The free game app Aki Hauora was released this month by the University of Otago, Christchurch. It was developed by the Christchurch-based Māori/Indigenous Health Institute (MIHI) in partnership with the Dunedin-based School of Māori, Pacific and Indigenous Studies (Te Tumu).

Associate Professor Suzanne Pitama, the director of MIHI, says having taught te reo to medical, nursing and allied health professionals over the years she is aware many are keen for something more engaging and interactive than rote learning lists of words.

A game is seen as both a fun way of learning but also provides professional development to help health professionals, like nurses, engage with patients who use te reo Māori.

Pitama says a colleague at Te Tumu, Professor Poia Rewi, developed the original Aki app as a fun game for families wanting to learn Māori vocabulary. The game has now been adapted to focus on words (kupu) used in the health environment.

Pitama says the words used in the game are built on an evidence-based glossary of commonly-used words in te reo that Māori patients are likely to use in a health setting.

The app was designed not only to teach medical and other health professional students but also for practicing health professionals wanting to expand their knowledge of te reo so they could understand more words and terms that a Māori patient may use without needing to ask for a translation.

For example, the first level of the game covers simple words like harikoa (happy), makariri (cold), wera (hot), mamae (sore), hōhā (annoyed/frustrated) and māuiui (sick/unwell/fatigued). At more advanced levels it goes on to words like pukupuku (cancer) and mate pāpōuri (depression).

The premise of the game is that a player starts in their waka at the bottom of the country at Rakiura (Stewart Island) and paddle their way up the country by successfully answering enough questions at each increasingly complex level to progress to the next landmark. Get too many questions wrong and they are swallowed by a taniwha (water monster) and have to start that level again.

“We’re hoping it’s fun and relaxing and you’d want to do it sitting out in the sun on a Sunday afternoon,” says Pitama.  “It’s a professional development opportunity that is designed to be done at your own pace.”

Pitama says their research has shown that the use of te reo by clinicians was seen as a quality indicator by Māori patients. She says one reason is that it is validating for Māori patients and secondly it shows a clinician’s readiness to engage in te reo and the aspects of being Māori that are important to that patient, including using words that they feel better express their symptoms or the context of their illnesses. “Lastly, it helps us develop a better relationship with patients and increases our sensitivity to do the most appropriate assessment with the patient,” says Pitama, adding that sensitivity will also help to inform a patient’s management plan.

When to use te reo?

Clinicians are always encouraged to be patient-led about when, or if, to use te reo terms with patients, says Pitama.

“We always teach clinicians to always start with ‘kia ora’ as that always opens the door to letting that person know you are ready to speak te reo – even if they don’t say ‘kia ora’ back.” From then on in it is patient-led – so if a patient uses a te reo term then clinicians are encouraged to use that re reo back in the right sentence or context. “Or you ask for clarification on what that word means and then you use it in a sentence.”

“Because you don’t want to have gone to a first-year te reo class than overwhelm a patient who may not know any te reo themselves,” said Pitama.  “So it is about tailoring to the individual Māori patient in front of you. It is giving you confidence that if they use te reo to take that direction and use the same term or specific kupu (word) back. And it is easier if you are more familiar with the terms and we are hoping that the app covers most of those (most commonly-used) terms.”

Pitama says current nursing training does look at the Treaty of Waitangi and cultural safety but the institute’s research is also indicating that the ability to use te reo, when a patient uses it, is a really good clinical skill. It would also be useful for nurses who are not New Zealand-trained.

The game shows each te reo word, says the word aloud and the gamer then has to chose which of four options is the correct translation. The words covered at each level are added to the player’s personal glossary, along with a percentage rating of how well the player remembers each word’s meaning. Players can go at their own speeds and return to lower levels to refresh their memories before pushing on to higher and harder levels. For competitive types there is also a leaderboard so they can see how their rankings compare with those of other gamers.

The Aki Hauora app is available for both Apple and Android devices.

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