La Saskatchewan est la première province à avoir rendu obligatoire l’enseignement des traités en 2007, bien avant les appels à l’action de la Commission de vérité et réconciliation (CVR) en 2015. L’Université de Regina, au sein de toutes ses facultés (dont la faculté d’éducation), n’a pas hésité à prendre ce virage en agissant comme leader en matière d’autochtonisation. Si la reconnaissance des savoirs et des connaissances autochtones commence avec la formation des maîtres et se poursuit ainsi au coeur de nos écoles, elle présente néanmoins quelques défis liés au manque de formation des enseignantes et enseignants. Ce texte propose quelques initiatives portées par des membres du programme du Baccalauréat en éducation française dans leur cheminement vers l’autochtonisation. L’intégration des perspectives des Premières Nations, des Métis et des Inuits est au coeur de la formation à la faculté d’éducation pour bien préparer les futurs enseignants à relever ce défi. Il s’agit d’expériences signifiantes qui reposent sur une réflexion éthique. Il s’agit de souligner les efforts qui sont faits au sein du baccalauréat en éducation française relativement à l’autochtonisation des programmes en éducation que les défis en contexte francophone minoritaire.
In this paper, we discuss methodological and ethical issues related to researching with children in a way that respects and validates their voices. Drawing on vignettes from one of the author’s inquiries with young multilingual children, we share strategies we see as central to positioning children as knowledgeable and active agents in their own and our learning. We propose three main criteria for doing qualitative research with children: fostering respectful relationships; using creative methods; and listening attentively to children’s stories. We discuss what these criteria can contribute to early childhood education, both in formal and non-formal settings.
ImportanceRacial disparities in treatment benchmarks have been documented among older patients with hip fractures. However, these studies were limited to patient-level evaluations.ObjectiveTo assess whether disparities in meeting fracture care time-to-surgery benchmarks exist at the patient level or at the hospital or institutional level using high-quality multicenter prospectively collected data; the study hypothesis was that disparities at the hospital-level reflecting structural health systems issues would be detected.Design, Setting, and ParticipantsThis cohort study was a secondary analysis of prospectively collected data in the PREP-IT (Program of Randomized trials to Evaluate Preoperative antiseptic skin solutions in orthopaedic Trauma) program from 23 sites throughout North America. The PREP-IT trials enrolled patients from 2018 to 2021, and patients were followed for 1-year. All patients with hip and femur fractures enrolled in the PREP-IT program were included in analysis. Data were analyzed April to September 2022.ExposuresPatient-level and hospital-level race, ethnicity, and insurance status.Main Outcomes and MeasuresPrimary outcome measure was time to surgery based on 24-hour time-to-surgery benchmarks. Multilevel multivariate regression models were used to evaluate the association of race, ethnicity, and insurance status with time to surgery. The reported odds ratios (ORs) were per 10% change in insurance coverage or racial composition at the hospital level.ResultsA total of 2565 patients with a mean (SD) age of 64.5 (20.4) years (1129 [44.0%] men; mean [SD] body mass index, 27.3 [14.9]; 83 [3.2%] Asian, 343 [13.4%] Black, 2112 [82.3%] White, 28 [1.1%] other) were included in analysis. Of these patients, 834 (32.5%) were employed and 2367 (92.2%) had insurance; 1015 (39.6%) had sustained a femur fracture, with a mean (SD) injury severity score of 10.4 (5.8). Five hundred ninety-six patients (23.2%) did not meet the 24-hour time-to-operating-room benchmark. After controlling for patient-level characteristics, there was an independent association between missing the 24-hour benchmark and hospital population insurance coverage (OR, 0.94; 95% CI, 0.89-0.98; P = .005) and the interaction term between hospital population insurance coverage and racial composition (OR, 1.03; 95% CI, 1.01-1.05; P = .03). There was no association between patient race and delay beyond 24-hour benchmarks (OR, 0.96; 95% CI, 0.72-1.29; P = .79).Conclusions and RelevanceIn this cohort study, patients who sought care from an institution with a greater proportion of patients with racial or ethnic minority status or who were uninsured were more likely to experience delays greater than the 24-hour benchmarks regardless of the individual patient race; institutions that treat a less diverse patient population appeared to be more resilient to the mix of insurance status in their patient population and were more likely to meet time-to-surgery benchmarks, regardless of patient insurance status or population-based insurance mix. While it is unsurprising that increased delays were associated with underfunded institutions, the association between institutional-level racial disparity and surgical delays implies structural health systems bias.
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