Professor Dennis McDermott, Poche Chair in Indigenous Health and Well Being, Flinders University
Professor Dennis McDermott is the Director of the Poche Centre for Indigenous Health and Well-Being, Adelaide. He is also currently undertaking a National Senior Teaching Fellowship through the Australian Government’s Office of Learning and Teaching (OLT). Dennis is a psychologist, academic and poet. A Koori man, his mother’s family are from Gadigal land (inner Sydney) with connections to Gamilaroi country (north-west NSW). Dennis’s teaching and research interests encompass early childhood, social determinants of Indigenous health, policy and health equity, racism, incarceration, Indigenous social, spiritual and emotional well-being, workforce development, Indigenous health pedagogy, and the nexus of culture and context in service delivery.
THE POWER OF ‘HOLDING’, THE DILEMMA OF DE-OTHERING
Eliciting individual and institutional transformation within Indigenous cultural safety education
[A considerable number of] students [are] not ... able to manage the dissonance in their own minds, when we introduce concepts to them around [their notions of] Australia,
that they are not comfortable with. I was held, very gently, through my journey of coming to understand my white privilege.
I was held, very gently, through my journey of coming to understand my white privilege.1
Part of the success … at Children’s Hospital had to do with the fact that it was simultaneously an education program and … an organising effort … and so [we] were clear that in order for the program to be successful it had to be embedded in the institution and that wasn’t simply going to happen by us asking … but that we had to think of the ways in which transformation would occur within the relationships in the institution so that it would become part of what was important for the institution to hold on to.2
In Aboriginal and Torres Strait Islander (Indigenous) health settings, clinical effectiveness is the end product of culturally-safe care. Becoming a culturally-safe health practitioner requires the development of a critical stance and a reflective practice. Full efficacy in Indigenous health, though, necessitates a courageous embrace of the inequity wrought by colonisation, along with a pursuance of appropriate responses to the underlying social determinants of Indigenous health.
The transition to a health professional able to decolonise their practice is challenging: in an Australian context of widespread denial of troubling elements of our shared national history, such analysis can create sufficient dissonance to prompt student disengagement. Further, a ‘decolonising’ health professional actively seeks to diminish current power imbalances and address the continuing impacts of structured privilege, including interpersonal and systemic racism.
(And hold their job)
This presentation will draw on the Western-Desert notion of Kanyirninpa, or ‘holding’ – one manifestation of a widespread Aboriginal mechanism to assist difficult or threatening transitions, such as the passage into adulthood. ‘Holding’ students through a necessary, but challenging, transition is an educational duty-of-care that models the duty-of-care of the later, culturally-safe, health professional. Through the development of ‘safe’ educational spaces, resistance is lessened, disengagement is minimised and disquiet rendered manageable. Modes of transition on an institutional level, however, present a dilemma: despite the presence of allies, even champions, and demonstrable good-will, Othering pervades the informal and hidden curriculum, ward practice and health policy – stereotyping, unconscious bias and institutional racism go unrecognised by many. ‘Holding’ allows students not only to commence, but also continue, a testing, decolonising journey; de-Othering may be an essential element of institutional transformation towards the same end.
1 David Sjoberg, 2016
2 Melanie Tervalon, 2015
Professor Charlotte Rees, Director of HealthPEER and Director of Medicine Curriculum, Monash University.
Charlotte was previously Professor of Education Research and Director of the Centre for Medical Education at the University of Dundee, Scotland and Founding Director of the Scottish Medical Education Research Consortium. Charlotte has 15 years’ experience as a health professions education researcher and has led a 10-year programme of research on healthcare professionalism. She has over 100 peer-reviewed journal articles, book chapters and books and has secured over £1.5M of health professions education research income as Principal or Co-Investigator over the last 10 years. She is Deputy Editor for Medical Education, Associate Editor for Advances in Health Sciences Education and was the medical education expert on the UK Research Excellence Framework (REF2014) sub-panel for education. Her areas of teaching expertise include research supervision, teaching education research methodologies and methods, educational management and leadership, and professionalism education.
TRANSITIONS IN HEALTH PROFESSIONS EDUCATION: THEORY, RESEARCH, AND PRACTICE
Transitions are ever present in health professions education. Although there are various ways of understanding transition in terms of its ongoing, multiple and multidimensional nature (1), it can be defined as ‘the capability to navigate change’ (2). Learner transitions in higher education have been conceptualized variously: as processes of induction, development, and becoming (2). Healthcare students and professionals navigate plentiful transitions through their educational journeys including time-related transitions such as those into higher education (e.g. 3), clinical learning (e.g. 4), clinical practice (e.g. 5-7), and leadership (e.g. 8-10), plus space-related transitions like those into new clinical settings (e.g. urban-rural: 11), new countries (e.g. Asia-Australia: 12) or new roles (e.g. clinician-academic: 13). While transitions can be challenging, thereby affecting healthcare students’ and professionals’ well-being adversely, they also offer opportunities for intense learning, ultimately benefiting learners’ well-being and patient care (6,9). In this keynote, Charlotte will draw on the published literature across the healthcare professions, including her own team-based research on medical education transitions (e.g. 7,10) to provide preliminary answers to three questions: What are transitions in the healthcare professions? How can we research healthcare professional transitions? How can we help healthcare students and professionals to navigate transitions?
- Jindal-Snape D, Rientes B (Eds.) Multidimensional Transitions of International Students to Higher Education. New York: Routledge; 2016.
- Gale T, Parker S. Navigating change: a typology of student transition in higher education. Studies in Higher Education 2015;39(5):734-753.
- Monrouxe LV, Sweeney K. Between two worlds. Medical students’ narrative identity tensions. In: C. Figley, P. Huggard & C.E Rees (Eds.) First Do No Self-Harm. Understanding and Promoting Physician Stress Resilience. New York: Oxford; 2013:44-66.
- Hyde E. A critical evaluation of student radiographers’ experience of the transition from the classroom to their first clinical placement. Radiography 2015;21:242-247.
- Ali K et al. Transition of new dental graduates into practice: a qualitative study. European Journal of Dental Education 2015;20:65-72.
- Kilminster S et al. Preparedness is not enough: understanding transitions as critically intensive learning periods. Medical Education 2011;45:1006–1015.
- Monrouxe LV et al. How Prepared are UK Medical Graduates for Practice? Final Report from a programme of research commissioned by the General Medical Council, May 2014 (see: http://www.gmc-uk.org/about/research/25531.asp).
- Poronsky CB. Exploring the transition from registered nurse to family nurse practitioner. Journal of Professional Nursing 2013;29(6):350-358.
- Westerman M et al. The transition to hospital consultant and the influence of preparedness, social support, and perception: A structural equation modeling approach. Medical Teacher 2013;35:320-327.
- Rees CE et al. Exploring the transition experiences of higher-stage medical trainees: A longitudinal audio-diary study across the trainee-trained doctor transition. Scottish Medical Education Research Consortium (SMERC) Large Research Grant; 2015-2017.
- Rohatinsky NK, Jahner S. Supporting nurses’ transition to rural healthcare environments through mentorship. Rural and Remote Health 2016;1:3637.
- Takeno Y. Facilitating the transition of Asian nurses to work in Australia. Journal of Nursing Management 2010;18:215-224.
- Murray C et al. The transition from clinician to academic in nursing and allied health: A qualitative meta-synthesis. Nurse Education Today 2014;34:389-395.
Dr Geoff Scott, Emeritus Professor of Higher Education and Sustainability, Western Sydney University
Dr Geoff Scott is Emeritus Professor of Higher Education and Sustainability at Western Sydney University, Australia. From 2004-‐ 12 he was Pro Vice-‐Chancellor (Quality) and Executive Director of Sustainability at UWS. During this time he led a range of successful external quality audits and established RCE-‐GWS. He is a widely published author on change leadership, professional capability, assuring achievement standards and quality assurance in higher education. His book Turnaround Leadership for Higher Education with Canada’s Michael Fullan (2009) was nominated for the 2010 US Colleges Bellwether Award.
He is a former director of the Australian Council for Educational Research, a Fellow of the Australian College of Education, a member of TEQSA’s Panel of Experts and a higher education auditor and consultant in many countries. From 2014-‐16 he was a National Senior Teaching Fellow with Australia’s Office for Learning and Teaching. In 2007, he was the Recipient of the Australian Higher Education Quality Award.
LEADERSHIP IN TRANSITION
In this final plenary session Emeritus Professor Geoff Scott will summarise the key lessons from 40 years experience as a change leader in higher education and the results of research on effective effective approaches to change management in our universities and colleges. He will address two key themes:
- Good ideas with no ideas on how to implement them are wasted ideas
- Change doesn’t just happen but must be led, and deftly