1. Professor Ian Anderson & Ms Debra Knoche Centre for Health & Society – Onemda VicHealth Koori Health Unit University of Melbourne National Workforce Strategy And Medical Workforce Development

2. Overview Context –Medical workforce development & national strategy in Aboriginal health Medical Deans Australia and New Zealand Indigenous Health Project –Background CDAM’s 2001 Indigenous Health Strategy National Curricula Framework & Accreditation –Current Program: The LIME Network Quality Review: Critical Reflection Tool Communications Framework

3. Context National Strategic Framework for Aboriginal and Torres Strait Islander Health 2003-2013. Nine Key Result Areas: –Community controlled primary health care –Health system delivery framework –A competent health workforce –Emotional and social well-being –Environmental health –Wider strategies that impact on health –Data, research and evidence –Resources and finance –Accountability

4. Context Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework –Increase the number of Aboriginal and Torres Strait Islander people working across all the health professions. –Improve the clarity of roles, regulation and recognition of Aboriginal and Torres Strait Islander Health Workers as a key component of the health workforce, and improve vocational education and training sector support for training for Aboriginal and Torres Strait Islander Health Workers. –Address the role and development needs of other health workforce groups contributing to Aboriginal and Torres Strait Islander health.

5. Context –Improve the effectiveness of training, recruitment and retention measures targeting both non-Indigenous Australian and Indigenous Australian health staff working within Aboriginal primary health services. –Include clear accountability for government programs to quantify and achieve these objectives and support for Aboriginal and Torres Strait Islander organisations and people to drive the process.

6. Context Key Issues for Policy –Indigenous leadership and values; –Indigenous community engagement –Achieve a critical mass of Indigenous graduates – influence reform across the sector, facilitate the development of social capital –Multi-disciplinary – but with a focus on the specifics of reform for the particular professions

7. Context Key Issues for Policy –Skilled workforce (Indigenous and non- Indigenous) under-pins quality, effective care –Regionalisation –Development of the momentum for institutional reform

8. Medical Deans Australia & New Zealand Committee of Deans Australian Medical Schools –2001: Strategic Framework for the Inclusion of Indigenous Health in Core Medical Curricula and Recruitment, Retention and Support Strategies for Indigenous Australians in Medical Education. –2002: The Australian Health Ministers’ Advisory Council (AHMAC) endorsed the Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework. –2003: CDAMS Indigenous Health Curriculum Project & the AIDA Best Practice in Indigenous Recruitment and Support Project

9. Medical Deans Australia & New Zealand -August 2004: A national audit of medical schools to assess existing Indigenous health content in curriculum and its delivery context. -August 2005: CDAMS Indigenous Health Curriculum Framework. -2005: Commenced work to establish the LIME Network of medical educators, Indigenous health professionals, community members, and representatives from medical postgraduate councils, medical colleges and medical students; -June 2005: The LIME connection Fremantle. -October 2005: Agreement for Collaboration signed by AIDA and CDAMS.

10. Medical Deans Australia & New Zealand National Curricula Framework: Guiding principles and rationale; Suggested subject areas and key student attributes; Ten key pedagogical principles which enunciate the basic approaches most likely to produce successful content and contexts for quality learning; Delivery and assessment guidelines; Suggested processes for curriculum development; Resources and capacity most likely to produce success.

11. Medical Deans Australia & New Zealand Australian Medical Council formally endorsed the curriculum framework working party reviewed actual standards New standards published approved 27 th July 2006

12. Medical Deans Australia & New Zealand Current projects: –Development of the LIME network & proposal Purpose, Structure, Relationships –Development quality review mechanisms The Critical Reflection Tool (CRT): purpose, structure, process of development, trial. –Development of communications framework Launch of the LIME Network Website & ongoing development

13. Medical Deans Australia & New Zealand The LIME network Purpose: A dynamic network dedicated to ensuring the quality and effectiveness of teaching and learning of Indigenous health in medical education and curricula and best practice in the recruitment and retention of Indigenous medical students. Objectives –Quality review; Professional development and support; Capacity building; Professionalisation of the Discipline; Multi-disciplinary/ Multi-sectoral networking; Advocacy and reform; Connection

14. Medical Deans Australia & New Zealand The LIME Connection The LIME Network Executive (MDs, AIDA, AMC, Host) Host Institution Staff The LIME network Structure and Governance

15. Medical Deans Australia & New Zealand Relationship with other networks: –Eg PRIDOC; INIHKND, ANZAME etc Medical Deans Australian & New Zealand is now a trans-Tasman organisation LIME structure should reflect this partnership –Advantage of enhanced network –Need further consultation and negotiation to develop

16. Medical Deans Australia & New Zealand The Critical Reflection Tool Purpose: support medical schools implement, monitor and sustain a nationally accredited Indigenous health curriculum framework and to adopt initiatives related to Indigenous student recruitment, retention and support. The CRT is designed to encourage internal reflection, critical thinking, a review of current practice, and focus on future planning among Australian and New Zealand medical faculties/schools Critical Reflection

17. Medical Deans Australia & New Zealand - Structure of the CRT -The CRT is arranged around eight overarching categories, some which may address more than one theme. Categories roughly conform to those used in the AMC guidelines and include: -context of the medical school ; outcome of the medical course; medical curriculum; teaching and learning; assessment and student learning; curriculum-monitoring and evaluation; Indigenous students; Implementing the curriculum. -Each has descriptive background; key questions; references to the Curriculum Framework, Healthy Futures and AMC guidelines; examples; and response prompts.

18. The Critical Reflection Tool

20. Medical Deans Australia & New Zealand Process of Development -A Working party was formed in February -The content of the CRT was developed by the Indigenous Health project team in consultation with the working party. -A pilot study was undertaken in June/July 2007 in 5 medical schools

21. Medical Deans Australia & New Zealand Trial –To be conducted by all medical schools in October –It is envisaged that the process will involve individual reflection, and a collective response by a working group or committee. –Each group member responds individually to CRT questions that are most relevant to their area of expertise. –The working group or committee then critiques current practice, establishes goals and objectives, devises strategies and plans the next steps. –This process supports the Dean and other decision makers in the implementation of the Indigenous health strategy.

22. Medical Deans Australia & New Zealand Communications framework The LIME Network website aim is to provide ongoing support to members through the provision and sharing of information and educational resources. The website will also provide a place where members can interact with one another through membership and access to member only areas.

23. The LIME Network Website

25. Medical Deans Australia & New Zealand Future developments in Medical workforce –Consolidation of network –Focus on multi-disciplinary links –Capacity Building –Indigenous students –Quality