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The book uses critical sociolinguistic analysis to examine the social consequences of courtroom talk. The focus of the study is the cross-examination of three Australian Aboriginal boys who were prosecution witnesses in the case of six police officers charged with their abduction. The analysis reveals how the language mechanisms allowed by courtroom rules of evidence serve to legitimize neocolonial control over Indigenous people. In the propositions and assertions made in cross-examination, and their adoption by judicial decision-makers, the three boys were constructed not as victims of police abuse, but rather in terms of difference, deviance and delinquency. This identity work addresses fundamental issues concerning what it means to be an Aboriginal young person, as well as constraints about how to perform or live this identity, and the rights to which Aboriginal people can lay claim, while legitimizing police control over their freedom of movement. Understanding this courtroom talk requires analysis of the sociopolitical and historical actions and structures within which the courtroom hearing was embedded. Through this analysis, the interrelatedness of structure, agency, constraint and change, which is central to critical sociolinguistics, becomes apparent. In its investigation of language ideologies that underpin courtroom talk, as well as the details of how language is used, and the social consequences of this talk, the book highlights the need for far-reaching changes to courtroom rules of evidence.

This study aimed to compare characteristics of nurse educators, factors related to teaching global nursing, contents of global education and support and the level of burden of global education and factors related to the burden between nurse educators among top nursing universities in Japan and four English-speaking countries. Intercultural sensitivity is the active desire to motivate oneself to understand, appreciate and accept different cultures. Nurse educators need to be culturally sensitive to teach cultural care to nursing students. This is a cross-sectional exploratory international comparative study using an online survey. Participants were nurse educators with a nurse license in the top 20 in Japan and the top 10 universitiesin the United States, Canada, United Kingdom and Australia (hereafter “English-speaking countries”), respectively. The questions in Google form selected participants by the inclusion criteria. Intercultural sensitivity was measured by the Intercultural Sensitivity Scale. Chi-square test, Fisher’s exact test, t-test, Mann-Whitney U test and Spearman’s correlation coefficients were used for the analyses. Data were collected from October 2023 to January 2024. A total of 144 in Japan (response rate=29.0 %) and 106 educators in English-speaking countries (response rate=2.4 %) were included in the analysis. Nurse educators in Japan had less work experience in foreign countries, had fewer opportunities to take part in cross-cultural interactions and had significantly lower intercultural sensitivity. In both groups, those who had more experience in foreign countries with higher intercultural sensitivity taught global nursing. While in Japan nurse educators who had higher proficiency in non-native languages and those who had more frequently taken part in cross-cultural interactions taught global nursing, in English-speaking countries full-time workers who had attended international academic conferences taught. In Japan, global nursing was a more optional course and the number of contents taught was lower. While participants in Japan had international seminars at universities as support for global nursing education, those in English-speaking countries had faculty members with different cultural backgrounds. Participants in Japan felt more burden for global nursing education. In Japan, more proficient non-native language, more frequent cross-cultural interaction and higher intercultural sensitivities were associated with a lower burden, while teaching other than in their native language, contents taught and performance evaluation were associated with a higher burden in English-speaking countries. Higher intercultural sensitivity, performance evaluation and proficiency in non-native language may be important for nurse educators to teach global nursing and support is necessary to enhance them.

Background Overseas study trips can enhance healthcare students’ intercultural communication competence. An opportunity to immerse in the new culture enables them to develop their ability to offer services to people from different countries. However, the role that open-mindedness (i.e., a personality trait) can play in this process has not been explored. Methods The present study adopted a mixed-method design to identify how open-mindedness trait affected this overseas learning process. Thirty-two undergraduate healthcare students in Australia took part in the study. Questionnaires, which measured socio-demographic information, intercultural communication competence and open-mindedness trait were administered to the participants before and after their overseas trip. Half of the participants ( n  = 16) were interviewed after the overseas trip. Results The correlational analysis showed that the open-mindedness trait was correlated with cultural skills, a component of intercultural communication competence, but not significant with the other three components. Three themes emerging from the qualitative data indicated that the open-mindedness trait affected students’ cultural exposure. This trait enabled participants to be actively involved in the immersion in the local culture. They were willing to learn from peer fellows, and keen to embrace novel challenges. Conclusion It is concluded that open-mindedness trait is vital for increasing cultural immersion, and hence promote intercultural communication skills.

To secure protection in the global North, asylum-seekers must overcome restrictive government policies and present a convincing refugee narrative. Their credibility becomes their main asset and must survive the multiple challenges arising from intercultural communication and interactions involving multiple institutional actors. Aiming to explore the impact institutional understandings of refugee narrative creation have on credibility assessment, I present the findings of an analysis of a corpus of documents from the Australian tribunal responsible for the administrative review of asylum decisions. I critically analyse these texts to identify how the tribunal and its agents discursively present the various actors involved in asylum appeals. I argue that despite the cautions of existing scholarship, these texts present the asylum-seeker as the sole author of the final refugee narrative, regardless of the role that decision-makers and other actors, such as lawyers and interpreters, play in its co-construction. Thus, the institution places disproportionate responsibility on the asylum-seeker for communication outcomes, creating significant challenges for their credibility.

Background In hospitals globally, patient centred communication is difficult to practice, and interpreters are underused. Low uptake of interpreters is commonly attributed to limited interpreter availability, time constraints and that interpreter-medicated communication in healthcare is an aberration. In Australia’s Northern Territory at Royal Darwin Hospital, it is estimated around 50% of Aboriginal patients would benefit from an interpreter, yet approximately 17% get access. Recognising this contributes to a culturally unsafe system, Royal Darwin Hospital and the NT Aboriginal Interpreter Service embedded interpreters in a renal team during medical ward rounds for 4 weeks in 2019. This paper explores the attitudinal and behavioural changes that occurred amongst non-Indigenous doctors and Aboriginal language interpreters during the pilot. Methods This pilot was part of a larger Participatory Action Research study examining strategies to achieve culturally safe communication at Royal Darwin Hospital. Two Yolŋu and two Tiwi language interpreters were embedded in a team of renal doctors. Data sources included interviews with doctors, interpreters, and an interpreter trainer; reflective journals by doctors; and researcher field notes. Inductive thematic analysis, guided by critical theory, was conducted. Results Before the pilot, frustrated doctors unable to communicate effectively with Aboriginal language speaking patients acknowledged their personal limitations and criticised hospital systems that prioritized perceived efficiency over interpreter access. During the pilot, knowledge of Aboriginal cultures improved and doctors adapted their work routines including lengthening the duration of bed side consults. Furthermore, attitudes towards culturally safe communication in the hospital changed: doctors recognised the limitations of clinically focussed communication and began prioritising patient needs and interpreters who previously felt unwelcome within the hospital reported feeling valued as skilled professionals. Despite these benefits, resistance to interpreter use remained amongst some members of the multi-disciplinary team. Conclusions Embedding Aboriginal interpreters in a hospital renal team which services predominantly Aboriginal peoples resulted in the delivery of culturally competent care. By working with interpreters, non-Indigenous doctors were prompted to reflect on their attitudes which deepened their critical consciousness resulting in behaviour change. Scale up of learnings from this pilot to broader implementation in the health service is the current focus of ongoing implementation research.

Background First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. Methods Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia’s Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick’s evaluation model. Results Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. Conclusion The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.

Internationalization and the concomitant flow of cultural diversity often associated with it are highly prized by universities; many tertiary institutions claim internationalization of the campus, the curriculum, research, and the student body as a major goal, a key performance indicator. However, in the current climate of global international education, overseas student integration and their adjustment difficulties into the life of the host country are often posited as personal failures, and international education scholarship focuses heavily on the failure of international students to integrate into host societies. We question the assumptions underpinning the tendency of universities to link internationalization to the development of interculturality across the campus through bringing together students from different national backgrounds. The belief is that students seek such interactions; internationalization could be achieved through such simplistic practices; this assumption needs empirical scrutiny. In this focused study, we report the motivations and experiences of 24 Chinese international students in an Australian university. A significant majority of the participants reported little interest in intercultural interactions with both host national students and other international students outside their own cultural groups. For those who have hopes of becoming some form of “global citizen,” the experiences of these Chinese students suggest that cross-cultural communication is not as successful as hoped in the spaces of encounters, including classrooms, university student accommodation, and social activities out of the classrooms. The voices of these students suggest the need for intervention in the realization of the internationalization vision held by most universities and a reframing of goals and practices to narrow the breach between lofty rhetoric and the practice of international education.

Background Aboriginal cultural awareness training aims to build a culturally responsive workforce, however research has found the training has limited impact on the health professional’s ability to provide culturally safe care. This study examined cultural awareness training feedback from healthcare professionals working with high Aboriginal patient caseloads in the Top End of the Northern Territory of Australia. The aim of the research was to assess the perception of training and the potential for expansion to better meet workforce needs. Methods Audit and qualitative thematic analysis of cultural awareness training evaluation forms completed by course participants between March and October 2018. Course participants ranked seven teaching domains using five-point Likert scales (maximum summary score 35 points) and provided free-text feedback. Data were analysed using the Framework Method and assessed against Kirkpatrick’s training evaluation model. Cultural safety and decolonising philosophies shaped the approach. Results 621 participants attended 27 ACAP sessions during the study period. Evaluation forms were completed by 596 (96%). The mean overall assessment score provided was 34/35 points (standard deviation 1.0, range 31-35) indicating high levels of participant satisfaction. Analysis of 683 free text comments found participants wanted more cultural education, designed and delivered by local people, which provides an opportunity to consciously explore both Aboriginal and non-Aboriginal cultures (including self-reflection). Regarding the expansion of cultural education, four major areas requiring specific attention were identified: communication, kinship, history and professional relevance. A strength of this training was the authentic personal stories shared by local Aboriginal cultural educators, reflecting community experiences and attitudes. Criticism of the current model included that too much information was delivered in one day. Conclusions Healthcare providers found cultural awareness training to be an invaluable entry point. Cultural education which elevates the Aboriginal health user’s experience and provides health professionals with an opportunity for critical self-reflection and practical solutions for common cross-cultural clinical encounters may improve the delivery of culturally safe care. We conclude that revised models of cultural education should be developed, tested and evaluated. This requires institutional support, and recognition that cultural education can contribute to addressing systemic racism.

Introduction Access to culturally appropriate healthcare is vital to ensure refugee and migrant women receive optimal care, particularly during the perinatal period. Refugee and migrant women report lower satisfaction with pregnancy care due to language barriers and a perceived lack of understanding of their needs. The aim of this study is to explore how to improve the experiences of migrant and refugee women with maternal health services through the lens of cultural humility. Methods Working collaboratively with maternal health service providers and managers and local refugee and migrant women, this research project used a World Café methodology to provide these stakeholders with an opportunity to discuss maternal healthcare in the region. World Café participants (n = 34) included women from multicultural backgrounds (n = 20), maternal healthcare providers such as midwives, social workers and management (n = 5) multicultural healthcare providers (n = 7) and a community‐based birth educator (n = 1). Data were analysed thematically. Results A key finding of the World Café was the need for staff training that is co‐designed and co‐delivered with members of multicultural communities and healthcare providers to enhance the practice of cultural humility. Training should focus on women's stories that capture the cultural nuances around pregnancy and birthing, their support needs including trauma‐informed care, and the importance of effective cross‐cultural communication. Conclusion This research gave refugee and migrant women a voice in future decision‐making, specifically in maternal health staff training. The refugee and migrant women shared their perspectives on how to enhance cultural humility practices in maternity services for them. The research has led to opportunities such as community‐based antenatal classes and improvements in maternity services development strategies. Public Contribution The project actively engaged with maternal healthcare providers, multicultural and refugee healthcare providers and women from multicultural communities in the design of the project and as participants. Their expertise and experience have been invaluable and have informed pilot programmes that emerged from this study.