It is well known that Aboriginal peoples from the now colonised continent of Australia are disproportionately represented within health and healthcare statistics. While various factors, such as structural, commercial, and social determinants, have been acknowledged to contribute to the evident data disparity, through the production of inequity, it is too recognised that poor healthcare access and experiences play a significant role in determining health outcomes for Aboriginal peoples. Healthcare professionals, and particularly medical practitioners, contribute significantly (and often unconsciously) to such access and experience issues within healthcare contexts. The persistently poor outcomes of national Aboriginal Health initiatives, such as those reported in the Closing the Gap reports, reflect, in part, a need to challenge the status quo in healthcare delivery for Aboriginal peoples. Transformation at every level of the healthcare system is needed to realise positive outcomes in Aboriginal Health, including at the physician-patient level. The significant role of primary medical education institutions in developing interculturally capable medical graduates cannot be overstated. However, there remains a general lack of understanding by such institutions as to how learner Aboriginal intercultural capability is effectively developed through medical education. Adopting a mixed-methods approach, this research sought to investigate the transformative phenomenon of Aboriginal intercultural capability development within medical students. Survey findings demonstrated minimal variation between first and final year students self-reported Aboriginal cross-cultural and intercultural capability, with statistical analysis revealing poorer self-reported capability among the final year cohort in certain survey item responses. Findings from the knowledge holder yarns exposed the vast extent of attention and action required to facilitate effective student Aboriginal intercultural capability within medical education, including, ideological, structural, systemic, programmatic, faculty, and student factors. How medical students and graduates perceive, advocate for, and interact with Aboriginal healthcare consumers, their families, and their communities is vital to cocontributing to the Aboriginal Health agenda, set by Aboriginal peoples and communities. Such an agenda centres Aboriginal axiologies, ontologies, epistemologies, and methodologies, to inherently promote self-determination and social justice within health and healthcare. For such an agenda to be tangibly realised, students and graduates must acknowledge and appreciate their positionality, including how this can unconsciously (or consciously) obstruct and/or enable agenda progression. For medical students to contribute to the Aboriginal Health agenda, they must appreciate and privilege the significance of critical humanistic skills development to their practice. Such skills include: consciousness; self-reflection, examination, and critique; reflexivity; engagement; communication; rapport and relationship building. As further health, social, education, economic, and political data come to light, a clear picture is emerging within the Aboriginal Health context, one that has, and continues to reveal the significance of centring principles and notions of self-determination, social justice, critical consciousness, epistemic pluralism, and perspective transformation. Based on the research findings, it is purported that centring such principles and notions within primary medical education will contribute to the re-humanisation of medicine, and subsequently enhance healthcare access, experiences, and outcomes for Aboriginal peoples.
| Date of Award | 2024 |
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| Original language | English |
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| Awarding Institution | - Western Sydney University
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| Supervisor | Iman Hegazi (Supervisor) |
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