The art of yarning in healthcare is bridging cultural gaps and fostering trust between Aboriginal patients and healthcare practitioners in the Midwest. Clinical Yarning is the brainchild of Professor Dawn Bessarab, Dr Charmaine Green and Dr Ivan Lin.
Through their collaborative efforts, they’re changing the way healthcare professionals engage with Aboriginal patients, ensuring communication is patient-centred, respectful and effective.
“Many years ago, Professor Dawn Bessarab developed a framework for qualitative research in Aboriginal health settings called Research Yarning,” Dr Ivan Lin said.
“This framework emphasised the importance of conversational and respectful dialogue in research, which inspired Dr Charmaine Green, a Yamatji elder, to adapt this approach for clinical settings. “The adaptation process started during co-teaching sessions with students in Geraldton, where Charmaine and I noticed some shortcomings in how healthcare students interacted with Aboriginal community members.”
“We were constantly prompting these students not to interrogate but to engage in friendly and conversational dialogue.” This observation led to the birth of Clinical Yarning, a model that integrates social, diagnostic, and management yarning into clinical practice.
“Traditional healthcare consultations often follow a rigid question-and-answer format, which can be off-putting for patients with previous negative experiences in healthcare,” he said.
“Clinical Yarning, on the other hand, encourages a more fluid and patient-led conversation. It comprises three key components: the social yarn, the diagnostic yarn and the management yarn.”
“A social yarn is the initial phase, which focuses on building a connection with the patient, recognising them as a person rather than just a health condition. It’s about making the patient comfortable and establishing trust.
“The diagnostic yarn is when healthcare providers gather necessary information through a conversational approach. It’s patient-led, allowing the patient to share their story and experiences in their own words.
“The management yarn is the collaborative phase which involves creating a care plan together, ensuring that health information is conveyed in ways the patient can relate to and understand. It often includes using metaphors and culturally relevant explanations.”
Ivan said Clinical Yarning borrowed from the traditional yarning processes, which made patients more comfortable leading to improved treatment. “It’s not prescriptive; it’s very much patient-led,” he said.
Since publishing their first paper on the model in 2016, Ivan and his colleagues have worked to integrate Clinical Yarning into various healthcare settings. “We have a partnership with WA Country Health Service (WACHS) Midwest to implement it across the region,” he said. “Both WACHS and WA Primary Health Alliance have been very supportive, and our e-learning program has been completed by more than 3,000 clinicians and students across Australia.”
Ivan believes Clinical Yarning is extremely important when working with Aboriginal people, something he personally saw when working on his PhD research.
“Continuity of care is crucial but that’s not always possible in remote areas, so it’s important to build trust. Building trust is incredibly powerful in changing people’s perceptions of healthcare. Good communication is fundamental to quality healthcare and can improve patient experiences, increase trust and enhance understanding of health conditions,” Ivan said.
“When completing my PhD, I interviewed Aboriginal people with chronic back pain which highlighted some of the communication barriers Aboriginal people face. “Aboriginal people much preferred to have a better relationship and yarn with somebody, which addresses some of the communication barriers. “It’s also something that can be changed relatively easily compared to the more complex systemic issues in healthcare.”
Ivan said he felt privileged to be working to develop Clinical Yarning. “The combination of clinical work, research, and teaching is fantastic, and it’s been a team effort all the way through,” he said.
“It’s been a partnership with First Nations and non-First Nations colleagues and working with inspiring people has been a highlight of my career.” Going forward, the team is focused on ensuring that the approach translates into positive patient experiences and outcomes.
“We’ve had a lot of good feedback from clinicians who like it and we are seeking a strong patient perspective in the next phase,” he said.
To learn more about Clinical Yarning visit www.clinicalyarning.org.au