BackgroundThe growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. One medical school in New Zealand explored the integration of the commonly used patient-centred model approach, with an intersectional framework in the development of a cultural competency training programme. In the Pacific Immersion Programme, medical students in their fourth year of training are given the opportunity to learn about different factors that influence the health and health care of a minority community through immersion in that community. The programme objectives include enabling students to learn through experience living within the local community context, and supporting them to re-evaluate their own personal beliefs, assumptions and/or prior prejudices. This study evaluates the usefulness of this programme in the training of medical students to work in diverse communities.MethodsTwo analytical approaches were used for evaluation. Deductive and inductive analyses were conducted on 235 reflective essays completed by three cohorts of students from 2011 to 2013 to ascertain the value of the programme for student learning. In addition, one cohort was invited to complete a pre and post-programme questionnaire.ResultsOverall, the students found the programme to be a valued learning environment. They found living within a Pacific family environment to be an eye opening experience. It increased students comfort level in cross cultural engagement and emphasised the importance of patient’s perspectives in health care provision. Students’ self-reported knowledge about Pacific cultural values, protocols, traditional beliefs and the main health challenges increased significantly after the programme. They appreciated learning directly from community members, and through observations about how culture, beliefs and the socio-economic environment influence peoples’ health and wellbeing.ConclusionsMedical schools are required to train a competent health workforce to meet the needs of diverse communities. The Pacific Immersion Programme provides a unique learning environment which can improve the training of doctors to work in diverse communities. The key to its success is enabling students to be engaged learners from “the inside” rather than an “outsider looking in”. The Programme enables experiential learning in a sensitive and meaningful way and can be useful for training in other institutions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-017-0858-7) contains supplementary material, which is available to authorized users.

Pacific students are from a minority group in New Zealand who like minority groups in other countries find transition to university difficult and success elusive. Nowhere is that successful transition more important at the University of Otago than in Health Sciences First Year (HSFY) which is a competitive entry pathway to health professional courses. Retention for Pacific students is similar to other students but poor academic achievement remains. Tinto argues that students' pre-entry attributes are major contributors to success in first year of university study. The aim of this paper is to describe the development of an instrument which predicts the performance of prospective students in the first year at university. The purpose of the instrument is to inform the development of tailored interventions aligned with students' needs. The instrument also provides an early proxy for student engagement and a benchmark for evaluating ongoing interventions.Please cite this article as: Kokaua, J., Sopoaga, F., Zaharic T., & Van der Meer, J. (2014). The development of a pre-enrolment screening tool to inform targeted support services in the first year in health sciences.

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Introduction: Health professional institutions are required to train a health workforce to meet the needs of their increasingly diverse communities. One approach is to increase the diversity of their student cohorts. This article provides some reflections on the approach from one institution to increase the participation and success of Pacific students, an under-represented group in its medical programme. Methods: A review of the University’s strategic documents and initiatives to improve the participation and success of Pacific students in the medical programme was conducted. The total number of Pacific students enrolled in medicine and their completion rates from 1996 to 2016 was requested from central university administration. The academic performance of Pacific students for the same period was requested from the medical school administration. The two extracts were merged and the annual performance for all Pacific students was analysed using Microsoft Excel. Interpretation of the results and perspectives discussed are shaped by the authors’ institutional knowledge. Results:  The earliest recorded efforts to increase the participation of Pacific students in the medical programme was through an affirmative action approach in 1951. Pacific student numbers, however, did not increase over subsequent years, until a more strategic approach was taken through the establishment of a Pacific Strategic Framework in 2011. The Framework coordinated a University-wide approach, engaged senior University leaders in the process, empowered Pacific staff, enabled targeted support for students and meaningful engagements with Pacific communities. These coordinated efforts coincided with positive outcomes for Pacific students’ in the medical programme. Conclusions: The building of capacity and capability for under-represented groups require patience, persistence, advocacy, diplomacy and risk-taking. Having a university-wide strategic approach that is endorsed at the highest levels, supported well through appropriate resourcing, including the empowerment of minority leadership within the institution is required. It is important also for senior institutional leadership to be consciously aware of institutional racism and the historical, economic and social forces that lie behind it.  Last by not least, building genuine and meaningful engagements with these minority communities is vital, and will support institutional efforts to meet the needs of their diverse communities.

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