Abstract:
Background: Indigenous peoples and other traditionally marginalised ethnic groups receive poorer quality health care than societies’ dominant ethnic groups. Differential quality of medical care is evidenced at the level of healthcare systems, providers, and patients. Formal health equity curricula have been implemented in medical and health science education programmes in view of preparing clinicians with knowledge, attitudes and skills to reduce ethnic disparities. Yet, existing evaluations question the efficacy of these curricular reforms, and it has been widely acknowledged that educational institutions inadvertently contradict health equity curricula through ‘hidden’ and ‘institutional’ curricula. Aims: Informed by Kaupapa Māori, Critical Theory and Poststructuralism, this study seeks to discover whether an unintentional curriculum pertaining to Māori health exists in the University of Auckland Faculty of Medical and Health Sciences’ undergraduate degree programmes. This study explores incongruence between the formal Hauora Māori curriculum and messages conveyed in the broader institutional context. Method: This study elicited student perceptions of stereotype content in learning environments. A mixed-methods survey based on the Stereotype Content Model was conducted in February and March 2014 (N=444). Students rated perceived warmth and competence characterisations pertaining to four target ethnic groups (Māori, Pacific Nations, Asian and Pākehā/European). A qualitative extension question prompted students to explain their responses. The rationale for this approach is grounded in extensive literature identifying stereotypes’ roles in instigating bias in clinical healthcare settings. Warmth and competence perceptions have been demonstrated to account for distinct affective and behavioural response patterns that can lead to discrimination. Results: Māori warmth and competence characterisations were moderate to low compared to the three other target ethnic groups. Characterisations of Māori warmth were rated lower than Pacific Nations peoples, comparable to Pākehā/European and higher than characterisations of Asian peoples. In reference to competence characterisations, Māori were rated equal to Pacific Nations and lower than both Asian and Pākehā/European. Students described negative stereotypical portrayals of Māori in formal lecture environments and informal learning sites. Conclusions: Study findings have implications for students’ educational outcomes and future clinical practices. The researcher argues for faculty-wide interventions.