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Welcome to

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Lisa Portail

on 15 October 2013

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Transcript of Welcome to

Your cultural awareness will grow throughout this workshop
What we have watered you with:
Who are we ?
The Medical Education Unit at the Royal Melbourne Hospital (RMH) is dedicated to the education and training of its medical staff.

Small team who work to support you, Overseas Trained Doctors, prior to arriving, on arrival and during your time at the RMH professionally and personnally.

RMH is professional environment characterized by its comradery and friendship.

Welcome to
Overview Continued
Your Fertile Ground

Wednesday 16th of October 2013

Thursday 17th of October 2013

Friday 18th of October 2013
Modules' Detailed Content
Australian Health Care System
Overview of the Australian Health Care System
Activities undertaken: Figures of the Australian Health Care System
Reading of articles related to current issues
Victorian Health Care System
Country Health Services
Community Health Services
Dental Health Services
Public Health Services and Health Protection
Mental Health Services
Private Health Services in Victoria
Other Health Service Organisations
Activities undertaken: Quizz on the different prevailing institutions and organizations in the healthcare field in Victoria
Cultural Awareness
The Australian Society
Aboriginal Australians
Interest of training in cultural awareness
Mind your language ! Intercultural communication and misunderstandings
Professional doctor conduct
Hospital Resources and external resources in relation to cultural awareness
Activities undertaken: Videos on cultural awareness in your daily life and your professional life
Health Idioms: match it!
Role plays.
Professional standards
Medical Board of Australia
Australian Medical Council
Competent Authority Pathway
Specialist pathway
Standard pathway
Professional development and Education
Working in Victoria
Living in Victoria
About Victoria
Visa Requirements
Opening a bank account
Learning English
Housing and Essential Services
Personal Health Care
Employment for Partners
Emergency Services
Getting around
Working in Hospitals
Medical Credentials and Scope of Practice
Working in General Practice
Infection Control
Taxation and Insurance
Medico Legal
Deaths in Hospitals
Medical Terminology
Health Industry Acronyms
Activities undertaken: Patients' case studies
Reading of pieces of work related to health care ethics.
Activities undertaken:
Activities undertaken:
10th to 17th of October
Orientation Week for Overseas Trained Doctors
Victorian Public Health Service
Metropolitan Health Services
To improve your orientations to the Australian healthcare system and workplaces

To facilitate communication with patients and co-workers
To alter you to the need of standardisation of OTD's assessment of knowledge and skills
Medical field as a culture in itself
Culture or Cultures?
Culture shock and conceptualization shock
What does this acronym stand for ?
Translation activities.
Film about the daily professional life in Australian hospitals.
Fieldtrip in Melbourne - Visiting some places of interest
To improve your education and training
in relation to professional and cultural issues
To facilitate a better information access for you/ provide opportunities for further education and training
What are the aims of this presentation?
- awareness that Australia is a multicultural country and that everybody's worldviews may not be the same as yours.
- Indigenous cultures
- Medical field as a culture
- cultural distance
- the 'shrinking world'
- awareness that the language is part of your culture and that it has effects upon communication.
- how to overcome cultural shocks and how to fit in.
- awareness that there are several definitions of culture
- essentialism and ethnicity

The Medical Education Unit of
Reminder/Overview of your Week
Friday 11th of October 2013
Monday 14th of October 2013
The fruits of your labours
To take out the most of this professional and personal experience
To overcome cultural or conceptualization shocks.
to efficiently fit-in in your new cultural environment
Australian healthcare industry's Reliance on OTDs
Issues raised that can be addressed through cultural awareness training
'the shrinking world'

Authoritative information and statistics to promote better health and wellbeing website (2000) ‘Overseas trained doctors reducing medical workforce shortages’, Media release, accessed 26th of September 2013, retrieved from: http://www.aihw.gov.au/media-release-detail/?id=6442464343

Bayram, C., Knox, S., Miller, G., Ng, A. & Britt, H. (2007) ‘ Clinical activity of overseas-trained doctors practising in general practice in Australia’, Australian Health Review 31(3): 440-448.

Cordella, M. (2011) Chapter 9: overcoming language and cultural differences in medical encounters: the use of a language and culture training course (LCTC) in educating IMG’s in Australia. http://www.emeraldinsight.com/books.htm?issn=2041-272X&volume=5

Harvey, K. & Faunce, T. (2005) ‘A Critical Analysis of Overseas-Trained Doctor (OTD) Factors in the Bundaberg Base Hospital Surgical Inquiry’, Law in Context 23(2) :73-91.

Jain, P. & Krieger, J.L. (2010) ‘Moving beyond the language barrier: The communication strategies used by international medical graduates in intercultural medical encounters’, Elsevier Patient Education and Counselling, 84: 94-104.

McGrath, B.P (2004), ‘Integration of overseas-trained doctors into the Australian Medical workforce’, MJA, 181(11-12).


Royal Melbourne Hospital Online Resources, accessed 26th of September 2013, retrieved from:
Closing the Gap video for our community 2013,
Closing the Gap, video for the Royal Melbourne Hospital’s staff


Shouten, B.C. & Meeuwesen, L. (2005) ‘Cultural differences in medical communication: A review of the literature’, Elsevier Patient Education and Counseling 64: 21–34.

RCH Junior Medical Staff - http://www.rch.org.au/Templates/RchPbTwoCol.aspx?pageid=8089

Doctors Speak Up - http://doctorsspeakup.com/home

Living and Working in Western Australia – Orientation Manual for International Medical Graduates - http://www.overseasdoctors.health.wa.gov.au/docs/IMG-

A multicultural Australian Society
Indigineity/ Aboriginal Australians
Australia is story laden with Indigenous culture and history
complexity of Indigeneity
Culture, cultures ?
Culture as a whole defining a part of society.
The advantages/disadvantages of this conception of culture.
Every individual is multicultural: Goodenough's cultural lens.
Communication in a multicultural framework. Mind your language !
Medical Language
The medical field: a culture within the culture
- its own language
- its own set of values and goals
- its own way of functioning & its own physical environment
- its own organisational culture
- specific acronyms
- specific vocabulary/ medical jargon

- health literacy
Cultures, Ethnicity and essentialism.

Ethnicity and essentialism are deeply embedded in our everyday professional and personal lives.
Assuming that each individual's cultural background is different can prevent us from categorizing and stereotyping.
Remember that you can discriminate against people but you can also be the target of such a discrimination;
Tuesday 15th of October 2013
Pharmaceutical Benefits Scheme
Department of Veteran's Affairs
Private Health Care
Disability Care
to cross-culturally communicate in a multicultural personal and professional environment.
to be aware of the diversity and the complexity of the cultures that are surrounding you
better comprehension of the Australian and Victorian Health Care System
About Aboriginal Australians
To learn more:
RMH Aboriginal Hospital Liaison Program - http://www.rmh.mh.org.au and www/353/1001127displayarticle/1033706.html

Remote Area Health Corps - http://www.rahc.com.au/elearning - online clinical training modules designed for health professionals working with Indigenous communities

Australian Indigenous HealthInfoNet - http://www.healthinfonet.ecu.edu.au/
Some interesting websites and associations
Doctors Speak Up – www.doctorsspeakup.com – is a multimedia resource that has been developed to address language and communication needs of international medical professionals working in Australia.

Doctor Connect – www.doctorconnect.com – is an Australian Government Department of Health online cultural education program.

The Australian Doctors Trained Overseas Association (ADTOA) – www.adtoa.org.au

“Life in Australia” is an online Immigration Department booklet provided in many different languages - http://www.immi.gov.au/living-in-australia/values/book/english/lia_english_full.pdf

“Beginning Life in Australia” is another booklet for newly arrived migrants - http://www.immi.gov.au/living-in-australia/settle-in-australia/beginning-

General Orientation Webpage of the RMH– this is a resource for all new RMH doctors and will provide information about support within the Hospital.

'This is Water', David Foster Wallace's video = this is a video explaining the interests of cultural awareness in the everyday life.

Adelaide to Outback GP Training Program - http://olle.aogp.com.au/course/view.php?id=62 – has developed an online communication and language module which can assist to improve communication with patients

RMH Transcultural & Interpreter Service - http://www.rmh.mh.org.au/www/353/1001127/displayarticle/1001244.html

Some guidelines in regards to the Australian social behaviour
Informal behaviour with co-workers and acquaintances
Use of the first name.
the first time you meet somebody, shake the person’s hand with your hand. Generally no kiss or hug on first meeting.
Regular use of 'please' and 'thank you' is part of a polite behaviour. So is punctuality .
Australia is made up of people from a variety of cultures, many of whom hold different values and beliefs about health and medical treatment. These different beliefs and values will impact on your patients’/co-workers' perceptions of appropriate behaviour and treatment. Determining what is appropriate, given the various cultures, beliefs and expectations, within which you must work, may not be easy.

It is important to be aware of your own cultural background, beliefs and values and be aware that this may influence your expectations and communication with your patients. At times, this cultural difference can result in clashes with the beliefs of your patients or co-workers.
- What is language?

- Why language is important

- Common language problems for OTD’s

- Language barriers for OTD’s whilst dealing with ESL patients and co-workers

About some cultural awareness programs:

Combined Universities Centre Rural Health (CUCRH) http://lms.cucrh.uwa.edu.au/login/index.php – provides information to assist health professionals develop a deeper understanding of Aboriginal culture, values and practices

Share our Pride - http://www.shareourpride.org.au/ – provide an introduction to ATSI people and their culture and assist in building respectful relationships

Diverse WA - http://www.diversewa.omi.wa.gov.au/ – cultural competency program to educate medical practitioners how to assist people from culturally and linguistically diverse backgrounds.
no standard approach to dealing with diverse Aboriginal patients.
Indigenous dramatic disadvantages in the health field
“Men’s business” and “Women’s business”
Gender and doctor
Activity time ! Health Idioms
From the left to the right:
Dr Louisa Ng: Supervisor of OTDs' Training.
Dr David Kwan: OTDs' Educator.
Dr Marisa Cordella : scholar specialized in medical intercultural communicatiom.
Dr Agathe Dupont: French doctor at RMH, former OTD.
Indigenous cultures & healthcare
Time Frame
9.00-10.00 : Welcoming and introduction.

10.00-12.00 PART I: The Australian multicultural society

12.00-14.00: Lunch Time

14.00-16.00 PART 2: Communication in a multicultural setting

"Mrs. Jones had a syncopal episode last night without any evidence of arrhythmia. I don't think it was vagal but I ordered a 2D echo and holter. I still can't rule out a vertebrobasilar event."
Full transcript