USyd Bandler Dec 09

From CDAMS to classroom Dr Lilon Bandler Senior Lecturer; Indigenous Health Education Unit Sydney Medical School

USyd Bandler Dec 09 CDAMS History History … in the hope that we may have a lasting positive impact on the health of the First Australians … and by extension, the well-being of the nation. … in the hope that we may have a lasting positive impact on the health of the First Australians … and by extension, the well-being of the nation.

USyd Bandler Dec 09 Australian Medical Council Australian Medical Council national standards body for medical education and training national standards body for medical education and training assesses medical school courses assesses medical school courses Set standards Set standards knowledge, skills and professional attributes expected on graduation knowledge, skills and professional attributes expected on graduation How education and training should be provided How education and training should be provided

USyd Bandler Dec , AMC accreditation standards 2007, AMC accreditation standards explicit focus on Indigenous health explicit focus on Indigenous health Indigenous health as a curriculum topic Indigenous health as a curriculum topic students’ experience in providing health care to Indigenous people students’ experience in providing health care to Indigenous people processes, settings and resources processes, settings and resources Australian Aboriginal & Torres Strait Islander, New Zealand Maori students Australian Aboriginal & Torres Strait Islander, New Zealand Maori students Admission Admission Recruitment Recruitment Support Support

USyd Bandler Dec 09 CDAMS Indigenous Health Curriculum Framework Guiding principles Guiding principles Suggested subject areas; Key student attributes & outcomes Suggested subject areas; Key student attributes & outcomes Pedagogical principles and approach Pedagogical principles and approach Delivery and assessment Delivery and assessment Suggested process for curriculum development Suggested process for curriculum development Resources, capacity and workforce development issues Resources, capacity and workforce development issues

USyd Bandler Dec 09 Faculty of Medicine Faculty of Medicine Sydney Medical School Sydney Medical School 1868 assassination attempt 1868 assassination attempt March 1883 March 1883 four students four students four-roomed cottage four-roomed cottage first year medical & dentistry students 380 first year medical & dentistry students University of Sydney

USyd Bandler Dec 09 Sydney Medical School Graduate entry Graduate entry GPA GPA GAMSAT GAMSAT Multiple mini interviews Multiple mini interviews Four year Four year PBL model PBL model

USyd Bandler Dec 09 Senior lecturer in Indigenous health education July 2006 … to July 2006 … to Increase numbers & support existing Indigenous medical students Increase numbers & support existing Indigenous medical students Community … clinical placements Community … clinical placements Review and develop teaching & learning resources in Indigenous health Review and develop teaching & learning resources in Indigenous health

USyd Bandler Dec 09

Implementation of CDAMS Translation – locality Translation – locality Pre-existing Pre-existing Course structure … process Course structure … process Content Content

USyd Bandler Dec 09 Curriculum review Timely Timely Re-configuring Re-configuring PBL PBL Complex Complex Linked Linked Indigenous health Indigenous health

USyd Bandler Dec 09 Sydney Medical Program Learning objectives Learning objectives CDAMS CDAMS SMP SMP Scope Scope No prior awareness No prior awareness Core Core Specialise Specialise

USyd Bandler Dec 09 Process … Stage 1 & 2 2 yrs on campus 2 yrs on campus Face to face Face to face Resources Resources Web Web Small group learning Small group learning Formal presentations Formal presentations Practical clinical sessions Practical clinical sessions Others … Others …

USyd Bandler Dec 09 Process … PBL Clinical problem Clinical problem Pivot – challenging, open ended Pivot – challenging, open ended Collaborative Collaborative Reflective Reflective Responsibility Responsibility Development of skills Development of skills Communication Communication Problem-solving Problem-solving Self-directed learning Self-directed learning

USyd Bandler Dec 09 Stage 1 … content PBLs PBLs Lectures, theme sessions, covering Lectures, theme sessions, covering Population, M&M Population, M&M History History Chronic disease Chronic disease Healthcare delivery initiatives Healthcare delivery initiatives Successes Successes Difficulties Difficulties Application Application Social determinants of health Social determinants of health International comparisons International comparisons

USyd Bandler Dec 09 Mrs Newman … Developed in response to Developed in response to Place in Stage 1 … Foundation Block Place in Stage 1 … Foundation Block PBL process PBL process Concerns from clinicians Concerns from clinicians Chronic disease Chronic disease Cardiovascular disease Cardiovascular disease

USyd Bandler Dec 09 Mrs Newman … Mrs Joyce Newman presents to the Emergency Department with 4½ hours of discomfort in her chest. She thinks she has indigestion. However the pain/discomfort is worsening, and now radiates into her neck and jaw. This has prompted her presentation. Mrs Joyce Newman presents to the Emergency Department with 4½ hours of discomfort in her chest. She thinks she has indigestion. However the pain/discomfort is worsening, and now radiates into her neck and jaw. This has prompted her presentation. 37 year old Aboriginal woman 37 year old Aboriginal woman Three children Three children Triage level 4 Triage level 4 potentially serious potentially serious to be seen within 1 hour to be seen within 1 hour

USyd Bandler Dec 09 Associated material Fixed didactic Fixed didactic PBL tutorials PBL tutorials

USyd Bandler Dec 09 Associated T&L resources PBL tutorials PBL tutorials Tutor briefing sheet Tutor briefing sheet Tutor meeting Tutor meeting Comprehensive medical history Comprehensive medical history Family tree Family tree Triage Triage Mechanism diagram Mechanism diagram

USyd Bandler Dec 09 Associated T&L resources

USyd Bandler Dec 09 Associated T&L resources

USyd Bandler Dec 09 Associated T&L resources Learning topics: anatomy, pain, arterial disease, treatment adherence, hypoxia, coronary artery disease in Australian Aborigines and Torres Strait Islanders Learning topics: anatomy, pain, arterial disease, treatment adherence, hypoxia, coronary artery disease in Australian Aborigines and Torres Strait Islanders Lectures Lectures Anatomy, biochem, pharm, radiology … Anatomy, biochem, pharm, radiology … References: ECGs, anatomy, ED guidelines for ACS management, triage References: ECGs, anatomy, ED guidelines for ACS management, triage

USyd Bandler Dec 09 Subsequently … Stage 2 Stage 2 Development of cultural training Development of cultural training Stage 3 Stage 3 Clinical rotations Clinical rotations PNW PNW Community Community Psychological medicine; D&A Psychological medicine; D&A Paediatrics Paediatrics

USyd Bandler Dec 09 Stage 3 year 4 community rotation Discharge to the community Discharge to the community Follow-up Follow-up Communication with AMS, AHWs, GP Communication with AMS, AHWs, GP Financial matters Financial matters Access to healthcare Access to healthcare Health promotion Health promotion

USyd Bandler Dec 09 Specialising … opportunities Stages I & 2 Stages I & 2 Independent learning activities Independent learning activities Campus Campus Dubbo Dubbo Broken Hill UDRH Broken Hill UDRH Northern Rivers UDRH Northern Rivers UDRH Rural placements Rural placements Stage 3 Stage 3 Honours Honours Electives Electives

USyd Bandler Dec 09 Assessment Drives Drives Essays Essays SBAs SBAs Student engagement Student engagement Student thinking Student thinking

USyd Bandler Dec 09 Evaluation Part of SMS Part of SMS Routine EOY qq Routine EOY qq Clinical school Clinical school Questions Questions

USyd Bandler Dec 09 Evaluation understanding of the history, cultural development and health of Indigenous people of Australia understanding of the history, cultural development and health of Indigenous people of Australia clinical experience clinical experience

USyd Bandler Dec 09 Feedback Students Students Faculty Faculty Block review Block review Emphasis on mechanism Emphasis on mechanism Not too hard Not too hard Review of group dynamics Review of group dynamics

USyd Bandler Dec 09 LEARNING OBJECTIVES

USyd Bandler Dec 09 Alignment Learning objectives Learning objectives T&L resources T&L resources Assessment Assessment Extension opportunities Extension opportunities Evaluation & review Evaluation & review

USyd Bandler Dec 09 Sydney Medical Program Indigenous stream throughout the course Indigenous stream throughout the course Guided by Guided by CDAMS CDAMS Learning objectives Learning objectives Clinical placements Clinical placements Within the program Within the program Core Core Extension opportunities Extension opportunities Embedded Embedded Engaged students Engaged students

USyd Bandler Dec 09 Bibliography … links … Phillips G (2004) Committee of Deans of Australian Medical Schools Indigenous Health Curriculum Framework t.au/content/curriculum- framework Phillips G (2004) Committee of Deans of Australian Medical Schools Indigenous Health Curriculum Framework t.au/content/curriculum- framework t.au/content/curriculum- framework t.au/content/curriculum- framework Australian Indigenous HealthInfoNet: au Australian Indigenous HealthInfoNet: au au au

USyd Bandler Dec 09