We’re so proud of our 2022 Australian Research Council (ARC) Discovery Early Career Researcher Award (DECRA) recipients. Dr Laura Rademaker and Dr Maria Dahm are working on important projects that will engage with people in our communities and professions, inform decision makers, and help make a difference. And we want you to hear from them about their work ahead.
Dr Laura Rademaker from the School of History is the Deputy Director of the Research Centre for Deep History at ANU. Laura has long worked with First Nations communities in northern Australia to help reveal and record their stories. Her 2018 book Found in Translation: Many Meanings on a North Australian Mission told the stories of the Anindilyakwa-speaking people of Groote Eylandt and their interactions with Christian Missionaries. It was a book made possible by the productive relationships and trust Laura built with communities over time, and the innovative research methods she employed.
Her project is titled Self-determination for Indigenous Australia: histories, visions and voice.
What has been the approach to self-determination for Indigenous communities in NT, and where has it been successful?
At the moment I’m writing about the community controlled sector as a successful example of self-determination. And its successes in relation to the COVID epidemic have been outstanding. Indigenous health organisations and bodies such as land councils have led the way in protecting Indigenous communities from the virus and in promoting vaccination. I would say that they have, at times, put government to shame and that governments have lagged behind Indigenous leadership on the pandemic.
What sort of research and collaboration will this DECRA support and who will you be working with on it?
I’m hoping to continue working with communities I’ve already worked with across the Top End of the Northern Territory. In particular, I’m looking forward to speaking with elders who remember the transition from assimilation to self-determination in the early 1970s about their experiences of that time. I’m also really hoping to work with communities to produce outputs that will be useful for them, particularly for communicating their histories to the next generation of emerging leaders. But, of course, that’s all open ended; it depends on what communities are going to find most useful.
What real world outcome would you like to see from your project?
Ultimately, I hope that my findings will make a useful contribution national discussions around treaty, sovereignty and, of course, self-determination through revealing some of the historical lineages of these debates. I hope that but understanding our past, we can imagine and work towards better futures, especially for Indigenous Australians. But more practically, I also hope the project produces outputs that the communities I work with will find useful for sharing their histories and that it might contribute to training a new generation of leaders, researchers and story-tellers.
Dr Mary Dahm is a Research Fellow at the Institute for Communication in Health Care (ICH). As a linguist, she analyses how the little (or big) things we do (or don't do) with language impact on patient safety and quality of care. She combines her passion for patient-centred health research with her interdisciplinary expertise in qualitative and mixed methods approaches in health communication and health services research. She has collaborated with clinicians, health consumer representatives, and patients on a wide range of health communication topics including patient-centred communication, clinical handovers, surgical risk communication, health information infrastructure, and rapport and trust in consultations.
She is working on a project called Addressing the challenge of communicating uncertainty in diagnosis.
What is "uncertainty" in healthcare and when is someone reading this article likely to have experienced it firsthand?
Uncertainty is everywhere in healthcare. I’m particularly interested in uncertainty during diagnosis, which is when clinicians feel unable to give the patient an accurate explanation for their health problem. We would all be familiar with experiencing back pain or a tummy ache. But how do we know what is causing the pain? Is it just an upset stomach, or something more serious like appendicitis or endometriosis? Because the symptoms are not clearly pointing towards a diagnosis we often face initial or prolonged uncertainty. That means more tests, examinations, doctor visits and maybe even referrals to specialist to find out what is wrong.
What's interesting for me is how clinicians address this uncertainty. Do they address it head on, remain silent or just allude to it? And how do these differences in clinician communication affect the way patients access and receive further health care?
What sort of research and collaboration will be involved in this project?
I will be working with clinicians and patients recording their interactions in emergency departments, for example in Melbourne, to understand how clinicians communicate uncertainty during diagnosis in this context. I'm also really excited about working with health consumer researchers who will collaborate with me in the analysis of the collected interactional data. Health consumers are rarely involved in the analytical stage of research projects so this will be really innovative. I will also work with policymakers, experts in diagnosis research, clinician stakeholders and consumer advocacy groups from a range of national and international organisations including the US Society to Improve Diagnosis in Medicine, and Health Consumers NSW. The collaborations will help me to get findings to where they need to go at the frontline in Emergency departments and to patients.
What real world outcome would you like to see from your project?
One of the planned outcomes of this project is communication frameworks co-developed with health consumers and clinicians. I would like to see these communication frameworks put into practice at the frontline through collaboration partners involved in emergency medical specialist colleges and patient advocacy organisations. This would give both doctors and patients the opportunity to become more aware of how important interpersonal communication and expressions of uncertainty are in the diagnostic process. Such increased awareness will help both parties be more aware of potential misunderstanding and hopefully prevent misdiagnosis, which affects an estimated 140,000 patients in Australia every year and I'd also be excited to gain some recognition of diagnosis in the health policy sector which can lead to improving diagnosis across the health spectrum.