A Situation Analysis of Indigenous Health Education at the Cumming School of Medicine, University of Calgary 公开
Lewis, Jody A. (Spring 2020)
Abstract
The history of colonization has resulted in major health disparities and poor health outcomes for Indigenous peoples across Canada. Mandates such as the United Nations Declaration on the Rights of Indigenous Peoples and the Truth and Reconciliation Commission’s (TRC) Report emphasize equal rights for Indigenous peoples around the world and encourage institutions to acknowledge and redress the long-term disparities that colonization has caused for Indigenous peoples, respectively.
The TRC Report directly addresses Canadian healthcare education, urging educators to provide Indigenous health training for all healthcare professionals, including “intercultural competency, conflict resolution, human rights and anti-racism.” This could start to address the documented cycle of misunderstanding and miscommunication between medical providers and Indigenous patients who access mainstream healthcare. Indigenous people experience systemic racism in the form of stereotyping, and this results in poorer quality of healthcare services. The literature also demonstrates that medical providers recognize and acknowledge the systematic racism in healthcare towards Indigenous people.
The qualitative research of this project draws on eleven in-depth interviews with physicians, educators, medical education experts and program directors at the Cumming School of Medicine (CSM) at the University of Calgary and an Alberta Health Services Cultural Competency Advisor. Data were transcribed, coded with MAXQDA software, and analyzed using thematic data analysis strategies. Findings illustrate current medical education curriculum and indicate that Indigenous health is only sporadically a focus in post-graduate medical education programs at CSM. Champions and allies support and lead Indigenous health initiatives, but piecemeal approaches are not enough to educate and train culturally competent medical providers. The framework in the last chapter of this work details suggested steps for CSM moving forward to provide equitable Indigenous health education and training. These suggestions include steps for ensuring longevity of initiatives, objectives and competencies to consider for Indigenous health, pedagogical approaches from the medical humanities to consider, and the importance of collaboration between physician educators, education experts and Indigenous health content experts to provide evidence-based education that achieves measurable outcomes.
Table of Contents
Distribution Agreement i
Abstract Cover Page. iii
Abstract iv
Acknowledgements. vi
Table of Contents. vii
List of Abbreviations and Definitions. ix
List of Tables and Figures. x
CHAPTER ONE: INTRODUCTION.. 1
Introduction and Rationale. 1
Problem Statement 3
Purpose Statement 3
Research Objectives. 4
CHAPTER TWO: LITERATURE REVIEW... 5
Historical background. 5
Residential School System.. 5
Fragmented relationships. 6
Other existing approaches. 7
Truth and Reconciliation Commission. 8
Global health context 8
Art and humanities in medical education. 10
CHAPTER THREE: STUDY METHODS. 12
Introduction. 12
Recruitment 12
Research design and procedures. 13
Plans for data analysis. 14
Ethical considerations. 15
Limitations and delimitations. 15
CHAPTER FOUR: FINDINGS. 16
Context and setting. 16
Current medical education. 16
Undergraduate medical education. 17
Post-graduate medical education. 18
Where the gaps are in current medical education. 19
Where are the challenges. 21
Where are the supports. 24
Simulation. 28
CHAPTER FIVE: DISCUSSION.. 33
Summary of results. 33
The need should be understood by leadership. 33
Learning objectives and competencies. 34
“If you add something, you have to take away something”. 36
Teaching methods. 37
Culture of medicine. 39
Learners at different levels. 41
The importance of collaboration. 42
Consolidation of champions’ efforts. 44
REFERENCES 47
About this Master's Thesis
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