Workshop Lowitja Institute International Indigenous Health and Wellbeing Conference 2016

Utilising storytelling and Indigenous art in medical student cultural competency training addressing Native Hawaiian health disparities (#58)

Martina L Kamaka 1 , Meleanna A Meyer
  1. University of Hawaii John A Burns School of Medicine, Honolulu, HI, United States

Introduction: Indigenous populations suffer from significant health care disparities. In order to improve Indigenous health, the impact of our health care systems and health care providers cannot be overlooked. The U.S. Institute of Medicine in 2002 acknowledged that provider factors such as stereotyping, biases and uncertainty contribute to health care disparities. In addition, students need to understand the context behind the historic, social and economic inequalities suffered by these disparate populations. The authors urged that cross cultural education be added to provider training. There is no consensus on how to teach this although accredited USA medical schools require curricular content which addresses self-awareness and knowledge about health disparities. The origins of Indigenous health disparities cannot be understood without considering the role of cultural trauma as it relates to multiple losses (physical, spiritual, emotional), colonisation and racism experienced by Indigenous people.

Methodology: The Department of Native Hawaiian Health at the University of Hawai’i John A. Burns School of Medicine has developed a cultural competency curriculum focusing on Native Hawaiian health. The contents of the curriculum are guided by Native Hawaiian ways of understanding ourselves and each other. We attempted to address self-awareness and cultural trauma through a series of three workshops incorporating a mix of teaching methodologies. Self-awareness exercises took the form of storytelling. These exercises were then paired with lectures and recently, the medium of art to help students understand Native Hawaiian history and the impact of cultural trauma on Native Hawaiians.

Results: Evaluations from these workshops show that students value these trainings and that learning can occur on deeper levels. While Native Hawaiian culture is used as the model for this curriculum, lessons allow any student to reflect on relevance to themselves, their future patients and their own histories.

Intended Outcomes and Target Audience: Results, curricular content and experiences will be shared. Hopefully, experiencing some of this curricular content will encourage discussion and sharing of ideas with others attempting to do similar work. Content is appropriate for educators, students and anyone with an interest in cultural competency training.

  1. Anderson, I. et al. 2006, ‘Indigenous health in Australia, New Zealand, and the Pacific’, The Lancet, vol. 367, pp. 1775–85.
  2. Smedley, B. 2002, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, Institute of Medicine of the National Academy Press, Washington D.C, USA.
  3. Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the M.D. Degree. LCME (Liaison Committee on Medical Education, 2015), accessed on October 8, 2015.
  4. Carpenter, D., Kamaka, M. and C. Malina Kaulukukui, 2011, ‘An Innovative Approach to Developing a Cultural Competency Curriculum; Efforts at the John A. Burns School of Medicine’, Hawai’i Medical Journal, Department of Native Hawaiian Health, vol. 70, Supp2, pp. 15-19.