The Moving Forward Together series is a collective effort developed to inform, guide and inspire musculoskeletal physical therapists to bring Indigenous health to the forefront of their work in clinical practice, research and education and to strengthen their roles in allyship and advocacy for Indigenous Communities. In the fourth article of the ‘Moving Forward Together’ series, we highlight how physical therapy education can influence, and have responsibility for, improving students’ knowledge and skills to care for Indigenous Peoples who are living with musculoskeletal conditions. Through a collaborative process, our group—comprising Indigenous educators from Aotearoa/New Zealand, Australia and Canada—has reflected on current initiatives, explored future directions, and offered suggestions on how physical therapists can contribute to positive change within Indigenous musculoskeletal education. An interconnected approach positions students to graduate as physical therapists, capable of demonstrating cultural humility to provide reflective, strengths-based and relational culturally-safe healthcare to all people with musculoskeletal conditions.

Background Understanding the experiences of Aboriginal and Torres Strait Islander peoples as healthcare recipients is essential for delivering culturally safe physiotherapy care; however, the literature inadequately explores these experiences. This study aimed to explore the experiences of Aboriginal and Torres Strait Islander peoples who have engaged with physiotherapists and understand their perspectives on how physiotherapists can provide culturally safe care in the community. Methods Semi-structured interviews were conducted with adult (aged >18 years) self-identified Aboriginal and Torres Strait Islander peoples (n = 12) who had received physiotherapy care within a community setting within the previous 3 months. A First Nations methodology approach alongside reflexive thematic analysis was used to interpret the data. Results Four themes were generated: (1) building trust through yarning; (2) acknowledging and respecting culture; (3) creating a culturally safe environment; and (4) the importance of professional training. Conclusions Aboriginal and Torres Strait Islander peoples have expressed that physiotherapists can establish trust with their patients by dedicating time to develop a therapeutic relationship and by demonstrating respect for their culture. It is essential for physiotherapists to carefully consider the physical environment in which they deliver care to ensure it is welcoming and culturally safe for Aboriginal and Torres Strait Islander peoples. Physiotherapists should undertake professional development to immerse themselves in First Nations culture and history through connecting with community. This study offers insights into the lived experiences of Aboriginal and Torres Strait Islander peoples receiving care in the community and provides recommendations that may assist physiotherapists, alongside other community-based health professionals, to provide culturally safe care.

Purpose Physiotherapists play an important role in the provision of safe and effective healthcare for First Nations Australians; however, little is known about how entry-level physiotherapy students can be supported to learn about cultural safety prior to engaging with First Nations Australians in professional healthcare settings. This study aimed to evaluate the effect of an online learning module in developing entry-level physiotherapy students’ cultural capabilities and awareness of cultural safety in preparation for professional practice and delivery of physiotherapy care for First Nations Australians. Methods This mixed methods study was implemented in a population of undergraduate and masters entry-level physiotherapy students at The University of Queensland, Australia. Participants engaged with a series of online modules, underpinned by constructivist pedagogical principles, integrated as a core component of their curriculum studies. Participants completed the Cultural Capability Measurement Tool (CCMT) before and after the intervention, and their perspectives on learning experiences were subsequently explored through qualitative focus group interviews, which were transcribed and subjected to reflexive thematic analysis. Main findings Total CCMT scores were significantly higher following completion of the online module series (n = 52; P < .05) and statistically significant improvements were demonstrated across five individual items (items 5, 18, 19, 20 and 22). Three themes were generated from focus group data (n = 10): establishing a fundamental understanding of cultural safety in preparation for placement; online learning supports self-reflection; and seeking person-to-person reflection and experiences. Principal conclusions The results indicate that physiotherapy students’ cultural capabilities improved after completing the online learning module series. Participants highlighted that the module series developed their foundational knowledge of cultural safety and allowed them to engage in self-reflection prior to practical placement. Participants emphasised the desire to engage in person-to-person reflection following the self-paced online module series and expressed the need for additional opportunities to participate in immersive experiences with First Nations Australians to support their own cultural safety learning journey.

Introduction: There is a considerable and ongoing health gap experienced by First Nations Australians. Physiotherapists play an integral role in the health care of this population; however, little is known about new graduate preparedness and training needs to work in a First Nations context.Objective: To explore the perceptions of new graduate physiotherapists regarding their prepared-ness and training needs for working with First Nation Australians. Methods: Qualitative telephone, semi-structured interviews of new graduate physiotherapists (n = 13) who have worked with First Nations Australians in the last two years. Inductive, reflexive thematic analysis was used.Results: Five themes were generated: 1) limitations of pre-professional training; 2) benefits of work integrated learning; 3) "on the job' development; 4) intrapersonal factors and efforts; and 5) insights into improving training. Conclusion: New graduate physiotherapists perceive that their preparedness to work in a First Nations health context is supported by practical and varied learning experiences. At the pre-professional level, new graduates benefit from work integrated learning and opportunities that evoke critical self-reflection. At the professional level, new graduates express a need for "on the job' development, peer supervision, and tailored professional development, that focuses on the unique perspectives of the specific community in which they work.

Objective This study aimed to explore equity of care for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians within a Queensland-wide musculoskeletal service. Method The service database was analysed between July 2018 and April 2022 across 18 Queensland Health facilities. Representation of Aboriginal and Torres Strait Islander peoples within the service’s patient population was first explored. Second, service and patient-related characteristics and outcomes between Aboriginal and Torres Strait Islander patients and non-Indigenous patients undergoing an episode of care in the service were compared using analysis of variance and chi-squared tests. Results A greater proportion of Aboriginal and Torres Strait Islander peoples (4.34%) were represented within the service’s patient population than in the general population (3.61%) state-wide. Aboriginal and Torres Strait Islander patients presented with a generally higher severity of clinical presentation across measures at initial consult. Very similar proportions of Aboriginal and Torres Strait Islander (63.2%) and non-Indigenous (64.3%) patients reported clinically meaningful treatment benefits. While a higher proportion of Aboriginal and Torres Strait Islander patients (69.7%) were discharged from the service without requiring specialist review compared to non-Indigenous patients (65.6%), Aboriginal and Torres Strait Islander patients had higher rates of discharge due to non-attendance (20.8%) when compared to non-Indigenous (10.6%) patients (P < 0.01). Conclusions Disparity in care retention for Aboriginal and Torres Strait Islander patients compared to non-Indigenous patients was observed within the musculoskeletal service. Consultation with Aboriginal and Torres Strait Islander communities is needed to address access barriers once in the service to guide service improvement.

IntroductionInternationally, there is growing momentum in the physiotherapy profession to improve the cultural safety and capabilities of physiotherapists. In Australia, this is essential given the important role physiotherapists play in the delivery of healthcare to First Nations Australians. Understanding the experiences of the newest members of the profession who work with First Nations Australians is an important step in exploring the broader professions' cultural safety journey.ObjectiveTo explore new graduate physiotherapists' experiences working in First Nations Australian health settings.MethodsThe study used an interpretative phenomenological approach through semi-structured interviews to explore the experiences of seven new graduate physiotherapists, in their first 2 years of practice. All participants worked within a First Nations Australian health setting for some or all of their experience as a new graduate physiotherapist.ResultsThree themes were generated: 1) enrichment through connection; 2) navigating challenges; and 3) a catalyst for self-reflection.ConclusionNew graduate physiotherapists reported positive experiences when working within a First Nations Australian health setting, underpinned by building a strong therapeutic relationship through rapport building; navigating challenges alongside their clients; and delving into critical self-reflection.