Two decades in the making : reflecting on an approach to increase the participation and success of Pacific students at the Otago Medical School in New Zealand.

Abstract

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.

Holistic health for Pacific seniors from a weekly group gathering run by a Pacific health provider

“…25 Evidence suggests that a closer connection to culture and ethnic identity supports enhanced Pacific health and wellbeing. 17,26 This aligns with some of the findings in Lilomaiava Silulu's PhD thesis 27 looking specifically at Samoan elders' perceptions of wellness where Soifua Manuia (good health) was associated with close links to family and faith.…”

“…Both the Kakala Research Framework and the Talanoa Research Methodology are regularly used together, having a complimentary relationship. 10,17 Ethical approval was granted by the University of Otago School of Physiotherapy Ethics Committee -Application number SoP/EC/2022/05.…”

Widening how we see the impact of culture on learning, practice and identity development in clinical environments

“…For new practitioners, there is much identity work to undertake in the challenge of moving into a profession and working in an environment that for many is at odds with their values and perception of their role as a health professional. The enculturation of the individual into a work environment has been well illustrated recently in New Zealand where the medical workforce has seen a substantial increase in indigenous (Māori) 36 and Pacific 37 graduating doctors. The following case study taken from the perspective of Emma Espiner, a newly graduated Māori doctor, in an award winning podcast, demonstrates the challenges of managing identity as a Māori medical student within a health workplace culture that is predominantly non‐Māori and within a health care system associated with unequal health outcomes for Maori.…”