Sharing the True Stories - a summary

Most experienced staff have some awareness of communication difficulties but there has been little research to explore the nature and extent of miscommunication between health staff and Indigenous patients.

In 2001 a six month study was conducted with renal staff and Yolŋu patients to find out more about communication problems in renal care and to identify strategies for improving communication.

THIS STUDY FOUND THAT MISCOMMUNICATION WAS MUCH MORE EXTENSIVE THAN ANY OF THE PARTICIPANTS REALISED. AS A RESULT, MOST INSTANCES OF MISUNDERSTANDING WENT UNRECOGNISED AND THEREFORE UNREPAIRED. THIS HAS SERIOUS IMPLICATIONS FOR THE QUALITY OF CARE PROVIDED TO INDIGENOUS PATIENTS.

Findings from this study provide examples of the kind of communication challenges experienced by Balanda health staff and their Yolŋu patients. Similar challenges may occur other intercultural contexts and with other language groups but this needs to be verified with people who understand the communication issues specifically relevant to each situation.

Five key encounters between staff and their Yolŋu patients were videotaped; the participants were then interviewed about the encounter and they also assisted with the interpretation of the videos.

Click here to find out more about these encounters

The high level of motivation of all participants to achieve the best possible communication was a common factor across these interactions. The findings of this study are therefore snapshots of current 'best practice' in intercultural communication in the renal context.

However, even in these conditions, miscommunication was extensive in all the encounters:

• little or no shared understanding about underlying biomedical or Yolŋu concepts and key terms was achieved
• there was little shared understanding between staff and patients about communication processes (roles and responsibilities; what is said and what is withheld etc)
• miscommunication was also extensive with Yolŋu participants who are relatively fluent in English. Click here for an example.

The extent of miscommunication was far more serious than even the most experienced staff - and clients - suspected.

• the effectiveness of communication was overestimated by all participants
  assumptions about shared knowledge were often inaccurate
• few attempts were made to predict or prevent communication difficulties
• effective strategies to monitor effectiveness or to repair miscommunication were rarely utilised.

The most dangerous feature of these interactions was the extent of unrecognised miscommunication.

Go to the Communication Challenges section of the menu to find out more about the barriers to effective communication in Indigenous health care identified through this (and other) research.

Go to the Guidelines and Strategies section of the menu to find out more about ways to prevent - or at least minimise - miscommunication in Indigenous health care.

A paper about the project ('Sharing the true stories: improving communication between Aboriginal patients and health carer workers' published in the Medical Journal of Australia in 2002) can be found at http://www.mja.com.au/public/issues/176_10_200502/cas10830_fm.pdf