the principle of Health equality and a human rights approach (Forsyth C. , Irving, Tennant, Short, & Gilroy, 2017). 

The research findings provide high level of knowledge that determines whether healthcare settings have been providing culture training in line with Aboriginal or not, whether they have dedicated Aboriginal staffs or not,  whether they practice referral of Aboriginal families to Aboriginal care providers or not and provide knowledge of Aboriginal health and services to staffs or not. It has been found from research findings that there remain a number of gaps in the cultural competency training and knowledge of the health care providers in health care initiatives of Aboriginal people which is essential to provide improved care facilities. Most of health care providers have agreed that in managing Aboriginal patients Aboriginal staffs were very important resource. Therefore investing in training towards more competent medical workforce is essential to achieve improvement in the health status of the Aboriginals (Durey, et al., 2016). 

Usefulness:

The chosen study is useful in generating information and knowledge which has identified the gaps that prevail with health service provision and the health plan design for Aboriginals. The study has identified the significance of information and knowledge about the Aboriginal health and services and importance of cultural competence in providing improved health care services to Aboriginals. The research also has shown that one third of participants have agreed that cultural training are not being provided to them although all of the participants are clinically trained. To provide effective care facilities, clinical and non-clinical staffs must be provided with cultural training, which however, has been identified to be missing as reported by majority of the clinical staffs (Wain, et al., 2016). Additionally the research also has identified the gap that lies in staffs’ knowledge about Aboriginal health and services. However most of the respondents have agreed that Aboriginal people have higher burden of illness when compared with non-Aboriginal Australians. 

Respondents further have opined that Aboriginal interpreter, Aboriginal liaison officer, and Aboriginal health education officer are the important resources in managing Aboriginal health issues. Therefore it can be stated that Aboriginal staffs are more efficient in managing health issues of Aboriginal patients. Less than quarter of all staff reported to have good knowledge about Closing the Gap initiative which included only 11 clinical staffs of 247. More than Aboriginal medical staffs and other clinical staffs, half of the health professionals have reported to referral of Aboriginal families to Aboriginal liaison officer.  Major reasons identified for referral of Aboriginal patients are some of the patients had asked for referral and to provide support to the Aboriginal patients. In contrast, half of the staffs have never referred Aboriginal care users to Aboriginal staffs while 51 of 286 have reported of unaware about the availability of the service. However, most of the staffs have supported importance of dedicated Aboriginal staffs but preferring Aboriginal liaison officer over Aboriginal care staffs.  

Identification of Aboriginal patients is important to ensure access to available services. However very little ratio of staffs reported about asking their care users whether they are Aboriginal although most of them have agreed to its significance. Some of the staffs have also stated that ward staffs have enquired and recorded while some of the clinical staffs have found asking about their culture may offend their beliefs. 

Implications for practice and future research:

The research outcome has identified the importance of culturally competence training to the health care staffs, which is essential in providing improved care services to Aboriginal patients (Clifford, McCalman, Bainbridge, & Tsey, 2015). Further implications that can be drawn from the particular study are importance of Aboriginal services and health knowledge, Aboriginal patients’ referral to Aboriginal staffs and identifying Aboriginal patients so that accurate health care services can be provided. Identified elements are some of the key parameters of providing accurate and improved health care services to Aboriginal patients. Therefore, conclusion can be drawn from the implications that Australian health care settings should make culturally competent training mandatory for the health care staffs and other practices that have been identified in the study such as referral to Aboriginal staffs, improving staffs knowledge about Aboriginal health and services and identifying Aboriginal patients (Forsyth C. , Irving, Tennant, Short, & Gilroy, 2018). By addressing the identified areas, principle of health equality and human rights approach to Aboriginal people can be achieved accurately. 

However, in the light of inadequate number of participants who have taken part in the study, further research must be conducted with higher number of respondents across wider number of health care settings. Wide number of respondents may have different perspective towards culturally competent training that they have received and its effectiveness in managing Aboriginal patients. Since the selected number of respondents have identified low satisfaction of cultural competence training in their health care settings, does not infer that training was ineffective. Further research also should be carried out that identifies knowledge, approach and practices of clinical staffs as these elements also determine improved health care experiences of Aboriginal patients.