Transformative effects of Aboriginal health placements for medical, nursing, and allied health students: A systematic review

Abstract

The aim of the present systematic review was to investigate whether placements in Aboriginal health affect the self-perceived skill in working in Aboriginal health settings and career aspirations of health students, and in particular, aspects of the placement that had the greatest impact. The Embase, Cinahl, ProQuest, Scopus, Informit, Ovid MEDLINE, PsychINFO, and PubMed databases were searched in April/May 2016. Placements of at least 1 week duration in an Aboriginal health setting involving Australian students of medical, nursing, dentistry, or allied health disciplines, with outcomes relating to changes in students' knowledge, attitudes, and/or career aspirations, were included. The search retrieved 1351 papers. Fourteen studies were eligible for inclusion in this review. Narrative synthesis found that work placements in Aboriginal health increased understanding and awareness of Aboriginal culture, promoted deeper understanding of Aboriginal health determinant complexity, increased awareness of everyday racism toward Aboriginal Australians, and enhanced desire to work in Aboriginal health. There is a need for improved teaching and learning scholarship to understand whether placements improve students' skill working with Aboriginal people in health care or increase the likelihood of future employment in these settings.

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives

“…Informed, culturally competent graduates were considered essential to efforts to reduce socio-economic and health disparities experienced by Aboriginal Australians; medical and health sciences accreditation bodies responded by mandating compulsory Aboriginal content in programs. Numerous initiatives across the country have provided evidence of a range of transformative impacts on students from classroom content and cultural immersion experiences [12][13][14][15][16][17]. Despite some encouraging findings, doubt has been expressed about a link between educational initiatives and improved outcomes for Aboriginal people due, in part, to embedded culture within organisations and barriers with implementation of knowledge [18][19][20].…”

Learning from follow-up of student placements in a remote community: a small qualitative study highlights personal and workforce benefits and opportunities

“…The importance and potentially transformative impact of such placements in Aboriginal settings has been described by a number of authors, and most recently been reported in a systematic review [10]. The review also identified the limitations of such studies: the lack of an independent measure to assess skill in working with Aboriginal people; whether the knowledge acquired on placement prepares students for encounters with Aboriginal people in mainstream settings; and whether a rural health placement influences students’ decision-making to work rurally or in Aboriginal health [10]. In medicine, studies reporting on the longer-term impact of rural or Aboriginal field placements on early career location in terms of rural career uptake have been encouraging [4, 5, 21].…”

“…Rural and remote placements have the unique capacity to introduce students to the advantages of rural living and promote rural practice, while also exposing them to the health consequences of remoteness and the realities of rural-based social disadvantage. Furthermore, many rural settings have substantial Aboriginal populations: placements can provide valuable opportunities to build cultural respect and understanding, and observe the role of cultural protocols in health care delivery [10]. The impact of this exposure on students can be profound; humility, respect and a challenging of stereotypes have been observed as outcomes of sustained interactions [11].…”

“…Small, in-depth qualitative studies have drawn attention to the personal and professional implications of cultural immersion experiences [10]. Few, however, have considered whether and how recent graduates have opportunities to apply clinical and cultural learnings acquired on these placements in workplaces after graduation, if they are supported in this process, and the factors that influence employment choices in the early years of their careers.…”

Rural medical students' self‐reported perceptions of preparedness to practice in the Aboriginal and Torres Strait Islander Health Context

“…Australian Aboriginal and Torres Strait Islander peoples' health is affected by political, social and environmental issues that have occurred since colonisation 1,2 . Australian medical schools recognise that there are problematic historical relationships between medical practitioners and Aboriginal and Torres Strait Islander people, 3 and are working to address this through curriculum change 4…”