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Folio edition · Set in Instrument Serif & Archivo

Paeds Vivaspreventive-and-community-paediatrics

Paeds Vivas · preventive-and-community-paediatrics

Māori child health, Te Tiriti and culturally safe care — branching viva

Structured oral on Te Tiriti principles, cultural safety, Hui Process, SUDI equity and ARF/ear pathways.

branching clinical structured oral
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Target exams

RACP DCEMRCPCH Clinical

Target exams

RACP DCEMRCPCH Clinical
Prompt
Community paediatric clinic: a Māori whānau with a young infant and a preschool sibling; examiner probes cultural safety, Te Tiriti and equity actions.

Stem

You are in a general paediatric clinic in Aotearoa New Zealand. [11]

Examiner: What is cultural safety? [1]

Strong answer: Care that the patient and whānau experience as safe. It addresses power, bias, racism and equity. It is not the same as a clinician self-rating “cultural competence.” [1]

Examiner: How does Te Tiriti shape your practice language? [11]

Strong answer: Partnership, active protection, equity of options and outcomes, and participation. Not a decorative mihi alone. I will not invent claim numbers I cannot defend. [11]

Examiner: Walk me through the Hui Process. [2]

Strong answer: Mihi — engage. Whakawhānaungatanga — connect with who is present. Kaupapa — shared purpose of the visit. Poroaki — close with clear next steps. [2]

Examiner: The infant’s mother smokes and bed-shares. What do you do? [9]

Strong answer: Non-shaming hazard map: smoke exposure, surface, sofa risk, substances, prematurity. Room-share, firm flat bare sleep space, cessation support, and culturally designed options such as wahakura where available. [7] [9]

Examiner: The preschool sibling failed hearing screening and missed ENT. Formulation? [12]

Strong answer: Incomplete care pathway, not “non-compliant ethnicity.” Remove barriers, rebook, close the loop; middle-ear disease and hearing inequity are biomedical equity problems. [12]

Examiner: Why mention skin infection in ARF regions? [15]

Strong answer: Superficial streptococcal disease burden links with ARF patterns; early accessible treatment and local programmes matter. Population-specific equity, not racial destiny. [15]

Examiner: How is this different from Australian Aboriginal child health? [1]

Strong answer: Different histories, rights frameworks and service architectures. Te Tiriti language is Aotearoa-specific; do not paste it onto Australian First Nations care. Transfer only high-level cultural safety and anti-racism principles carefully. [1]

References

  1. [1]Curtis E Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition International journal for equity in health, 2019.PMID 31727076
  2. [2]Lacey C The Hui Process: a framework to enhance the doctor-patient relationship with Māori The New Zealand medical journal, 2011.PMID 22237570
  3. [3]Pitama S Improving Maori health through clinical assessment: Waikare o te Waka o Meihana The New Zealand medical journal, 2014.PMID 24816961
  4. [7]Tipene-Leach D Innovation to prevent sudden infant death: the wahakura as an Indigenous vision for a safe sleep environment Australian journal of primary health, 2019.PMID 31513759
  5. [9]MacFarlane M Smoking in pregnancy is a key factor for sudden infant death among Māori Acta paediatrica, 2018.PMID 29869345
  6. [11]Sheridan N Hauora Māori - Māori health: a right to equal outcomes in primary care International journal for equity in health, 2024.PMID 38413987
  7. [12]Oliver T B4 School Check hearing screening and middle ear disease: a five-year analysis of prevalence and inequity The New Zealand medical journal, 2025.PMID 41264818
  8. [15]Bennett J Pandemic mitigations reveal an association between superficial group A streptococcal infections and acute rheumatic fever incidence in Auckland New Zealand Emerging microbes & infections, 2025.PMID 40704453