Raising the voice of dissatisfaction : a qualitative study of the Queensland acute health care consumer and the experience of complaining

Research into complaints handling in the health care system has predominately focused on examining the processes that underpin the organisational systems. An understanding of the cognitive decisions made by patients that influence whether they are satisfied or dissatisfied with the care they are receiving has had limited attention thus far. This study explored the lived experiences of Queensland acute care patients who complained about some aspect of their inpatient stay. A purposive sample of sixteen participants was recruited and interviewed about their experience of making a complaint. The qualitative data gathered through the interview process was subjected to an Interpretative Phenomenological Analysis (IPA) approach, guided by the philosophical influences of Heidegger (1889-1976). As part of the interpretive endeavour of this study, Lazarus’ cognitive emotive model with situational challenge was drawn on to provide a contextual understanding of the emotions experienced by the study participants. Analysis of the research data, aided by Leximancer™ software, revealed a series of relational themes that supported the interpretative data analysis process undertaken. The superordinate thematic statements that emerged from the narratives via the hermeneutic process were ineffective communication, standards of care were not consistent, being treated with disrespect, information on how to complain was not clear, and perceptions of negligence. This study’s goal was to provide health services with information about complaints handling that can help them develop service improvements. The study patients articulated the need for health care system reform; they want to be listened to, to be acknowledged, to be believed, for people to take ownership if they had made a mistake, for mistakes not to occur again, and to receive an apology. For these initiatives to be fully realised, the paradigm shift must go beyond regurgitating complaints data metrics in percentages per patient contact, towards a concerted effort to evaluate what the qualitative complaints data is really saying. An opportunity to identify a more positive and proactive approach in encouraging our patients to complain when they are dissatisfied has the potential to influence improvements.

Queensland Business Women Stories

These projects build on the research of Klaebe and Burgess into digital story-telling, specifically variable workshop scenarios, co-creative media, participatory public history, and the development of co-creative production processes for cultural institutions. The projects represented a partnership between QUT and the State Library of Queensland. The Five Senses project focused on the distributed digital storytelling workshop model and the development of audiences for digital storytelling. The team worked with regional artists whose work had been selected for inclusion in the Five Senses exhibition at the State Library of Queensland to produce stories about their work; these works were then integrated into the physical exhibition space. The Queensland Businesswomen project produced four digital stories profiling the lives of leading Queensland businesswomen. The digital story telling workshop model was disbanded and research teams worked individually with participants to create the digital stories. Academic research and oral history interviews were conducted initially to foreground these productions. This pilot led to a larger project, Business Leaders Hall of Fame, which now has a dedicated viewing room in the SLQ sponsored by an annual silver service dinner event. With the Responses to the Apology project, which stimulated similar projects in Mt Isa and Cairns, the research team worked with Indigenous facilitators, and the participants created their digital stories with assistance from these facilitators and the QUT research team using a mix of workshop and individual meetings. The research component of the work relates to the further development of co-creative production processes for cultural institutions, involving a wide range of institutional and individual partners, while authentically representing the intensely personal perspectives of each of the primary participants. The Queensland Business Leaders Hall of Fame was a research project that included interviews with eminent Queenslanders that produced oral history interviews and digital stories about the achievements of both Queensland personalities and businesses. This model was able to test and evaluate the use of oral history and digital storytelling for learning and community heritage purposes. Interviewees include; Sir John and Valmai Pidgeon, Joseph Saragossi, Robert Bryan, Clem Jones, Jim Kennedy, Sr Angela Mary, Castelmaine Perkins, Burns and Philp, Qantas, Don Argus & Steve Irwin All digital stories, oral history interviews and transcripts were accessioned into the library collection – an international first for digital stories. Two publications in refereed journals have resulted, and the digital stories are stored in the SLQ permanent collection for the benefit of national and international scholars and the general public.

Saying sorry in the 21st century : public apologies in a digital world

The public apology to the Forgotten Australians in late 2009 was, for many, the culmination of a long campaign for recognition and justice. The groundswell for this apology was built through a series of submissions which documented the systemic institutionalised abuse and neglect experienced by the Forgotten Australians that has resulted, for some, in life-long disadvantage and marginalisation. Interestingly it seems that rather than the official documents being the catalyst for change and prompting this public apology, it was more often the personal stories of the Forgotten Australians that resonated and over time drew out quite a torrent of support from the public leading up to, during and after the public apology, just as had been the case with the ‘Stolen Generation.’ Research suggests (cite) that the ethics of such national apologies only make sense if their personal stories are seen as a collective responsibility of society, and only carry weight if we understand and seek to Nationally address the trauma experienced by such victims. In the case of the Forgotten Australians, the National Library of Australia’s Forgotten Australians and Former Child Migrants Oral History Project and the National Museum’s Inside project demonstrate commitment to the digitisation of the Forgotten Australians’ stories in order to promote a better public understanding of their experiences, and institutionally (and therefore formally) value them with renewed social importance. Our project builds on this work not by making or collecting more stories, but by examining the role of the internet and digital technologies used in the production and dissemination of individuals’ stories that have already been created during the period of time between the tabling of the senate inquiry, Children in Institutional Care (1999 or 2003?) and a formal National apology being delivered in Federal Parliament by PM Kevin Rudd (9 Nov, 2009?). This timeframe also represents the emergent first decade of Internet use by Australians, including the rapid easily accessible digital technologies and social media tools that were at our disposal, along with the promises the technology claimed to offer — that is that more people would benefit from the social connections these technologies allegedly were giving us.

Coping with aggressive driving : driver accounts of how they manage themselves and others to reduce conflict on the road

Dealing with the aggression of other drivers on the road is an important skill given that driving is a common activity for adults in highly motorised countries. Even though incidents of extreme aggression on the road (such as assault) are reportedly rare, milder forms, some of them dangerous (such as tailgating or deliberately following too closely) are apparently common, and may be increasing. At the very least, this is likely to render the driving environment more stressful, and at worst elevates the risk of crashing by increasing both the level of risky driving behaviours and the likelihood of responses that escalate the situation. Thus the need for drivers to manage incidents of conflict is likely to become increasingly important. However, little research examines how drivers manage their own or others’ aggressive driving behaviour. Recently greater attention has been paid to driver cognitions, especially the attributions that drivers make about other drivers, that then might influence their own driving responses, particularly aggressive or risky ones. The study reported below was the first in a larger exploration of aggressive driving that focussed on driver cognitions, emotions and underlying motivations for aggressive behaviours on the road. Qualitative, in-depth interviews of drivers (n = 30, aged 18-49 years) were subjected to thematic analysis to investigate driver experiences with aggressive driving. Two main themes were identified from these accounts: driver management of self; and driver attempts to influence or manage other drivers. This paper describes the subthemes falling under the management of self main theme. These subthemes were labelled ‘being magnanimous’, ‘chilling out’, ‘slowing down’, and ‘apology/acknowledgment’. ‘Being magnanimous’ referred to situations where the respondent perceived him/herself to be a recipient of another’s aggressive driving and made a deliberate choice not to respond. However, a characteristic of this sub-theme was that this choice was underpinned by the adoption of morally superior stance, or sense of magnanimity. ‘Chilling out’ was a more general response to both the milder aggressive behaviours of other drivers and the general frustrations of driving. ‘Slowing down’ referred to reducing one’s speed in response to the perceived aggressive driving, often tailgating, of another. This subtheme appeared to consist of two separate underlying motivations. One of these was a genuine concern for one’s own safety while the other was more aimed at “getting back” at the other driver. ‘Apology’ referred to how drivers modified their more negative reactions and responses when another driver made gestures that acknowledged their having made a mistake, indicated an apology, or acknowledged the recipient driver. These sub-themes are discussed in relation to their implications for understanding aggressive driving and intervening to reduce it.

The role of the internet and digital technologies in the struggle for recognition of the forgotten Australians

Our contemporary public sphere has seen the 'emergence of new political rituals, which are concerned with the stains of the past, with self disclosure, and with ways of remembering once taboo and traumatic events' (Misztal, 2005). A recent case of this phenomenon occurred in Australia in 2009 with the apology to the 'Forgotten Australians': a group who suffered abuse and neglect after being removed from their parents – either in Australia or in the UK - and placed in Church and State run institutions in Australia between 1930 and 1970. This campaign for recognition by a profoundly marginalized group coincides with the decade in which the opportunities of Web 2.0 were seen to be diffusing throughout different social groups, and were considered a tool for social inclusion. This paper examines the case of the Forgotten Australians as an opportunity to investigate the role of the internet in cultural trauma and public apology. As such, it adds to recent scholarship on the role of digital web based technologies in commemoration and memorials (Arthur, 2009; Haskins, 2007; Cohen and Willis, 2004), and on digital storytelling in the context of trauma (Klaebe, 2011) by locating their role in a broader and emerging domain of social responsibility and political action (Alexander, 2004).

The role of the internet in testimony : the case of the ‘Forgotten Australians’

This paper examines the case of the Forgotten Australians as an opportunity to examine the role of the internet in the presentation of testimony. ‘Forgotten Australians’ are a group who suffered abuse and neglect after being removed from their parents – either in Australia or in the UK - and placed in Church and State run institutions in Australia between 1930 and 1970. The campaign by this profoundly marginalised group coincided with the decade in which the opportunities of Web 2.0 were seen to be diffusing throughout different social groups, and were considered a tool for social inclusion. We outline a conceptual framework that positions the role of the internet as an environment in which the difficult relationships between painful past experiences and contemporary injunctions to remember them, are negotiated. We then apply this framework to the analysis of case examples of posts and interaction on websites with web 2.0 functionality: YouTube and the National Museum of Australia. The analysis points to commonalities and differences in the agency of the internet in these two contexts, arguing that in both cases the websites provided support for the development of a testimony-like narrative and the claiming, sharing and acknowledgement of loss.

Effective public speaking for the Australian curriculum

Public speaking has been with us since the great orators of the cultural heritage tradition and is by no means a dying art. There is no substitute for the human voice in real time, and technology-delivered speeches cannot really move an audience in precisely ways that effective, live speaking can. Many teachers go to history to access models such as the great Martin Luther King’s “I have a dream” speech, or Winston Churchill’s call to battle. Most of us can recall Kevin Rudd’s historical apology to Indigenous Australia’s stolen generation, and more recently Noel Pearson’s moving eulogy delivered to a mourners at Gough Whitlam’s funeral. We are fortunate now to be able to access speeches from more recent history, closer to home and in our own accents through online repositories. This paper is, in part, written as a guide for pre-service teachers who did not learn this at school, and experienced teachers may also find it useful.