Dale Sheehan & David Jansen - Tertiary Teaching Excellence Teaching Profile
Teaching profile from Dale Sheehan & David Jansen (A Kona - Bicultural and Collaborative Teaching and Learning on the Graduate Certificate in Clinical Teaching, Christchurch College of Education) - a Excellence in Innovation Award winner 2004
A Kona - Bicultural and Collaborative Teaching and Learning on the Graduate Certificate in Clinical Teaching, Christchurch College of Education
A key goal of Māori health provider development in New Zealand is to establish programmes run by Māori for Māori. This goal requires a pool of qualified health professionals who are willing and confident to teach the next generation of practitioners. Within this frame of reference, Dale Sheehan and David Jansen's innovation was to adapt a mainstream health education programme - the Graduate Certificate in Clinical Teaching - to meet the needs of interdisciplinary groups of Māori health professionals. The content is mainstream, international and interdisciplinary, but the pedagogy is Māori, with Māori customs, values and traditions upheld and practised.
Whāia te pae tawhiti kia tata,whāia te pae tata kia tina. Seek the distant horizon, celebrate each goal attained.
I runga i te ngakau whakaiti ka mihi atu ki te Mana Tohu Mātauranga o Aotearoa e whakanuia nei a mātou mahi. Heoi ano ka mihi hoki ki te kaupapa nei, otira te whakakaha i te kaimahi hauora e hāpai nei i te hauora o te iwi Māori. Kāti rā, ka mihi ake, ka mihi, ka mihi.
This whakatauki incites us to seek the supreme aim, to keep our eyes on the ultimate target, and yet allows us the satisfaction of acknowledging the achievement of each step towards that goal. We are greatly humbled by the award from the New Zealand Qualifications Authority. In accepting the award, we acknowledge the contribution and support of so many people, including the Māori health professionals and Māori health workers whose passion and commitment has been demonstrated so positively in their own successes.
Summary of the innovation
Our innovation was to transform a mainstream health education programme - the Graduate Certificate in Clinical Teaching - to meet the needs of Māori health professionals. The intention of the Graduate Certificate in Clinical Teaching (Māori) (GCCT-M) is to develop Māori clinical teachers who can contribute to the development of a clinically and culturally competent Māori health workforce.
The course has the same core content as the mainstream programme, but where and how it is taught has been altered to meet the needs of Māori clinicians and to ensure the involvement of Māori communities. Introduced in 2000, the course involves Māori health professional and non-professional health workers from mainstream and Māori provider environments and is an important component in the overall Māori health workforce development strategy. The intention behind the programme is to develop Māori clinical teachers who can contribute to the development of a Māori health workforce that is clinically and culturally competent. It is hard to imagine how this aim can be realised without Māori clinical teachers.
This wānanga-based programme is delivered in three-day residential blocks on marae throughout New Zealand. The content is mainstream and international but the pedagogy is Māori, with Māori customs, values and traditions upheld and practised.
The promotion of learning
In a Māori paradigm, students and teachers have interconnected, interchangeable and complementary roles. The Māori word "ako" denotes both teaching and learning, thereby reflecting the fact that at times we are learners and at other times, teachers. This notion also implies that we are each responsible for accepting knowledge passed to us and then, at the appropriate time, passing that knowledge on to others. The marae environment reflects this interplay of complementary roles and reciprocity when kaumātua take part in teaching by presenting the history of the marae, its ancestors and tikanga, and their own areas of expertise. It is also seen when students present what they have learned to the local people for discussion and invite them to take part in all sessions.
It is essential when teaching Māori that the whole-person approach is used. For Māori, this includes consideration of the specific learning tasks and of spiritual, family, community and cultural dimensions. The marae environment supports this approach in several ways. First, marae have an innate sense of family and community, with activities such as cleaning, cooking, sleeping and eating undertaken with fellow students, teachers and local people. Second, the relationships between the learning tasks and the community are easily highlighted. Third, the diverse spiritual and cultural views of each person are treasured and encouraged. Participants may come from different iwi, each with its own customs.
Māori value group activities and place emphasis on consensus and common goals. However, this does not mean that the collective subsumes gifted individuals or that individuals are discouraged from gaining additional knowledge and skills. A Māori community expects that its talented individuals will pursue their strengths and use these to better the whole community.
A vital characteristic of Māori learning is the passing of knowledge from one generation to the next, and the associated responsibility that older children have for their younger siblings, nephews and nieces.
Key driving philosophy
Total commitment to the principles of Tiriti o Waitangi through the delivery of a wānanga-based curriculum: Programme delivery is wholly delivered on marae throughout the country. Marae thus provide our learning environment and ensure we remain committed to our key long-term goals of providing accessible and effective healthcare to Māori and improving the overall health status of Māori.
Other underlying principles
- Integration of tikanga and te reo in a mainstream qualification: This stance has produced a bicultural programme within a Māori learning framework in which the focus is on collective endeavour and community.
- The interdisciplinary nature of the programme: Having a full range of health professionals represented among the people who take this qualification (e.g., medical, physiotherapists, nurses, Māori health workers, anaesthesiologists, midwives, social workers) builds interdisciplinary understanding. The employment backgrounds of the students also vary (e.g., kaupapa Māori health provider organisations, mainstream healthcare provider services and community mental health settings). Some students work in primary health care; others in tertiary teaching organisations and health provider management roles. This diversity enhances the network of expertise that students can draw on in their clinical practice and teaching.
- Recognition of prior learning (RPL): Recognition is given to Māori health care workers for the informal (non-credentialed) yet significant learning and skills development they experience within Māori health provider organisations.
- Collaboration: The certificate is the result of a mainstream provider, a Māori private provider and a Māori health workforce development agency working collaboratively to meet an identified workforce development need.
This innovation has stood the test of time and produced excellence in our graduates. We hope that it will also provide a model by which others can adapt their teaching and planning to meet the needs of Māori learners.
Throughout our evaluation of the outcomes of the programme, we were guided by a traditional Māori saying: "Ehara mā te kumara e kārero mā tāna reka." The English translation suggests that one should not "speak of one's own sweetness" and it applies here: we both feel uncomfortable speaking of excellence in reference to our own teaching. So, instead of doing this, we would like to lay down a challenge for other educators.
The principles of partnership and participation contained in Te Tiriti o Waitangi/Treaty of Waitangi challenge mainstream health educators to recognise what has been lost by excluding Māori pedagogy and perspectives on health and well-being from their curricula. The Māori content included in many health professional courses errs on the side of being predominantly knowledge based. Any consideration of a Māori health curriculum needs to make very clear what is needed and to reject immediately a "one-off marae experience" component or module to the course, offering instead a programme that is entirely marae-based, entirely wānanga-based.
When a programme is held on marae, Māori expect their customs, values and traditions to be upheld and practised. The marae is tārangawaewae, a place to stand. Delivering a course on the marae is a powerful endorsement of Māori custom, and a powerful approval of Māori world views.
Educational organisations have historically recognised that the method of delivery needs to be consistent with the underlying educational philosophy of a course and that it needs to teach the generic skills that allow graduates to practise in vocational environments. There has been widespread acceptance of integrated curricula (e.g. anatomy, physiology, pathology), and problem-based curricula (presenting clinical scenarios, real-life problems, problem-solving tasks). Such curricula challenge the way content is organised, how it is delivered, and how learning is assessed. There has been little attempt to date to deliver a Māori curriculum in health. We believe that ongoing initiatives to deliver such a curriculum must acknowledge that the teaching, content, processes and values that underlie it and, most importantly, the place at which it is delivered, and the way it is delivered have to be different from much of what has gone before.
The implications for designing courses that meet the needs (both clinically and culturally) of Māori health professionals are far-reaching. Such courses require careful preparation, consideration, resources, time and, most essentially, a commitment by course developers, teachers and learners to share control of the development and direction of the course.
Peer and Student Comments
Because you are in a course with people from many disciplines, you get to see what they do, what their issues are, as well as their experiences. [This] gives you a better overview of what is out there. It also gives you a sense that we all care about the health of Māori.
[Staying on a marae] is just what we need. We need to continue and nurture that wānanga on the marae. The marae is totally conducive to my learning as opposed to a school room or lecture room
I feel I learnt a lot more and was able to get more from this course because it was held on a marae. Standing to do group work or practise stuff was non-threatening and really worthwhile.
[The course has] given me self-belief and because of that I have had a lot more faith about what I could achieve.
Anonymous comments from course evaluations
For me personally, the course provided knowledge and skills directly applicable to my roles as a GP and primary care team member, health manager, medical school senior lecturer, GP supervisor and mentor. More than this the course extended my knowledge of tikanga and te reo, and provided extensive opportunities to learn in a supportive manner and in culturally competent ways.
There is no doubt that the course exceeded my expectations and those of the other participants, and provided the same to my fellow graduates. I want to continue to encounter like-minded Māori clinicians from a range of disciplines and observe the many new initiatives in health that have arisen from these connections.
Dr Peter Jansen, MB ChB, Grad Cert Clin Tch, FRNZCGP, Director of Research & Development, Mauri Ora Associates Lt
The bigger picture of course is the contribution this programme makes towards a skilled Māori health workforce with cultural and clinical competence
I had the privilege of undertaking this programme and whilst on the programme grew both personally and professionally.
The benefits of learning in a kaupapa MÐori (Māori-focused) environment is immense. Having the opportunity to network with other Māori health professionals, learning te reo (language) and tikanga (customs), all the while the energies of the marae replenishing the wairua (spirit).
Differentiating between cultural and clinical supervision was one of my greatest learnings, to the extent that a colleague and I developed a supervision model for Māori nurses.
I also had the privilege of representing this programme at a health education conference in South Africa. The experience was incredible, where initially biculturalism required extensive definition, however feedback identified the applicability of the programme to indigenous peoples all over the world.
Margareth Broodkoorn, Associate Director of Nursing and Midwifery: Maori Health, He Kamaka Oranga, Auckland District Health Board