1. Teaching Best Practice Indigenous Health Maggie Grant Yvette Roe JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU

2. THE CONTEXT  numbers of Indigenous students  numbers of Indigenous teaching staff  Indigenous health content JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU

3. THE CONSEQUENCES  more talk on Indigenous subjects  more opportunities for culturally unsafe practice  more opportunity to promote understanding of Indigenous health JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU

4. MANAGING THE CONSEQUENCES A considerable balancing act JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU open & free discussion amongst all students a culturally safe environment for Indigenous students

5. THE BARRIERS Non-Indigenous Students  a lifetime of conditioning  even the best-intentioned can clumsy & racist  previously little chance to test their views and beliefs in an environment that is:-  informed  supportive  critical JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU

6. THE BARRIERS Indigenous Students  a lifetime of conditioning  cross-cultural training that targets non-Indigenous  previously little previous chance to test their views and beliefs in an institutional environment that is:-  informed  supportive  critical JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU

7. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Explicit discussion of culturally safe behaviour Example; ‘use of them and us’ language  build empathy by building understanding of what if feels like to be an ‘outsider’

8. The Story Three Anglo-Australian students (2 females, 1 male) were doing a subject “Religion and Societies” in a university in the western suburbs of an Australian city. These 3 students are all committed Christians studying to be teachers. All other students doing the subject are Islamic (20% female, 80% male). Over the time the subject ran there were many open classroom and tutorial discussion about many religions and cultures, including a number about Christianity and Christians and about western civilisation. All the Islamic students except one or two, were polite and friendly to the 3 students out of class. The 3 students heard all the following comments about Anglo-Ausies discussed openly during class.

9. Actual quotes from classrooms Their religion is quite backward compared to ours. They have many superstitions Their women are quite promiscuous Drinking is a huge problem with them – they do not seem to be able to leave it alone. Families in that society seem to be crumbling with adultery and alcoholism. My brother who is a doctor says they never take his advice about their health. They get many privileges we do not get Even ones with poor results can get into uni They are favoured by government

10. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Bulletproof Indigenous Students & Staff Give Indigenous students:  explicit resilience training  knowledge of their rights and institutional obligations  access to influential and powerful staff

11. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Promote leadership by Indigenous students & supporters  build special interest groups  don’t allow negative or racist students to dominate classroom discussion and take leadership  award positive participation

12. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Show that best practice medicine can only occur in a non-racist environment  US experience of sub-optimal care management determined by race or ethnicity

13. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Non-racist medicine can only be practised when doctors provide best quality clinical care  less than optimal training and care of high burden health issues is a form of racism - and bad medicine

14. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Things that are especially convincing  Teaching anti-racism seems to work best for us when it is centre clinical care  one cannot practice good medicine unless one’s practice is culturally insightful & equitable

15. THE STRATEGIES JAMES COOK UNIVERSITY SCHOOL OF MEDICINE JCU Things that are especially convincing  Experience of racism and colonialism has universal impacts not confined to Australian Indigenous people  De-bunking obvious myths  Never denying the obvious … but giving it context