Medical Education - Theses
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ItemThe indigenous health agenda in medical education( 2017)This thesis describes the indigenous health agenda as a unique landscape located within the wider field of medical education. The indigenous health agenda offers medical educators the opportunity to contribute to indigenous health and wellbeing. The thesis reviews the commitments of medical schools in Aotearoa New Zealand and Australia to the indigenous health agenda and asks how these commitments are currently being enacted and can best be realised in future. The research identifies an indigenous rights to health approach as under-utilised and potentially beneficial. Using Kaupapa Māori methodology a research study consisting of thirty-two semi-structured interviews (28 individual, two joint, and two focus group interviews) was undertaken across two research phases. In Phase One, key informant interviews were conducted to gain insight into stakeholder perceptions of medical school commitments to the indigenous health agenda. In Phase Two, a case study was carried out at The University of Auckland Faculty of Medical and Health Sciences, in which key informants discussed the relevance and potential applications of Phase One findings. Thematic analysis was used to encode and order data. Study findings establish the viability of a rights approach, and bring into focus drivers of the indigenous health agenda, obstacles to the indigenous health agenda, and strategic pathways for the indigenous health agenda. The indigenous health agenda is redefined as building a strong indigenous presence in medical schools via four strategic pathways - indigenous knowledge and information, indigenous process and practice, indigenous personnel, and indigenous resource base - and transforming institutions to enable that presence to have impact. When the four strategic pathways are applied across the domains of clinical teaching and learning, cultural understanding and critical awareness, community relations, and indigenous leadership and organisational autonomy, a 4 X 4 table of the indigenous health agenda is developed. The indigenous health agenda is then understood to consist of ends, means, and motives. The ends are to reduce indigenous health inequities and contribute to indigenous health and wellbeing. The practical means are to develop indigenous presence within and across pathways and domains in medical education. The motives are human rights to health and more specifically and powerfully, indigenous rights to health. Developing each facet of the indigenous health agenda is a task still to be achieved, as is mastering the complex dynamics of equitable partnerships between medical schools and indigenous communities, and between indigenous leaders and their non-indigenous allies. Even so, the thesis predicts a bright future for better understanding and further practical developments of the indigenous health agenda in Aotearoa New Zealand and Australian medical schools.