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Hearing from leaders in Indigenous medical education – plus #LIMEvi Twitter wrap

Leaders in Indigenous medical education from Australia, Aotearoa, Canada and Hawai’i gathered in Townsville last week, on the country of the Bindal and Wulgurukaba Peoples, for the sixth conference of the Leaders in Indigenous Medical Education (LIME) Network.

With the conference theme of “knowledge systems, social justice and racism in health professional education”, many sessions heard about efforts to improve cultural safety in teaching, learning and practice environments.

As the #LIMEvi Twitter stream illustrates, there were many vibrant discussions and strong presentations. The impact of racism upon Indigenous educators, practitioners and patients was a recurring theme.

Also noted on Twitter was the absence of some senior medical educators, perhaps illustrating the challenges for those seeking to create institutions that are more culturally safe. Please see a selection of conference tweets in the second half of this post.

Thanks to Dr Tammy Kimpton, president of the Australian Indigenous Doctors’ Association (AIDA), a Palawa woman from the west coast of Tasmania, and a GP in Scone, NSW, for the following report.

****

Dr Tammy Kimpton writes:

On Monday August 10th, AIDA and Medical Deans Australia and New Zealand (Medical Deans) celebrated the signing of our fourth Collaboration Agreement.  In launching this agreement, we reaffirmed our strong commitment to working together to increase the numbers of Aboriginal and Torres Strait Islander doctors, and to ensure that our Australian universities deliver culturally safe medical education.

The launch also provided an opportunity to reflect on some of the significant milestones during ten years of collaboration.  Since the signing of the first Collaboration Agreement, we have more than doubled the number of Aboriginal and Torres Strait Islander doctors, and have dramatically increased the Aboriginal and Torres Strait Islander medical student cohort.

In the spirit of collaboration, AIDA and Medical Deans have worked together on the National Medical Education Review and the Building Indigenous Medical Academics project.  AIDA and Medical Deans also co-auspice, along with Te ORA – The Maori Medical Practitioners Association – and Melbourne University, the biennial Leaders in Medical Education (LIME) Connection.  The theme for LIME Connection VI was Knowledge Systems, Social Justice and Racism.

It was, therefore, disappointing to realise that some of the non-Indigenous leadership were not active participants throughout out the conference and did not hear directly about the shared experiences of delegates from across the globe. While this was a missed opportunity, we look forward to their ongoing participation at future conferences.

Throughout the streams of LIME Connection VI, presenters and delegates from Australia, Aotearoa, Canada and Hawaii shared stories of research and programs, lessons learned and lessons taught.

Brave students shared with us their journeys through life and into medical training.  We explored the continuum of medical education, and the supports that are needed to ensure today’s medical students become tomorrow’s competent and resilient doctors. Assessment in all forms from pre-entry to medical school through to accreditation of our universities and Medical Colleges was debated. There was even an opportunity to explore the issues of cultural safety through literature at the first LIME Connection book club.

Each day we were privileged to have the opportunity to hear a keynote speech from an international expert in Indigenous Health and Medical Education – Dr Chelsea Bond from Australia, Tania Huria from Aotearoa and Professor Keawe’aimoku Kaholokula from Hawai’i.  For me, it was through these three keynote addresses that the themes of the LIME Connection ran most boldly.

Dr Chelsea Bond entitled her Keynote “Embodying Race and Encountering Racism: Cultural Safety FOR Indigenous Educators”.  She spoke to us of race, and of the challenges that arise through embodying “the other”.  Some interactions with learners can be hostile, creating a culturally unsafe environment for the Indigenous educator.

In one particularly poignant example, Dr Bond recalled a student who felt uncomfortable because “the lecturer was an Aboriginal woman” – intriguingly, the course was called “Aboriginal Woman”.  Dr Bond identified racism as a workplace health and safety risk, which risks reducing the already small pool of Indigenous Academics.

Tania Huria’s Keynote address “Externalising a complicated situation: teaching racism in an Indigenous curriculum, a case study” discussed how universities can teach not just about race and the health effects of race, but about racism.  She reflected on the well-documented evidence of the effects of racism on health outcomes, and described the scaffolding that has been developed for University of Otago students to explore the effects of racism with patients and their whanau.

Through active audience participation, Tania urged all universities to start teaching their students not just to ask about race, but to further question patients about their experience of racism. Tania also launched the catchy hashtag – #externaliseareallycomplicatedsituationandthenteachit

Professor Kaholokula’s Keynote address, on the final day of LIME Connection VI, was entitled “Mauli Ola: Pathways towards Social Justice for Native Hawaiians and Pacific Islanders in Hawai’i”. Professor Kaholokula made the comment that in order to have a racism-free health care system, we first require a racism-free society.  He explored the critical role of social justice, social and cultural determinants of health and increasing the numbers of Native Hawaiian medical practitioners in achieving “Mauli Ola” or optimal health and wellbeing for all Native Hawaiians.

And so, the LIME Connection Keynotes drew us on a journey, from race and racism through the need for organisational and systemic change.  The depth into which these issues were explored, and the extent to which we in the audience were drawn into the dialogue and along the journey was, for me, the educational highlight of the Connection.

It is timely that these conversations occur.  We have recently seen the Adam Goodes debate in the media and the beyond blue racism campaign.  In 2013, the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 identified that racism is a key social determinant of the health of Aboriginal and Torres Strait Islander people and leads to poorer health outcomes.  It is time to close the health and life expectancy gap and to make sure that any Aboriginal or Torres Strait Islander child born in this country has the same opportunity as other Australian children to live a long, healthy and happy life.

• Dr Tammy Kimpton is president of AIDA. Follow her on Twitter: @tammykimpton

***

Croakey thanks #LIMEvi tweeps for helping to share the conference news.










Before the conference, participants had a day on Palm Island



And a final image from #LIMEvi