Embedding Indigenous Health within a New Medicine Program

Philip Jones & Lisa Jackson-Pulver

Faculty of Medicine, UNSW

UNSW Medicine Program

6-year UG program

Three phases.

Modular structure (8-week courses).

Common organising domains in Phases 1

& 2 with recurring themes.

Vertical integration.

Graduate Capabilities

Using basic and clinical sciences. Social/cultural aspects of health & disease. Patient assessment and management. Effective communication. Team work. Self-directed learning and critical evaluation. Ethics and legal responsibilities. Becoming a reflective practitioner.

Graduate Capabilities Relating to Indigenous Health

Awareness of cultural issues.

Reflections on personal value system.

Cultural sensitivity, tolerance and respect for

others.

Communicates effectively with culturally

diverse patients and families.

Phase 1: Scenario based learning

Health scenarios provide a context for learning activities.

Predominantly campus-based activities.

Scenario groups.

Phase 1 learning activities related to Indigenous Health Scenarios illustrating health problems

affecting Indigenous peopleTeenage pregnancyChild developmentWeight control and diabetesAlcohol-related disorders

Teenage Pregnancy Scenario

Jessica is an Anglo-Celtic girl living in a small country town and is in year 9 at the local high school. She is worried that she is pregnant because her period is two weeks overdue.

Deborah is an Aboriginal girl living in western Sydney as part of an urban Aboriginal community. She is 22 weeks pregnant and attends an Aboriginal Medical Centre. Doctors are worried because her fetus may be small for her apparent dates.  

Phase 1 learning activities related to Indigenous Health Lectures

Lecture on diabetes from an Indigenous speaker

Small group sessionsViewing and discussing “Lonely Boy Richard”

Communication skills tutorials

Phase 1 assessment activities

Individual assignments Trachoma & equity in child health. Rheumatic heart disease in Indigenous Australians - a

third world disease in a first world country.

Group projects Planning a health promotion and education campaign

on nutrition and/or weight control for type 2 diabetes. Evaluate campaigns to reduce risky alcohol

consumption among specific sub-populations.

Phase 2: Practice based learning Structured clinical

experiences based on weekly themes.

Linking to biomedical sciences on campus.

Independent learning project.

“Cross cultural and Indigenous health” theme in Phase 2 Lectures

Overview of Indigenous healthCommon health problems especially skin

problems. Communication skills tutorials

Case studies involving Aboriginal health workers.

Case method tutorial

This is the story of how several remote Indigenous communities made efforts to control skin infections in their community members, particularly their children.

Chronic scabies and the resulting streptococcal skin infections are a significant cause of long-term serious health complications.

The community of Minjilang on Croker Island in Torres Strait tried a health intervention to reduce the prevalence of these infections. The desert communities of the Kimberley in Western Australia tried an environmental intervention.

Phase 2 assessment activities

Group projectAnalysis of a Health Problem in a Local

Population

Station in Phase 2 Integrated Clinical Examination Evaluate communication skills in interview of

aboriginal patient.

Phase 3: Independent reflective learning Clinical clerkships. Hospital and

community settings. Flexibility in choice of

courses within guidelines.

Portfolio Assessment

Students required to demonstrate evidence of achievement for graduate capabilities.

Reflective essay on learning and development of graduate capabilities.

Conclusions

Outcomes-based curriculum with graduate capabilities linking to Indigenous Health.

Learning activities relating to Indigenous Health within different courses across each phase of the curriculum.

Learning activities involving Aboriginal patients and health care workers.

Increased awareness and understanding of issues affecting Indigenous Health.