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Exploring learning goals and assessment approaches for Indigenous health education: a qualitative study in Australia and New Zealand

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Abstract

In higher education, assessment is key to student learning. Assessments which promote critical thinking necessary for sustained learning beyond university are highly valued. However, the design of assessment tasks to achieve these types of thinking skills and dispositions to act in professional practice has received little attention. This research examines how academics design assessment to achieve these learning goals in Indigenous health education. Indigenous health education is an important area of learning for health practitioners to help address worldwide patterns of health inequities that exist for Indigenous people. We used a constructivist qualitative methodology to (i) explore learning goals and assessment strategies used in Indigenous health tertiary education and (ii) examine how they relate to higher education assessment ideals. Forty-one academics (from nine health disciplines) involved in teaching Indigenous health content participated in a semi-structured interview. Thematic analysis revealed learning goals to transform students’ perspectives and capacities to think critically and creatively about their role in Indigenous health. In contrast, assessment tasks encouraged more narrowly bounded thinking to analyse information about historical and socio-cultural factors contributing to Indigenous health. To transform students to be critical health practitioners capable of working and collaborating with Indigenous people to advance their health and well-being, the findings suggest that assessment may need to be nested across many aspects of the curriculum using a programmatic approach, and with a focus on learning to think and act for future practice. These findings accord with more recent calls for transformation of learning and assessment in health education.

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References

  • AIDA/MDANZ. (2012). A review of the implementation of the Indigenous health curriculum framework and the healthy futures report within Australian medical schools. Sydney: Medical Deans Australia and New Zealand Inc. and the Australian Indigenous Doctors’ Association Ltd..

    Google Scholar 

  • Anderson, I., Crengle, S., Kamaka, M., Chen, T.-H., Palafox, N., & Jackson-Pulver, L. (2006). Indigenous health in Australia New Zealand and the Pacific. Lancet, 367(9524), 1775–1785.

    Article  Google Scholar 

  • Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., et al. (2016). Indigenous and tribal peoples’ health (the Lancet-Lowitja Institute Global Collaboration): a population study. The Lancet, 388(10040), 131–157.

    Article  Google Scholar 

  • Andrews, T. (2012). What is social constructionism. Grounded Theory Review, 11(1).

  • Australian Association of Social Workers. (2012). Australian Social Work and Accreditation Standards (ASWEAS). Canberra: AASW.

    Google Scholar 

  • Australian Dental Council/Dental Council (NZ). (2016). Program accreditation standards. Melbourne: Australian Dental Council.

  • Australian Medical Council. (2012). Standards for assessment and accreditation of primary medical programs by the Australian medical council 2012. Canberra: AMC.

    Google Scholar 

  • Australian Nursing and Midwifery Accreditation Council. (2015). Nurse practitioner accreditation standards 2015. Canberra: ANMAC.

    Google Scholar 

  • Australian Physiotherapy Council. (2015). Accreditation standard for entry-level physiotherapy in Australia. Melbourne: Australian Physiotherapy Council.

    Google Scholar 

  • Australian Qualifications Framework Council. (2013). Australian qualifications framework. South Australia: Australian Qualifications Framework Council.

    Google Scholar 

  • Bainbridge, R., McCalman, J., Clifford, A., & Tsey, L. (2015). Cultural competency in the delivery of health services for Indigenous people. Issues paper no. 13 Canberra: Australian Institute of Health and Welfare & Australian Institute of Family Studies.

  • Barnett, R. (1997). Higher education: a critical business. Buckingham: Open University Press.

    Google Scholar 

  • Barnett, R. (2015). A curriculum for critical being. In M. Davies & R. Barnett (Eds.), The Palgrave handbook of critical thinking in higher education. New York: Palgrave MacMillan.

    Google Scholar 

  • Bearman, M., Dawson, P., Bennett, S., Hall, M., Molloy, E., Boud, D., et al. (2016). How university teachers design assessments: a cross-disciplinary study. Higher Education 1–15.

  • Bearman, M., Dawson, P., Boud, D., Hall, M., Bennett, S., & Molloy, E., et al. (2014). Guide to the assessment design decisions framework. Sydney: Office for Learning and teaching.

  • Boud, D., & Falchikov, N. (2006). Aligning assessment with long-term learning. Assessment and Evaluation in Higher Education, 31(4), 399–413.

    Article  Google Scholar 

  • Boud, D., Lawson, R., & Thompson, D. (2015). The calibration of student judgement through self-assessment: disruptive effects of assessment patterns. Higher Education Research and Development, 34(1), 45–59.

    Article  Google Scholar 

  • Boud, D., & Molloy, E. (2013). Rethinking models of feedback for learning: the challenge of design. Assessment and Evaluation in Higher Education, 38(6), 698–712.

    Article  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Article  Google Scholar 

  • Brigg, M. (2016). Engaging Indigenous knowledges: from sovereign to relational knowers. The Australian Journal of Indigenous Education, 45(2), 152–158.

  • Carless, D. (2007). Learning-oriented assessment: conceptual bases and practical implications. Innovations in Education and Teaching International, 44(1), 57–66.

    Article  Google Scholar 

  • Carless, D. (2015a). Excellence in university assessment: learning from award-winning practice. Abingdon: Routledge.

    Google Scholar 

  • Carless, D. (2015b). Exploring learning-oriented assessment processes. Higher Education, 69(6), 963–976.

    Article  Google Scholar 

  • Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Los Angeles: Sage.

    Google Scholar 

  • Crenshaw, K. (1991). Mapping the margins: intersectionality, identity politics and violence against women of colour. Stanford Law Review, 43(6), 1241–1299.

    Article  Google Scholar 

  • Creswell, J. (2013). Qualitative inquiry and research design: choosing among five approaches. London: SAGE Publications.

    Google Scholar 

  • Cruess, R., Cruess, S., & Steinert, Y. (2016). Amending Miller’s pyramid to include professional identity formation. Academic Medicine, 91(2), 180–185.

    Article  Google Scholar 

  • Dao, D., Goss, A., Hoekzema, A., Kelly, L., Logan, A., Mehta, S., et al. (2016). Integrating theory, content, and method to foster critical consciousness in medical students: a comprehensive model for cultural competence training. Academic Medicine, 92(2), 335–344.

  • Delany, C., & Golding, C. (2014). Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC Medical Education, 14(20), 1–10.

    Google Scholar 

  • Delany, C., Kosta, L., Ewen, S., Nicholson, P., Remedios, L., & Harms, L. (2016). Identifying pedagogy and teaching strategies for achieving nationally prescribed learning outcomes. Higher Education Research and Development, 35(5), 895–909.

    Article  Google Scholar 

  • Delany, C., & Watkin, D. (2009). A study of critical reflection in health professional education: ‘learning where others are coming from’. Advances in Health Sciences Education, 14(3), 411–429.

    Article  Google Scholar 

  • Department of Health. (2016). Aboriginal and Torres Strait Islander health curriculum framework. Canberra: Commonwealth Government of Australia.

    Google Scholar 

  • Eckenfels, E. (2000). The case for keeping community service voluntary: narratives from the rush community service initiatives program. In D. Wear & J. Bickel (Eds.), Educating for professionalism: creating a culture of humanism in medical education (pp. 165–173). Iowa City: University of Iowa Press.

    Google Scholar 

  • Ewen, S. (2014). Indigenous health and the hidden curriculum: a view from the outside in. In F. Hafferty & J. O’Donnell (Eds.), The hidden curriculum in health professional education. Hanover: Dartmouth College Press.

    Google Scholar 

  • Ewen, S., Barrett, J., & Howel-Meurs, S. (2016). Health disparity and health professional education: a new approach. Medical Science Educator, 26, 247–253.

    Article  Google Scholar 

  • Ewen, S., Mazel, O., & Knoche, D. (2012). Exposing the hidden curriculum influencing medical education on the health of Indigenous people in Australia and New Zealand: the role of the critical reflection tool. Academic Medicine, 87(2), 200–205.

    Article  Google Scholar 

  • Fraser, S., & Greenhalgh, T. (2001). Coping with complexity: educating for capability. BMJ, 323, 799.

    Article  Google Scholar 

  • Gair, S. (2016). Critical reflections on teaching challenging content: do some students shoot the (white) messenger? Reflective Practice: International and Multidisciplinary Perspectives, 17(5), 592–604.

    Article  Google Scholar 

  • Golding, C. (2011). Educating for critical thinking: thought-encouraging questions in a community of inquiry. Higher Education Research and Development, 30(3), 357–370.

    Article  Google Scholar 

  • Hafferty, F. (1998). Beyond curriculum reform: confronting medicine’s hidden curriculum. Academic Medicine, 74(4), 403–407.

    Article  Google Scholar 

  • Harms, L. (2010). Understanding human development: a multidimensional approach (Second Edition ed.). Oxford: Oxford University Press.

    Google Scholar 

  • Holmboe, E. S., & Batalden, P. (2015). Achieving the desired transformation: thoughts on next steps for outcomes-based medical education. Academic Medicine, 90(9), 1215–1223.

    Article  Google Scholar 

  • Hook, G. (2012). Towards a decolonising pedagogy: understanding Australian Indigenous studies through critical whiteness theory and film pedagogy. The Australian Journal of Indigenous Education, 41(2), 110–119.

    Article  Google Scholar 

  • Hutchings, P., & Shulman, L. (1999). The scholarship of teaching: new elaborations. New Developments Change, 31, 10–15.

    Google Scholar 

  • Jackson, D., Power, T., Sherwood, J., & Geia, L. (2014). Amazingly resilient Indigenous people! Using transformative learning to facilitate positive student engagement with sensitive material. Contemporary Nurse, 46(1), 105–112.

    Article  Google Scholar 

  • Jones, S., & Wijeyesinghe, C. (2011). The promises and challenges of teaching from an intersectional perspective: core components and applied strategies. New Directions for Teaching and Learning, 125, 11–20.

    Article  Google Scholar 

  • Martimianakis, M. A., Maniate, J. M., & Hodges, B. D. (2009). Sociological interpretations of professionalism. Medical Education, 43(9), 829–837.

    Article  Google Scholar 

  • McDermott, D., & Sjoberg, D. (2012). Managing a diverse student discomfort with an Indigenous health curriculum. In C. Lochert (Ed.), LIME good practice case studies: volume one. Melbourne: Onemda VicHealth Koori Health Unit, The University of Melbourne.

    Google Scholar 

  • Metzl, J., & Hansen, H. (2014). Structural competency: theorizing a new medical engagement with stigma and inequality. Social Science and Medicine, 103, 126–133.

    Article  Google Scholar 

  • Miller, G. (1990). The assessment of clinical skills/competence/performance. Academic Medicine, 65(9), S63–S67.

    Article  Google Scholar 

  • Nakata, M. (2004). Indigenous Australian studies and higher education (Wentworth lecture). Canberra, ACT: Australian Institute of Aboriginal and Torres Strait Islander Studies.

    Google Scholar 

  • Normann, R. (2001). Reframing business: when the map changes the landscape. Chichester: Wiley Publishing.

    Google Scholar 

  • Norton, L., Norton, B., & Shannon, L. (2013). Revitalising assessment design: what is holding new lecturers back? Higher Education, 66(2), 233–251.

    Article  Google Scholar 

  • Palys, T. (2008). Purposive sampling. In L. Given (Ed.), The sage encyclopedia of qualitative research methods. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Physiotherapy Board of New Zealand. (2009). Physiotherapy competencies: for physiotherapy practice in New Zealand. Wellington: PBNZ.

    Google Scholar 

  • Ramjan, L., Hunt, L., & Salamonson, Y. (2015). Predictors of negative attitudes toward Indigenous Australians and a unit of study among undergraduate nursing students: a mixed methods study. Nursing Education in Practice, 17, 200–207.

    Article  Google Scholar 

  • Ranzijn, R. O. B., McConnochie, K., Day, A., Nolan, W., & Wharton, M. (2008). Towards cultural competence: Australian Indigenous content in undergraduate psychology. Australian Psychologist, 43(2), 132–139.

    Article  Google Scholar 

  • Riley, L., Howard-Wagner, D., Mooney, J., & Kutay, C. (2013). Embedding aboriginal cultural knowledge in curriculum at university level through aboriginal community engagement. In R. Craven & J. Mooney (Eds.), Seeding success in Indigenous Australian higher education: diversity in higher education (Vol. 14, pp. 251–276). Bingley: Emerald Group Publishing Limited.

    Chapter  Google Scholar 

  • Rust, C., Price, M., & O’Donovan, B. (2003). Improving students’ learning by developing their understanding of assessment criteria and processes. Assessment and Evaluation in Higher Education, 28(2), 147–164.

    Article  Google Scholar 

  • Ryan, C., Mazel, O., & Nicholls, E. (Eds.). (2015). LIME connection VI: knowledge systems, social justice and racism in health professional education, conference program, abstracts and biographies, 2015 Aug 11–13; Townsville, Queensland. Melbourne: The LIME Network.

    Google Scholar 

  • Ryder, C., & Edmondson, W. (2015). Developing an enhanced aboriginal health curricula for medical student engagement. In C. Ryan & O. Mazel (Eds.), LIME good practice case studies: volume three. Melbourne: Faculty of Medicine, Dentistry and Health Sciences.

    Google Scholar 

  • Sadler, R. (2010). Beyond feedback: developing student capability in complex appraisal. Assessment and Evaluation in Higher Education, 35(5), 535–550.

    Article  Google Scholar 

  • Thackrah, R., & Thompson, S. (2013). Confronting uncomfortable truths: receptivity and resistance to aboriginal content in midwifery education. Contemporary Nurse, 46(1), 113–122.

    Article  Google Scholar 

  • Tobin, J., Atkinson, W., Ferguson, P., Charles, S., & James, R. (2015). OnCountry4Health: Yorta Yorta Elders lead tomorrow’s doctors. In C. Ryan & O. Mazel (Eds.), LIME good practice case studies volume three (pp. 31–38). Melbourne: Faculty of Medicine, Dentistry and Health Sciences.

    Google Scholar 

  • van der Vleuten, C., & Schuwirth, L. (2005). Assessing professional competence: from methods to programmes. Medical Education, 39(3), 309–317.

    Article  Google Scholar 

  • Virdun, C., Gray, J., Sherwood, J., Power, T., Phillips, A., Parker, N., et al. (2013). Working together to make Indigenous health care curricula everybody’s business: a graduate attribute teaching innovation report. Contemporary Nurse, 46(1), 97–104.

    Article  Google Scholar 

  • Williamson, J., & Dalal, P. (2007). Indigenising the curriculum or negotiating the tensions at the cultural interface? Embedding Indigenous perspectives and pedagogies in a university curriculum. The Australian Journal of Indigenous Education, 36(Supplement), 51–58.

    Article  Google Scholar 

  • Zubrzycki, J., Green, S., Jones, V., Stratton, K., Young, S., & Bessarab, D. (2014). Creating partnerships for change. In Integrating aboriginal and Torres Strait Islander knowledges in social work education and practice: teaching and learning framework 2014. Sydney: Office for Learning and Teaching.

    Google Scholar 

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Acknowledgment

We would like to acknowledge the Office for Learning and Teaching (OLT) who provided funding for the research project that developed the data source used in this paper. We would also like to thank academics involved in Indigenous health education in Australia and New Zealand for providing their time to be interviewed.

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Correspondence to Lachlan Doughney.

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Ethics approval (HREC protocol 1443255) for the study was obtained from The University of Melbourne, School of Health Sciences Human Research Ethics Advisory Group.

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Delany, C., Doughney, L., Bandler, L. et al. Exploring learning goals and assessment approaches for Indigenous health education: a qualitative study in Australia and New Zealand. High Educ 75, 255–270 (2018). https://doi.org/10.1007/s10734-017-0137-x

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