Journal articles on the topic 'Health, Health care professionals, Health education curricula, Human trafficking'

Abstract Background Content knowledge surrounding transgender (trans) medicine is currently lacking in the formal medical education curricula. Evidence indicates that the main protocols used to assess and refer trans patients for gender-affirming medicine are misunderstood by health professionals, and require flexible adaptation to achieve health equity and patient-centred care. Approach A free online educational tool for gender-affirming medicine, The Path to Patient-Centred Care, was developed to teach learners how to adapt assessment protocols. Resource creation was supported by a knowledge translation grant that endorsed design thinking, a human-centred and solutions-focused framework recommended for use in curriculum development. Evaluation The Path to Patient-Centred Care provides learners with information related to key principles of patient-centred care in gender-affirming medicine, including a guide on how to adapt the main assessment protocols to achieve equitable care. The curriculum also includes narratives from trans patients and health professionals that focus on health equity, and a clinical vignette about a complex case, designed to foster critical thinking on medical ethics. Project future directions involve an implementation and evaluation pilot study with a diverse group of continuing professional development medical learners using a mixed-methods program evaluation design. Reflection The use of design thinking to develop this resource exemplifies a novel approach to curriculum development. By using pedagogical strategies that foster critical reflection, this innovative online education tool strives to teach self-directed learners how to provide care that emphasizes trans people’s self-determination and autonomy in medical decision-making.

Background and Purpose: Spirituality has been identified as the essence of being human and is recognized, by many health care professionals, as a central component in health and healing. Scholars have identified spiritual nursing care as essential to nursing practice and include caring for the human spirit through the development of relationships and interconnectedness between the nurse and the patient. However, despite the recognition of spiritual practices as important to health, little attention has been given to spirituality in nursing practice and education in the literature. The purpose of this article is to explore factors contributing to the invisibility of spiritual nursing care practices (SNCP), recognition and offer strategies to enhance the visibility of SNCP. Two major factors that reduce visibility of SNCP are conceptual confusion differentiating between spirituality and religion and limited education in the area of spirituality including nursing curricula and organizations. Strategies to enhance visibility of SNCP include educational approaches in nursing curricula and health care organizations. to influence nurses’ perceptions about spirituality and creation of a culture of spiritual care. Conclusion: Holistic nursing includes assessing and responding to the spiritual needs of patients. Changes in nursing education and health care systems are needed to increase the visibility of SNCP.

Purpose This paper aims to focus on the impact of Coronavirus (COVID-19) on victims of child trafficking. It highlights findings from research on other pandemics and outbreaks, the impact of child trafficking on children, the impact of COVID-19 on children and the impact of COVID-19 on victims of child trafficking. Design/methodology/approach This paper focuses on the global impact of COVID-19 on victims of child trafficking. It highlights findings from research on other pandemics, the impact of child trafficking on children, the impact of COVID-19 on children and the impact of COVID-19 on victims of child trafficking. The findings provide a useful framework to guide the development of social policies to address this global crisis and to empower social workers and allied professionals to implement effective service responses. This is a crucial time for the entire world to diminish the impact of COVID-19, address this unprecedented crisis and uphold the human rights of all children. Findings These findings provide a useful framework to guide the development of social policies to address this global pandemic and to support social workers and allied professionals to implement effective service responses. Originality/value The author proposes three basic action items: commit to the promises made in international and regional mandates and guidelines; address the risk and vulnerability factors that have been identified; and implement the promising prevention activities described in the literature.

Background and objective: Nurses deal with complex human rights issues arising from difficult situations and ethical dilemmas involving patients, relatives, and health care professionals. Human rights education can enable nurses to understand principles of human rights and apply them at work in their efforts to provide high quality care. The objective for this study was to describe how human rights material was integrated into a professional ethics course for master degree nursing students and to facilitate nurse educators’ efforts to include such material in their courses.Methods: In this qualitative study, data consisted of responses to a human rights assignment by 23 nursing students at a university of applied sciences in Finland. Thematic analysis was used to identify patterns and themes from the assignment.Results: Participants’ consensus was that human rights education should be part of nursing curricula. Students described what they learned, identified similarities and differences between human rights principles and ethical codes, gave examples applying human rights principles to their work, and stated how they could better protect human rights of nurses and their patients.Conclusions: Learning about human rights reinforces nurses’ knowledge and application of ethical codes and increases their awareness of factors necessary for quality care.

Abstract Teamwork and collaboration across disciplines is becoming critically important as we meet the health and human service needs of people growing older and their families. The myriad of competencies, language and tasks specific to each discipline are not easily or intuitively mastered within discipline specific curricula. This presentation aims to provide a model that addresses the curricular needs for course preparation through inter-professional educational strategies. While the traditional IPE components are address, this model also integrates in the training process, education through the lens of the social determinants of health, community collaboration through health and human service networks, population health and public policy. This presentation will lay out the model and articulate specific educational strategies to address each of the dimensions of the model, to include the flip classroom, experiential activities, assessment and intervention tools, panel discussions with community and agency partners and epidemiologic/population health data. This model identifies a unique approach to teaching students and professionals about collaboration across disciplines for the benefits of addressing the needs of an older adult target group. This model also moves the process of teaching interprofessional collaboration and education beyond understanding values and ethics, roles and responsibilities, team care and communication.

INTRODUCTION Nursing education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. The scope of nursing practice reflects all the role and responsibilities undertaken by the nurse to address the full range of human experiences and responses to health and illness. The instructional strategies utilized in both didactic and clinical components of nursing education courses are highly influential in determining critical thinking and clinical decision making ability as well as in developing the psychomotor skill performance of new graduates. Simulation provides nursing students with opportunities to practice their clinical and decision-making skills through various real-life situational experiences. Although endorsed in nursing curricula, its effectiveness is largely unknown.

Adolescents are increasingly at risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. The prolonged latency period, sometimes in excess of five years, and the incubation period of up to 10 years before the manifestation of symptoms, may foster adolescents’ false sense of invincibility and denial as they often do not see the devastating effects of the disease in their peers until they are older. In turn, their practice of safer sex may be hindered and thereby contribute to the escalation of this public health crisis among sexually active adolescents. Prevention-focused recommendations were made in the USA as a result of this crisis. Recommendations were made to: (1) include STD/HIV education in the curricula of grades kindergarten to 12; (2) increase to at least 75% the proportion of primary care and mental health professionals who provide age-appropriate STD/HIV prevention counselling to adolescents; and (3) expand HIV prevention services to include age-appropriate HIV education curricula for students in grades 4-12 in 95% of schools. Yet, in the USA, the provision of school-based comprehensive STD/HIV education has been difficult to achieve owing to certain limitations and, in some instances, legal action. These limitations include: limited student access; restricted content; and the implementation of sporadic and/or brief educational programmes. Given these recommendations and the fact that adolescents are acquiring STDs and HIV infections at increasing rates, and despite the limitations and legal actions, do health care professionals not have an ethical obligation to provide adolescents with comprehensive STD/HIV prevention education? This ethical dilemma will be discussed using the ethical decision-making principles of ‘autonomy’ and ‘beneficence’, and a decision-making model proposed by Thompson and Thompson, and by Chally and Loric.

Purpose – This paper is about a single case study of a three-year BSc Mental Health Nursing degree programme based at a London University. The purpose of the paper is to evaluate the extent to which the programme sufficiently addresses the ten quality criteria developed by the “PROMISE” (2009) Mental Health Promotion Project. PROMISE (2009) is a European public health project funded by the European Commission and was conducted from 2009 to 2012. Its aim was the European-wide development of criteria and training guidelines in mental health promotion and recommended these should be integrated into the professional training curricula of nurses, psychiatrists, psychologists and social workers. Design/methodology/approach – A content analysis method (Bryman, 2012) was used for this case study. This method allowed for a line-by-line scrutiny of the contents of the curriculum for evidence of the ten PROMISE quality criteria for mental health promotion (PROMISE project; http://promise-mental-health.com/training-guidelines.html). Findings – The findings revealed that the PROMISE (2009) project was not one of the four key documents stated as forming the basis for the design of the curriculum content. However, the study found evidence of the curriculum addressing the first PROMISE criterion of embracing the principles of mental health promotion in seven of the 14 modules (50 per cent) in the programme. In the first year of the programme five of the ten PROMISE quality criteria were embedded in two of the four modules. In year 2, quality criteria 1, 4 and 7 were addressed in the course content of four of the five modules (see Table I). In the final year of the programme PROMISE quality criteria 1, 2, 4 and 8 were embedded in the syllabus and assessment strategy in two out of the five final year modules. It was also found that quality criteria 2 and 9 were not included in any of the modules in the programme. Research limitations/implications – This is a case study based on the content analysis of a single curriculum document in a London University. It is therefore not possible to make wide generalisation of its findings across the countries involved in the EU Promise project. However, it could be argued that it is possible to find a number of the key findings present in other UK University programmes that may be similar in structure to that selected for this study. The other limitation to this content analysis is that the evaluation process did not include accounts of the students’ experience on the programme. This could have contributed significantly to the outcome of the evaluation exercise. Although the methodology used is simple, practical and relatively sound, it is not necessarily rigorous in terms of quantitative research methodology but arguably an acceptable contribution to the spectrum within qualitative research paradigm. Practical implications – The emergence of the “PROMISE” criteria especially on a European-wide basis puts emphasis on the importance of mental health promotion in the training of health care professionals. This is expected to be achieved by the training institutions in the European Union. In the UK, this notion is well embraced in various health policy documents (e.g. “No Health Without Mental Health” DH 2011). In the case of the programme examined at one London University, work is required to ensure that a pervasive incorporation of mental health promotion strategies in the curriculum in order to help the students to become better equipped to understand and effectively apply the mental health promotion criteria in their work upon qualification. Originality/value – This is one of the first papers to address the “PROMISE” project and the issue of incorporating mental health promotion criteria in a pre-registration mental health pathway training programme in a university in the UK.

Abstract The long-term goal of Genetic Education for Native Americans (GENA), a project funded by the National Human Genome Research Institute (NHGRI), is to provide a balance of scientific and cultural information about genetics and genetic research to Native Americans and thereby to improve informed decision making. The project provides culturally sensitive education about genetic research to Native American medical students and college and university students. Curriculum development included focus groups, extensive review of available curricula, and collection of information about career opportunities in genetics. Special attention was focused on genetic research to identify key concepts, instructional methods, and issues that are potentially troublesome or sensitive for Native Americans. Content on genetic research and careers in genetics was adapted from a wide variety of sources for use in the curriculum. The resulting GENA curriculum is based on 24 objectives arranged into modules customized for selected science-related conference participants. The curriculum was pretested with Native American students, medical and general university, health care professionals, and basic scientists. Implementation of the curriculum is ongoing. This article describes the development and pretesting of the genetics curriculum for the project with the expectation that the curriculum will be useful for genetics educators working in diverse settings.

<p>With an emerging transformation in global health from ‘<em>diseases</em>’ to ‘<em>Health Systems</em>’, there is increased recognition that Health Systems need to be resilient and receptive to the accelerated demographic and epidemiological transition, posing unconventional health challenges. Health System strengthening is also crucial for progressing towards Universal Health Coverage which is an intrinsic attribute of health related SDGs (2030).</p><p> In light of contemporary threats to health security, Health systems are becoming more complex and placing supplementary demands on the Health Workforce which is one of the key components of health systems. Pakistan has been categorized as one of 57 countries that are facing an HRH (Human Resource for Health) crisis i.e. that its health workforce is below the threshold level defined by WHO, required to deliver the essential health interventions to attain the Sustainable Development Goals (UN) by 2030.¹ The crisis is complex and is related not just to the quantity but the quality, efficiency and effectiveness of the health work-force.</p><p> In a series of studies about Health Professionals education, the landmark 1910 Flexner Report² triggered revolutionary reform in Health Professionals education by consolidating modern science into the curricula at universities, equipping the health professionals with the knowledge that contributed to enhanced life expectancy and improved quality of life in the 20^th century. Marking the centenary of the reform initiative, the Lancet Commission on ‘Education of Health Professionals for the 21^st Century’ accented the fact that professional medical education especially in developing countries, has not kept pace with emerging challenges because of obsolete and inert curricula that has led to production of valueless and ill equipped graduates who have not been able to address the contextual challenges effectively.³</p><p> According to the commission some of the impinging issues include weak leadership to improve health system performance, persistent mismatch of competencies to individual patient and population needs, limited technical focus without broader contextual understanding, predominant clinical orientation at the expense of primary health care, intermittent episodic encounter<br /> of the patient with clinic rather than a ‘continuum of care’ approach etc.</p><p> The Commission draws attention to ‘three generations’ of Health Professional education reform in the past century starting with a science based curriculum in the first generation (start of the 20^th century) followed by problem based instructional innovation (mid-century). Authorities emphasize that a third generation of reform is now required that employs a systems approach for improving health system performance and adapts core professional competencies to specific contexts while drawing on global knowledge. They maintain that actualization of this vision will require a series of instructional and institutional reforms, which should be guided by transformative learning which is the highest of three successive levels, moving from in-formative to formative to transformative learning. In-formative learning is about acquisition of knowledge and skills with the objective to produce experts. Formative learning is about socializing students around values to produce professionals. Transformative learning is about developing leadership attributes; its purpose being production of enlightened and cultivated change agents. Effective education builds each level on the previous one. As a valued outcome, transformative learning involves three fundamental shifts: from fact memorization to searching, analysis, and synthesis of information for decision making; from seeking professional credentials to achieving core competencies for Effective teamwork in health systems; and from non-critical adoption of educational models to innovative adoption of global resources to address local priorities.³</p><p> Pursuance of these reforms requires leadership from within the academic and professional communities, increased investments and stewardship followed by shared learning by supporting evaluation and strengthening of research to build the knowledge base about which innovations work in which settings. It is critically important to subscribe to the vision and recommendations of the Commission for development of cadres of skilled, competent and motivated health professionals who can in due course, be agents of change within their domains and work towards addressing the daunting health challenges of our times.</p><p>(Adapted from The Lancet Commission on ‘Education of Health Professionals for the 21^st Century, 2010)</p>

The benefits of implementing interprofessional and team­based programs are well recognized. However, for interprofes­ sional education to be effective and broadly implemented, the health professions, policymakers, insurers, academic institutions, health care providers, and regulatory bodies should embrace and adopt a new, interprofessional education framework. These stakeholders should create a shared value and vision for interprofessional health professions’ educa­ tion, research, and practice. This vision should be patient­oriented and contain a measurable component across the entire educational continuum, from admission into a health professional program through retirement. Such a framework would maximize and value the strengths of individual professions in the integrated delivery of high quality care. Finally, in creating a successful model, a series of questions should be considered: how best can team competence be measured, how should individual behavioral changes be documented when we think of individual rather than team­level changes, how do we create and measure performance criteria based on shared understanding and experience in the practice setting? Within academic settings, there are more specific barriers including a lack of administrative support, financial and human resources for interprofessional education, conflicts in schedules and health professions’ curricula, and limitations to the time required to plan and implement faculty development for interprofessional learning. Finally, despite progress, there remain regulatory and professional barriers to achieving full and meaningful implementation of effective models. Recom­ mendations which are given emphasize that investing in research to evaluate the efficacy of continuing education and its impact on patient outcomes and the healthcare delivery system is inherent in this process.

The Queen’s University Interprofessional Working Team, as part of the Interprofessional Education (IPE) Curricula Models for Healthcare Providers in Ontario (IPECM) working group, has been tasked to present a scoping review of existing national and international interprofessional education programs and to develop a guiding curriculum framework for pre‐registration, continuing education and post‐ registration health provider education. Achieving this project’s aims will ultimately provide a foundation that promotes collaborative, patient‐centred practice by utilizing the skills, knowledge and scope of practice of all members of the health care team. The current scoping review of interprofessional continuing education programs for the 21 regulated health professions and social work in Ontario will be presented here. A comprehensive scoping review of voluntary and suggested IPE continuing‐education programs available for registered health care professionals was investigated. Both peer, and non‐peer reviewed literature, as well as grey literature, from sources such as university/ college websites and professional organizations, were examined. Identified gaps in research include a widespread lack of IPE curriculum documentation in research as well as few available IPE continuing education programs. Some barriers enabling these shortfalls may include lack of funding, lack of human resources, and lack of support, experience and knowledge in developing interdisciplinary programs. Next steps include synthesizing and summarizing the current available training courses and modules for each regulated health profession. These summaries will be integrated with the pre‐ and post‐registration scoping review and guiding curricula framework.

Abstract Background The discussion on the inclusion of sexuality in the school curriculum is old, but the same cannot be said of the proposition of this theme as a guide of national public policies in the area of education. We discussed in this article, how the absence of the biopsychosocial dimension of sexuality in the training of health professionals compromises the recognition of people's diversity, assistance and the guarantee of human rights. Methods Review of the literature in the scientific databases Science Direct, Web of Science and BVS. 16 articles constituted the corpus. This review followed the recommendations of PRISMA. The instrument proposed by CASP was used to evaluate the methodological quality of the selected studies. Results The publications on health training highlighted several aspects, from the need for training for the team of health professionals, regarding the reception and clinical care of LGBT people until the creation of teaching materials to fill the curriculum gaps on this subject. Several studies discuss the near absence of LGBT teaching hours in the medical and nursing curricula. The low permeability of LGBT discussions in academia reinforces a sexist, heterocisnormative training that has repercussions on the low quality of care provided to these individuals. Conclusions It makes it necessary to understand the uniqueness of the LGBT community for health support for different sexual genders. The inclusion of these themes in the training path can make possible a professional practice that overcomes the prejudices, violence and binarism present in a sexist and heteronormative society and implies breaking with hegemonic power relations. The construction of a pedagogy that values the diversities and a curriculum that does not standardize the subjects from standards, whatever they are, and that even meet those who are on the borders, is necessary for a true democratization. Key messages We cannot deny the constant setbacks in the scope of these policies guided in a conservative society in a kind of political and social game with confrontations sometimes aggressive. Promote the longitudinal improvement and insertion along the training, in the interface with other determinants that go through the health care of the integral being.

The issues of Improper protection of rights and legal interests of the patients due to improper performance of professional duties by a medical or pharmaceutical worker are considered. In particular, problems arising during the application of the norm of criminal liability for specified socially dangerous acts are considered. At the same time, cases of serious consequences to the patient's life and health due to a medical error or actions of medical or pharmaceutical workers committed in the absence of fault are considered although they result in the death of the patient or other grave consequences. Particular attention is paid to iatrogenic mental illness, caused by improper professional activity of the medical workers and peculiarities of the psyche of the patients. Particular attention is paid to the study of the practice of the European Court of Human Rights regarding the legal guarantee of the right to life in Ukraine in the context of criminal proceedings. Ukraine is a party to virtually all international human rights treaties. It imposes on it the obligation to adhere to European norms in the field of human protection. The need for comparative study of laws and effectiveness of their application at the present stage of society's development is due to the process of globalization affecting today not only economic and political processes but also the process of lawmaking. This requires the lawyers of different countries to join in the development of the theoretical foundations of lawmaking to formulate in the aggregate knowledge about the effect of laws based on world legal traditions and experience of the separate states. The complex structure of the health care organizations has led to the need for new models of healthcare professionals to ensure the quality of care and patient safety. In the current situation, patient safety is one of the new challenges faced by the medical students in undergraduate and postgraduate education. This involves incorporating a patient safety culture into curricula, in particular for the doctors and other health care professionals. The scientific article is aimed at solving the issues of criminal law protection as the rights of people in need of the medical services as well as medical and pharmaceutical workers who provide these services.

Aunty Mary Graham, Kombu-merri elder and philosopher, writes, “you are not alone in the world.” We have a responsibility to each other, as well as to the land, and violence is the refusal of this relationship that binds us (Rose). Similarly, Emmanuel Levinas, a French-Lithuanian Jewish teacher and philosopher who lived through the Holocaust, writes that, “my freedom does not have the last word; I am not alone” (Levinas, Totality 101). For both writers, the recognition that one is not alone in the world creates an imperative to act ethically. For non-Indigenous educators working in the Indigenous Studies space—as arguably all school teachers are, given the Australian Curriculum—their relationship with Indigenous Australia creates an imperative to consider ethics and responsibility in their work. In this article, I use Emmanuel Levinas’s thinking and writing on epistemological violence and ethics as a first philosophy to consider how pre-service teachers engage with the ethical responsibilities inherent in teaching and learning Indigenous Studies.To begin, I will introduce Emmanuel Levinas and his writing on violence, followed by outlining the ways that Indigenous perspectives are incorporated into the Australian Curriculum. I will finish by sharing some of the reflective writing undertaken by pre-service teachers in a compulsory Indigenous education subject at an Australian university. These data show pre-service teachers’ responses to being called into responsibility and relationality, as well as some of the complexities in avoiding what I term here epistemological violence, a grasping of the other by trying to make the other infinitely knowable. The data present a problematic paradox—when pre-service teachers write about their future praxis, they necessarily defer responsibility to the future. This deferral constructs an image of the future which transcends the present, without requiring change in the here and now.Of note, some of this writing speaks to the violence enacted upon Indigenous peoples through the colonisation of Australia. I have tried to write respectfully about these topics. Yet the violence continues, in part via the traumatic nature of such accounts. As a non-Indigenous educator and researcher, I also acknowledge that such histories of violence have predominantly benefited people like myself and that the Countries on which this article was written (Countries of the sovereign Bindal and Wulgurukaba peoples) have never been ceded.Emmanuel Levinas: Ethics as First PhilosophyEmmanuel Levinas was a French-Lithuanian Jewish teacher and philosopher for whom surviving the Holocaust—where most of his family perished—fundamentally changed his philosophy. Following World War II, Levinas critiqued Heidegger’s philosophy, writing that freedom—an unencumbered being in the world—could no longer be considered the first condition of being human (Levinas, Existence). Instead, the presence of others in the world—an intersubjectivity between oneself and another—means that we are always already responsible for the others we encounter. Seeing the other’s face calls us to be accountable for our own actions, to responsibility. If we do not respect that the other is different to one’s self, and instead try to understand them through our own frames of reference, we commit the epistemological violence of reducing the other to the same (Levinas, Totality 46), bringing their infinity into our own totality.The history of Indigenous and non-Indigenous relations both in Australia and globally has been marked by attempts to bring Indigenous peoples into non-Indigenous orders of knowledge (Nakata, “Cultural Interface”). The word “Aboriginal”, derived from the Latin “of the original”, refers to both Indigenous peoples’ position as original inhabitants of lands, but also to the anthropological idea that Indigenous peoples were early and unevolved prototypes of human beings (Peterson). This early idea of what it means to be Indigenous is linked to the now well-known histories of ontological violence. Aboriginal reserves were set up as places for Aboriginal people to perish, a consequence not just of colonisation, but of the perception that Indigenous people were unfit to exist in a modern society. Whilst such racist ideologies linger today, most discourses have morphed in how they grasp Indigenous people into a non-Indigenous totality. In a context where government-funded special measures are used to assist disadvantaged groups, categories such as the Indigenous/non-Indigenous binary can become violent. The Closing the Gap campaign, for example, is based on this categorical binary, where “sickness=Indigenous” and “whiteness=health”. This creates a “moral imperative upon Indigenous Australians to transform themselves” (Pholi et al. 10), to become the dominant category, to be brought into the totality.Levinas’s philosophical writings provide a way to think through the ethical challenges of a predominantly non-Indigenous teaching workforce being tasked to not just approach the teaching of Indigenous students with more care than previous generations, but to also embed Indigenous perspectives and knowledges into their teaching work. Levinas’s warning of a “disinterested acquisition of knowledge” (Reader 78), seemingly unrestrained by memory or relationships, is useful in two ways. First, for pre-service teachers learning about Indigenous education, Levinas’s work provides a reminder of the ethical responsibilities that all members of a community have to each other. However, this responsibility cannot be predicated on unwittingly approaching Indigenous topics through Western knowledge lenses. Instead, Levinas’s work also reminds us about the ethics of knowledge production which shape how others—in this case Indigenous peoples—come to be known; teachers and pre-service teachers must engage with the politics of knowledge that shape how Indigenous peoples come to be known in educational settings.You Are Not Alone in the World: Indigenous Perspectives in the Australian CurriculumIn 2010, the Australian Curriculum was launched by the Australian Curriculum, Assessment and Reporting Authority (ACARA) with the goal of unifying state-driven curricula into a common approach. Developed from the 2008 Melbourne Declaration on Educational Goals for Young Australians (Ministerial Council for Education, Early Childhood Development and Youth Affairs [MCEECDYA]), the Curriculum has occupied a prominent position in the Australian educational policy space. As well as preparing a future workforce, contemporary Australian education is essentially aspirational, “governed by the promise of something better” (Harrison et al. 234), with the Australian Curriculum appearing to promise the same: there is a concerted effort to ensure that all Australians have access to equitable and excellent educational opportunities, and that all students are represented within the Curriculum. Part of this aspiration included the development of three Cross-Curriculum Priorities (CCPs), focus areas that “give students the tools and language to engage with and better understand their world at a range of levels” (ACARA, “Cross-Curriculum Priorities” para. 1). The first of these CCPs is Aboriginal and Torres Strait Islander Histories and Cultures and is organised into three key concepts: connection to Country/Place; diversity of Aboriginal and Torres Strait Islander cultures; and diversity of Aboriginal and Torres Strait Islanders societies. In the curriculum more broadly, content descriptions govern what is taught across subject areas from Prep to Year 10. Content elaborations—possible approaches to teaching the standards—detail ways that Aboriginal and Torres Strait Islander Histories and Cultures can be incorporated. For example, Year 7 Science students learn that “predictable phenomena on Earth, including seasons and eclipses, are caused by the relative positions of the sun, Earth and the moon”. This can be taught by “researching knowledges held by Aboriginal and Torres Strait Islander Peoples regarding the phases of the moon and the connection between the lunar cycle and ocean tides” (ACARA, “Science” ACSSU115). This curriculum priority mandates that teachers and learners across Australia engage in representations of Indigenous peoples through teaching and learning activities. However, questions about what constitutes the most appropriate activities, when and where they are incorporated into schooling, and how to best support educators to do this work must continue to be asked.As Indigenous knowledges and perspectives are brought into the classroom where this curriculum is played out, they are shaped by the discourses of the space (Nakata, “Cultural Interface”): what is normalised in a classroom, the teachers’ and students’ prior understandings, and the curriculum and assessment expectations of teaching and learning. Nakata refers to this space as the cultural interface, the contested space between Indigenous and Western knowledge systems where disciplinary discourses, practices and histories translate what is known about Indigenous peoples. This creates complexities and anxieties for teachers tasked with this role (Nakata, “Pathways”). Yet to ignore the presence of Indigenous histories, lifeworlds, and experiences would be to act as if non-Indigenous Australia was alone in the world. The curriculum, as a socio-political document, is full of representations of people. As such, care must be given to how teachers are prepared to engage in the complex process of negotiating these representations.The Classroom as a Location of PossibilityThe introduction of the Australian Curriculum has been accompanied by the Australian Professional Standards for Teachers (APST) which govern the requirements for graduating teachers. Two particular standards—1.4 and 2.4—refer to the teaching of Indigenous students and histories, cultures and language. Many initial teacher education programs in Australian universities have responded to the curriculum requirements and the APSTs by developing a specific subject dedicated to Indigenous education. It is difficult to ascertain the success of this work. Many in-service teachers suggest that more knowledge about Indigenous cultures is required to meet the APST, risking an essentialised view of the Indigenous learner (Moodie and Patrick). Further, there is little empirical research on what improves Indigenous students’ educational outcomes, with the research instead focusing on engaging Indigenous students (Burgess et al.). Similarly, there is yet to be a broadscale research program exploring how teacher educators can best educate pre-service teachers to improve educational outcomes for Indigenous students. Instead, much of the research focuses on engaging (predominantly non-Indigenous) becoming-teachers through a variety of theoretical and pedagogical approaches (Moreton-Robinson et al.) A handful of researchers (e.g. Moodie; Nakata et al.; Page) are considering how to use curriculum design to structure tertiary level Indigenous Studies programs—for pre-service teachers and more generally—to best prepare students to work within complex uncertainties.Levinas’s philosophy reminds us that we need to push beyond thinking about the engagement of Indigenous peoples within the curriculum to the relationship between educator-researchers and their students. Further, Levinas prompts us to question how we can research in this space in a way that is more than just about “disinterested acquisition of knowledge” (Reader 78), instead utilising critical analysis to consider a praxis which ultimately benefits Indigenous students, families and communities. The encounter with Levinas’s writing challenges us to consider how teacher educators can engage with pre-service teachers in a way that does not suggest that they are inherently racist. Rather, we must teach pre-service teachers to not impress the same type of epistemological violence onto Indigenous students, knowledges and cultures. Such questions prompt an engagement with teaching/research which is respectful of the responsibilities to all involved. As hooks reminds us, education can be a practice of freedom: classrooms are locations of possibilities where students can think critically and question taken-for-granted assumptions about the world. To engage with praxis is to consider teaching not just as a practice, but as a theoretically and justice-driven approach. It is with this backdrop that I move now to consider some of the writings of non-Indigenous pre-service teachers.The Research ProjectThe data presented here is from a recent research project exploring pre-service teachers’ experiences of a compulsory Indigenous education subject as part of a four-year initial teacher education degree in an Australian metropolitan university (see McDowall). The subject prepares pre-service teachers to both embed the Aboriginal and Torres Strait Islander Histories and Cultures CCP in their praxis and to teach Indigenous students. This second element engages both an understanding of Indigenous students as inhabiting an intercultural space with particular tensions (Nakata, “Pathways”), and the social-political-historical discourses that impact Indigenous students’ experiences. This includes the history of Indigenous education, the social construction of race, and a critical awareness of deficit approaches to working with Indigenous students. The subject was designed to promote a critical engagement with Indigenous education, to give pre-service teachers theoretical tools to make sense of both how Indigenous students and Indigenous content are positioned in classrooms and develop pedagogical frameworks to enable future teaching work. Pre-service teachers wrote weekly reflective learning journals as an assessment task (weighted at 30% of their total grade). In the final weeks of semester, I asked students in the final weeks of semester for permission to use their journals for a research project, to which 93 students consented.Reading the students’ reflective writing presents a particular ethical paradox, one intricately linked with the act of knowing. Throughout the semester, a desire to gain more knowledge about Indigenous peoples and cultures shifted to a desire to be present as teacher(s) in the Indigenous education landscape. Yet for pre-service teachers with no classroom of their own, this being present is always deferred to the future, mitigating the need for action in the present. This change in the pre-service teachers’ writing demonstrates that the relationship between violence and responsibility is exceedingly complex within the intersection of Indigenous and teacher education. These themes are explored in the following sections.Epistemological ViolenceOne of the shifts which occurred throughout the semester was a subtle difference in the types of knowledges students sought. In the first few weeks of the subject, many of the pre-service teachers wrote of a strong desire to know about Indigenous people and culture as a way of becoming a better educator. Their expectations were around wanting to address their “limited understandings”, wanting to “heighten”, “develop”, and “broaden” “understanding” and “knowledge”; to know “more about them, their culture”. At the end, knowing and understanding is presented in a different type of way. For some students, the knowledge they now want is about their own histories and culture: “as a teacher I need the bravery to acknowledge what happened in the past”, wrote one student in her final entry.For other students, the idea of knowing was shaped by not-knowing. Moving away from a desire to know, and thereby possess, the students wrote about the need to know no longer being present: “I owe my current sense of confidence to that Nakata article. The education system can’t expect all teachers to know exactly how to embed Indigenous pedagogy into their classrooms, can they?” writes one student in her final entry, following on to say, “the main strategy I got from the readings … still stands true: ‘We don’t know everything’ and I will not act like I do”. Another writes, “I am not an expert and I am now aware of the multitude of resources available, particularly the community”.For the students to claim knowledge of Indigenous peoples would be to enact epistemological violence, denying the alterity—difference—of the other and drawing them into our totalities. In the final weeks of the semester, some students wrote that they would use hands-on, outdoor activities in order to enact a culturally responsive pedagogy. Such a claim shows the tenacity of Western knowledge about Indigenous students. In this case, the students’ sentiment can be traced back to Aboriginal Learning Styles (Harris), the idea that Aboriginal students inherently learn via informal hands-on (as opposed to abstract) group approaches. The type of difference promoted in Aboriginal learning styles is biological, suggesting that on account of their Indigeneity, Aboriginal students inherently learn differently. Through its biological function, this difference essentialises Indigenous learners across the nation, claiming a sameness. But perhaps even more violently, it denies the presence of an Indigenous knowledge system in the place where the research took place. Such an Indigenous knowledge system begins from the land, from Country, and entails a rich set of understandings around how knowledge is produced, shared, learnt and, enacted through place and people-based knowledge practices (Verran). Aboriginal learning styles reduces richness to a more graspable concept: informal learning. To summarise, students’ early claims to knowledge shifted to an understanding that it is okay to ‘not know’—to recognise that as beginning teachers, they are entering a complex field and must continue learning. This change is complicated by the tenacity of knowledge claims which define Indigenous students into a Western order of knowledge. Such claims continue to present themselves in the students writing. Nonetheless, as students progressed through the semester and engaged with some of the difficult knowledges and understandings presented, a new form of knowing emerged. Ethical ResponsibilitiesAs pre-service teachers learned about the complex cultural interface of classrooms, they began to reconsider their own claims to be able to ‘know’ Indigenous students and cultures. This is not to say that pre-service teachers do not feel responsibility for Indigenous students: in many journals, pre-service teachers’ wanted-ness in the classroom—their understanding of their importance of presence as teachers—is evident. To write for themselves a need to be present demonstrates responsibility. This took place as students imagined future praxis. With words woven together from several journals, the students’ final entries indicate a wanting-to-be-present-as-becoming-ethical-teachers: I willremember forever, reactionsshocked, sad, guilty. A difference isI don’t feel guilt.I feelI’m not alone.I feelmore aware ofhow I teachhow my opinionscan affect people. I guesswe are the oneswho must makethe change. I feelsomewhat relieved bywhat today’s lecturer said.“If you’re willingto step outfrom behind fencesto engage meaningfullywith Indigenous communitiesit will not be difficult.” I believethe 8-ways frameworkthe unit of workprovide authentic experiencesare perfect avenuesshape pedagogical practicesI believemy job isto embrace remembrancemake this happenmake sure it stays. I willtake away frameworkssupport Indigenous studentsalongside Indigenous teacherslearn from themconsult with communityimprove my teaching. In these students’ words is an assumed responsibility to incorporate Indigenous knowledges and perspectives into their work as teachers. To wish representations of Indigenous peoples and knowledges present in the classroom is one way in which the becoming-teachers are making themselves present. Even a student who had written that she still didn’t feel completely equipped with pedagogical tools still felt “motivated” to introduce “political issues into Australia’s current system”.Not all students wrote of such presence. One student wrote of feeling left “disappointed”, “out of pocket”, “judged” – that the subject had “just ‘ticked the box’” (a phrase used by a second student as well). Another student wrote a short reflection that scratched the surface of the Apology¹, noting that “sorry is something so easy to say”. It is the mixture of these responses which reminds us as researchers and educators that it is easy to write a sense of presence as a projection into the future into an assessment task for a university subject. Time is another other, and the future can never be grasped, can never truly be known (Levinas, Reader). It is always what is coming, for we can only ever experience the present. These final entries by the students claim a future that they cannot know. This is not to suggest that the words written—the I wills and I believes which roll so quickly off the pen—are not meaningful or meant. Rather, responsibility is deferred to the future. This is not just a responsibility for their future teaching. Deferral to the future can also be a way to ease one’s self of the burden of feeling bad about the social injustices which students observe. As Rose (17) writes,The vision of a future which will transcend the past, a future in which current contradictions and current suffering will be left behind enables us to understand ourselves in an imaginary state of future achievement … enables us to turn our backs on current social facts of pain, damage, destruction and despair which exist in the present, but which we will only acknowledge as our past.The pre-service teachers’ reflective writing presents us with a paradox. As they shift away from the epistemological violence of claiming to know Indigenous others from outside positions, another type of violence manifests: claiming a future which can transcend the past just as they defer responsibility within the present. The deferral is in itself an act of violence. What types, then, of presence—a sense of responsibility—can students-as-becoming-professionals demonstrate?ConclusionRose’s words ask us as researchers and educators to consider what it might mean to “do” ethical practice in the “here and now”. When teachers claim that more knowledge about Indigenous peoples will lead to better practice, they negate the epistemological violence of bringing Indigeneity into a Western order of knowledge. Yet even as pre-service teachers’ frameworks shift toward a sense of responsibility for working with Indigenous students, families, and communities—a sense of presence—they are caught in a necessary but problematic moment of deferral to future praxis. A future orientation enables the deflection of responsibility, focusing on what the pre-service teachers might do in the future when they have their own classrooms, but turning their backs on a lack of action in the present. Such a complexity reveals the paradox of assessing learnings for both researchers and university educators. Pre-service teachers—visitors in placement classrooms and students in universities—are always writing and projecting skill towards the future. As educators, we continually ask for students to demonstrate how they will change their future work in a time yet to come. Yet when pre-service teachers undertake placements, their agency to enact difference as becoming-teachers is limited by the totality of the current school programs in which they find themselves. A reflective learning journal, as assessment directed at projecting their future work as teachers, does not enable or ask for a change in the here and now. We must continue to engage in such complexities in considering the potential of epistemological violence as both researchers and educators. Engaging with philosophy is one way to think about what we do (Kameniar et al.) in Indigenous education, a complex field underpinned by violent historical legacies and decades of discursive policy and one where the majority of the workforce is non-Indigenous and working with ideas outside of their own experiences of being. To remember that we are not alone in the world is to stay present with this complexity.ReferencesAustralian Curriculum and Assessment Reporting Authority. “Cross-Curriculum Priorities.” Australian Curriculum. Australian Curriculum and Assessment Reporting Authority, n.d. 23 Apr. 2020 <https://www.australiancurriculum.edu.au/f-10-curriculum/cross-curriculum-priorities/­>.———. “Science.” Australian Curriculum. 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