The Bachelor Of Indigenous Health Studies Program Irene Stein, Department of Nursing The University of Wollongong and Russell Gluck, Aboriginal Education Centre The University of Wollongong 3rd National Rural Health Conference Mt Beauty, 3-5 February 1995 Proceedings
The Bachelor Of Indigenous Health Studies Program Irene Stein, Department of Nursing The University of Wollongong and Russell Gluck Aboriginal Education Centre The University of Wollongong This paper describes the development of The Bachelor of Indigenous Health Studies program at The University of Wollongong [TUW] and the implementation of the Pilot Program in which four subjects will be offered in 1995 to Indigenous Health Care Workers. The paper provides some background information, details the course objectives and course outcomes and provides material concerning the course structure. Background Information To date, the course is funded by the National Priority (Reserve Fund) - Education Initiatives-Aboriginal and Torres Strait Islander Education. It is a joint project of The Aboriginal Education Centre, Tharawal Aboriginal Corporation located at Campbelltown, NSW, and the Faculty of Health and Behavioural Sciences, in particular the Department of Nursing at the University of Wollongong. The Program is consistent with the policy directions of The Royal Commission Into Black Deaths in Custody-265, the National Aboriginal Education Policy (NAEP), the Council For Reconciliation Act 1991 and the University of Wollongong Aboriginal Education Strategy. The demand for the course has been identified by needs analysis in the Aboriginal communities in which the students and graduates will be working. This program utilises the Aboriginal extended family networks as the primary focus for the delivery of health care services. These services are currently being provided by Aboriginal Health Workers or non-aboriginal Health Workers who require further education and training. This course will increase the competencies and numbers of trained Aboriginal Health Workers, thereby enhancing access to health and education for the Aboriginal community. To date, the Tharawal community has identified ninety-eight mature aged people who are able to undertake the course. Many of these people have previously been limited by reduced learning opportunities. The first student intake would be limited to twelve people. This small number is necessary to allow for the establishment of pastoral care and community and academic support for a new program. It is anticipated that a ceiling of thirty students would apply in subsequent years. 1
Overall Course Objectives The Bachelor of Indigenous Health Studies will: provide Aboriginal primary health care workers with the knowledge and skills to effectively address Aboriginal health issues; provide a pipeline for Aboriginal people working in primary health care through mainstream professional recognition; enhance the development of an Aboriginal community of special interest in health; and provide Aboriginal Health Workers with professional accreditation, based on a competency-based program. Course Outcomes At the end of this course the graduate will have community development skills in: management, advocacy, liaison with outside agencies, and negotiation, particularly at a community level; and health professional skills in: health management, health promotion, health planing, counselling, inter-agency referral, and monitoring of the health status of the community. Program Structure The two programs that may be undertaken are the Bachelor of Indigenous Health Studies and a combined Bachelor of Nursing and Graduate Diploma in Indigenous Health Studies. 2
Program 1: Bachelor of Indigenous Health Studies This program would permit the student three exit points. Exit Point 1 Award: Certificate of Indigenous Health Studies - after successful completion of one year of full-time study or its parttime equivalent. Exit Point 2 Award: Diploma of Indigenous Health Studies - after successful completion of two years of full-time study or its part-time equivalent. Exit Point 3 Award: Bachelor of Indigenous Health Studies - after successful completion of the three year full time program or its part-time equivalent. Admission to this program will be via the Aboriginal Education Centre s Alternative Admissions Program and mainstream entry processes. Award Title: Bachelor of Indigenous Health Studies Course Structure: (P/T or F/T) Year 1 Introductory Communication Studies Introductory Psychology for Health Care Workers Indigenous Family Studies 1 Health & Personal Choice Indigenous Health Patterns Indigenous Family Studies 2 Health: A Community Perspective Plus one subject from either the Health and Behavioural Sciences Schedule or the General Schedule. Year 2 Sociological Dimensions of Nursing Current Issues in Food and Nutrition Introduction to Research Current Services in Aboriginal Health Contemporary Indigenous Health Issues Functional Community Structures Special Topic (Work Place analysis) Plus one subject from either the Health and Behavioural Sciences Schedule or the General Schedule. 3
Year 3 Community Development Nursing Nursing Resources Management Aboriginal Health - New Directions (New subject) Social Aspects of Health & Illness Community Health Nursing Health & Human Ecology Special Topic (Work Place Analysis) Program 2: Bachelor of Nursing and Graduate Diploma in Indigenous Health Studies Award Title: Bachelor of Nursing and Graduate Diploma in Indigenous Health Studies. Course Structure The program will be a minimum of three years duration. It will follow the existing prescribed nursing program. Maximum use of Summer sessions will enable flexible provision of the Graduate Diploma subjects. The subjects that will be offered in Summer session are: Year 1 Indigenous Family Studies 1 Current Services in Aboriginal Health Year 2 Indigenous Health Studies 2 Functional Community Structures Year 3 Aboriginal Health-New Directions Special Topic (Work Place Analysis) This program is innovative in that no other University in Australia provides a mechanism by which nurses can obtain a State registration credential and a Graduate Diploma simultaneously. The significance of these innovations is great when placed in the context of the Report of the National Review of Nurse Education in the Higher Education Sector 1994 and Beyond. This Report noted that: At the University of Wollongong, the Aboriginal Education Centre (AEC) operated on a community of special interest approach, based on the needs of Aboriginal communities for Aboriginal nurses. A memorandum of understanding had recently been developed between the Illawarra Area Health 4
Service (IAHS), the Illawarra Shoalhaven Institute of TAFE and the AEC. Under this arrangement Aboriginal people interested in nursing were recruited into nursing-focused pre-vocational courses in TAFE which prepared them for access to and success in EN [Enrolled Nurse] nursing. On successful completion of these courses, the IAHS interviewed them for an EN training position: the IAHS had agreed to train at least four Aboriginal people per year as ENs. In the future, on successful completion of the EN program, trainees will be offered a further two years employment with the IAHS. They will also be encouraged to enter the undergraduate nursing program at the University of Wollongong through the University s alternative admissions program. Individual students who take this option will be offered vacation employment with the IAHS as well as two years further employment at IAHS on completion of their degree. The AEC at the University of Wollongong also provided a range of support for Aboriginal people seeking enrolment in undergraduate nursing as well as for those already enrolled in the nursing course. A preparatory gateway program was established in July 1993 to prepare Aboriginal and Torres Strait Islander students for the demands of university nursing studies. These students undertook a range of general preparatory subjects for nine hours a week for one semester plus an additional two days on the discourse of nursing. During undergraduate studies, AEC support focused on the fundamental skills and specialised vocabulary necessary for success in the nursing program. For example, the AEC had developed a tutorial program for the teaching of chemistry to Aboriginal nursing students based on co-operative effort, peer support and close work with the appropriate lecturers and tutors (S213). The Committee noted that the work of the AEC at the University of Wollongong is consistent with two of the main themes which have emerged throughout the Review: the need for closer collaboration between the health and higher education sectors, and the value of broader and more managed pathways from EN to RN courses. The AEC has also put into practice a program for Aboriginal and Torres Strait Islander peoples which has set out to increase Aboriginal people s ability and knowledge of how to match what they want with what is required for professional nurse training and employment (S213:5). It is understood that access means not just access to higher education but access to nursing and that depends on the successful completion of higher education. 5
The work of the AEC is complemented by the Department of Nursing and Faculty of Health and Behavioural Sciences. The Department of Nursing has initiated a support program for Aboriginal students. A tutorial program is run in conjunction with subject co-ordinators. The Department employs a support teacher one day a week to run these small groups or, if needed, to work on a one-to-one basis with an individual student. Considerable effort has been made to transfer the many positive outcomes of the existing Bachelor of Nursing program to the Bachelor of Indigenous Health Studies and the combined Bachelor of Nursing/Graduate Diploma program. This is in keeping with the Recommendations of the Nursing Education in Australian Universities Report, specifically Recommendations 14.5 and 14.6: 14.5 Aboriginal and Torres Strait Islander peoples and nursing education in Universities That, in order to ensure appropriate numbers of Aboriginal and Torres Strait Islander nurses and nurses working in Aboriginal communities, and the development of the role of universities in relation to Aboriginal health: 14.5.1 National targets be set for the recruitment and course completion, in undergraduate nursing courses, of Aboriginal and Torres Strait Islander students; 14.5.2 National and institutional strategies be developed to encourage recruitment and retention; 14.5.3 Demonstration projects be funded as appropriate; 14.5.4. Research (particularly multi-disciplinary research) focusing on health care and nursing in Aboriginal and Torres Strait Islander communities be developed and conducted in partnership with those communities and be supported by such bodies as the Public Health Research and Development Committee of the National Health and Medical Research Council (NH&MRC), the Research and Development Grants Advisory Council and the Aboriginal and Torres Strait Islander Commission (ATSIC); 14.5.5 University projects designed to encourage and assist the recruitment of Aboriginal and Torres Strait Islander students into nursing education programs and the student s successful completion of those programs be a designated priority area in the distribution of grants under DEET s National Priority (Reserve) Fund. 6
These projects should encourage collaboration between higher education institutions, Aboriginal and Torres Strait Islander communities and the health sector and provide ongoing support to Aboriginal and Torres Strait Islander students throughout their studies; and 14.5.6 Scholarship programs funded by the health and education sectors be established. 14.6 Articulation of courses preparing Aboriginal Health Workers That, given (1) the Committee s support for the HSH-funded project to develop competency standards for Aboriginal Health Workers (AHWs) through the National Community Services and Health Industry Training Advisory Board and (2) the potential of this project on completion to provide the basis for articulation of courses preparing AHWs with courses preparing ENs and RNs: 14.6.1 The question of articulation be further investigated on a joint basis by HSH and DEET, in consultation with the Australian National Training Authority, the National Community Services and Health Industry Training Advisory Board, ATSIC, and other bodies as appropriate, with a view to establishing at least one demonstration project in each State and Territory; 14.6.2 The Departments (HSH and DEET) prepare a joint report for their respective Ministers with a view to further advancing articulation for AHWs (p. 304). 7
Conclusion Health care workers and registered nurses today work in a wide variety of institutional and community settings and with a varied client group. Clients come from across the age spectrum and from a diverse ethno-cultural backgrounds. The Health Care Workers (HCW) and the registered nurses roles cover care and service delivery to physically or mentally ill people, to the aged, to mothers and babies, to people with disabilities and in a wide range of health promotion, health maintenance and education activities. Both of these education programs fit the HCW or registered nurse with the skills needed to work as a member of a multi-faceted and multi-focal health care team. Bibliography Nursing Education in Australian Universities. Report of the National Review of Nurse Education in the Higher Education Sector, AGPS, Canberra, 1994. Johnston, E., Royal Commission Into Aboriginal Black Deaths in Custody, National Report, Vols 1-5, AGPS, Canberra, 1991. Tharawal Aboriginal Corporation, Aboriginal health in South West Sydney: The Tharawal Aboriginal Family Environmental Health Survey, Campbelltown, 1994 Tharawal Aboriginal Corporation, 5 year Plan, Campbelltown, 1994. 8