Barriers to Including Indigenous Content in Canadian Health Professions Curricula

Abstract

Indigenous peoples in Canada continue to face health care inequities despite their increased risk for various negative health outcomes. Evidence suggests that health professions students and faculty do not feel their curriculum adequately prepares learners to address these inequities. The aim of this study was to identify barriers that hinder the inclusion of adequate Indigenous content in curricula across health professions programs. Semi-structured interviews were conducted with 33 faculty members at a university in Canada from various health disciplines. Employing thematic analysis, four principal barriers were identified: (1) the limited number and overburdening of Indigenous faculty, (2) the need for non-Indigenous faculty training and capacity, (3) the lack of oversight and direction regarding curricular content and training approaches, and (4) the limited amount of time in curriculum and competing priorities. Addressing these barriers is necessary to prepare learners to provide equitable health care for Indigenous peoples.
 Keywords: Indigenous health, health professions, curricula, faculty perspectives, barriers, Canada

A Concept Analysis of Cultural Appreciation in Addressing the Wholistic Health Needs of Indigenous People

“…The knowledge gap can be recognized as additional learning or a targeted rationale for obtaining the knowledge (Han, 2019; Edwin & Bahr, 2021; Meade et al, 2022; Power et al, 2020). Knowledge gaps in integrating Indigenous health content, history, and culture is prominent in both nursing educators and nurses (Doran et al, 2019; Doria et al, 2021; Metheny & Dion Fletcher, 2021; Wylie et al, 2021).…”

“…Awareness involves the individual being able to reflect on their own biases, prejudices, and privilege carefully and strategically (Edwin & Bahr, 2021; Han et al 2019; Power 2020). Nurse educators and nurses have an ethical responsibility and need to foster awareness of biases, prejudices and privilege that is embedded into curriculums and their practice (Doran et al, 2019; Doria et al, 2021; Hantke et al, 2022; Wiley et al, 2021). Knowledge acquisition is the obtainment of learning in a particular area.…”

“…Nursing leaders must focus on honoring Indigenous wholistic health beliefs at all levels of practice, education, and research. Through providing adequate resources, time allocation, collaborating with Indigenous leaders at local levels, and adequate training for nurses in clinical practice, education, and research, nurse leaders can ensure Indigenous wholistic health beliefs can be integrated (Doria et al, 2021, Kurtz et al, 2018; Pitama et al, 2018). Nursing leaders can apply the concept analysis of cultural appreciation as a base in a culturally safe environment to prioritize integrating Indigenous content into curricula, foster culturally appropriate care in practice, and ensure research is conducted along aside Indigenous people collaboratively.…”

“…In nursing education, the literature highlights that health programs do not prepare graduates to deliver culturally appropriate care to Indigenous people and very few programs have integrated the Calls to Action or Indigenous health content adequately (Doria et al, 2019; Doria et al, 2021; Metheny & Dion Fletcher, 2021; Pitama et al, 2018; Vass & Adams, 2021). Where Indigenous content is integrated into the curriculum occurred, it focused on a single course or course module and often was not compulsory or throughout the curriculum (Blanchet Garneau et al, 2021; Metheny & Dion Fletcher, 2021; Wiley et al, 2021).…”

“…The same may be true for nurse leaders. A major barrier for nurse educators is faculty lack the knowledge of Indigenous people, their culture, and the history of colonization in Canada (Blanchet Garneau et al, 2022; Doria et al, 2021; Pitama et al, 2018; Vass & Adams, 2021). In nursing research, Indigenous people have been researched and often without consultation, permission, or adherence to Indigenous ontology (Biin et al, 2021; Lovo et al, 2021; Stiegman & Castleden, 2015).…”