Category: Approaches to teaching and the support of learning that influence, motivate and inspires students to learn.
Creating relationships of trust and hope for reconciliation and a new social contract of health equity for Australians. ‘Restorative Healthcare Team’
Our team present a research informed decolonised approach that has revolutionised how Unit 7434 Indigenous Health: Contemporary Issues is delivered. The mandatory undergraduate nursing and midwifery unit development involved an authentic and iterative learning, teaching and assessment feedback loop commencing in 2017. The unit content and delivery has been revised and co-created with guidance from First Nations Elders, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), expert Aboriginal and Torres Strait Islander academics, community leaders and researchers to deliver a more authentic teaching and learning experience- to include the students as partners in learning. Building a relationship of respect, empathy, collaboration, and hope between non-Indigenous and Indigenous peoples in the classroom- for life!! This citation relates to the work of this team in convening and supporting the unit for semester 2 for the years 2017, 2018, 2020, 2021. Frequent feedback includes this sentiment expressed in recent ISEQ data, “I'm really excited that this is a compulsory course for my study as I think it is so important for everyone in the healthcare field (or really just everyone in aus!) to have an understanding of Indigenous culture and how history has impacted on current conditions for Indigenous Australians”(2021 S1 7434 ISEQ 370735 comment). The unit has filled a curriculum gap for other health disciplines, and is a popular cross faculty elective including Law, Business, Arts, Design, Communication and Media, with enrolments of around 250 students in 2017 up to 400 -500 recently. In 2021 the demand for this kind of education, continuing positive feedback and opportunities to deliver external short courses led us to modularise the unit for external short course delivery in 2022.
The unit pedagogy is philosophically framed and implemented using critical theory and restorative justice approaches for powerful transformative learning. Decolonising approaches such as ‘Dadirri’ (West, Stewart, Foster, Usher, 2012)- authentic deep listening- utilised in Yarning Circles are aligned to Freire (1993) for transformative education enabling the possibility of just reconciled relationships. Informed by ‘Restorative Healthcare’ participatory action research (Northam, Brown, Applebee et al, 2017), students partner with teachers and each other in Yarning Circles using approaches of ‘unconditional positive regard’ (Wilkins, 2000). Non-Indigenous teachers model and practice cultural humility, defined as “a lifelong commitment to self-evaluation and critique, to redressing power imbalances in the patient-physician dynamic and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations (Tervalon and Murray-Garcia, 1998, p.123)” or “to say that they do not know when they truly do not know” (p.119) in all unit activities. We seek to challenge, unsettle, and disrupt assumptions- unconscious and conscious bias’s- and enable new, sometimes painful growth towards truth, learning and relationship building with transformational - ‘epochal’ moments (Dirkx & Mezerow, 2006, p.125).
Teaching approaches for transformative learning- evidenced when a person’s previous assumptions are disrupted, new information conveyed- and a new understanding of the world and their situation in it becomes obvious, where choices required in this new paradigm are understood by the ‘learner’ (Dirkx & Mezarow, 2006) were carefully planned. These anticipate and lesson the harm of the impact of new information in situations of intergenerational trauma and the emotions of disbelief and shame that may be revealed when ideas attendant to ‘white fragility’ (McWhorter, 2020), emerge. Restorative justice philosophies and practices frame all the approaches. Content delivery challenges existing paradigms to help Indigenous and non-Indigenous students’ understanding grow to form positive, meaningful, health affirming reconciled relationships- to become change champions -for a new social contract between themselves and First Australians. References: Australian Nursing and Midwifery Accreditation Council (2019). Registered Nurse Accreditation Standards 2019. ISBN: 978-0-6487395-0-0 Available at https://www.anmac.org.au/search/publication CATSINaM, NMBA, ACM, ACN, ANMF, (2018). Joint Statement March 23rd. Cultural safety: Nurses and midwives leading the way for safer healthcare. Available: file:///C:/Users/s425062/Downloads/Nursing-and-Midwifery-Board---Statement---Nurses-and-midwives-leading-the-way-for-safer-healthcare.PDF Dirkx, J.M. & Mezarow, J. (2006). Musings and reflections on the meaning, context, and process of transformative learning. Journal of Transformative Education. Vol 4 (2). P.123-139. DOI:10.1177/1541344606287503 Friere, P. (1993) Pedagogy of the Oppressed. Penguin Classics, Great Britain. McWhorter, J. (2020). The dehumanising condescension of ‘White fragility’. Artilce July 15, 2020. The Atlantic. https://www.theatlantic.com/ideas/archive/2020/07/dehumanizing-condescension-white-fragility/614146/ Ramsden, I. M. (2002). Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu. Thesis. Victoria University. Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9, 117-125. Watego, C., Singh, D. & Macoun, A. (2021). Partnership for Justice in Health: Scoping Paper on Race, Racism and the Australian Health System. Lowitja Institute. ISBN 978-1-921889-76-9. https://www.lowitja.org.au/content/Image/Lowitja_PJH_170521_D10.pdf West, R., Stewart, L., Foster, K. & Usher, K., (2012). Through a Critical Lens: Indigenist Research and the Dadirri Method. Qualitative Health research 22(1) 1582- 1590. Sage. DOI: 10.1177/1049732312457596 Wilkins, P. (2000). Unconditional positive regard reconsidered. British Journal of Guidance & Counselling, 28(1), 23–36. https://doi.org/10.1080/030698800109592
Prize money: $1,500 for the use of the team in continuing this work.