Online Learning for Clinicians and Researchers Who Work with Cancer-Affected First Nations People

FormalPara Key Points

• Online learning modules can be a useful part of ongoing clinician education, filling a gap in professional development.

• There was high uptake of the modules, indicating strong interest from researchers and clinicians for knowledge and skills in this field.

• Building knowledge and skills in culturally appropriate healthcare and research practice is key to improving psychosocial outcomes for First Nations people with cancer.

Strengthening the capacity of health services to deliver high-quality, culturally appropriate care for Aboriginal and Torres Strait Islander people affected by cancer is a key priority to improve cancer outcomes [1]. However, appropriate educational resources are lacking. To help address this shortfall, an e-learning package was developed to increase the knowledge, skills, and confidence of health professionals who work with Aboriginal and Torres Strait Islander people affected by cancer.

Who Was Involved

The e-learning package was created through a partnership between the Psycho-oncology Co-operative Research Group (PoCoG) and the Centre of Research Excellence in Targeted Approaches to Improve Cancer Services for Aboriginal and Torres Strait Islander Australians (TACTICS CRE).

PoCoG was established in 2005 as 1 of 14 Cancer Clinical Trials Groups funded by Cancer Australia, the national government’s cancer control agency. It brings together researchers, clinicians, and people with personal experience of cancer [2]. PoCoG’s multidisciplinary membership includes Australian researchers and clinicians with an interest in psycho-oncology and supportive care research. PoCoG’s goals focus on promoting research and health-system improvements in the provision of psychosocial aspects of cancer across all stages, from cancer prevention, treatment, recovery, and survivorship through to end-of-life care and bereavement. PoCoG’s work to promote the psychosocial aspects of cancer care reflects broader national priorities in cancer, including specific efforts to reduce inequities in cancer outcomes for Aboriginal and Torres Strait Islander people.

The TACTICS CRE is an Aboriginal-led consortium of researchers from institutions across Australia. This 5-year program, funded by Australia’s National Health and Medical Research Council (NHMRC), is focused on improving cancer outcomes for First Nations people through applied research on (1) increasing prevention and early detection through immunization and screening, (2) improving diagnosis through health-service innovation, and (3) providing appropriate care to enhance the psychosocial wellbeing of cancer survivors, their partners, and carers [3]. Key aspects of the CRE include a focus on translating research knowledge into policy and practice, training and developing future research leaders, and building community awareness and understanding of cancer.

Members of the TACTICS CRE have been instrumental in guiding the work undertaken by PoCoG to identify research priorities and develop research programs that directly address the psychosocial needs of Aboriginal and Torres Strait Islander people affected by cancer. Through this collaboration, a need was identified to build greater capability and cultural understanding among clinicians, researchers, and healthcare providers. This was seen as critical to promoting inclusive care that improved access to cancer screening and early access to treatment and promoting participation in clinical trials—through building a greater understanding of the health and wellbeing of Aboriginal and Torres Strait Islander people and their experiences with cancer. This included the need to promote understanding of the evidence regarding cancer outcomes and the contributing factors to disparities in outcomes, along with supporting and guiding clinicians on ways they can better engage, support, and communicate effectively with Aboriginal and Torres Strait Islander patients, their families, and carers. Promoting such capability is key to improving experiences of cancer care for Aboriginal and Torres Strait Islander people, and it is fundamental to minimizing, identifying, and responding to psychosocial needs at all stages of cancer.

Action Taken

Online learning modules were developed to increase knowledge in three specific areas: (1) Aboriginal and Torres Strait Islander health and current disparities in cancer outcomes, (2) culturally inclusive communication with patients and carers, and (3) strategies to address the under-representation of Aboriginal and Torres Strait Islander people in clinical trials.

The content for the series was developed by TACTICS CRE members from the Menzies School of Health Research and The University of Queensland in collaboration with PoCoG members from the University of Sydney and the University of Newcastle. Module development was guided by adult-learning principles.

Three modules were produced and released and are freely available on the PoCoG YouTube channel [4].

Each module was designed to be self-contained but complementary, with clear learning outcomes (Figs. 17.1, 17.2, and 17.3). There is a common look and feel across the modules, and all three are narrated by the same First Nations actor. Each module begins with an Acknowledgement of Country (recognition of traditional custodians of the land) and a statement of respect for First Nations Elders.

Fig. 17.1

Module 1 title slide and learning outcomes

Fig. 17.2

Module 2 title slide and learning outcomes

Fig. 17.3

Module 3 title slide and learning outcomes

Module 1: Cancer Overview and Factors Impacting Health Inequalities

Module 1 provides an overview of cancer among Aboriginal and Torres Strait Islander peoples and explores the factors that impact on the current health inequalities affecting First Nations Australians (Fig. 17.1). It covers various aspects that clinicians and researchers need to know regarding the context in which Aboriginal and Torres Strait Islander people live, and the burden of cancer for this group, including the most common types of cancer. It provides details of inequities across the cancer continuum, using Australia’s National Cancer Control Indicators as a framework. Individual-, service-, and system-level factors that impact on outcomes are discussed, as well as enablers of improved outcomes, including cultural safety, communication, and appropriate, evidence-based resources and tools. References and links are provided. The module also includes a First Nations cancer survivor talking about his experiences of diagnosis, treatment, and survivorship. The module, which runs for just under 24 minutes, was released in March 2021.

Module 2: Communicating with Patients and Carers

Module 2 aims to build effective and culturally appropriate communication skills among clinicians and researchers working with First Nations peoples (Fig. 17.2). Safe, effective, and culturally inclusive communication is an important aspect of high-quality, patient-centered care. The module begins by discussing what health literacy is and the factors that influence it before offering a range of practical strategies that clinicians and researchers can use to improve communication with First Nations patients and their carers. These strategies include understanding your impact, considering culture and cultural complexities, seeking support from people who can help, building rapport and creating a safe environment, thinking about how you communicate, and using other forms of communication. Module 2, which is just under 21 min long, was originally developed as part of an NHMRC-funded project (the 4Cs Project—Coordination and Collaboration in Cancer Care) undertaken under the auspices of the TACTICS CRE. It was modified for a more general audience and released as part of the e-learning series ahead of World Cancer Day in February 2023.

Module 3: Aboriginal and Torres Strait Islander People’s Participation in Clinical Trials

Module 3 focuses on understanding and improving Aboriginal and Torres Strait Islander people’s access to and participation in clinical trials (Fig. 17.3). The module begins by addressing why clinical trials are important and why it is important to include Aboriginal and Torres Strait Islander people in trials, as well as what is known about current levels of participation. The module outlines key barriers and facilitators and highlights important resources—including the new National Clinical Trials Governance Framework, which explicitly addresses the inclusion of Aboriginal and Torres Strait Islander people in clinical trials [5]. Module 3 is approximately 24 min long and was released in April 2023.

Impact of the Modules

The modules were promoted through cancer-professional networks and clinical-trials groups to their memberships. As of October 9, 2023, the three modules had been viewed approximately 2250 times. Some 220 participants registered to attend a webinar held in July 2023 to build on the information and resources shared in the series and to provide practical examples of implementation.

Modules 1 and 2 were utilized as part of the 4Cs Project. A pre−/post-evaluation looked at changes in the confidence, skills, and knowledge of those who completed the modules, as well as health professionals’ feedback on the modules themselves. Although the sample size for the project was small (n = 21), everyone who completed the training rated the modules as good to excellent, with most or all indicating that the modules’ content was relevant (100%), easy to follow (95%), and useful in the context of their work (100%).

While no formal evaluation has been conducted beyond what was done in the 4Cs project, the number of views does indicate interest and willingness among many health professionals to engage in activities aimed at improving their skills, knowledge, and understanding of what is needed to ensure high-quality, culturally appropriate care for Aboriginal and Torres Strait Islander people with cancer.

We gratefully acknowledge the contributions of all those involved in the development of the modules. The TACTICS CRE is funded by the National Health and Medical Research Council (GNT#1153027). PoCoG is funded by Cancer Australia Cancer Support for Cancer Clinical Trials Program. The artwork in the online modules was created by Casey Coolwell-Fisher from Chaboo.