title: A typology of longitudinal integrated clerkships.

authors: Worley, Paul

subjects: Australia

abstract: CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

text: A typology of longitudinal integrated clerkships. CONTEXT: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. 
OBJECTIVES: This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. 
METHODS: Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. 
RESULTS: Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. 
CONCLUSIONS: Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context.

year: 2016

title: Making history beyond neoliberalism: Response to Roper

authors: Neilson, David

subjects: New Zealand

abstract: Roper (2011a, p. 39) sums up his account of neoliberalism in New Zealand with the following conclusion: “In the absence of a major upsurge in working class and social movement struggle, the neoliberal policy regime is likely to remain firmly in place.” The bulk of his article lends weight to this conclusion in the course of offering a detailed analysis of National’s neoliberalism and New Zealand’s social inequality. In his final assessment Roper turns to list mid-range factors that underpin his conclusion. In particular, he refers to structural constraints resulting from the neoliberalisation of New Zealand’s financial regime; neoliberalisation of the outlooks of successive New Zealand Governments since 1984; and the balance of class forces in favour of capital (pp.37-8). This response focuses, first, on building a sympathetic analysis of these mid-range factors which are linked here with the form and dynamic of the ‘neoliberal model of development’ (Neilson, 2011). In his conclusion Roper also states that if there is an upsurge in social movement and working class politics ‘then the question of alternatives to neoliberalism will come to the forefront of New Zealand politics’ (Roper, 2011a, p. 39). The second theme of this essay is linked to an exploratory discussion of why this might or might not happen and how more specifically a ‘counter-hegemonic project’ could be more consciously constructed and actively pursued.

text: Making history beyond neoliberalism: Response to Roper Roper (2011a, p. 39) sums up his account of neoliberalism in New Zealand with the following conclusion: “In the absence of a major upsurge in working class and social movement struggle, the neoliberal policy regime is likely to remain firmly in place.” The bulk of his article lends weight to this conclusion in the course of offering a detailed analysis of National’s neoliberalism and New Zealand’s social inequality. In his final assessment Roper turns to list mid-range factors that underpin his conclusion. In particular, he refers to structural constraints resulting from the neoliberalisation of New Zealand’s financial regime; neoliberalisation of the outlooks of successive New Zealand Governments since 1984; and the balance of class forces in favour of capital (pp.37-8). This response focuses, first, on building a sympathetic analysis of these mid-range factors which are linked here with the form and dynamic of the ‘neoliberal model of development’ (Neilson, 2011). In his conclusion Roper also states that if there is an upsurge in social movement and working class politics ‘then the question of alternatives to neoliberalism will come to the forefront of New Zealand politics’ (Roper, 2011a, p. 39). The second theme of this essay is linked to an exploratory discussion of why this might or might not happen and how more specifically a ‘counter-hegemonic project’ could be more consciously constructed and actively pursued.

year: 2011

title: Hoera Te Mimiha

authors: Hart, Philip

abstract: Hoera Te Mimiha was a rangatira of Ngati Koi, an inferior hapu to Ngati Tamatera, and had affiliations to other hapu. Although to Pakeha he was a mere labourer, in Maori society in Ohinemuri in the 1870s and 1880s he was a leading figure. Details have been traced of his whakapapa, his wider family, and especially his children, one of whom married Hone Werahiko. 
Mimiha spent much time in the Maori Land Court trying to prove his entitlement to be included as an owner of several blocks of land, not always successfully, for he could not prove some of his cases either through ancestry or occupation. Other rangatira with superior whakapapa were able to show the weaknesses of some of his claims, forcing him into giving evasive answers to cross-examination. His evidence did reveal what land he had occupied and farmed.
Mimiha willingly sold land, including his interest in the Ohinemuri goldfield (the boundaries of which he had pointed out to surveyors), and obtained a good income, for a time. Being interested in mining from the early 1870s onwards, he was one of the few Maori willing to descend a shaft at Thames, an experience that encouraged him to push for opening Ohinemuri to mining, even, it seemed, if that endangered Maori control of their land. Having prospected at Karangahake before it was opened to mining in 1875, he participated in this rush and subsequently in the Te Aroha one of 1880, having interests in claims at all three portions of the latter field. When his daughter’s partner was murdered at Te Aroha, he calmed Maori anger, once again winning the gratitude of Pakeha.
Because of selling much of his land, he struggled financially, although unlike some Maori he did not drink his money away. Cutting off part of the ear of a Pakeha accused of raping his wife resulted in several court cases marked by dubious evidence presented by both sides. After being imprisoned for perjury, efforts by Pakeha to have his conviction reviewed resulted in his being judged to have been the only witness not to have lied to the court, but this sordid affair blackened his character.

text: Hoera Te Mimiha Hoera Te Mimiha was a rangatira of Ngati Koi, an inferior hapu to Ngati Tamatera, and had affiliations to other hapu. Although to Pakeha he was a mere labourer, in Maori society in Ohinemuri in the 1870s and 1880s he was a leading figure. Details have been traced of his whakapapa, his wider family, and especially his children, one of whom married Hone Werahiko. 
Mimiha spent much time in the Maori Land Court trying to prove his entitlement to be included as an owner of several blocks of land, not always successfully, for he could not prove some of his cases either through ancestry or occupation. Other rangatira with superior whakapapa were able to show the weaknesses of some of his claims, forcing him into giving evasive answers to cross-examination. His evidence did reveal what land he had occupied and farmed.
Mimiha willingly sold land, including his interest in the Ohinemuri goldfield (the boundaries of which he had pointed out to surveyors), and obtained a good income, for a time. Being interested in mining from the early 1870s onwards, he was one of the few Maori willing to descend a shaft at Thames, an experience that encouraged him to push for opening Ohinemuri to mining, even, it seemed, if that endangered Maori control of their land. Having prospected at Karangahake before it was opened to mining in 1875, he participated in this rush and subsequently in the Te Aroha one of 1880, having interests in claims at all three portions of the latter field. When his daughter’s partner was murdered at Te Aroha, he calmed Maori anger, once again winning the gratitude of Pakeha.
Because of selling much of his land, he struggled financially, although unlike some Maori he did not drink his money away. Cutting off part of the ear of a Pakeha accused of raping his wife resulted in several court cases marked by dubious evidence presented by both sides. After being imprisoned for perjury, efforts by Pakeha to have his conviction reviewed resulted in his being judged to have been the only witness not to have lied to the court, but this sordid affair blackened his character.

year: 2016