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

Context of assessment:

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

Assessment must therefore be undertaken by a assessors who is qualified as per the relevant NVR standards/AQTF standard 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

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

Assessment should replicate workplace conditions as far as possible.

Access must be provided to appropriate learning and/or assessment support when required. Where applicable, physical resources should include equipment modified for people with disabilities.

Reasonable adjustments can be made to ensure equity in assessment for people with disabilities. Adjustments include any change to the assessment process or context that meet individual needs of the person with disability, but do not change the competency outcome.

When assessing people with disabilities, assessors are encouraged to apply good practice assessment methods with sensitivity and flexibility

Interdependence of units:

This unit may be assessed independently although it is maybe delivered and assessed in conjunction with other units, with associated workplace application

Access and equity considerations:

All workers in the health industry should be aware of access and equity issues in relation to their own area of work

All workers should develop their ability to work in culturally and linguistically diverse (CALD) environments

In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people

Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

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:

Epidemiology and pathophysiology:

Common signs and symptoms that aid early detection of cancer

How cancer is detected and treated

The basic definition of cancer and how cancer multiplies and spreads (the ‘weed’ analogy)

The outcomes for Aboriginal and Torres Strait Islander people and why outcomes are generally worse than other Australians

The statistical incidence of the main cancers affecting Aboriginal and Torres Strait Islander people including the common cancers affecting men and women

Prevention and risk factors

An understanding of how the social determinants of health affect well being in relation to family, community and culture

An understanding that Aboriginal and Torres Strait Islander people face a much higher burden of tobacco related cancers

Ways to prevent or reduce the risk of cancer including lifestyle associated risk factors such as smoking, alcohol, physical inactivity, overweight, obesity, poor diet, overexposure to sunlight, unsafe sex, Hepatitis B, Human Papilloma Virus (HPV) and the role of vaccinations

Screening and early detection

Factors that influence an individual’s decision to participate in screening programs relevant to Aboriginal and Torres Strait Islander communities

The benefits of early diagnosis

The difference between cancer screening and early detection

The three national screening programs available for breast screening, cervical screening,, and bowel cancer

The value of an opportunistic approach to cancer screening when clients present at the clinic or health service

Treatment:

Relationship of evidence based treatments to bush medicine/complementary therapies

Methods that are patient choice lead and individualised to cultural values of people under treatment:

Methods whereby multi-disciplinary team (MDT) principles and practice (including supportive care needs) are identified before treatment starts

The common forms of treatment including surgery, radiotherapy, chemotherapy, non-active and traditional healing

The locations of where treatment options and support services are available

The importance of patient choices (including the engagement of traditional healers and adherence to religious belief systems)

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

Current recommendations

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 in this process

Current recommendations can be from the Cancer Council or the National Health and Medical Research Council (NHMRC), including the three national population screening programs

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

Support for clients with cancer and their families in Aboriginal and/or Torres Strait Islander communities may include but is not limited to:

All the following areas in line with health service guidelines and identified protocols:

Aboriginal and Torres Strait Islander agencies and networks coordinating care for clients who have experienced cancer and their families

Referral agencies (eg: Cancer Council Helpline)

Strategies to communicate with clients, their families, and service providers

The ‘people you meet’: The roles of people accessible during the cancer journey from screening through to palliation

The emotional and psychosocial impact of cancer diagnosis and treatment.

The importance of responding appropriately to ‘women’s business’ and ‘men’s business’ for clients with cancer

Ways of supporting clients in the ‘survivorship’ (recovery) stage including information about the importance of follow-up checks and re-treatment options

Ways to address the psychological stress of being a survivor

Ways to judge the appropriate time and to use appropriate language to talk about the principles and philosophy of palliative care

Ways to support clients and their families suffering loss and grief

Information includes:

Plain English information available from:

Cancer Australia

Cancer Council Australia

Plain English background information to cancer available on Australian Indigenous HealthInfoNet

Impacts of cancer include:

Impacts on Aboriginal and Torres and Torres Strait Islander people specifically.

Visual aids include:

Flip charts, models, anatomy models, charts, games, DVDs, ‘talking posters’ and computer programs

Risk factors include:

Lifestyle factors, including:

Alcohol

Hepatitis B infection

Human Papilloma Virus (HPV) infection

Over exposure to ultraviolet radiation

Physical inactivity

Poor nutrition

Smoking

The role of vaccinations

Unhealthy weight

Screening programs include:

The three national population based screening programs are for breast cancer, bowel cancer and cervical cancer

Early detection includes:

The benefits of early detection through:

Faecal Occult Blood Test

Mammographic screening

Papanicolaou Test

Culturally appropriate educational resources include:

Resources with a cultural perspective of cancer

Patient choice lead includes:

The imperative of respecting the client’s choice regarding treatment

Appropriate referrals include:

Agencies that may be of use to an AHW in developing a network for clients. For example:

Aboriginal Liaison Officers in major hospitals

Cancer Cancer Helpline

Cancer Nurse Coordinators

Hospital based social workers

Integrated services between hospitals and communities of origin, for regional and remote Aboriginal people (eg Kanggawodli in SA)

Computer information systems include:

Client management systems used by Aboriginal Community Controlled (and other) health services, e.g.

Communicare

Medical Director

Project Ferret

Palliation includes:

Understanding of the care approach which improves the quality of life of patients and their families facing terminal illnesses. It includes the principles of prevention and relief of suffering by means of early identification, assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual

Social and environmental factors that impact on cancer may include but are not limited to:

Broad understanding of the social determinants of health and ways to address disadvantage including:

Access to education and employment

Access to healthy and affordable food

Access to medical services and medicines

Access to reliable transport

Access to screening programs

Regular physical activity programs (such as sport and recreational activities)