Indigenous Health Curriculum and Health Professional Learners: A Systematic Review

Francis‐Cracknell, Alison; Murray, Margaret; Palermo, Claire; Atkinson, Petah; Gilby, Rosemary; Adams, Karen

doi:10.1080/0142159x.2018.1497785

Cited by 33 publications

(39 citation statements)

References 29 publications

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“…Institutions must question whether poor quality teaching is better than none, especially regarding the perseverance of hidden curricula, 16,24 and to consider whether clinical educators from other disciplines would describe similar perspectives as this GP educator cohort. Curriculum implementation in Australia, as well as comparable Western settler‐colonial countries, ranges from stand‐alone Indigenous health subjects to integrated approaches such as that of the study institution, with challenges identified by many institutions as to how best to share teaching responsibility 26 . This study further raises questions as to who is best placed to teach Reflection‐related content in particular.…”

Section: Discussionmentioning

confidence: 97%

“…Most thought their teaching expertise was hampered by limited clinical or educational experience. There is little understanding of what constitutes effective educator preparation 26 . Clinical experience or skill alone, however, does not always translate to good teaching practice, and notably, there was a prominent absence in the educator group of clearly articulated pedagogy that would enable an anti‐racist, self‐reflexive approach to Reflection teaching.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, in Australian vocational general practice training contexts, racism and self‐reflexivity have been identified as a prominent gap in teaching 25 . The relative absence of these elements is situated in the broader context of Indigenous health curriculum implementation internationally, which remains patchy, under‐resourced, predominately at novice level, and not rigorously or consistently evaluated, leaving medical graduates feeling underprepared for care with Indigenous patients 24,26 …”

Section: Introductionmentioning

confidence: 99%

“…25 The relative absence of these elements is situated in the broader context of Indigenous health curriculum implementation internationally, which remains patchy, under-resourced, predominately at novice level, and not rigorously or consistently evaluated, leaving medical graduates feeling underprepared for care with Indigenous patients. 24,26 In general practice training, general practitioner (GP) educators are often tasked with contributing to the implementation of Indigenous health curricula, similarly to clinical educators in other disciplines. Yet few studies have explicitly examined GP educator preparedness, 26 with little specific exploration of delivery of racism, privilege and self-reflexivity teaching in particular.…”

Section: Introductionmentioning

confidence: 99%

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Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity

Vass¹,

Adams

2020

Medical Education

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Introduction: General practitioners (GPs) and family medicine clinicians should respond to Indigenous peoples' health needs. However, medical graduates feel underprepared for this work. The foundational elements of racism, white privilege and cultural self-reflexivity remain conspicuously absent from medical education in general practice programmes, despite inclusion in curriculum frameworks. This study explored the perception and experiences of Australian GP educators in teaching this content. Methods: We undertook a qualitative study that gathered data through semi-structured interviews with GP educators (n = 12) at a medical school in Victoria, Australia. We utilised the Reflection learning domain of the Aboriginal and Torres Strait Islander Health Curriculum Framework to shape interview questions on racism, white privilege and cultural self-reflexivity. Data were analysed from constructivist and Critical Indigenous Theory paradigms to formulate key themes. Results: General practitioner educators were challenged by Reflection content, struggled to articulate a refined pedagogy for provision of anti-racist, self-reflexive learning and felt poorly qualified to teach Indigenous health, articulating preference for delegation of teaching to Indigenous peoples. They simultaneously stated the importance of inclusion of Reflection teaching in general practice, alongside expressing beliefs that appeared to devalue its perceived relevance. Students were perceived as being either disinterested or incapable of Reflection learning, or conversely, more engaged than previous generations with these topics. Discussion: The results call into question how skilled are GP educators to teach elements of Indigenous health education such as racism, white privilege and cultural self-reflexivity. Unskilled educators can reinforce colonialism in curricula, including through minimisation of content. Stronger anti-racist pedagogy is urgently required in medical education. Vital to this is active research on educator preparedness, evidence-based teaching models and accountable curriculum accreditation.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity

Vass¹,

Adams

2020

Medical Education

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“…However, to our knowledge, formal GME curricula for rotations in AI/AN communities in the United States have not been published. 14,15 In this article, we describe 4 topics useful in directing the development of GME curricula in partnership with rural AI/AN communities, and discuss the unique relevance of each topic in the context of AI/ AN health. The topics are intended to align with international consensus recommendations for health equity education in Indigenous populations and with Accreditation Council for Graduate Medical Education Clinical Learning Environment Review Program objectives to improve health disparity education for trainees.…”

mentioning

confidence: 99%

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities

Sundberg

Charge

Owen

et al. 2019

Journal of Graduate Medical Education

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Cultural proficiency starts here: Drawing on staff and student perceptions to Indigenise curricula

McIver

Murphy

Curran

et al. 2022

Health Prom J of Aust

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Issue Addressed: This study reports outcomes from initial steps taken to promote cultural proficiency among our next generation, nonclinical health workforce, including addressing any tendencies towards stereotyping, biases and discrimination, when redeveloping and Indigenising curricula.Methods: This qualitative study involved purposive sampling of undergraduate students enrolled in a final-year health promotion unit (subject), as well as staff within the Faculty of Health. Thematic analysis was applied to two datasets: (i) outcomes from a staff survey examining insights and reactions to delivering Indigenous content (n = 16) and (ii) a collection of online student posts describing their observations and reflections during delivery of an Indigenous health module (n = 91).Results: Staff survey data highlighted the need for targeted professional development and support. Findings from student data emphasised the need to embed course content that has the capacity to (i) help students understand health within an equity, social justice and human rights context and (ii) encourage students to self-identify any conscious and unconscious biases that work against these principles in the workplace.Conclusions: This study demonstrates the usefulness of conducting a preliminary analysis prior to initiating changes to curriculum design and delivery. Strategies were identified to provide and implement renewed initiatives and directions for professional development for staff. Similarly, there was a clear need to effectively train students in cultural awareness, sensitivity and knowledges through specific and targeted resources and support throughout the span of the course.So What: Lack of knowledge and confidence among staff can negatively impact content and delivery, and ultimately, student learning outcomes. However, this was balanced by an appetite for collaboration and guidance. Findings contribute to current discourses exploring effective approaches to Indigenising discrete unit and coursewide curricula and provide a useful template for others seeking evidence-based approaches and ideas when aiming to improve cultural proficiency.

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Indigenous Health Curriculum and Health Professional Learners: A Systematic Review

Cited by 33 publications

References 29 publications

Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity

Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities

Cultural proficiency starts here: Drawing on staff and student perceptions to Indigenise curricula

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