The Development of an Indigenous Health Curriculum for Medical Students

Abstract

Indigenous populations experience dramatic health disparities; yet, few medical schools equip students with the skills to address these inequities. At the University of Minnesota Medical School, Duluth campus, a project to develop an Indigenous health curriculum began in September 2013. This project used collaborative and decolonizing methods to gather ideas and opinions from multiple stakeholders, including students, community members, faculty, and administration, to guide the process of adding Indigenous health content to the curriculum to prepare students to work effectively with Indigenous populations. A mixed-methods needs assessment was implemented to inform the instructional design of the curriculum. In June 2014, stakeholders were invited to attend a retreat and complete a survey to understand their opinions of what should be included in the curriculum and in what way. Retreat feedback and survey responses indicated that the most important topics to include were cultural humility, Indigenous culture, social/political/economic determinants of health, and successful tribal health interventions. Stakeholders also emphasized that this content should be taught by tribal members, medical school faculty, and faculty in complementary departments (e.g., American Indian Studies, Education, Social Work) in a way that incorporates experiential learning.Preliminary outcomes include the addition of a seven-hour block of Indigenous content for first-year students taught primarily by Indigenous faculty from several departments. To address the systemic barriers to health and well-being and provider bias that Indigenous patients experience, this project sought to gather data and opinions regarding the training of medical students through a process of Indigenizing research and education.

Assessment of Internal Medicine Resident Preparedness to Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Patients

“…[25][26][27] Improved physician knowledge has been proposed as a strategy to mitigate health disparities for other minority groups. [28][29][30] It is our intention that through improved trainee knowledge of SGM health and healthcare needs, SGM patients will have improved health outcomes and health disparities will be reduced.…”

“…28 Although physician education has not been directly linked to improved patient outcomes in this context, we adopted an educational strategy for addressing SGM health disparities-which other institutions have championed to improve the treatment and overall health of racial and ethnic minorities. 29,30 We developed an online didactic module on health issues relevant to sexual and gender minorities, including an assessment of baseline knowledge and knowledge after module completion, and tracked performance based on year of training and training program. We hypothesized that trainees would have limited knowledge of sexual and gender minority health and that a didactic module would provide immediate improvement in knowledge.…”

Educating for Indigenous Health Equity: An International Consensus Statement

“…In articulating these principles, we acknowledge the significant body of work that has contributed to development of the field to date, which is represented in a number of national guidelines, curriculum frameworks, and other resources. 22–26,31–33 This statement seeks to build on, rather than duplicate, the directives in these documents that are already being addressed in medical education. Rather than recommending specific actions or tasks, we articulate key principles that should underpin institutions’ efforts to promote effective Indigenous health development.…”

Micro-Reconciliation as a Pathway for Transformative Change

“…Central to cultural humility is an understanding that it is a dynamic and life-long learning process (First Nations Health Authority, 2017; Lewis & Prunuske, 2017). Cultural humility asks learners to acknowledge the psychological roots of discrimination, and reflect on personal experiences and understandings of the world, and how these might differ from the lived experiences of others.…”