Tātou Tātou: Success For
All. Improving Māori
student success in health
professional degree level
programmes.
Dr Elana Curtis, AP Papaarangi Reid, Dr
Mark Barrow, Dr Airini
University of Auckland, Aotearoa - New
Zealand
Ako Aotearoa Colloquium
Wellington, 4h May, 2011
Presentation summary
• Tātou Tātou Project
• Faculty of Medical and Health
Sciences
• Methods/Methodology
• Nursing findings
• Challenges/lessons
Tātou Tātou Project
• 18-month qualitative project
– Builds on TLRI project “Success For All”
• Māori student “success”
in health professional programmes at FMHS
– Nursing, Medicine, Pharmacy, Health Sciences
– Involves academic representatives and MAPAS
staff (working together)
– Unique, novel research project
• Non-lecture based teaching and learning,
includes clinical contexts
– tutorials/seminars/workshops/laboratories, small group clinical
teaching (e.g. ward rounds, bed-side), case studies/Problem
Based Learning (PBL), work based placement / internships
Research Questions
• What teaching practices in non-lecture
contexts help or hinder Māori success?
• What changes does research suggest are
needed to teaching/higher education to best
support Māori success in degree-level study
health professions?
Faculty of Medical and Health Sciences
• 4 degree programmes
–
–
–
–
Nursing – 3 years, clinical placements Y2/3
Pharmacy – 4 years, clinical Y4
Medicine – 6 years, clinical Y4-6
Health Sciences – 3 years, non-clinical,
work experience
• Limited exploration/research
within faculty to date
• Supported by MAPAS
– Māori and Pacific Admission Scheme
MAPAS
• Eligibility is whakapapa based
• Admission process
– MMI (multiple mini-interview), Maths/English
testing, whānau feedback, recommendations
post NCEA
• Academic support
– Tutorials, study weeks/retreats, space
• Pastoral support
– Co-ordinator, wānanga, cohort meetings
• Academic representation
– Board of Examiners, Faculty Committees
Methods
• Student interviews
– Aimed for 10 per programme
• Critical Incident Technique
– Can you describe a time when the
teaching and learning practices has helped
(or hindered) your success in X?
– Trigger, Action, Outcome
– Collaboratively group incidents into
categories, sub-categories
• 3 contexts
– Non-clinical, Clinical, MAPAS
• Validation/Reliability Testing
• Focus Groups
Methodology
• Kaupapa Māori
– Research design, implementation, analysis, report
writing and dissemination
– Māori-led, Māori input all stages
– Culturally appropriate, safe
– Give way rule (acknowledge limitations)
– Rejection of victim blame/cultural deficit theories
Progress to Date
• 41 interviews (transcribed, categorised)
–
–
–
–
Medicine – 17
Health Sciences – 14
Nursing – 7
Pharmacy - 3
• Progress made (VRT and Focus groups)
- Conducted but not ideal
• Second phase of data analysis in progress
– Re-categorisation
– Nursing data most developed
Overall results - preliminary
No. of
interviews
No. of
incidents
No. of
Incidents/IV
Help
%
Hinder
%
MBChB
17
393
23
264
67
129
33
BNurs
7
201
29
137
68
64
32
BHSc
14
644
46
415
64
229
36
BPharm
3
114
38
76
67
38
33
• BHSc data provided nearly double no. of incidents
• Similar proportions of help and hinder across programmes
• Likely to change as data fully reviewed
Nursing - preliminary
Categories (n = 13)
• Provide culturally appropriate academic and pastoral
support
Totals (per Percentage (of
category)
total)
58
29%
• Use best practice teaching and learning methods
37
18%
• Provide a supportive learning environment
29
14%
• Recognise the importance of Nursing cohort cohesion
14
7%
• Address stigma regarding MAPAS quota
13
6%
• Provide opportunities to link theory to practice
10
5%
9
4%
9
4%
• Understand the complexities of student life
8
4%
• Provide a well organised programme
7
3%
• Provide a separate/safe cultural space
4
2%
• Provide culturally appropriate clinical placements
2
1%
• Support independent learning
2
1%
• Ensure clinical staff understand their impact on student
learning
• Support whakawhanaungatanga
Provide culturally appropriate
academic and pastoral support
• MAPAS tutorials/study groups
• MAPAS Coordination
Trigger: what’s really great about MAPAS you know [is that] always everything
that they do for students is in order to really get them to succeed. Action: the
more you kind of you go down the studying track you know with MAPAS the more
good you feel you know, cause there are these people there and they’re really
routing for you, you know, and they’re always really approachable and you know
if you’ve got any problems, they’re always there for you and are willing to, you
know, give you extra help if you need it. Outcome: I guess confidence is probably
the biggest thing when you’re studying ... its quite good to have someone
standing there, you know, well don’t worry just try it from a different angle for
next time you know and we’ll get you through and I think that’s always been
really good.
MAPAS domain, Help, Year 1 Nursing student.
Use best practice teaching and learning
methods
• Māori Health Week
• Nursing tutorials (content/size)
Trigger: I think Māori Health week Action: I mean, you know I heard a
lot of people during Māori health week say oh you guys get a whole week
you know what about Somalian health week or you know Indian health
week and yeah I think that that’s what kind of promoted a lot of the angst
between other cultures and Māori students. Outcome: I think that that’s
what aggravates the, it aggravates the hate or the kind of, it just promotes
this idea that we get special opportunities.
Non-clinical Domain, Hinder, Recent Graduate Nursing.
Provide a supportive learning
environment
• Resources
• Awareness of tertiary study
Trigger: So I like to study at the university Action: my house isn’t
particularly, I don’t know it’s got too many distractions so I find it
really hard to study at my house. But when there isn’t like, cause I
don’t have internet at my house either, when there isn’t a computer
I can find at the university that’s annoying. And when there isn’t a
text book I can borrow. Outcome: for the last exam I sat, I don’t
know, cause I probably didn’t do enough of the study that I should
have and that had a lot of, that had a lot to do with not having a text
book to borrow at the university
Non-clinical Domain, Hinder, Year 1 Nursing student.
Recognise the importance of Nursing
cohort cohesion
• Group learning
Trigger: if you don’t have that support network in place to begin
with Action: You know, you don’t have a “go to” person who you feel
comfortable with to say you know, “Shoot, I’m really struggling, what
do I do? Can you help me?” Outcome: It’s really important, oh
absolutely important.
Non-clinical Domain, Help, Year 1 Nursing student.
Address stigma regarding MAPAS
quota
• Awareness of MAPAS support
Trigger: not knowing how to access MAPAS and all that stuff.
Action: So, like, just not having that support, not knowing what to
do, who to go see to help out, you know, in that first semester, was
really hard, you know Outcome: then at the end of the year I had
my interview and I got in....I realised that MAPAS was there to help,
and that they offered all these things
MAPAS Domain, Hinder, Year 3 Nursing student.
Ensure clinical staff understand their
impact on student learning
• Staff characteristics
Trigger: I just don’t understand why a lot of the preceptors are like
that towards student nurses Action: a lot of times they just ignore
you, like you hear a lot of people in our class – I just stood there. I
didn’t do anything. I’ve done that, because they just ignore me, and if
you just stand there and you’re not doing anything, you’re not going to
learn. Outcome: because it really does affect the way you learn
Clinical Domain, Hinder, Year 3 Nursing student.
Challenges/Lessons
• Get student recruitment right
– Know/use your denominator
• Get interviewers on track
– Invest in training/tracking (++++)
• Invest in research administration
• Overestimate time/resources required to
complete analysis
•
Avoid going on maternity leave!
Summary
• Need to ensure quality analysis
– Need to fully review categories/sub-categories within
and across the 4 programme
– Explore domains – what have we learnt about clinical
contexts etc?
• Next steps
– Repeat VRT
– Develop QTTe toolkit
– Draft papers/present findings
Acknowledgments
•Students
•Tātou Tātou Team
MBChB – AP Philipppa Poole, Dr
Myra Ruka
BHSc – Dr Bridget Kool
Nursing – Michelle Honey
Pharmacy – Fiona Kelly
MAPAS – William Nepia, Dwain
Hindricksen, Torise Lualua, Fa’asou
Manu
Research Asssistant – Erena
Wikaire
•PI
Dr Elana Curtis
•Ako Aotearoa