Facilitating Collaborative Inquiry: A Case Illustration

Ruth O. Beltran Shane John Merritt

Introduction

Collaborative inquiry was defined by Bray, Lee, Smith, and Yorks (2000, 6) as “a process consisting of repeated episodes of reflection and action through which a group of peers strives to answer a question of importance to them.” According to them, this kind of inquiry was based on the model of cooperative inquiry developed by John Heron and elaborated by Peter Reason. They pointed out that there are three parts to their definition of collaborative inquiry. These are cycles of reflection and action, peers as co-inquirers, and the inquiry question. Collaborative inquiry involves a four-phase process. These phases are not necessarily discrete, fixed, and autonomous structures. The process is fluid and is offered as a guide and not a dogma for conducting collaborative inquiry. The process begins with the first phase, forming a collaborative inquiry group, followed by creating the conditions for group learning. The third phase, which is central to the process, is acting on the inquiry question. The final phase is making meaning by constructing knowledge. The same authors suggested that collaborative inquiry is a strategy that has potentials for adult education and as a form of research.

Much as we facilitate and encourage our students to reflect on their experiences to enhance learning, as educators we also seek to learn about and enhance our teaching by reflecting on our teaching experiences. This chapter is a case study of the process of reflection of our teaching within the framework of collaborative inquiry and in the context of facilitating students' exploration of Indigenous mental health issues. The question that drove us through this five-year collaborative process was how learning about Indigenous health issues could be facilitated so that students would be equipped to deal with Indigenous clients in their practice.

We will discuss how we introduced and explored these issues within a two-year professional preparation course for occupational therapists. Firstly, we will give an overview of the Master of Occupational Therapy (MOT) course. Secondly, we will discuss the principles and processes we used in facilitating students' understanding of Indigenous health issues. Thirdly, we will discuss the feedback provided by the students about this learning experience and our reflections on this feedback; and finally, we will discuss the developments that were initiated as an outcome of this feedback. These discussions will be framed in the context of collaborative inquiry as developed by Bray, Lee, Smith, and Yorks (2000).

The Curriculum: Capability Professional Education

In 1998, the School of Occupation and Leisure Sciences, Faculty of Health Sciences, University of Sydney, introduced for the first time an MOT degree. This is a two-year professional master's preparation program in occupational therapy for graduates from a variety of undergraduate programs. In the last five years, students who enrolled in the course had come from a variety of first-degree backgrounds, including nursing, medicine, economics, nutrition, psychology, sociology, anthropology, sports science, leisure and health, and other related disciplines. These students bring with them a wealth of specialized knowledge and skills learned from their undergraduate education, which they can access in the process of learning and subsequently contribute to the profession.

The curriculum's conceptual framework is based on capability professional education (Stephenson & Weil, 1992). It incorporates elements of various approaches to learning, including adult learning (Boud & Feletti,1991), reflective learning (Boud, Keogh, & Walker, 1985; Schon, 1987), and self-directed learning (Knowles, 1975). In accordance with a capability professional education framework, students assess their own entry level against a list of expected outcomes they must achieve at the end of the course. At the beginning of the first semester, students in the first year of the course undertake six weeks of fieldwork with occupational therapists in order to identify for themselves the capabilities of occupational therapists. Based on their self-assessment of their entry level, students determine their learning program in consultation with an academic adviser. This self-assessment is an ongoing process throughout the course. All students enroll in the six core subjects and some elective units and are required to complete integrated assessments related to the core subjects. The type of independent learning that each student requires to support their progress through the six subjects will differ depending on the nature of their first degree and experience. This component of their learning is negotiated with the relevant teaching staff. For example, a student who did not do human biological sciences in their undergraduate course may opt to do an independent study or an elective unit on the anatomy of the hand in order to successfully deal with the dysfunction that a particular case scenario presents on rehabilitation of hand trauma.

Six capabilities of an occupational therapist were identified as important for students to develop (School of Occupational Therapy, 1997). It is expected that the students will be able to:

• assess a client's ability to perform daily activities (problem identification)
• assess daily activities appropriate to the client's roles (taking into account biocognitive and psychosocial factors as well as client contexts and the impact these have on the roles)
• implement occupational therapy intervention, including adapting daily activities to achieve the client's goals (taking into consideration the occupational therapy process from setting goals to implementing selected interventions)
• evaluate and research their practice critically and reflectively (including the evaluation of intervention effectiveness as well as of research and programs)
• use a range of strategies to maximize their ability to manage and work competently within a variety of work contexts (including health-care systems, teamwork, ethics, professional behaviors, management theory and skills, and the university's generic attributes)

• critically articulate the theoretical and practice rationales that underpin the occupational therapy process as outlined in the first four capabilities above (using documentation, verbal presentation, and written presentation for the audience of other health professionals, clients, and students)

These capabilities form the basis for the core subjects in the course. The core subjects are problem identification, activity analysis and adaptation, occupational therapy intervention, evaluation and research, professional management, and professional presentation. Each of these subjects integrates information from four streams: occupational therapy theory; contextual (contexts of the occupational therapist and the clients, including fieldwork);biocognitive (including biological sciences and psychology); and psychosocial-cultural (including behavioral and social sciences). Figure 1 illustrates the organization of the subjects and the streams.

The subjects are taught using Problem–based case scenarios and issues-based content. These scenarios are structured around the domains of occupational therapy, namely daily activities appropriate to client roles. In order to ensure that a broad range of client concerns and issues is addressed in the course, the following variables are considered when developing the range of scenarios and issues for the two years of the course in both campus-based and fieldwork settings: age, roles, type of disability, populations and community-based groups, culture, socioeconomic status, gender, occupational therapy worksites, environments, and type of intervention (e.g., individual, group, community, or population based).

Problem–based Case Scenario: Indigenous Mental Health

Considering the above variables, one of the case scenarios introduced in the first-year curriculum is on Indigenous mental health. The current undergraduate and graduate curricula in occupational therapy in the University of Sydney are limited in exposing students to Indigenous health issues. Occupational therapists are constantly challenged with these issues in a variety of practice contexts. One of the strategies identified in the New South Wales Aboriginal mental health policy as essential in determining, administering, and providing health services in relation to all mental health issues affecting Aboriginal people is that “education is an integral aspect of the workplace for both aboriginal and non-aboriginal people” (NSW Department of Health, 1997, 22). The inclusion of a Problem–based case

scenario on Indigenous mental health in the MOT curriculum is in response to this strategic direction. The process of case scenario development, implementation, and evaluation will now be described using the collaborative inquiry framework.

The Collaborative Inquiry Process

Phase I: Forming a Collaborative Inquiry Group

C onsulting with anI ndigenous person

In the process of developing the case scenario and the learning experiences that students need to encounter in order to gain an understanding of Indigenous mental health issues, the case coordinator (R. Beltran) consulted with an Indigenous person who is also a health professional with expertise on Indigenous mental health (S. Merritt). The case coordinator, who is of a migrant background and has practiced as an occupational therapist in mental health and has taught undergraduates and graduates in this area of practice, recognized that one needs more than knowledge and experience to have a real understanding and appreciation of mental health issues within the Australian Aboriginal community. It was therefore important to consult with an Indigenous person who has insider knowledge of the issues. This started the collaboration between the two authors, which was to become a cyclical series of experiencing, reflecting on these experiences, and acting together (Heron, 1996).

INQUIRY QUESTION

In our planning and subsequent reflective processes, the question we constantly asked ourselves was: How can learning about Indigenous health issues be facilitated so that students would be equipped to deal with Indigenous clients in their practice? The inquiry question should fulfill two basic principles: one, that the inquirers can explore the question through their experiences; two, that inquiry members are equal peers in terms of their ability to address the question (Bray et al., 2000).

Phase II: Creating the Conditions for Group Learning

Critical in this phase is agreeing on the structure for collaboration (Bray et al., 2000). For us, it was important that our roles as case coordinator and resource person, respectively, were clear to each other and that both were committed to pursuing answers to the inquiry question as peer learners ourselves. In addition to these roles, we were aware of the fact that we were facilitators of our students' learning.

S etting the scene: D evelopment of a problem–based case scenario

Our aim here was to develop a scenario that is representational and true, a composite case that does not present a stereotype picture of the issues nor breach confidentiality. We decided that, for confidentiality reason, it was safer to use a published case than to write a new one. We searched the literature and decided to use the case history published in the New South Wales Aboriginal mental health policy document (Swan, 1997) as the basis for the case scenario. We reviewed published cases to ensure that specific problems and issues embedded in the case scenario represent the current Indigenous condition. The case history provides the framework by which the history and context of Indigenous health, specifically mental health and well-being, can be outlined for the MOT students. The aim is for students to develop an understanding of Indigenous issues in a broader sense and to be aware of cultural and individual differences of clients in order to be a more effective health professional.

I ndigenous person as a resource

It is important to enlist an Indigenous person as a resource to guide some of the learning experiences of the students. This person's insider view provides credibility, authenticity, and better understanding of the issues. Additionally, our faculty has a School of Indigenous Health Studies, which has expertise in and a strong commitment to Indigenous health.

At this point, we reviewed the chosen case history and brainstormed on possible issues that might be raised by students as well as how they might be addressed by the Indigenous resource person. For example, we identified that Aboriginal history, mental health problems, and grief and loss might be raised.

We also attempted to preempt possible barriers to learning, such as students' stereotypes of what it might mean to be Aboriginal, what an Aboriginal is, what grants or subsidies that “blacks” get off the government, and so on. We then determined which of these issues could be directly addressed by the Indigenous resource person.

Phase III: Acting on the Inquiry Question

I nitial exploration of issues

On the initial presentation of the case scenario, students are asked a few focus questions (see later). The use of these focus questions is consistent with the principles of Problem–based course construction (Bouhuijs & Gijselaers, 1993). Scenario Part A is given to students in the first session of this curriculum:

Scenario—Part A

You are an occupational therapist in a large psychiatric hospital in the Central Sydney Area Health Service. You are a member of the In-patient Rehabilitation Service. One of the referrals you received during the week was June, a 43-year-old female of Aboriginal descent, who was admitted to hospital eight days ago. You decided to read June's chart, and the following is the information that you learned about her.

June lives in a housing commission unit, which she was able to obtain a few weeks after she was released by the Corrective Services. She was referred from the Aboriginal Medical Service. She apparently had been feeling anxious and depressed for the last six months since her children, Mira, 8, and Richard, 11, were placed under the care of the Community Services. She became worse three months prior to admission with loss of appetite and weight. She had been treated with medications without response. Two days prior to admission, her behavior changed; she became labile, excitable, and restless. She was also noted to be thought disordered with loosening of association and pressure of speech. She was constantly verbalizing about her dreams of her children being taken by four large animals and that she last saw them riding on the back of these strange-looking animals at a vacant land near La Perouse.

June has no past psychiatric admission. For her family and developmental history, see attached.

On admission, June was unable to give a detailed history. However, her sensorium was clear and was oriented. She denied auditory hallucinations; however, there was evidence of loosening of association and pressure of speech. She also spoke briefly of feeling in the past few days that something special was about to happen to her and her children. She would frequently associate these special events with circumstances around her, for example, believing that when the phone rang it would be someone with special news just for her. She also appeared to be elated and was restless and energetic.

June was admitted with a provisional diagnosis of bipolar disorder (manic phase) and was commenced on medications. Her mood quickly stabilized, and it became apparent that she was extremely insightful and was quick to grasp ideas and open about her personal concerns. Her serum lithium level was 0.6 mmol/L.

Over time, as her mood stabilized, it became apparent that she continued to have an underlying depression. She often found it difficult to speak of painful things and her smile, although frequent, was not congruent with the content of her thoughts.

Focus Questions

• What issues and key concepts do you need to know to deal with this situation?
• Given your background and experiences and previous cases that you have studied, what are the things that you already know?
• What resources will you need to find out the things that you don't know?
• Since June is referred to you in the Rehabilitation Service, how would you go about assessing June's needs and concerns?

With this case scenario, we aimed to tap students' current knowledge and experience. Based on students' responses to the focus questions, it appeared that they were able to identify questions and specific issues related to the therapy management of the case. They also identified that they needed a broader understanding of the sociocultural, political, economic, and historical factors that have a significant impact on Indigenous health. This response has been more or less consistent in the last five years that we have been teaching this curriculum.

B reaking down stereotypes

Introducing the notion of stereotype is necessary to help students gain a broader understanding of factors influencing Indigenous mental health. It is important to facilitate a forum that has a respectful and nonjudgmental atmosphere and is accepting of every member's beliefs and opinions. It is crucial to acknowledge that everyone has certain stereotypes that impact on one's perceptions of people. By presenting this issue in a nonthreatening way and putting it in the agenda, students become prepared to look at their stereotypes of Indigenous people without fear of being judged. One exercise that facilitates this process is the question posed by the facilitator: What do you think of when you think about Aboriginal health? The stereotypes about black skin versus white skin are also presented supplemented with an understanding of the psychosocial, cultural, and economic consequences of white policy on the Aboriginal community and its impact on the health of the community. However, breaking down stereotypes may not always work, as our experience in one of the years suggests. This is discussed later in the chapter.

I mparting knowledge of history

It is important for facilitators to encourage students to read and update their knowledge of Aboriginal history in Australia and to challenge some of the stereotypical views that may have filtered through in the Anglo-Saxon view of history as presented in some sectors of society. The Indigenous resource person also presents an insider's view of history, which broadens and challenges students' knowledge and views. This was ascertained from the first round of evaluation of the curriculum.

R esource sessions onA boriginal mental health issues

The curriculum content covering Aboriginal mental health issues was developed based upon students' identification of what they considered to be relevant issues. Occupational therapy academics, clinicians, and researchers with expertise on such issues are invited to speak on topics such as community approaches with Indigenous people, occupational therapy and Indigenous mental health in the context of a psychiatric hospital, parenting and vocational issues, culture and mental health, and mental illness.

S tudents' determination of learning needs

Within the capability professional education framework, students take an active role in determining their own learning needs. For example, they are given the option of identifying whether they need extra sessions with the Indigenous and other resource persons. They also are asked to identify which topics they want to pursue. These additional sessions (if asked for) are then negotiated between the resource persons and the students.

F eedback from students

As part of standard practice in the provision of higher education, student feedback is sought in relation to teaching and learning. In the MOT course, students are asked for their written feedback after each case scenario. A feedback sheet was developed for this purpose by the MOT team. Students are asked to reflect on the case that they have just finished and to write their responses on the form. Feedback is not compulsory for students. Appendix A is the standard feedback form used for all case scenarios in the MOT course.

Feedback is collated and reflected upon, as a matter of course, by the curriculum team. This feedback helps us in future curriculum development.

Selected excerpts from feedback forms are included here to give a sense of students' views and perceptions and to illustrate how useful these comments can be in relation to curriculum development.

• Q_UESTION: Describe an aspect of the case which has been most useful in terms of your learning.

In general, students found almost all the learning experiences related to the case useful. In particular, the feedback reflected change that had happened to the students because of this case study. They commented on change in attitude and a broadening of their views. The case is an “eye-opener” for them.

“It is a joy to be exposed to so much new learning about aboriginal issues in mental health, parenting, community occupational therapy. Thank you. It has been an experience to ‘open my mind’!”

“Learning about Aboriginal mental health is an issue that I didn't realize was as significant as I do now.”

“Having my myth of mental health, and what OTs do in mental health, dispelled.”

“Made me aware I do have stereotypes but now I am reshaping these.”

“… which opened my mind about aboriginal people and their culture.”

“This was a most interesting case. I enjoyed it so much and it was such an eye opener. Having Shane Merritt was probably the most useful aspect. I'm 27 and I've only just learned about these issues. That is a national disgrace. Every Australian should be taught about the Aboriginal perspective when at school.”

“The case as a whole made me question my stereotype (which has been formed from a very selected knowledge) and the cultural awareness related to Aboriginal people (and other groups of people).”

Among students' comments on the lectures and lecturers, most notable were those on the challenge brought by an insider's as well as experts' perspectives.

“Every lecture was fantastic, thought provoking and very interesting.”

“Having Shane lecture us was fantastic because of his own personal background and experience, as well as his knowledge basis.”

“Particularly liked the four hours spent with Shane; liked the way he challenged our views—really gave me something to think about.”

“Session with Shane Merritt (1st session) about indigenous people …”

“Especially good were lectures by Shane, plus the panel of three on parenting and the … hour on OT in mental health …”

“[the lecturer from OT] on community rehabilitation. This provided me with a real sense of excitement as to what OTs can provide people who are not so fortunate.”

“Also session by [name omitted] on community-based rehab in India was an eye opener about how OTs can really help indigenous people.”

Students commented on the case coordinator's input and role, as well as the way the focus questions were framed, which directed them on the relevant issues to pay attention to and challenged them to identify what other learning they needed to pursue.

“Focus questions, which directed Part B of the case scenario.”

“The focus questions given to us gave us opportunities to explore the issues and what we already know of Part B.”

“Consulting with Ruth about our concerns about what we would learn and having these worries addressed. … Ruth really heard what we were concerned about and acted on this even if we were too hasty!!”

“Great in that Ruth sat in on each of the sessions, this is very encouraging as often the coordinators don't attend lectures.”

Students commented strongly on the teaching/learning process used in class. These comments centered around the benefit of making the content relevant, the manner in which students were urged to exercise self-determination in their own learning, and the encouragement that they be active learners.

“Being introduced to Aboriginal health in a very practical, realistic manner.”

“Consulting with Ruth about our concerns about what we would learn and having these worries addressed. Good lesson in being up front about issues in an assertive manner. Consequently I got heaps out of nearly all the lectures … I felt the lecturers really involved us in the learning.”

• Q_UESTION: What would you add or change in this case?

Students suggested, among other issues, introducing the case study in the undergraduate program; expanding the discussion on therapy intervention;extending the session on parenting; covering experiential components; and including speakers from other indigenous groups. One of the issues identified by students in relation to the case “Stolen Generation” was parenting—the repercussions of poor parenting and how to facilitate development of parenting skills in people who have not experienced love and care from their own parents.

“I would add this whole case study to the undergraduate program.”

“ADD it to the undergraduate course!!”

“How to actually attempt to implement some of the intervention.”

“… roles of community health in Aboriginal communities in more depth.”

“… maybe just a little bit more on intervention.”

“More about appropriate intervention for aboriginal people. Maybe OT more specifically involved with Aboriginals.”

“More time for the session on parenting.”

“Have a longer session with [names omitted] on parenting.”

“Another hour to parenting issue session.”

“Have more practical component in Aboriginal issues? For example, talking to mothers who lost their children.”

“Maybe add a speaker outside of aboriginals, i.e. Torres Strait Islanders, etc., for their view.”

• Q_UESTION: Indicate (on the scale) how confident you would feel dealing with a similar case in practice? What leads you to mark your level of confidence where you have on the scale?

Students assessed their confidence level from the midpoint of the scale up toward the “very confident” level. Among their answers for their level of confidence were increased awareness; better understanding of issues, approaches, and resources; realization of the importance of the case study;and agreement of the case study with occupational therapy philosophy.

“More awareness of the culture and people and awareness of my attitudes etc.”

“More aware of aboriginal people but still very unsure of appropriate intervention to help a client such as June.”

“Have a much better understanding of problems involved with Aboriginal Mental Health and approaches to take plus resources available to help—people plus community places such as …”

“I feel confident that I would be more open and understanding of the possible issues of an aboriginal client. However, I being white, will still not ever be able to fully help an indigenous person, because I am not aboriginal.”

“The readings as well as Shane's lectures brought out the issues in Aboriginal Mental Health. I feel confident in discussing them to a certain extent.”

“This information has just provided me with a base understanding about Aboriginal issues so that I am in a better position to provide appropriate OT services.”

“Feel I have a much better understanding as to why this case has been included and its importance. Excellent case!!”

“What we have been taught fits in beautifully with OT philosophy re providing intervention for the individual.”

• Q_UESTION: What advice would you give future students about this case?

Students' recommendations ranged from reading and listening to keeping an open mind.

“Read lots.”

“Read more about Aboriginal history and health issues.”

“Read the poems and stories from the stolen generation.”

“Listen and hear.”

“Attend every lecture.”

“Have 2 sessions with Shane (like we did) because they both were so valuable to my understanding.”

“Watch the recommended videos. They help quite a bit.”

“Use this case as an introduction for being aware of indigenous issues. So that we can change the general attitude of the health profession in treating indigenous people.”

“Soak this case up. It is fascinating. It should be a part of every high school student's education not just MOT…”

“To use this case as an opportunity to learn about the people (not only aboriginal people in this country) and their beliefs and attitudes about the issue.”

“Important to keep a real open mind and challenge the views that you have about Aborigines and their state of mental health.”

“Keep an open mind.”

“Enjoy it and keep an open mind.”

“And to be open to all the lecturers' views regardless of the present view of others (i.e. students).”

It can be noted above that some students suggested that perhaps there should be more input on specific occupational therapy intervention built into the case. However, one particular feedback highlights the importance and the priority of understanding the history and the broader contexts of Aboriginal mental health issues first before specific therapy interventions:

“Don't be concerned about not learning so much the intervention. Very important to obtain the background/history such as the Stolen Generation.”

Perhaps an understanding of the issues, on the part of health-care professionals, may be sufficient in itself to make changes or interventions possible. Changes or interventions may not necessarily come from health-care professionals but can arise from people's self-determination.

Phase IV: Making Meaning by Constructing Knowledge

This phase centers around capturing our experiences as facilitators, understanding and interpreting our experiences, and sharing them with colleagues and students. It is also during this phase that we seek validation of our experiences and celebrate meaningful collaboration (Bray et al., 2000).

I nterpreting our experiences

Our decisions and actions taken in the teaching of this case scenario relied heavily on our evaluation of the feedback that we gathered every year for the last five years. Table 1 tabulates the total enrollment in the MOT course and the number of feedback responses received. Table 2 presents a comparison of the general trend in the evaluation from 1998 to 2002.

Overall, the evaluation throughout the five years suggests a positive experience for the students, except for 1999. A total reversal seemed to have occurred that year in comparison with the other years. The general feeling that year seemed to have changed from “Why weren't we told [about Indigenous history]?” in other years to “I don't want a history lesson.” This issue was shared with peers at a curriculum conference (see next section). Throughout the past five years, the curriculum basically stayed the same with very minor revisions.

C ommunicating our experiences in the public arena

At various stages throughout the process of this curriculum development, part of the cycle of action and reflection is communicating our work to peers in the faculty (Research Forum, School of Indigenous Health Studies, October 1999) and in the wider university (Faculty of Medicine Curriculum Conference, University of Sydney, December 1999), as well as at state and international conferences (New South Wales Aboriginal Mental Health Conference, Sydney, September 1999; the 26th Biennial Congress of the World Federation of Mental Health, Vancouver, July 2001). We also provided subsequent cohorts of students with relevant information about feedback from past students about the case scenario. At the Faculty of Medicine Curriculum Conference, we discussed with curriculum experts in the audience, in a workshop setting, about the negative feedback in 1999. We were encouraged to leave the curriculum as it was and to see how evaluation in subsequent years would fare.

C elebrating meaningful collaboration: O utcome and developments

As an outcome of our experiences in facilitating this case and based on the feedback of students, we maintain an ongoing commitment to address the issues of Indigenous mental health in the occupational therapy curriculum. The Indigenous case scenario is one of the core learning units for MOT students. Indigenous mental health is now included in the undergraduate occupational therapy course, although in a different format to that of the MOT course. Students are encouraged to undertake fieldwork placement with Indigenous health workers and with Indigenous communities.

Implications and Recommendations

Figure 2 illustrates and summarizes the process adapted for the collaborative inquiry used to reflect and act on the development, implementation, and evaluation of the Indigenous mental health curriculum within the MOT program.

Collaborative inquiry is an action-based inquiry method that has wide-ranging implications as a strategy for adult learning and as a research method (Bray et al., 2000). As a strategy for adult learning, we have illustrated in this chapter its use to enhance our learning within the context of our various roles as curriculum planners, case coordinator, resource persons, and facilitators. Collaborative inquiry can be used as a framework for reflecting and acting on the planning, implementation, and evaluation of a curriculum. As is the case with this method of inquiry, the process of reflection and action is driven by an inquiry question. As stated earlier, our inquiry question was how we could facilitate learning about Indigenous health issues so that students would be equipped to deal with Indigenous clients in their practice. From our experience, this process certainly was not linear. At various phases, we kept going back to where we started: the inquiry question. Consistent with the findings of Gamble, Chan, and Davey (2001), we have found that

critical to the use of collaborative inquiry as a tool for reflection is the condition of trust between collaborators and between peers who may be part of the public arena. For us, the MOT team has certainly played an excellent sounding board for our reflections, decisions, and actions.

As a research method, we have used collaborative inquiry as a framework for this case study in which we attempted to narrate our experiences of a five-year collaborative process. A critical aspect of collaborative inquiry as a research process is the production of meaning and knowledge for the public arena (Bray et al., 2000). We have been conscious of this from the very start as evidenced by the presentations we have made at various levels with the hope of generating critical debate, new insights, and enhanced understanding.

An important recommendation and an action worth pursuing that arose from this case study is to use collaborative inquiry as a learning strategy for students, which can run parallel with its use as a learning strategy for teachers (as illustrated in this chapter) within the same curriculum context.

Collaborative inquiry as a strategy for adult learning and as a form of research has facilitated our understanding of our experiences and enabled us to make informed decisions about our teaching. So far the outcome has veered toward the positive side, which strengthens our commitment in facilitating students' understanding of Indigenous mental health issues in the context of society, culture, personality, economics, politics, and history.

Acknowledgments

We would like to thank our respective schools for their support of the MOT curriculum, the MOT team for their collegiality, and all the MOT students—past, current, and future—whose enthusiasm for learning makes our experiences and insights possible.

References

Boud, D., & Feletti, G. (Eds.) (1991). The challenge of Problem–based learning. London: Kogan Page.

Boud, D., Keogh, R., & Walker, D. (Eds.) (1985). Reflection: Turning learning into experience. London: Kogan Page.

Bouhuijs, P. A. J., & Gijselaers, W. H. (1993). Course construction in Problem–based learning. In P. A. J. Bouhuijs, H. G. Schmidt, & H. J. M. van Berkel (Eds.), Problem–based learning as an educational strategy (Chap. 5). Maastricht: Network Publications.

Bray, J. N., Lee, J., Smith, L. L., & Yorks, L. (2000). Collaborative inquiry in practice: Action, reflection, and making meaning. Thousand Oaks, CA: Sage.

Gamble, J., Chan, P., & Davey, H. (2001). Reflection as a tool for developing professional practice knowledge expertise. In J. Higgs & A. Titchen (Eds.), Practice knowledge and expertise in the health professions (Chap. 15). Boston: Butterworth-Heinemann.

Heron, J. (1996). Co-operative inquiry: Research into the human condition. London: Sage.

Knowles, M. (1975). Self-directed learning: A guide for learners and teachers. New York: Association Press.

NSW Department of Health, Centre for Mental Health (1997). New South Wales Aboriginal mental health policy. Sydney.

Schon, D. A. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass.

School of Occupational Therapy, Faculty of Health Sciences, University of Sydney (1997). Course proposal for the Master of Occupational Therapy, Draft 7. Sydney.

Stephenson, J., & Weil, S. (1992). Quality in learning: A capability approach in higher education. London: Kogan Page.

Swan, P. (1997). 2000 years of unfinished business. In NSW Department of Health, New South Wales Aboriginal mental health policy. Sydney.

Appendix A

School of Occupation & Leisure Sciences Master of Occupational Therapy

Student Feedback Sheet

We are seeking your feedback about the learning experiences which have been part of the MOT. Your ideas will help us to strengthen future cases in which you and other students participate.

Thank you for your time and for your comments.

Case number/title:

Please reflect on the case which you have just finished as part of your MOT studies and answer the following questions.

1. Describe an aspect of the case which has been MOST useful in terms of your learning.
2. Describe an aspect of the case which has been LEAST useful in terms of your learning.
3. What would you ADD or CHANGE in this case, within the 11/2-week time frame?
   1. I would add …
   2. I would change …
4. Indicate (on the scale) how confident you would feel dealing with a similar case in practice?
   Not very confident           Very confident
   What leads you to mark your level of confidence where you have on the above scale?
5. What advice would you give future students about this case?

School of Occupation & Leisure Sciences Master of Occupational Therapy

Student Feedback Sheet—Procedures

Following each case, the case coordinator is responsible for arranging for students to provide feedback about the case.

Provide copies of the attached blank form to be distributed by another member of staff not involved with the case as soon as possible after the case has finished.

Allow about 15 minutes for students to complete and return the form.

Students are not obliged to provide feedback; however, indicate that we are grateful to those who do.

Return the feedback forms to the case coordinator, who will then summarize key issues raised and make recommendations for future modifications to the case.

It is highly desirable that the summary and recommendations be documented by the case coordinator as a record for the future development of the case.