Up close and real: living and learning in a remote community builds students’ cultural capabilities and understanding of health disparities

Abstract

BackgroundRural and remote communities in Australia fare worse than their urban counterparts across major health indicators, with geographic isolation, restricted accessibility to health services, socioeconomic disadvantage, lifestyle and behavioural factors all implicated in poorer health outcomes. Health disparities, which are especially stark in Australian Aboriginal and Torres Strait Islander populations, underscore the urgent need to build a culturally responsive and respectful rural health workforce.Allied health student placements in settings with high Aboriginal populations provide opportunities for the development of cultural capabilities and observation of the causes and impact of health disparities. A service learning pedagogy underpinned by strong campus-community partnerships can contribute to effective situated learning. Positive placement experiences can also encourage future rural practice alleviating workforce shortages. This article reports on the first stage of a proposed longitudinal investigation into the impact of remote placements on clinical practice and employment choices.MethodsIn-depth interviews were undertaken with health science students and recent graduates from Australian universities who spent up to 4 weeks at the remote community of Mt. Magnet (Badimaya country) in Western Australia. Interviews, which occurred between two and 12 months following the placement were recorded, transcribed and thematically analysed for patterns of meaning.ResultsFactors which contributed to positive professional, personal and socially responsive learning experiences were identified. These included pre-placement cultural training to build understanding of the local Aboriginal community, peer support, community engagement, cultural exchanges and interprofessional collaboration. Highlights were associated with relationship-building in the community and opportunities to apply insights into Aboriginal cultural ways to clinical and community practice. The role of the Aboriginal mentor was integral to students’ understanding of the social and cultural dynamics in the practice setting. Challenges related to the logistics of supervision in remote locations and workloads.ConclusionsThe interprofessional placement offered students a unique opportunity to experience how isolation, socioeconomic disadvantage and cultural factors conspire to produce health inequities in remote Australian settings and to observe how communities respond to their circumstances. Despite difficulties encountered, learnings derived from the application of clinical, social and interprofessional skills, and rural employment opportunities that arose following graduation, were all highly valued.

‘Bumping along’: a qualitative metasynthesis of challenges to interprofessional placements

“…A total of 41 studies were included in the final synthesis . Study characteristics are summarised in Tables .…”

“…Data were typically collected during or soon after IPP completion. Three of the 41 studies included follow‐up investigations after 12 months …”

“…These were the Leicester Model of Interprofessional Education, the integrative pedagogy model, the Kirkpatrick framework and the model of interprofessional mentorship . Nine studies applied seven broader meso‐level theories, namely problem‐based learning, complexity theory, contact theory, self‐presentation theory, sociocultural theory, 3P theory and situated learning theory . From this pool of 11 theories, six groups of authors adopted theories that focused on how individuals or groups learned: the Leicester Model of Interprofessional Education; the integrative pedagogy model; the model of interprofessional mentorship; problem‐based learning; contact theory, and self‐presentation theory .…”

“…The remaining five theories considered situational or organisational contexts for learning, including the Kirkpatrick framework, complexity theory, sociocultural theory, 3P theory and situated learning theory …”

Enhancing cultural safety among undergraduate nursing students through watching documentaries

“…Cultural diversity courses have been introduced to nursing curricula, particularly in the United States, in an effort to promote cultural safety and as a way of helping to improve health outcomes for diverse populations (Lynch & Perera, ; Thackrah, Hall, Fitzgerald, & Thompson, ). There is limited literature, however, on how these courses can be tailored to enhance effective learning that will contribute toward a greater understanding among future professional nurses about the unique health needs of various populations in an effort to improve disparate health outcomes.…”