Indigenous child health and culturally safe care — formative SAQs

SAQ 1 (10 marks)

You supervise a registrar who completed a cultural competence workshop. They say this means their care is automatically culturally safe for Indigenous families. [1]

1. Define cultural safety and contrast it with cultural competence. (3) [1] [2]
2. Using Jones’s framework, give one example each of institutional and personally mediated racism in a paediatric service. (4) [3]
3. State two organisational strategies (beyond individual politeness) that improve equity with Indigenous populations. (3) [8]

Model answer

Cultural safety is care free of racism as defined by the person receiving care. Cultural competence is clinician knowledge/skills; useful but incomplete if the family still experiences racism or power abuse. [1]

Institutional example: clinic hours/location/transport rules that systematically exclude remote or low-income Indigenous families. Personally mediated example: a staff comment that shames a caregiver for “non-compliance” or uses a stereotype. [3]

Organisational strategies: flexible appointment systems and outreach; Indigenous workforce and liaison roles; partnership with community-controlled services; anti-racism policies with complaint pathways; welcoming physical environments. (Any two well explained.) [8]

SAQ 2 (10 marks)

A 5-year-old Indigenous child has recurrent otitis media, possible hearing loss, and three missed audiology visits. Notes say “DNA — non-compliant.” Housing is crowded; the family travels 90 minutes by bus. [12]

1. Reframe the “non-compliant” label using structural drivers. (3) [6] [8]
2. Outline your clinical and system plan for ears/hearing. (4) [12]
3. List three teach-back points you will confirm with the family before they leave. (3) [1]

Model answer

Missed visits likely reflect transport, cost, timing and prior distrust — not moral failure. Crowding and infection ecology raise OM risk; racism and access barriers worsen incomplete care. [6] [8]

Plan: examine ears today; treat active disease per indication; arrange audiology with transport/support or outreach; consider Indigenous OM guideline pathways; link ACCHO/primary care; address smoke and unfinished treatment barriers; school communication if family consents. [12]

Teach-back: what the ear problem is; what treatment to give and for how long; when/where hearing test is and how they will get there; when to return urgently (fever, severe pain, mastoid signs). [1]