Measuring attitude change in nursing students after completion of a First Nations peoples’ health unit - Embedding a validated tool in learning and assessment practices

Oct 15, 2026

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Examines whether an Aboriginal and Torres Strait Islander Peoples’ Health and Wellbeing unit changes nursing students’ attitudes toward providing culturally safe care to First Nations peoples. A quasi-experimental study used a validated questionnaire administered before unit materials and at completion. The cohort included all undergraduate nursing students starting the unit in 2020 at a Western Australia university (339 with complete paired data). Results showed a statistically significant attitude shift, supporting targeted educational embedding in learning and assessment.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Summary of relevance

Issue

What is already known

What this paper adds

Introduction

Health inequities and determinants

Accreditation and cultural safety frameworks

Prior curriculum and standards evidence

Measuring attitude change in nursing students after completion of a First Nations peoples’ health unit: Embedding a validated tool in learning and assessment practices Kylie McCullough1, Angela Genoni2, Melanie Murray1, Darren Garvey3 and Linda Coventry1 1 School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027 2 School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027 3 Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, 2 Bradford Street, Mount Lawley, Western Australia 6050 The health inequities experienced by Aboriginal and Torres Strait Islander peoples, rooted in the historical and ongoing negative impacts of colonisation and disrupted traditional lifestyles, sees higher rates of illness and hospitalisations, increased morbidity and higher premature death rates than other Australians. Nurses represent the majority of Australia’s health workforce and nursing students must have knowledge to provide culturally safe care to Australia’s Aboriginal and Torres Strait Islander peoples. An Aboriginal and Torres Strait Islander Peoples’ Health and Wellbeing unit was developed and introduced into an undergraduate nursing curriculum. This project aimed to determine the effectiveness of the unit content in changing the attitude of nursing students towards care of First Nations peoples. A quasi-experimental design was used and included all undergraduate nursing students commencing this unit in 2020 at one university in Western Australia. Students completed a validated questionnaire prior to engaging with unit learning materials and again at completion of the unit. Complete paired data was available for 339 participants. Results demonstrated statistically significant change in attitude following completion of the unit. Embedding targeted education concerning Aboriginal and Torres Strait Islander peoples’ health and wellbeing positively influences attitudes in caring for this population of patients. Keywords: Aboriginal people, cultural competence, First Peoples’ health, Indigenous peoples, nursing student curriculum, transformative learning Summary of relevance Issue: Awareness of cultural health and wellbeing of First Nations people is necessary in nursing and midwifery studies. An assessment tool designed to measure attitude change has been validated but not tested on a large cohort of undergraduate nursing students. What is already known: Cultural safety principles outline the need for critical thinking and transformative unlearning via reflective practice. What this paper adds: Embedding research into learning and assessments is acceptable to students and provides additional evaluation opportunities. Targeted cultural education positively influences nursing student attitudes to care. Introduction Aboriginal and Torres Strait Islander peoples in Australia experience significant health disparities compared to the non-Indigenous population, resulting in higher morbidity and premature deaths (Australian Indigenous HealthInfoNet, 2024) . These inequities are rooted in the historical and ongoing negative impacts of colonisation, which disrupted traditional lifestyles, dispossessed Indigenous peoples of their lands, and imposed foreign systems and values (Biles & Biles, 2020; Paradies, 2016) . Furthermore, intergenerational trauma and loss of cultural identity resulting from colonisation continue to affect mental health and wellbeing (Darwin et al., 2023) . Racism, both systemic and individual, further exacerbates these disparities by limiting access to quality health care, education and employment opportunities, contributing to poorer health outcomes (Bourke et al., 2019; Kairuz et al., 2021; Paradies et al., 2015) . Social determinants of health, including socioeconomic status, education, housing and access to health care, play a crucial role in

FAQs

What was the study trying to determine?

The project aimed to assess the effectiveness of unit content in changing nursing students’ attitudes toward care of First Nations peoples.

How was attitude change measured?

Students completed a validated questionnaire before engaging with unit learning materials and again at the unit’s completion.

What was the main result after students completed the unit?

Completion of the unit produced a statistically significant change in student attitudes, indicating positive influence of targeted education on attitudes toward caring for this patient population.

Oct 15, 2026

Upload by Kurz