# Online Learning to Support Culturally Safe Communication with First Nations Australians in Radiation Therapy: A Pre-Post Intervention Study

## TL;DR

An online training program improved healthcare professionals' confidence and skills in providing culturally safe radiation therapy to First Nations Australians.

## Contribution

A novel online learning program was developed and evaluated to enhance culturally safe communication with First Nations cancer patients.

## Key findings

- Participants showed significant increases in confidence and preparedness to support First Nations patients after training.
- 95% of participants rated the online modules as good or excellent.
- The training program is likely to improve trust and communication between healthcare professionals and First Nations patients.

## Abstract

Culturally safe communication is essential for supporting First Nations Australians undergoing radiation therapy. First Nations Australian patients, however, often face barriers in accessing culturally safe communication and cancer care. This study evaluates changes in healthcare professionals’ (HCPs) confidence, skills, and knowledge in culturally safe communication with First Nations cancer patients after completing an online learning program.

This single group pre-post intervention study recruited HCPs from three regional Australian cancer centres. Pre- and post-training surveys, administered via Qualtrics, assessed self-reported confidence, knowledge, and communication skills for engaging with First Nations radiation therapy patients. Participants completed an online learning program consisting of three self-directed modules focused on cultural competency, health literacy and communication, and application of an Indigenous radiation therapy talking book resource. The post-training survey also included module evaluation items. Pre- and post-training data were analysed using paired-sample t-tests (α = 0.05). Descriptive statistics and content analysis were applied to evaluate participant feedback.

Of the 49 participants recruited, 38 participated in this study, most were non-Indigenous (94.7%), 52.6% were radiation therapists, and 65.8% reported seeing between 11-50 First Nations Australian patients annually. The participants’ mean confidence in communicating with First Nations Australian patients increased from 3.50 to 4.03 (p = 0.006), and preparedness to support patient needs rose from 3.55 to 3.95 (p = 0.04). The online modules were highly rated as good or excellent by 95% of participants.

The findings demonstrate that tailored online learning modules can significantly enhance HCP’s self-reported confidence, skills, and knowledge in communicating with First Nations cancer patients receiving radiation therapy. Integrating training into routine practice may promote more culturally responsive cancer care, strengthening engagement and support for First Nations Australian radiation therapy patients.

Why this research matters: Culturally safe communication helps First Nations Australians feel respected, understood, and supported during cancer treatment. Yet, many First Nations people experience barriers to culturally safe care when receiving radiation therapy. To help improve this, our research evaluated an online training program for healthcare professionals (HCPs) in communicating well with First Nations Australians receiving radiation therapy.

What we did: We invited radiation therapy HCPs to complete three self-directed online learning modules. These modules focused on understanding culture, improving communication, and using a resource called the Indigenous Radiation Therapy Talking Book to support communication with patients. Participants completed surveys before and after the online learning program to see if their knowledge, confidence and skills in culturally safe communication improved.

What we found: Thirty-eight HCPs participated in this study. After completing the training, most reported feeling more confident, knowledgeable, and better prepared to communicate with First Nations patients. Almost all rated the modules as good or excellent.

Why this is important: Our findings show that an online training program designed to improve culturally safe communication can help HCPs to provide more respectful and responsive care. Implementation of this training program is likely to improve trust and communication between HCPs and First Nations Australians receiving radiation therapy.