1. Tātou Tātou: Success For All
Tātou Tātou: Success For All. Improving Māori student success in health professional degree level programmes.
Dr Elana Curtis, AP Papaarangi Reid, Dr Mark Barrow, Dr Airini
University of Auckland, Aotearoa - New Zealand
Ako Aotearoa Colloquium
Wellington, 4h May, 2011

2. Presentation summary Tātou Tātou Project
Faculty of Medical and Health Sciences
Methods/Methodology
Nursing findings
Challenges/lessons

3. Tātou Tātou Project 18-month qualitative project
Builds on TLRI project “Success For All”
Māori student “success”
in health professional programmes at FMHS
Nursing, Medicine, Pharmacy, Health Sciences
Involves academic representatives and MAPAS staff (working together)
Unique, novel research project
Non-lecture based teaching and learning, includes clinical contexts
tutorials/seminars/workshops/laboratories, small group clinical teaching (e.g. ward rounds, bed-side), case studies/Problem Based Learning (PBL), work based placement / internships
How non-lecture teaching and learning helps or hinders Māori student and Pasifika student success in preparing for or completing degree-level studies
National Institute of Creative Arts and Industries (NICAI)
Faculty of Medical and Health Sciences (FMHS)
Faculty of Educations (PASS)
Careers Services

4. Research Questions
What teaching practices in non-lecture contexts help or hinder Māori success?
What changes does research suggest are needed to teaching/higher education to best support Māori success in degree-level study health professions?

5. Faculty of Medical and Health Sciences
4 degree programmes
Nursing – 3 years, clinical placements Y2/3
Pharmacy – 4 years, clinical Y4
Medicine – 6 years, clinical Y4-6
Health Sciences – 3 years, non-clinical, work experience
Limited exploration/research within faculty to date
Supported by MAPAS
Māori and Pacific Admission Scheme

6. MAPAS Eligibility is whakapapa based Admission process
MMI (multiple mini-interview), Maths/English testing, whānau feedback, recommendations post NCEA
Academic support
Tutorials, study weeks/retreats, space
Pastoral support
Co-ordinator, wānanga, cohort meetings
Academic representation
Board of Examiners, Faculty Committees

7. Methods Student interviews Critical Incident Technique 3 contexts
Aimed for 10 per programme
Critical Incident Technique
Can you describe a time when the teaching and learning practices has helped (or hindered) your success in X?
Trigger, Action, Outcome
Collaboratively group incidents into categories, sub-categories
3 contexts
Non-clinical, Clinical, MAPAS
Validation/Reliability Testing
Focus Groups

8. Methodology Kaupapa Māori
Research design, implementation, analysis, report writing and dissemination
Māori-led, Māori input all stages
Culturally appropriate, safe
Give way rule (acknowledge limitations)
Rejection of victim blame/cultural deficit theories

9. Progress to Date 41 interviews (transcribed, categorised)
Medicine – 17
Health Sciences – 14
Nursing – 7
Pharmacy - 3
Progress made (VRT and Focus groups)
Conducted but not ideal
Second phase of data analysis in progress
Re-categorisation
Nursing data most developed

10. Overall results - preliminary
No. of interviews
No. of incidents
No. of Incidents/IV
Help %
Hinder
MBChB 17
393 23
264 67
129 33
BNurs 7
201 29
137 68 64 32
BHSc 14
644 46
415
229 36
BPharm 3
114 38 76
BHSc data provided nearly double no. of incidents
Similar proportions of help and hinder across programmes
Likely to change as data fully reviewed

11. Nursing - preliminary Categories (n = 13) Totals (per category)
Percentage (of total)
Provide culturally appropriate academic and pastoral support 58
29%
Use best practice teaching and learning methods 37
18%
Provide a supportive learning environment 29
14%
Recognise the importance of Nursing cohort cohesion 14 7%
Address stigma regarding MAPAS quota 13 6%
Provide opportunities to link theory to practice 10 5%
Ensure clinical staff understand their impact on student learning 9 4%
Support whakawhanaungatanga
Understand the complexities of student life 8
Provide a well organised programme 7 3%
Provide a separate/safe cultural space 4 2%
Provide culturally appropriate clinical placements 2 1%
Support independent learning

12. Provide culturally appropriate academic and pastoral support
MAPAS tutorials/study groups
MAPAS Coordination
Trigger: what’s really great about MAPAS you know [is that] always everything that they do for students is in order to really get them to succeed. Action: the more you kind of you go down the studying track you know with MAPAS the more good you feel you know, cause there are these people there and they’re really routing for you, you know, and they’re always really approachable and you know if you’ve got any problems, they’re always there for you and are willing to, you know, give you extra help if you need it. Outcome: I guess confidence is probably the biggest thing when you’re studying ... its quite good to have someone standing there, you know, well don’t worry just try it from a different angle for next time you know and we’ll get you through and I think that’s always been really good.
MAPAS domain, Help, Year 1 Nursing student.

13. Use best practice teaching and learning methods
Māori Health Week
Nursing tutorials (content/size)
Trigger: I think Māori Health week Action: I mean, you know I heard a lot of people during Māori health week say oh you guys get a whole week you know what about Somalian health week or you know Indian health week and yeah I think that that’s what kind of promoted a lot of the angst between other cultures and Māori students. Outcome: I think that that’s what aggravates the, it aggravates the hate or the kind of, it just promotes this idea that we get special opportunities.
Non-clinical Domain, Hinder, Recent Graduate Nursing.

14. Provide a supportive learning environment
Resources
Awareness of tertiary study
Trigger: So I like to study at the university Action: my house isn’t particularly, I don’t know it’s got too many distractions so I find it really hard to study at my house. But when there isn’t like, cause I don’t have internet at my house either, when there isn’t a computer I can find at the university that’s annoying. And when there isn’t a text book I can borrow. Outcome: for the last exam I sat, I don’t know, cause I probably didn’t do enough of the study that I should have and that had a lot of, that had a lot to do with not having a text book to borrow at the university
Non-clinical Domain, Hinder, Year 1 Nursing student.

15. Recognise the importance of Nursing cohort cohesion
Group learning
Trigger: if you don’t have that support network in place to begin with Action: You know, you don’t have a “go to” person who you feel comfortable with to say you know, “Shoot, I’m really struggling, what do I do? Can you help me?” Outcome: It’s really important, oh absolutely important.
Non-clinical Domain, Help, Year 1 Nursing student.

16. Address stigma regarding MAPAS quota
Awareness of MAPAS support
Trigger: not knowing how to access MAPAS and all that stuff. Action: So, like, just not having that support, not knowing what to do, who to go see to help out, you know, in that first semester, was really hard, you know Outcome: then at the end of the year I had my interview and I got in....I realised that MAPAS was there to help, and that they offered all these things
MAPAS Domain, Hinder, Year 3 Nursing student.

17. Ensure clinical staff understand their impact on student learning
Staff characteristics
Trigger: I just don’t understand why a lot of the preceptors are like that towards student nurses Action: a lot of times they just ignore you, like you hear a lot of people in our class – I just stood there. I didn’t do anything. I’ve done that, because they just ignore me, and if you just stand there and you’re not doing anything, you’re not going to learn. Outcome: because it really does affect the way you learn
Clinical Domain, Hinder, Year 3 Nursing student.

18. Challenges/Lessons Get student recruitment right
Know/use your denominator
Get interviewers on track
Invest in training/tracking (++++)
Invest in research administration
Overestimate time/resources required to complete analysis
Avoid going on maternity leave!

19. Summary Need to ensure quality analysis Next steps
Need to fully review categories/sub-categories within and across the 4 programme
Explore domains – what have we learnt about clinical contexts etc?
Next steps
Repeat VRT
Develop QTTe toolkit
Draft papers/present findings

20. Acknowledgments Students Tātou Tātou Team
MBChB – AP Philipppa Poole, Dr Myra Ruka
BHSc – Dr Bridget Kool
Nursing – Michelle Honey
Pharmacy – Fiona Kelly
MAPAS – William Nepia, Dwain Hindricksen, Torise Lualua, Fa’asou Manu
Research Asssistant – Erena Wikaire PI
Dr Elana Curtis
Ako Aotearoa