Internationalisation' or 'localisation'? Promoting dental students' cultural responsiveness through outplacements with Maori health providers

Year: 2012

Author: Anderson, Vivienne, Broughton, John, Rapana, Sonia

Type of paper: Abstract refereed


Higher education literature reveals a growing concern with promoting students' intercultural awareness and skilfulness; sense of social and ethical responsibility; and ability to move between socio-geographical contexts. This is often cast in terms of 'internationalisation': as a necessary response to increased on-campus diversity and student and graduate mobility. Dental education literature reveals parallel concerns with fostering a culturally responsive and ethically minded workforce. However, these concerns are often related to socio-economic disparities 'at home' and associated health inequalities for low-income indigenous, rural and/or minority communities. New Zealand's only dental school at the University of Otago has a highly 'internationalised' student population. About a third of dental students identify as 'Pakeha' (European New Zealanders), a third as 'Asian', and around 20 percent as first generation New Zealanders or 'international students'. Very few identify as indigenous (Maori) students. However, since low-income Maori communities bear a disproportionate burden of dental disease in New Zealand, a key educational priority is the development of a dental workforce that is responsive to the needs of Maori. It was therefore strategic that six Maori Health Providers (MHPs) led the way in hosting students when compulsory clinical outplacements were introduced for final-year dental students in 2012. METHODS This paper discusses the rationale for and preliminary findings from a three-year Kaupapa Maori project involving University-MHP partnership. Kaupapa Maori research is research driven by Maori aspirations and conducted by or with Maori communities. This project draws on a participatory action research methodology and is informed by critical theoretical perspectives. The project aims are to examine student expectations of and reflections on clinical outplacement within predominantly Maori communities, and community members' perspectives of hosting predominantly non-Maori dental students. Data collection is through pre and post-outplacement student questionnaires and twice-yearly focus group interviews, clinical supervisor questionnaires and hui korero (discussion meetings), and client/caregiver questionnaires. Descriptive analysis is used for yes/no and Likert-scale type questionnaire responses while discourse and inductive analysis are used for comment responses and qualitative data. RESULTS Research findings are preliminary but promising. Initial client feedback reflects a warm appreciation of the students' work and most students express a view of outplacements as rich sites for learning. For some students, outplacement experiences have been personally and professionally transformative, resulting in new clinical and cultural understandings, and a new willingness to work with/in low-income Maori communities as graduates. CONCLUSION Preliminary research findings suggest that dental student outplacements with MHPs provide an effective approach to 'localising' dental students in New Zealand: promoting their responsiveness to Maori, understanding of socio-demographic oral health inequalities, and commitment to addressing these through their future professional work.