Anatomical sciences education needs to promote academic excellence of ethnic minority students—Evidence from Pasifika students at the University of Otago

The Department of Anatomy at the University of Otago offers anatomical sciences education for various programs, but currently, little information is available on how the academic performance of anatomy students differ based on ethnicities. Here, we aim to determine if there is an ethnic disparity in academic performance among anatomy students at the University of Otago. We conducted a 5‐year review of academic performance of New Zealand European (NZE) and Pasifika students in 10 undergraduate anatomy courses, including clinical anatomy, neuroscience, reproduction, cell biology, and biological anthropology. NZE students achieved higher marks than Pasifika students in each academic year for four courses and in 3–4 of 5 academic years for the remaining courses. In eight courses, there were higher proportions of Pasifika students than NZE students who repeated the courses (in 4–5 of 5 academic years for two courses, in 1–2 of 5 academic years for six courses). Multiple regression analyses showed that Pasifika students were more likely to achieve lower marks than NZE students in all courses. Other predictors for academic marks included year of study for five courses, age for three courses, international student status for two courses, major specialization for eight courses, home location for one course, and gender for one course. Data from this research provide evidence that ethnic inequity may exist in anatomical sciences education, and can be used by institutions globally to justify evaluating their anatomy programs, with the aim to better support ethnic minority students who may be struggling academically.

performance are also present in Aotearoa New Zealand, for example, between Pasifika and New Zealand European (NZE) healthcare professional students (Wikaire et al., 2017).While these programs incorporate anatomy in their curriculum, the marks are not specifically on anatomy.Therefore, the aim of this study was to compare academic performances in anatomy courses between NZE and Pasifika students.
Approximately 8% of the population in Aotearoa New Zealand are Pacific people according to the 2018 census (Stats NZ, 2018c).
The term "Pasifika" refers to "peoples who have migrated from Pacific nations and territories … [and] New Zealand-based (and born) population, who identify as Pasifika, via ancestry or descent" (Airini et al., 2010).The term is an umbrella term and does not reflect the diversity of cultures, languages, and experiences of the various Pacific ethnic groups.They may have migrated from the Pacific Islands or were born from people who migrated to Aotearoa New Zealand from the Pacific region.
Past studies have indicated that Pasifika students are overrepresented in low academic performance.For example, Pasifika students in the First Year Health Sciences program at the University of Otago have lower academic marks than non-Pasifika students (Sopoaga et al., 2013).Similarly, data from the Auckland University of Technology showed that first-year Pasifika students in a Human Anatomy and Physiology course have lower academic marks than Māori and NZE students (Brown et al., 2018).In addition, Pasifika students are at higher rate to leave tertiary studies without a qualification compared to NZE students (Benseman et al., 2006).To our knowledge, there is no published data on the academic performance of Pasifika anatomy students beyond the first-year undergraduate level.
Currently, there are limited data on ethnic differences in anatomy students performance.However, such a difference may exist, especially because anatomical sciences education involves using cadaver and prosection as learning materials.In many cultures, body donation for teaching purpose is not common (Habicht et al., 2018), and people from such cultures may not be aware much about body donation practice and thus be reluctant to have physical interaction (e.g., doing dissection or handling prosections) with cadavers.Furthermore, discussion on topics that may be sensitive to some cultures (e.g., the anatomy of reproductive organs).In an international survey, anatomists from Asia reported a higher proportion of their students not being involved in cadaver dissection than those in Europe (Arraez-Aybar et al., 2014), which may be related to differences in cultures.
There are likely other contributing factors that may result in ethnic differences in academic performance such as social factors (Vaughan et al., 2015), socioeconomic status of previous high school (Sopoaga et al., 2013), and academic self-efficacy (Zajacova et al., 2005).
Cultural factors may influence anatomical learning in the context of Pasifika students in Aotearoa New Zealand.In our previous study, some Pasifika students expressed feeling uncomfortable in viewing some materials in the lectures and labs (Fakapulia, 2022).For example, in learning reproductive anatomy, they may not be comfortable seeing surface anatomy of the genitals or working with prosections that have exposed genitals.In addition, in anatomy labs, some Pasifika students are reluctant to do cadaver dissections or work with prosections, which may affect their understanding of the three-dimensional nature of anatomical structures.There may also potentially be differences in learning styles between Pasifika and NZE students, as a past study has noted differences in learning strategies for anatomy topics in other cultures (Mitchell et al., 2009).Even the concept of asking questions to academic staff may vary (Levinsohn, 2007), for instance, Chinese students are less likely to challenge their teacher.
From our experience in anatomy classes, we notice that Pasifika students are less likely to ask questions from academics than NZE students.Therefore, when they experience difficulties in their study, they may seek help from other sources such as friends.
The Department of Anatomy at the University of Otago is involved in various teaching including undergraduate sciences, postgraduate studies, and healthcare professional programs (e.g., medicine, dentistry, and physiotherapy) (University of Otago, 2023a).The student body in these courses is comprised of diverse ethnic groups.While the majority are NZE, there are substantial proportions of students of other ethnicities, including Māori students.For example, about 20% of the medical students are Māori.
Since cadaver use is common for many courses with practical classes in the dissecting room, the Department holds the whakawātea (clearing of the way) ceremony to allow spiritual safety for students (Māori and students of other ethnicities) and acknowledge the significance of the cadavers (tūpāpaku) in society (McClea & Stringer, 2010;Nicholson et al., 2011).The whakawātea is led by the University of Otago's kaumatua (Māori elder) and this is the students' first introduction to the dissecting room and the cadavers.
The Anatomy Head of Department gives students a background to the body donor program and staff from the Kōhatu Centre for Hauora Māori explain the connection for Māori between the dead (tūpāpaku) and the living worlds.The ceremony itself blesses the space and provides an environment where students can feel that they can be in the space and work in a free and unfettered way.
In addition, before the craniotomy lab, the Department hosts the whakatūpato ceremony to support students before they proceed with head dissection.At the end of the year, the Department also holds a poroporoaki (farewell) ceremony in our dissecting room.
The Department of Anatomy at our institution has about 90-100 Pasifika students who are completing their undergraduate studies in sciences.The numbers are expected to increase in the coming years.
Internal data from the department, for example, show that two of the second-year courses had 9% Pasifika students in 2017 and the proportions increased to 13% in 2021.Currently, however, there is no published information on whether there is a disparity in academic performance between NZE and Pasifika anatomy students at second-year or third-year undergraduate levels.Information on the ethnic difference in academic performance may help academics in strategic planning on how to best support students who are struggling academically.
Two of the authors in this manuscript are Pacific student supports in the department.They provide information to Pasifika students on different items such as tutorials specific for Pasifika students, scholarships, and student associations.Anecdotally, some Pasifika students face challenges in learning anatomy for cultural reasons.For example, in Pacific cultures, cadavers are considered tapu (sacred or taboo), and thus Pasifika students may not be comfortable performing dissections or using prosections as learning tools.In addition, Pasifika students appreciate a holistic approach to education, but Western pedagogy tends to be more individualistic and objective (Alkema, 2014).Consequently, Pasifika students may face challenges in adapting to the Western-style education system.

Data source
This research was approved by the Human Ethics Committee (D22/215) at the University of Otago.Data analyzed in this study were obtained from the University of Otago's Business Objects software.Demographic data and student marks from 2017 to 2021 from 10 undergraduate anatomy courses (4 at second-year levels, and 6 at third-year levels) were downloaded as separate files.They were later matched based on the student ID information.Identifying information such as names and phone numbers was removed before any analyses.From the demographic data, the following information was gathered: year of study, course code, student ID, date of birth, gender, home address, residency status, ethnicity(ies), and major selection.The academic mark documents contain information on year of study, course code, student ID, final marks, and academic grades.
Data from 2016 were also downloaded, only to indicate how many students repeated anatomy courses in 2017.

Data processing
In this study, variables were analyzed as follows: • The list of anatomy courses reviewed in this manuscript is in Table 1.The actual course codes are not disclosed in this manuscript.
• For the regression analyses, the year of studies was coded as 1 to 5 to represent 2017 to 2021 in chronological order.
• Age information was obtained by deducting the year of study from the year of birth.
• Home addresses were categorized into four groups: Pacific Islands, North Island of Aotearoa New Zealand, elsewhere in Aotearoa New Zealand, and overseas.For the regression analyses, they were coded as 1 for North Island and 0 for elsewhere.
• For the regression analyses, students who were New Zealand Citizens, New Zealand Residence, and Australian Citizens were coded as 1, whereas international students were coded as 2. This is because international students do not get the resources (e.g., scholarship options and school fee amount) which otherwise are available for the other three categories.
• Ethnicities were coded as 1 for NZE and 2 for Pasifika in our regression analyses.In Aotearoa New Zealand, ethnicity is considered as a cultural affiliation, not a measure of race, ancestry, nationality, or citizenship.People in one ethnic group may share common cultures, origins, ancestry, or geographic origin.There are six major ethnic groups and students can identify as more than one ethnicity.Ethnicity(ies) were coded based on the categories that students selected when they enrolled in the University of Otago.Under each major ethnic group, there are sub-categories.In this study, those coded as 1 are students who only identified as "New Zealand European/Pākehā."To avoid confounding factors, we excluded those who identify as Australian, British/Irish, Dutch, German, or Other European.Students coded as 2 were the ones who identified at least one of the following "Pacific Peoples" sub-categories: Cook Island Māori, Fijian, Samoan, Niuean, Tongan, Tokelauan, or Other Pacific Peoples.Pasifika students who also identified as "New Zealand European/Pākehā" were coded as 2. Data from students who identified as other ethnicities were not analyzed.
• For major specialization, students who selected anatomy as their degree's major were coded as 1, and the remaining were coded as 0 in our regression analyses.

TA B L E 1
The list and type of 10 anatomy courses analyzed in this article.

Anatomy courses Type of course
Second-year undergraduate courses

Course I Neuroscience
Course J Biological anthropology • For our regression analyses, genders were coded as 1 for male and 0 for female or gender diverse.This is because a previous meta-analysis showed that male students tend to perform worse in higher education (Voyer & Voyer, 2014).

Data analyses
Data were analyzed using the SPSS software (IBM, Armonk, NY, and gender (male or not).p < 0.05 was considered significant.
Additional demographic data of students are presented in Table S2.
In brief, the second-year students were on average around 20 years old and the third-year students were on average around 21-22 years old.Majority of the students came from either the North Island or elsewhere in New Zealand, with <6% from Pacific Islands and <6% from other countries.The proportions who took anatomy major were approximately 25%-45% in four courses (a third-year neuroscience course, and all second-year courses except for the reproductive biology course) and 50%-85% in the remaining courses.In terms of gender, approximately 58%-85% were female and 15%-50% were male.
As shown in Figure 2, in four (a third-year functional anatomy course, and all second-year courses except for the biological anthropology course) of ten anatomy courses, NZE students achieved significantly higher marks than Pasifika students in each academic year.In the two biological anthropology courses, NZE students had

DISCUSS ION
In this study, we compared the academic performance of Pasifika and NZE anatomy students in Aotearoa New Zealand, based on academic data from 10 anatomy courses.Pasifika students were more likely to achieve lower marks in all anatomy courses, and to repeat anatomy courses than NZE students.Unfortunately, their academic performance limits them to pursue further studies (e.g., postgraduate studies or healthcare professional programs).In a meta-analysis of 22 reports in the United Kingdom (Woolf et al., 2011), the effect size for the difference in academic performance of white and nonwhite medical students is −0.42.However, in our study, the effect sizes for the difference in the academic performances of NZE and Pasifika students were generally larger (on average ranging from 0.90 to 1.18 for the 10 courses).In addition, we found that students' academic performances may vary based on year of study, age, international student status, major specialization, home location, and gender.Our findings highlight the importance to support underrepresented minorities in anatomy sciences education who face academic challenges.

Reasons for ethnic disparity in academic performance
Disparity in academic performance may exist in Aotearoa New Zealand and elsewhere.Our findings show evidence of an ethnic disparity in anatomy students performance in Aotearoa New Zealand.
The number of Pasifika people in Aotearoa New Zealand is projected to increase in the coming years (Stats NZ, 2018c).Expectedly, the number of Pasifika students in universities will rise.Indeed, data from the past few years showed that universities in Aotearoa New Zealand have an increasing number of Pasifika students (University of Auckland, 2021; University of Otago, 2023b).Similarly, universities outside Aotearoa New Zealand may also have increasing enrolment of ethnic minority students, and some have developed initiatives to better prepare them academically (Ashley et al., 2017;Bradford et al., 2021).
There are likely many reasons which may lead to the disparities in academic outcomes among anatomy students.While not being investigated in this research, we discuss here possible explanation for the ethnic difference in academic performance of Pasifika and NZE anatomy students.Difference in academic preparedness could be one reason for such difference.Pasifika students are more likely to have come from lower socioeconomic households (Stats NZ, 2018c) than students of other ethnicities in Aotearoa New Zealand, and thus they may not have the financial resource to attend high-decile high schools.Indeed, there are reports indicating that there are proportionally more Pasifika students in low-decile high schools (Sopoaga et al., 2013;Education Counts, 2023) than students of other ethnicities in Aotearoa New Zealand.Attending low-decile schools may limit how they were prepared for higher education.Anecdotally, we have met Pasifika students who did not have any biology background from high school or did not have science labs in their high schools.Thus, they may not be as prepared for university study.
Pasifika students also live as an ethnic minority while studying at the University of Otago, so they may have added stresses which affect their well-being and subsequently their academic outcome.
Recently, we found that their social anxiety as an ethnic minority correlates with their academic stress (Fakapulia et al., 2023).Studies in other institutions indicate that ethnic minority students are more likely to perceive discrimination (Nora & Cabrera, 1996).This is also true for Pasifika students in Aotearoa New Zealand, where they may face discrimination within the education setting (Mayeda et al., 2014;McAllister et al., 2022).In addition, a negative perception of the university environment (Wei et al., 2011) and more severe anxiety symptoms (Manzo et al., 2022) mediate the relationship between minority stress and academic outcomes for higher education students.
Furthermore, many ethnic minority students are first generation in their families to enter higher education (Zalaquett, 1999), and thus, they may not know someone close who can help them navigate the university system.
In our department, we recently conducted a study to gather information about the experience of Pasifika students (Fakapulia, 2022).
Culture shock was reported by some students in that study.As an example, many were surprised that they do not meet many Pacific peoples in Dunedin.In the current study, about 65%-85% of Pasifika students come from the North Island, which has a much higher proportion of Pacific peoples than in Dunedin.They may therefore be unfamiliar with the environment like in Dunedin, where only about 3% of the population is Pasifika (Stats NZ, 2018a).For social support, they often reach out to family members and Pasifika friends (Fakapulia et al., 2023 Furthermore, social anxiety as ethnic minority is also associated with academic stress among Pasifika students (Fakapulia et al., 2023).In academic settings, such a finding may potentially translate to ethnic minority students not seeking academic help from the academic staff who are not of the same ethnicity, as noted in our previous study (Fakapulia, 2022).Financial distress was also reported by some students.Anecdotally, we have met Pasifika students who need to work 20-40 h per week in order to cover their living expenses.Unfortunately, working would reduce the time available for their study.

Recommendations
Universities should explore ways to improve the support infrastructure for ethnic minority students who have challenges in their studies, especially in anatomical sciences education, where there are topics that may be sensitive to different cultures.In the context of Aotearoa New Zealand, Pasifika students have been underserved in the higher education system (Reynolds, 2016;Theodore, Taumoepeau, Kokaua, et al., 2018;Theodore, Taumoepeau, Tustin, et al., 2018), including in anatomical sciences education.Here, we provide some recommendations for universities in Aotearoa New Zealand and elsewhere.
First, universities need to embrace the importance of establishing a strong relationship between students and teachers in some cultures, for example, in Pacific cultures (Alkema, 2014) because Pacific peoples value vā (relationship/relatedness) including in education (e.g., between students and academics) (Reynolds, 2016;Ponton, 2018).This aspect may differ from Western pedagogy which is more individualistic, but a holistic approach to education is important for Pasifika students (Alkema, 2014).Establishing better vā between staff and students may potentially help students adapt better in the academic setting, and reduce their culture shock.
Second, universities need to increase ethnic representations among the academics.Currently, universities in Aotearoa New Zealand have low number of Pasifika academic staff (Naepi, 2019), and thus few staff are competent in Pacific cultures.In our Department, currently, there is only one Pasifika staff who teaches anatomy, and she only teaches the healthcare professional programs, not the undergraduate science students.Our previous study indicated that social anxiety as an ethnic minority is associated with more academic stress in Pasifika students (Fakapulia et al., 2023).
Thus, having more Pasifika staff may help Pasifika students to approach them for academic help, and also reduce their social anxiety in academic spaces.Thomsen et al. (2021)  Fourth, another initiative that universities can explore is to offer a bridging program for Pasifika students during the extended summer break, as previously done in other institutions for various science programs (Strayhorn, 2011;Ashley et al., 2017;Bradford et al., 2021).Such a program can be a space to prepare underrepresented students academically for the upcoming year because learning materials, assessment types, and learning styles change as students transition to a more senior undergraduate year.In our department, for example, second-year students use prosections for their anatomy study, whereas third-year students learn to do some cadaver dissection.In addition, the amount of writing in our anatomy courses also varies between the year of study, for example, short abstracts in second-year courses, but long lab reports in third-year courses.

Correlates of academic performance
In this study, we also found that factors other than ethnicity may influence academic performance.These include major specialization, age, year of study, international student status, home location, and gender.Of particular concern is the fact that those taking anatomy major are more likely to achieve lower marks in seven courses.
One possible explanation may relate to the difference in learning styles and assessment types for various anatomy courses.First-year anatomy courses require much rote learning and often use multiplechoice questions.Those who do well may think this is also the case for more senior courses.However, second-and third-year courses require more contextual understanding and the assessments involve more writing (e.g., essay and lab report).Furthermore, some majors (e.g., biomedical sciences majors) have stricter entry criteria, that is, they cannot fail any first-year courses.Thus, students who cannot enter such programs may elect anatomy major.
The remaining factors were only associated with academic marks in one to three courses.Year of study may influence the academic marks for some courses because of changes in teaching staff over the years as the Department had new staff in the past few years.The COVID-19 pandemic also affected teaching delivery because we moved from in-person teaching to online teaching suddenly, and even after the lockdown period, in-person teaching did not return to normal completely until 2023.Older age may be a negative predictor for some courses because of the higher proportion of students who failed in those courses (e.g., the second-year neuroscience and reproductive biology courses).Thus, when they repeated the courses in later years, they would be older than new students of those years.International student status may affect academic performance in two courses due to language barriers.
For example, the third-year functional anatomy course requires students to learn many new anatomical terms, whereas the thirdyear reproductive biology course has substantial writing assessments.The reason why students from the North Island were more likely to perform better in the second-year biological anthropology course may possibly relate to academic preparedness before entering university, as high schools in the North Island are generally better ranked than those in the South Island.The finding that male students were more likely to perform worse in the thirdyear neuroscience course was not surprising as female students tend to perform better in higher education (Voyer & Voyer, 2014).
Furthermore, one past study in neuroscience students showed that female students have higher motivation to perform well academically than male students (Gaudier-Diaz et al., 2019).

Limitation
We recognize that our study has a limitation in how ethnicities were analyzed.The Pasifika students consist of students from different Pacific ethnic groups.By doing so, it does not capture the diversity in Pacific cultures.Thus, we may not be able to determine if students of a specific Pacific ethnicity require additional support.Similarly, for the comparison group, we only included those who only identified as NZE.We excluded those who identified as "Australian," "British/Irish," "Dutch", "German," and "Other European" as well as those identifying as NZE in addition to other ethnicities.While these groups are under the "European ethnic group" (Stats NZ, 2018b), we did not include them to avoid any confounding effects from the different European ethnicity groups.

CON CLUS ION
In conclusion, ethnic disparities may exist in anatomical sciences education.We show here evidence for disparities in academic performance of Pasifika and NZE students.Pasifika students are more likely to achieve lower academic marks than NZE students.
Unfortunately, this may lead to them repeating the course, and their marks become a major barrier to enter into postgraduate studies or healthcare professional programs.Anatomy educators in Aotearoa New Zealand and elsewhere internationally should consider conducting a regular review of the academic performance in their institution to ensure equity and identify underrepresented students who face academic challenges.Such a review should enable the academic team to improve equity by tailoring the support infrastructure for students who need additional academic support.
Recently, the University of Otago released a Pacific Strategic Framework document for 2022 to 2030 (University of Otago, 2022), with various aims including improving academic excellence among Pasifika students.Consistent with this goal, the aim of this study is to determine if there is an ethnic disparity in academic performance among anatomy students at the University of Otago.The main objective of this study is to compare academic performances of NZE and Pasifika anatomy students.The research question is as follows: is there a disparity in the academic performances of NZE and Pasifika anatomy students at the University of Otago?Data from this research can help identify which courses require further academic support.Universities internationally may use data from this research as evidence to justify an evaluation of their anatomical sciences education locally, with the aim to better support ethnic minority students academically.
version 28).Data were compared between Pasifika and NZE students.Academic marks were compared using t-test.The proportions of students' grades and students who repeated the courses were compared using the Chi-squared test.Academic grades were divided into four categories: (1) A− (80 to 84) to A+ (90 to 100), (2) B (70 to 74) to B+ (75 to 79), (3) C− (50 to 54) to B− (65 to 69), and (4)those who failed the course (49 or below).The reason for the third category was that the minimum criteria to get into postgraduate studies in the Department of Anatomy was a B average.Multiple linear regressions were performed for each course.The dependent variable was the academic mark.The independent variables were ethnicity, year of study, age, international student status, major specialization (anatomy or not), home location (North Island or not), higher marks than Pasifika students from 2017 to 2020, but not in 2021.For the remaining third-year courses, disparities in academic marks were found in 3 of 5 academic years, and whenever they were present, the marks for Pasifika students were lower than those of NZE students.The distribution of the academic grades for the NZE and Pasifika students is shown in FigureS1.In four courses (a third-year functional anatomy course, and all second-year courses except for the biological anthropology course), the grade distribution varied between ethnicities in 4-5 of 5 academic years.For the remaining six courses, the grade distribution varied between ethnicities in 1-3 of 5 academic years.Of particular concern is the high proportion of Pasifika students who obtained grades below B for third-year courses.For example, in 2021, over 50% of Pasifika students in all third-year courses achieved below B.

Figure 3
Figure3shows the number and proportions of students who repeated various anatomy courses.In the second-year neuroscience and reproductive biology courses, there were significantly higher proportions of Pasifika students than NZE students who repeated the courses in 4-5 of 5 academic years.There was no significant difference in the proportions of students who repeated the two biological anthropology courses from 2017 to 2021.For the remaining courses, there were significantly higher proportions of Pasifika students than NZE students, who repeated the courses in 1-2 of 5 academic years.Multiple regression analyses (Table 2)indicate that, for all anatomy courses, Pasifika students were more likely to achieve lower academic marks than NZE students (Course A: β = −0.30,Course B: β = −0.31,Course C: β = −0.36,Course D: β = −0.36,Course E: β = −0.33,Course F: β = −0.32,Course G: β = −0.27,Course H: β = −0.32,Course I: β = −0.37,and Course J: β = −0.33;all ps <0.001).In addition, the more recent year of study was associated with better academic marks in the second-year anatomy course (β = 0.06, p < 0.05), the second-year reproductive biology course (β = 0.09, p < 0.05), and the third-year neuroscience course (β = 0.17, p < 0.001), but lower academic marks in the third-year developmental biology (β = −0.14, p < 0.05) and biological anthropology (β = −0.17,p < 0.01) courses.Older age was associated with lower academic marks in the second-year neuroscience (β = −0.07)as well as the second-year (β = −0.10)and third-year (β = −0.14)reproductive biology courses (all ps < 0.05).International student status was associated with lower marks in the third-year functional anatomy (β = −0.14, p < 0.01) and reproductive biology (β = −0.21,p < 0.001) courses, but not for other courses.Having a major in anatomy was associated with their academic marks in all courses [higher mark for the third-year biological anthropology course (β = 0.16, p < 0.05), and lower mark for the other seven courses (Course A: β = −0.13,p < 0.001; Course B: β = −0.13,p < 0.001; Course C: β = −0.11,p < 0.01; Course E: β = −0.15,p < 0.01 Course F: β = −0.17,p < 0.01; Course G: β = −0.23,p < 0.001; Course H: β = −0.20,p < 0.01)], except in the second-year biological anthropology and third-year neuroscience courses.Being from the North Island was a positive predictor for academic marks in the second-year biological anthropology course only (β = 0.11, recently discussed the various benefits of having more Pasifika academics in universities in Aotearoa New Zealand, such as by being role models, providing mentorship, and culturally-sensitive support.Furthermore, Pasifika staff can be the voice for Pasifika students.Third, universities should allocate more funds for academic support for ethnic minority students, such as Pasifika students in Aotearoa New Zealand.Such financial support could potentially be used to hire more tutors, ideally, those who are culturally-competent to the target audience.As noted above, not many academic staff in universities in Aotearoa New Zealand are Pasifika (Naepi, 2019).Two of the authors have regularly organized tutorials for Pasifika students who study anatomy courses and, from our experience, we rarely find tutors who are Pasifika.Universities can allocate funding to offer cultural competency workshops for academics and tutors so they are more familiar with different cultures.In Aotearoa New Zealand, university academics should be more familiar with indigenous Pacific ways or cultures (e.g., anga fakatonga and fa'asamoa) because upskilling in Pacific cultures may help academics in establishing vā with Pasifika students (Ministry of Education, 2018).
Currently, the University of Otago offers a program to help Pasifika students transition from high school to university health sciences program (University of Otago, 2023c).Such a program may help Pasifika students prepare for first-year university courses.However, not all Pasifika students go through that program.Universities in Aotearoa New Zealand could potentially offer a similar program to help students transition from first to second year and from second to third year of studies, during the extended summer break.Fifth, universities in Aotearoa New Zealand should also create an entry pathway for Pasifika students to be admitted into postgraduate studies.Our data highlight that many Pasifika students achieve below B in their third-year courses.Unfortunately, this limits them from being admitted into postgraduate studies, which have a minimum entry requirement of B averages in four third-year anatomy courses.Until such a pathway is created, many Pasifika students will continue to face barriers in pursuing postgraduate studies, and the shortage of Pasifika researchers will remain.In developing such a pathway, academics should consider getting inputs from key stakeholders, including Pasifika students, Pasifika academics, and Pacific Strategic Framework Groups within the university.