The Deadly Aboriginal Nurses and Midwifery Mentoring Program

Project summary

The DANMM program (Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring) was purposefully created to support Aboriginal and Torres Strait Islander nurses and midwives in their professional journeys.

Originally launched as a quality improvement initiative at a regional hospital in New South Wales (NSW), the program showed promising results in strengthening workforce capacity and providing culturally safe, meaningful support for Aboriginal health professionals. Building on this success, DANMM was expanded into a multi-site pilot feasibility and acceptability study across four diverse NSW Local Health Districts.

Project objectives

The project aimed to assess the feasibility, acceptability, resource implications, and early indicators of the impact of implementing DANMM across five LHDs in NSW. Research questions were designed to measure the feasibility and acceptability of the DANMM program and to measure early indicators of the impact through the following questions:

Research question 1: Was the DANMM program feasible to implement as planned?

Research question 2: Was DANMM acceptable to nurses, midwives, and key leaders?

Research question 3: What were the resource implications of administering DANMM across participating LHDs?

Research question 4: Was participation in DANMM associated with changes in workforce satisfaction, retention, and experience of cultural safety?

Project details

Project period: 2019- 2025

Project funding:

Charles Sturt University Faculty of Science Seed Grant $10,000

New South Wales Translational Research Grant Scheme Round 5 $360,000

Field of Research:

42050 Nursing Workforce

450409 Aboriginal and Torres Strait Islander Health

The problem

The low representation and high attrition of Aboriginal and Torres Strait Islander Nurses and Midwives remain a challenge for Australian local health districts. A strong Aboriginal and Torres Strait Islander Nursing and Midwifery workforce is crucial for fostering a culturally safe environment to address health inequities and the equitable provision of patient centred care.

The approach

This research adopted an exploratory mixed-methods approach to evaluate the impact of the Deadly Aboriginal Nurses and Midwifery Mentoring Program. Importantly, a Cultural Governance Group guided all facets of the research process.

Quantitative data was collected before and after the program using the following validated tools:

  • Nursing Workplace Satisfaction Questionnaire (NWSQ).
  • Ganngaleh nga Yagaleh (GY) Cultural Safety Tool.
  • Organisational Commitment and Health Professional Program Readiness Assessment Compass (OCHPPRAC).

Statistical analysis was performed by a qualified statistician using non-parametric tests in SPSS and R. To enrich these findings, individual qualitative yarns were gathered and analysed using the Braun & Clarke Thematic Analysis Framework.

Additionally, a comprehensive cost-analysis of the program was conducted by a health economist.

The results, why this matters?

Mentorship programs like DANMM (Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring) show strong potential as a meaningful way to support and retain Aboriginal and Torres Strait Islander Nurses and Midwives.

When evaluated, the DANMM program proved to be a cost-effective workforce strategy that enhances cultural safety and workplace satisfaction for Aboriginal health professionals.

To ensure the program can be successfully expanded and embedded across healthcare settings, it’s essential to upskill key organisational staff, particularly Nursing and Midwifery managers, and secure executive-level support.

Looking ahead, further research using rigorous methods such as randomised controlled trials and long-term studies is needed to better understand how mentoring programs impact staff retention over time.

Artist Darren Wighton and Mentoring Project Founder Angela Damm

Figure 1: Artist Darren Wighton and Mentoring Project Founder Angela Damm

Project partners

DANMM was originally piloted at Murrumbidgee Local Health District. This then expanded into a multi-site pilot across four diverse NSW Local Health Districts - rural, regional, and metropolitan—including:

  1. Murrumbidgee LHD
  2. Sydney LHD
  3. Western NSW LHD
  4. Western Sydney LHD

Researchers presenting project artwork to Murrumbidgee Local Health District Senior Executives July 2025

Figure 2: Researchers presenting Project artwork to Murrumbidgee Local Health District Senior Executives July 2025

This broader rollout aimed to test the program's effectiveness in different healthcare settings and communities.

The project connected four universities:

  1. Charles Sturt University.
  2. The University of Sydney.
  3. University of New South Wales.
  4. Deakin University.

The project involved one community Controlled organisation - Albury Wodonga Aboriginal Health Service.

Ethics approval: NSW Health Human Research Ethics (2022/ETH01971), AH&MRC Ethics committee (2054/23), and university partners (2054/23).

Our research team

Meet the team

Associate Professor Jessica Biles

Charles Sturt University

Dr Shanna Fealy

Charles Sturt University

Mr Bradley Christian

University of Sydney

Associate Professor Brett Biles

University of New South Wales

Associate Professor Judith Anderson

Charles Sturt University

Professor Grant Sara

University of Sydney

Ms Angela Damm

Murrumbidgee Local Health District

Ms Nicolle Dawson

Charles Sturt University

Mr Troy Pietsch

NSW Department of Education, Marathon Health, Argyle Housing

Professor Faye McMillan

University of Technology Sydney

Dr Utsana Tonmukayakul

Ms Rebecca Willis

Murrumbidgee Local Health District

Ms Jasmin Pietsch

Murrumbidgee Local Health District

Acknowledgement

We also acknowledge the contributions and expertise of Mr Peter Fernando, Dr Tara Flemington, Ms Charmaine Marshall, Professor Linda Deravin, Mr Nathaniel Alexander, Ms Helen Emmerson, Dr Jane Havelka & Ms Nikki Trudgett.

In the media

Aboriginal and/or Torres Strait Nursing and Midwifery workforce mentoring program in a rural NSW Local Health District 2018- Charles Sturt University

Read now

DANMM that’s good!”: Evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Program across rural, regional, and metropolitan NSW

Read now

Charles Sturt University: $360,000 grant for First Nations Nursing and Midwifery Mentoring program

Read now

Figure 3: Project Cultural Governance Face to face Meeting - Burraja Cultural Centre Albury Wodonga Aboriginal Health Service July 2024

Figure 3: Project Cultural Governance Face to face Meeting - Burraja Cultural Centre Albury Wodonga Aboriginal Health Service July 2024

Publications

Biles, J., Deravin, L., Seaman, C. E., Alexander, N., Damm, A., & Trudgett , N. (2021). Learnings from a mentoring project to support Aboriginal and Torres Strait Islander nurses and midwives to remain in the workforce. Contemporary Nurse, 57(5), 327-337. https://doi.org/10.1080/10376178.2021.1991412

Biles, J., Deravin, L., McMillan AM, F., Anderson, J., Sara, G., & Biles, B. (2023). Aboriginal and Torres Strait Islander nurses and midwives culturally safe mentoring programmes in Australia: A scoping review. Contemporary Nurse, 59(2), 173-183. https://doi.org/10.1080/10376178.2023.2175700

Biles, J., Damm, A., Fernando, P., Pietsch, T., Biles, B., Anderson, J., McMillan AM, F., Flemington, T., Alexander, N., Sara, G., Bradley, C., Willis, R., Fealy, S., Davies, N., & Havelka, J. (2023). "DANMM that’s good!”: Evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Program across rural, regional, and metropolitan NSW. The journey so far…. Abstract from ASMIRT 2023 Conference, Sydney, New South Wales, Australia.

Biles, J., Fealy, S., Sara, G., Anderson, J., McMillan AM, F., Christian, B., Davies, N., Willis, R., & Biles, B. (2025). What is the state of play? A nursing and midwifery workplace satisfaction survey across five local health districts. Contemporary Nurse, 61(1), 58-76. https://doi.org/10.1080/10376178.2024.2425753

Biles, B., Christian, B., Marshall, C., McMillan, F., Sara, G., Anderson, J., Davies, N., Fealy, S., & Biles, J. (2024). ‘DANMM that’s good!’: evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Programme across rural, regional and metropolitan NSW–a collaborative study protocol. BMJ Open, 14(2), 1-9. Article e079416. https://doi.org/10.1136/bmjopen-2023-079416

Fealy, S., McMillan, F., Damm, A., Biles, B., Dawson, N., Anderson, J., & Biles, J. (2025). Evaluating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme: A mixed-methods pilot study conducted across four local health districts in New South Wales, Australia. BMJ Open, 15(9), 1-12. Article e101980. https://doi.org/10.1136/bmjopen-2025-101980

Addressing the nursing workforce crisis through mentorship

With nursing shortages reaching critical levels across Australia, the need for strong mentorship has never been more urgent. The Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring research team is actively seeking new partnerships to expand and evaluate this vital program across diverse health domains and disciplines.

If you're interested in collaborating or exploring opportunities to support and grow this initiative, please contact:

Associate Professor Jessica Biles - jbiles@csu.edu.au and Dr Shanna Fealy- Cargill- sfealy@csu.edu.au

Looking ahead - further research

This study has been used to inform a NHMRC targeted call for research: Aboriginal and Torres Strait Islander Health – Addressing Violence for Safer Families and Communities 2025. The submission is titled: Aboriginal and Torres Strait Islander Health.

In addition, findings from this study will be disseminated internationally at the Transcultural Nursing Conference in Portland Maine, October 2025.