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.
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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]
References6ShowHide
- [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
- [3]Jones CP Levels of racism: a theoretic framework and a gardener's tale American journal of public health, 2000.PMID 10936998
- [4]Paradies Y Racism as a Determinant of Health: A Systematic Review and Meta-Analysis PloS one, 2015.PMID 26398658
- [6]King M Indigenous health part 2: the underlying causes of the health gap Lancet, 2009.PMID 19577696
- [8]Browne AJ Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study BMC health services research, 2016.PMID 27716261
- [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