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Folio edition · Set in Instrument Serif & Archivo

Paeds Vivaspreventive-and-community-paediatrics

Paeds Vivas · preventive-and-community-paediatrics

Indigenous child health and culturally safe care — branching viva

Structured oral on cultural safety, racism as a determinant, clinic partnership and emergency priorities.

branching clinical structured oral
On this page & tools

Target exams

RACP DCEMRCPCH Clinical

Target exams

RACP DCEMRCPCH Clinical
Prompt
Outpatient clinic: Indigenous child with recurrent ear infections; family distrustful after prior dismissive care. Later stem shifts to septic shock in ED.

Stem

You are the paediatric registrar in a regional clinic. [1]

Examiner: What is cultural safety? [1]

Strong answer: Care free of racism as judged by the child and family — not by my self-rating of competence. [1]

Examiner: Why do Indigenous child-health gaps exist in high-income countries? [6]

Strong answer: Structural drivers — colonisation, racism, material deprivation and health-system power — not culture as defect or genetic essentialism. [6] [4]

Examiner: The notes say non-compliant. How do you respond? [8]

Strong answer: Reframe as access and trust. Ask about transport, cost, housing, prior racism. Rebuild partnership; do not shame. [8]

Examiner: Outline your ear/hearing plan. [12]

Strong answer: Examine and treat today; audiology with practical supports; use Indigenous OM pathways where relevant; link community-controlled care; protect school hearing. [12]

Examiner: Same child later presents in septic shock. Family want a cultural process first. What do you do? [1]

Strong answer: Start standard paediatric resuscitation immediately. Integrate family supports and communication in parallel. Do not delay ABC care. [1]

References

  1. [1]Curtis E Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition International journal for equity in health, 2019.PMID 31727076
  2. [3]Jones CP Levels of racism: a theoretic framework and a gardener's tale American journal of public health, 2000.PMID 10936998
  3. [4]Paradies Y Racism as a Determinant of Health: A Systematic Review and Meta-Analysis PloS one, 2015.PMID 26398658
  4. [6]King M Indigenous health part 2: the underlying causes of the health gap Lancet, 2009.PMID 19577696
  5. [8]Browne AJ Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study BMC health services research, 2016.PMID 27716261
  6. [12]Leach AJ Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: summary of recommendations The Medical journal of Australia, 2021.PMID 33641192