Lesleyanne Hawthorne

A case study in the globalization of medical education: assisting overseas-born students at the University of Melbourne

Over the past decade there has been a remarkable increase in ethnic diversity among Australian medical students. This phenomenon has been driven by two forces: the disproportionate school-level academic success achieved by first-generation migrant and refugee-origin youth, and the rapid globalization of Australias tertiary education system, in a context where reduced government funding has accelerated the development of ‘academic capitalism’ (Slaughter & Leslie, 1997). This paper briefly examines each trend, prior to exploring select pedagogical implications of these changes for the University of Melbourne, the destination of choice by 2001 for 30% of all international students electing to study medicine in Australia. Two key questions are addressed: (1) What are the potential problems in delivering Western-style medical education to culturally and linguistically disparate groups?; (2) What model of international student support has been developed by the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne? The paper suggests the model may have potential relevance for other universities, in the context of the accelerating globalization of medical education.

How Valuable is “Two-Step Migration”? Labor Market Outcomes for International Student Migrants to Australia

In the past decade, Australia has developed unprecedented reliance on skilled migrants, a process intensified by a period of sustained economic boom. By 2007, two-thirds were former international students recruited in Australia rather than offshore applicants, exemplifying a transition to what is termed “two-step migration.” How acceptable, however, are such onshore applicants to employers, in a context where Australias 2006 skilled migration review found less favorable outcomes for former international students than migrants recruited offshore? To address this question, key education enrollment, migration and employment databases were analyzed in-depth. Overall, former international students were found to achieve comparable labor market participation rates to migrants recruited offshore. However, former students qualified in two-year courses and/or in oversubscribed fields performed worse than offshore migrants. Between 2007 and 2010, Australia introduced major policy reforms to improve the outcomes for international students applying under the skilled migration program. In February 2010, the government corrected education sector abuses while significantly changing selection processes. This decade of Australian policy experimentation may be instructive to other countries which have introduced study-migration pathways designed to attract and retain former students as skilled migrants.

Labour Market Outcomes for Migrant Professionals: Canada and Australia Compared

Canada and Australia are global exemplars of nation-building through government planned and administered economic, family and humanitarian migration programs. By 2005 Australia included the world’s highest percentage of foreign-born (24.6% of the population, with over 240 nationalities) followed by Canada at 19.2% and the US at 11.7% (Miller 2005).

Framing Collaborative Behaviors: Listening and Speaking in Problem-Based Learning.

Abstract PBL is described as small-group collaborative learning; however, literature on how col-laboration is enacted in PBL contexts is limited. A two-year ethnographic study exam-ined the experiences and responses of Asian students to the obligations of PBL in aWestern context. Participant-observation, videotape data, and video-stimulated recallinterviews provided insights into collaborative behaviors in PBL classrooms. Eventhough students recognized that listening and speaking were important to collabora-tion, speaking was clearly privileged over listening in this PBL setting. A framework wasdeveloped that incorporated both collaborative and noncollaborative listening andspeaking behaviors. This Collaborative Listening/Speaking (CLS) framework provides astructure for tutors to scaffold the novice learners’ collaborative skills, and thereforemore effectively facilitate the group’s learning through collaboration. Introduction Small-group collaborative learning is a fundamental component of the problem-basedlearning (PBL) approach (Barrows & Tamblyn, 1980; Savery, 2006). In the context of PBL,collaborative learning has been described as “the process by which individuals,workingfrom different perspectives, come to an understanding of rich, complex concepts”(Kelson & Distlehorst, 2000, p. 172). The collaborative nature of PBL is mentioned as a

Motivations of nurses who migrate to Canada as domestic workers

BACKGROUND While some trained nurses migrate to destination countries to work as domestic workers, little is known about their migration motivations. AIM This study explores the motivations of Philippine educated nurses who migrated to Canada through the Live-in Caregiver Program from 2001 to 2011 (a Canadian domestic worker programme). METHODS A single case study qualitative methodology and the transnational feminist concept of global care chains were utilized for this study. Interviews of 15 Philippine educated nurses who migrated to Canada as domestic workers were conducted in the province of Ontario, Canada, between February to October 2012. All participants had a baccalaureate degree from the Philippines. Interviews were tape recorded, transcribed verbatim and analysed using critical discourse analysis, aided by NVIVO 10 data analysis software. RESULTS Findings reveal a multi-step immigration process in which nurses migrate from the Philippines to the Middle East (especially Saudi Arabia) and finally to Canada. While emigration from the Philippines is mainly economically driven, migration from the Middle East to Canada is primarily motivated by the desire for Canadian citizenship for the family. Also, perceived social status and lifestyle in Canada as compared to the Middle East motivates this group of women to migrate to Canada. LIMITATION The major limitation of this study is the lack of input from nursing policy makers. CONCLUSION Gender-based familial ideologies and perspective on social status influence the migration decision of this group of nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY Implications for nursing and health policy makers include the provision of clear pre-migration information (including on the nursing registration process) to internationally educated nurses, advocacy for stronger immigration policies to ensure the integration of internationally educated nurses and a consideration of gender in all health human resource policies.

Workforce Integration of Philippine-Educated Nurses who Migrate to Canada through the Live-in Caregiver Program

Nurses who migrate through the Canadian Live-in Caregiver Program face significant barriers to their subsequent workforce integration as registered nurses in Canada. This study applies the concept of global care chains and uses single case study methodology to explore the experiences of 15 Philippine-educated nurses who migrated to Ontario, Canada, through the Live-in Caregiver Program. The focus is the various challenges they encountered with nursing workforce integration and how they negotiated their contradictory class status. Due to their initial legal status in Canada and working conditions as migrant workers, they were challenged by credential assessment, the registration examination, access to bridging programs, high financial costs, and ambivalent employer support. The results of the study are pertinent for nursing policymakers and educators aiming to facilitate the integration of internationally educated nurses in Canada.

Transcultural skills content in a dental curriculum: a comparative study

BACKGROUND Australia has the highest proportion of immigrants in the world (24% of the population is overseas-born, compared to 22% in New Zealand, 19% in Canada and 12% in the USA). In this context, dental students have become increasingly diverse in a milieu where patients are derived from increasingly diverse backgrounds. AIM The study aims to analyse the degree to which transcultural and communication skills content is currently embedded in the medical, physiotherapy and dental curricula at a major Australian university. MATERIALS AND METHODS   Undergraduate dental, medical and physiotherapy curricula were compared and critically assessed. Researchers considered the amount of transcultural and communication skills content, the number of formal contact hours for each course and the number of teaching staff involved. In addition, 21 interviews were conducted with staff at the three schools, who were involved in the curriculum development process. RESULTS The medical and physiotherapy curricula had an explicit focus on transcultural and communication skills as a major and continuing element, delivered by teaching staff from a wide variety of academic and professional backgrounds. In contrast, the dental course showed an under-representation of transcultural and communication skills content which was taught by a limited number of staff from the School of Dental Science. CONCLUSIONS In marked contrast to medical and physiotherapy curricula, transcultural and communication skills content had a low formal profile in the dental curriculum. A curriculum review process may be a positive step towards the development of a new training curriculum giving higher priority to transcultural and communication skills to support more effective workforce development.

Asian female students in Australia: Temporary movements and student migration

The most significant population movement affecting Australia in recent years has been a dramatic growth in the number of short term arrivals. Within these arrivals overseas students have become prominent, given the rapid expansion of Australia’s ‘export education’ industry throughout the past decade. By 1994, 87,000 overseas students were studying in Australia — the vast majority of these Asian in origin. While a substantial literature has evolved concerning overseas students’ temporary migration and settlement, there has been only limited demographic analysis undertaken to date, including minimal attempt to explore the participation and specific student experience of women. This paper seeks to address this omission through presentation of a detailed analysis of the characteristics of Asian female students within the overall student movement, together with a preliminary exploration of issues related to their personal and academic transition.

Reversing past stereotypes: Skilled NESB women in Australia

Australians erroneously depicted migrant workers as having peasant origins, poor English and little education. Their domestic skills were highlighted over professional skills and they were thought of as occupying manufacturing or service-sector position. This stereotype may have been partially true in the 1970s, but it will be less so in the 1990s.

How clinical reasoning is taught and learned: Cultural perspectives from the University of Melbourne and Universitas Indonesia.

BackgroundThe majority of schools in the Asia-Pacific region have adopted medical curricula based on western pedagogy. However to date there has been minimal exploration of the influence of the culture of learning on the teaching and learning process. This paper explores this issue in relation to clinical reasoning.MethodA comparative case study was conducted in 2 medical schools in Australia (University of Melbourne) and Asia (Universitas Indonesia). It involved assessment of medical students’ attitudes to clinical reasoning through administration of the Diagnostic Thinking Inventory (DTI), followed by qualitative interviews which explored related cultural issues. A total of 11 student focus group discussions (45 students) and 24 individual medical teacher interviews were conducted, followed by thematic analysis.ResultsStudents from Universitas Indonesia were found to score lower on the Flexibility in Thinking subscale of the DTI. Qualitative data analysis based on Hofstede’s theoretical constructs concerning the culture of learning also highlighted clear differences in relation to attitudes to authority and uncertainty avoidance, with potential impacts on attitudes to teaching and learning of clinical reasoning in undergraduate medical education.ConclusionsDifferent attitudes to teaching and learning clinical reasoning reflecting western and Asian cultures of learning were identified in this study. The potential impact of cultural differences should be understood when planning how clinical reasoning can be best taught and learned in the changing global contexts of medical education, especially when the western medical education approach is implemented in Asian contexts.