Te Paatu o Te Ao Hurihuri – pandemic-related virtual adaptation of an established marae-based workshop for rural doctors: a qualitative study
Katharina Blattner
1 2 * , Marara Rogers-Koroheke 2 , Lynne Clay 1
1
2
Abstract
Due to COVID-19 pandemic restrictions in Aotearoa New Zealand, an established remote community marae-based workshop (a component of a postgraduate rural medical programme) was converted into a virtual platform.
The aim of this study was to explore student and teacher experiences of this virtual adaptation with focus on cultural aspects.
A qualitative exploratory study was undertaken that involved document review and qualitative interviews. Students and teachers were invited to participate. Semi-structured interviews were conducted. Thematic analysis was undertaken using a framework-guided rapid analysis method. The two participant groups’ data were analysed concurrently but separately.
Students found the virtual workshop valuable in furthering their knowledge of Māori culture, cross-cultural communication skills and health inequities in rural clinical practice. Through the innovative efforts of their teachers, they felt some sense of connection with the remote locality and its people. Teachers were able to impart knowledge, connect and keep everyone culturally safe through their commitment and adaptability. However, moving to a virtual platform meant compromise to the cultural experience for students and loss of sharing the learning and experience with their place and their people.
In the event of a further pandemic or other emergency situation, where strong established relationships exist, replacing an in-person remote marae-based workshop with a virtual workshop, while limited, is achievable and has value. When urban tertiary institutions partner with remote Māori communities to deliver virtual teaching, caution is needed in ensuring sustained transparency in priorities and expectations to avoid further exacerbations of power imbalance and resulting loss of value.
Keywords: community engagement, community-oriented partnership, COVID-19 pandemic, distance education, Māori health, postgraduate medical education, rural and remote health, rural health workforce.
References
1 Crengle S, Davie G, Whitehead J, et al. Mortality outcomes and inequities experienced by rural Māori in Aotearoa New Zealand. Lancet Reg Health West Pac 2022; 28: 100570.
| Crossref | Google Scholar | PubMed |
2 Whitehead J, Davie G, de Graaf B, et al. Unmasking hidden disparities: a comparative observational study examining the impact of different rurality classifications for health research in Aotearoa New Zealand. BMJ Open 2023; 13(4): e067927.
| Crossref | Google Scholar | PubMed |
3 Seymour-Walsh AE, Bell A, Weber A, et al. Adapting to a new reality: COVID-19 coronavirus and online education in the health professions. Rural Remote Health 2020; 20(2): 6000.
| Crossref | Google Scholar | PubMed |
4 Mak DB, Russell K, Griffiths D, et al. Lessons learned from adapting a remote area health placement from physical to virtual: a COVID-19-driven innovation. Int J Med Educ 2021; 12: 274-99.
| Crossref | Google Scholar | PubMed |
5 Blattner K, Miller R, Smith M, et al. Doing without the residential component of a blended postgraduate rural medical programme during the 2020 COVID-19 pandemic in New Zealand: student perspectives. Educ Prim Care 2022; 33(2): 77-84.
| Crossref | Google Scholar | PubMed |
7 Rural Hospital Training programme. The Royal New Zealand College of General Practitioners (RNZCGP). Wellington, New Zealand: RNZCGP; 2023. Available at https://www.rnzcgp.org.nz/[cited 7 June 2023].
8 Blattner K, Nixon G, Gutenstein M, et al. A targeted rural postgraduate education programme – linking rural doctors across New Zealand and into the Pacific. Educ Prim Care 2017; 28(6): 346-50.
| Crossref | Google Scholar |
9 University of Otago. Rural Postgraduate Programme; 2023. Available at https://www.otago.ac.nz/oms/education/postgraduate‐rural‐health/study/gena‐725‐reflections‐in‐rural‐clinical‐practice [cited 20 July 2023]
10 Curtis E, Jones R, Tipene-Leach D, et al. Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. Int J Equity Health 2019; 18(1): 174.
| Crossref | Google Scholar | PubMed |
11 Hauora Hokianga, Hokianga Health. Hokianga Health Enterprise Trust. Rawene, NZ: Hokianga Health; 2023. Available at https://www.hokiangahealth.org.nz/ [cited 20 July 2023].
12 Gale RC, Wu J, Erhardt T, et al. Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the Veterans Health Administration. Implement Sci 2019; 14(1): 11.
| Crossref | Google Scholar | PubMed |
13 Zink T, Halaas GW, Finstad D, et al. The rural physician associate program: the value of immersion learning for third‐year medical students. J Rural Health 2008; 24(4): 353-9.
| Crossref | Google Scholar | PubMed |
14 Greenwood J, Te Aika LH, Davis NE. Creating virtual marae – an examination of how digital technologies have been adopted by Māori in Aotearoa New Zealand. In: Leigh P, editor. International Explorations of Technology Equity and the Digital Divide: Critical, Historical and Social Perspectives. Information Age Press; 2011, pp. 58–79. 10.4018/978-1-61520-793-0.ch004
15 Strasser RP. Community engagement: a key to successful rural clinical education. Rural Remote Health 2010; 10(3): 1543.
| Google Scholar | PubMed |
16 Worley P, Murray R. Social accountability in medical education – an Australian rural and remote perspective. Med Teach 2011; 33(8): 654-8.
| Crossref | Google Scholar | PubMed |
