Transformative Learning: A Precursor to Preparing Health Science Students to Work in Indigenous Health Settings?

Abstract

Australian undergraduate programmes are implementing curriculum aimed at better preparing graduates to work in Indigenous health settings, but the efficacy of these programmes is largely unknown. To begin to address this, we obtained baseline data upon entry to tertiary education (Time 1) and follow-up data upon completion of an Indigenous studies health unit (Time 2) on student attitudes, preparedness to work in Indigenous health contexts and transformative experiences within the unit. The research involved 336 health science first-year students (273 females, 63 males) who completed anonymous in-class paper questionnaires at both time points. Paired sample t-tests indicated significant change in student attitudes towards Indigenous Australians, perceptions of Indigenous health as a social priority, perceptions of the adequacy of health services for Indigenous Australians and preparedness to work in Indigenous health settings. Hierarchical multiple regression analyses indicated that after controlling for Time 1 measures, the number of precursor steps to transformative learning experienced by students accounted for significant variance in measures of attitudes and preparedness to work in Indigenous health contexts at Time 2. The knowledge gained further informs our understanding of both the transformative impact of such curriculum, and the nature of this transformation in the Indigenous studies health context.

Critical Reflexivity in Indigenous and Cross‐cultural Psychology: A Decolonial Approach to Curriculum?

“…If these are indeed the skills with potential for equipping individuals to interoperate in intercultural settings, they may also be the skills with potential for enacting decoloniality. For example, extant literature specific to the complex Australian Indigenous studies space points to the occurrence of critical reflection within curricula based on decolonial intentions and the experience of transformative learning (Bullen & Roberts, , ).…”

“…The unit, delivered at a large Australian university, is on Indigenous and cross‐cultural psychology and is designed to promote cultural capabilities within undergraduate psychology students. Of note, this core third‐year unit follows delivery of a core inter‐professional first year unit on Indigenous cultures and health behaviors designed to support students development of foundational cultural capabilities with specific reference to Indigenous Australians (for an overview of this first year unit, inclusive of curricular, pedagogical, and assessment models in the context of critical reflexivity and transformative learning, see Bullen & Roberts, ). Importantly, this first year unit is typically students’ first exposure to models of critical reflexivity and (for the vast majority), to Indigenous knowledge, perspectives and people.…”

Cultural safety training for allied health students in Australia

“…Taking into consideration that these workshops indicate an improved cultural humility, findings suggest that, while cultural safety programmes can lead to these short-term improvements (Durey, 2010), one-off workshops may not be sufficient for promoting ongoing knowledge and attitudinal changes required for culturally safe practice. Indeed, a recent study by Bullen and Roberts (2018) found that an entire 1st year learning unit dedicated to Indigenous Australian cultures and health only brought about small but measurable changes in students' attitudes and preparation towards working with Indigenous Australians. According to Gibbs (1984), it is difficult for a person to fully understand the value system of another culture unless he/she is brought up in, or has lived in, that culture for a long period of time.…”

Reaching Across the Divide (RAD): Aboriginal Elders and Academics working together to improve student and staff cultural capability outcomes

“…RAD processes and the transformative properties of the Indigenous pedagogy (Bullen and Roberts, 2018 a , 2018 b ) ignited student interest and passion to work with Aboriginal and Torres Strait Islander peoples. The process of transformational learning is theorised by a shift in the way we understand and make sense of our world which starts with a process or experience that ignites new ways of sense making and then ‘subsequent understanding, appreciation and action’ (Mezirow, 1990, p. 1).…”