The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects of assessment:

The individual being assessed must provide evidence of specified essential knowledge as well as skills

Consistency of performance should be demonstrated over the required range of situations relevant to the workplace

Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible

Conditions of assessment:

This unit includes skills and knowledge specific to Aboriginal and/or Torres Strait Islander culture

Assessment must therefore be undertaken by a workplace assessor who has expertise in the unit of competency or who has the current qualification being assessed and who is:

Aboriginal or Torres Strait Islander him/herself

or:

accompanied and advised by an Aboriginal or Torres Strait Islander person who is a recognised member of the community with experience in primary health care

It is critical that in assessing this unit, consideration is given to the sensitive nature of some aspects of the unit, particularly as they apply to Aboriginal and/or Torres Strait Islander history and culture and to the culture of the person or group being assessed

Assessment methods should be sensitive to emotional reactions of individuals being assessed, and it is highly recommended that access be made available as required to support, such as counselling in social and emotional well-being

Context of assessment:

Competence should be demonstrated working individually, under supervision or as part of a primary health care team in a clinical care environment, with Aboriginal and/or Torres Strait Islander clients.

Where applicable, assessment should replicate workplace conditions as far as possible.

Related units:

This unit may be assessed independently or in conjunction with other units with associated workplace application

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

Aboriginal and/or Torres Strait Islander health, including:

relevant definitions of 'health' (such as those of the World Health Organisation, NACCHO)

Aboriginal and/or Torres Strait Islander community perceptions of major health issues affecting them and underlying causes

perceptions of non-Aboriginal and/or Torres Strait Islander people relating to major Aboriginal and/or Torres Strait Islander health issues and underlying causes

key health statistics (national, state and/or local) for Aboriginal and/or Torres Strait Islander people compared to those of non-Aboriginal and/or Torres Strait Islander population (such as expectation of life at birth, infant mortality rate, age standardised mortality ratios for selected health conditions)

Aboriginal and/or Torres Strait Islander history, including:

history, social structures, beliefs and values of traditional and contemporary Aboriginal and/or Torres Strait Islander communities in Australia

effects of colonisation as experienced by Aboriginal and/or Torres Strait Islander people

historical dilemmas faced by Aboriginal and/or Torres Strait Islander people (acknowledge or deny Aboriginality)

impacts of government policies and legislation and their impact on Aboriginal and/or Torres Strait Islander communities, families and individuals

Social, cultural and environmental determinants and strategies to address Aboriginal and/or Torres Strait Islander health status, including:

traditional Aboriginal and/or Torres Strait Islander cultural practices and lifestyle and their impact on Aboriginal and/or Torres Strait Islander health

importance of land, tradition and cultural practice to Aboriginal and/or Torres Strait Islander health

impact of socio-economic factors on health

social and political factors that perpetuate disadvantage

importance of personal achievement, education and supportive family/social networks

strategies Aboriginal and/or Torres Strait Islander families may employ to maintain strong culture and supportive social networks and maximise educational, employment and social opportunities for their children

Impact of environmental factors on health

Barriers to improving environmental determinants of ill-health

continued ...

Essential knowledge (contd):

Lifestyle and behavioural determinants Aboriginal and/or Torres Strait Islander health and strategies to address them, including:

Nutrition, physical activity, rest and sleep in relation to holistic health

Known behaviours that pose a significant risk to Aboriginal and/or Torres Strait Islander people

Aboriginal and/or Torres Strait Islander lifestyle practices and the effects on health

Education and promotion of healthy lifestyle practices

Principles of well-being applied to work and study practices

Primary health care model, including:

WHO Primary Health Care model and Ottawa Charter principles

Comparison of Primary Health Care model and conventional Western 'medical' model

Development of Aboriginal and/or Torres Strait Islander health services in Australia

Community control in relation to health service delivery to Aboriginal and/or Torres Strait Islander people

Issues in implementation of health services at local, state/territory and national levels

Relevant aspects of health care system, including:

Access to Medicare benefits

Pharmaceutical benefits

Related social benefits

Essential skills:

It is critical that the candidate demonstrate the ability to:

Work consistently in a culturally safe manner with and on behalf of Aboriginal and/or Torres Strait Islander clients in line with identified community needs and workplace requirements

Apply the principles of Primary Health Care in the delivery of health care services

Work with an understanding of the impact of historical, social, political, spiritual and environmental factors on the health of Aboriginal and/or Torres Strait Islander people

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

Take into account social, political and environmental factors that influence the health of Aboriginal and/or Torres Strait Islander clients

Conduct an accurate and effective holistic assessment of the health of Aboriginal and/or Torres Strait Islander clients, including:

taking and recording relevant details of client's history, including body language

observation and assessment of client's health, using appropriate tests and instrumentation

using a structured approach to assessment

Communicate effectively and establish a relationship of trust with clients

Initiate appropriate actions in response to assessment and in accordance with organisation procedures and protocols for commonly presented health conditions

Engage the client in self-management principles and practices

Make appropriate referrals, providing accurate and relevant details to clients and referral agencies

Reflect on and improve own level and application of skills and knowledge to achieve desirable outcomes and maintain own capabilities

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Cultural respect

This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoples

It recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance

Its application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices

Community control

Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community and/or key decision-makers in this process

Aboriginal and/or Torres Strait Islander community control is:

the guiding principle and model for the delivery of holistic primary health care services to Aboriginal and Torres Strait Islander people

a sector of the Australian health industry with its own history

a practice which underpins Aboriginal community strengthening and survival

a statement of self-determination

Supervision

Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirements

References to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionals

A person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines

Legislative requirements

Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of Variables

Aboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute 'usual practice' due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by 'usual practice circumstances'

Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework

The history of Aboriginal and/or Torres Strait Islander people includes:

Aboriginal and/or Torres Strait Islander customs and lifestyle before European colonisation

Aboriginal and/or Torres Strait Islander experience of colonisation and invasion

Post-colonial legacy of social and economic disadvantage

Survival and maintenance of culture, kinship and connection with the land

Evolution and scope of the role of the Aboriginal Health Worker up to the contemporary context

Cultural safety refers to:

Maintaining the traditional and contemporary protection of Aboriginal and/or Torres Strait Islander communities':

intellectual property

human rights

resources

ownership of materials

Community and self-protection of Aboriginal and/or Torres Strait Islander Health Workers.

Cultural factors that may produce stress include:

Community and/or own expectations that may involve, for example:

extended work hours

functions outside health work role

unrealistic accountability/responsibility for resolving community problems

family pressures

Multiple accountabilities to employer, family, personal and community

Motor vehicle accidents

Social, political, economic and environmental factors that impact on Aboriginal and/or Torres Strait Islander health include:

Health outcomes

Stolen generations

Colonisation and invasion

Land rights and native title

Dispossession

Acts of government including assimilation policies

Racism and discrimination

Media

Employment

Poverty

Mortality/morbidity

Police-community relations

Housing

Education

Substance misuse

Acculturation and

Political leverage

Diseases and injuries responsible for high levels of death or disability in Aboriginal and/or Torres Strait Islander populations include:

Coronary heart disease

Respiratory infection

Diabetes

Kidney disease

Suicide/self-harm, family violence/homicide and accidents

Substance misuse (alcohol and other drugs)

Failure to thrive (infants)

Pregnancy and lactation problems

Cardiovascular disease

Cancers

Sexually transmitted diseases

Mental health problems

Oral diseases

Agencies associated with health care services may include:

Community controlled health providers

Women's/men's centres

Government health services

Welfare agencies

Emergency services

Police

Education and training organisations

Non-government and private enterprise

Community Government Councils

Elected community organisations

Homeland/outstation service providers

Churches

Aboriginal and/or Torres Strait Islander health bodies, strategies, policies and resources may include:

National, state/territory and regional Aboriginal and/or Torres Strait Islander health strategies, policies, joint planning bodies

The National Aboriginal and Torres Strait Islander Health Council

The National Aboriginal Community Controlled Health Organisation (NACCHO) and its state/territory affiliates

Resources available nationally, locally and at the state/territory level

National Aboriginal Health Strategy (1989)

ABS publications

Barriers to access and equity in relation to Aboriginal and/or Torres Strait Islander health may include:

Racism, including community and institutionalised racism

Discrimination

Socio-economic status

Access to essential services and infrastructure

Lack of co-ordination of government at all levels

Inadequate resources/funding

Lack of community control and ownership

Lack of political leverage

Language barriers

Disease focus of mainstream health care delivery

Differences in concept of ill health

Geographic access to Primary Health Care and specialist health services

Cultural barriers, such as family and kinship barriers

Language/literacy

Organisation policies and regulatory requirements may include:

Privacy and confidentiality guidelines

Treatment manuals

OH and S guidelines

Infection control guidelines