دورية أكاديمية
أعرض في EDS

A narrative inquiry into non-Indigenous medical educators and leaders participation in reconcilatory work.

التفاصيل البيبلوغرافية
العنوان: A narrative inquiry into non-Indigenous medical educators and leaders participation in reconcilatory work.
المؤلفون: Burm S; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Dean L; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Alcock D; Southwest Ontario Aboriginal Health Access Centre, London, Ontario, Canada., LaDonna KA; Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Watling CJ; Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Bishop L; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
المصدر: Medical education [Med Educ] 2024 Feb 22. Date of Electronic Publication: 2024 Feb 22.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 7605655 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2923 (Electronic) Linking ISSN: 03080110 NLM ISO Abbreviation: Med Educ Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Wiley-Blackwell
Original Publication: Oxford, Blackwell Scientific Publications.
مستخلص: Introduction: Globally, medical schools are operationalising policies and programming to address Indigenous health inequities. Although progress has been made, challenges persist. In Canada, where this research is conducted, Indigenous representation within medical schools remains low, leaving a small number of Indigenous advocates leading unprecedented levels of equity-related work, often with insufficient resources. The change needed within medical education cannot fall solely on the shoulders of Indigenous Peoples; non-Indigenous Peoples must also be involved. This work aims to better understand the pathways of those engaged in this work, with careful consideration given to the facilitators and barriers to ongoing engagement.
Methods: Data collection and analysis were informed by narrative inquiry, a methodology that relies on storytelling to uncover nuance and prompt reflection. In this paper, we focus on interview data collected from Canadian non-Indigenous medical educators and leaders (n = 10). Participants represented different career stages, (early to late career) and occupied a mix of clinical, administrative and education roles.
Results: Although each participant's entry into reconciliatory work was unique, we identified common drivers actuating their engagement. Oftentimes their participation was tied to administrative work or propelled by experiences within their roles that forced them to confront the systemic inequalities borne by Indigenous Peoples in both academic and healthcare settings. Some admitted to struggling with understanding their appropriate role in Indigenous reconciliation; their participation often proceeded without firm support.
Conclusion: Medical schools have an obligation to ensure their faculty, including non-Indigenous Peoples, are equipped to fulfil social accountability mandates regarding Indigenous health. Our findings generate a better understanding of the tensions inherent in this equity work. We urge others to reflect on their role in Indigenous reconciliation, or else medical schools risk generating a false sense of individual and institutional progress.
(© 2024 The Authors. Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
References: Jones R, Crowshoe L, Reid P, et al. Educating for indigenous health equity: an international consensus statement. Acad Med. 2019;94(4):512-519. doi:10.1097/ACM.0000000000002476.
United Nations. United Nations declaration on the rights of indigenous peoples [Internet]. 2007. Available from: https://social.desa.un.org/sites/default/files/migrated/19/2018/11/UNDRIP_E_web.pdf.
Health Canada. Social accountability-Health Canada Report: a vision for Canadian medical schools [Internet]. 2001. Available from: https://www.afmc.ca/wp-content/uploads/2022/10/sa_vision_canadian_medical_schools_en.pdf.
Barber C, van der Vleuten C, Leppink J, Chahine S. Social accountability frameworks and their implications for medical education and program evaluation: a narrative review. Acad Med. 2020;95(12):1945-1954. doi:10.1097/ACM.0000000000003731.
Statistics Canada. First Nations people, Métis and Inuit in Canada [Internet]. 2022. Available from: https://www150.statcan.gc.ca/n1/en/catalogue/11-627-M2022057.
Truth and Reconciliation Commission of Canada. Truth and Reconciliation Commission of Canada: Calls to Action [Internet]. 2015. Available from: https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/indigenous-people/aboriginal-peoples-documents/calls_to_action_english2.pdf.
Jewell E, Mosby I. Calls to Action accountability: a 2023 status update on reconciliation [Internet]. 2023. Available from: https://yellowheadinstitute.org/trc/.
Henderson RI, Walker I, Myhre D, Ward R, Crowshoe LL. An equity-oriented admissions model for Indigenous student recruitment in an undergraduate medical education program. Can Med Educ J. 2021;12(2):e94-e99. doi:10.36834/cmej.68215.
Anderson M, Crowshoe L, Diffey L et al. Joint commitment to action on indigenous health [Internet]. 2019. Available from: https://www.afmc.ca/wp-content/uploads/2022/10/AFMC_Position_Paper_JCAIH_EN.pdf.
Strasser R, Hogenbirk JC, Minore B, et al. Transforming health professional education through social accountability: Canada's Northern Ontario School of Medicine. Med Teach. 2013;35(6):490-496. doi:10.3109/0142159X.2013.774334.
Sadler K, Johnson M, Brunette C, et al. Indigenous student matriculation into medical school: policy and progress. Int Ind Policy J. 2017;8(1):1-17. doi:10.18584/iipj.2017.8.1.5.
Committee on Accreditation of Canadian Medical Schools. CACME Standards and Elements [Internet]. 2021. Available from https://cacms-cafmc.ca/wp-content/uploads/2022/12/CACMS_Standards_and_Elements_AY_2022-2023.pdf.
Melro CM, Landry J, Matheson K. A scoping review of frameworks utilized in the design and evaluation of courses in health professional programs to address the role of historical and ongoing colonialism in the health outcomes of Indigenous Peoples. Adv Health Sci Educ Theory Pract. 2023;28(4):1311-1331. doi:10.1007/s10459-023-10217-y.
Lewis M, Prunuske A. The development of an indigenous health curriculum for medical students. Acad Med. 2017;92(5):641-648. doi:10.1097/ACM.0000000000001482.
Herzog LS, Wright SR, Pennington JJ, Richardson L. The KAIROS Blanket Exercise: engaging Indigenous ways of knowing to foster critical consciousness in medical education. Med Teach. 2021;43(12):1437-1443. doi:10.1080/0142159X.2021.1956679.
Sauvé A, Cappelletti A, Murji L. Stand up for indigenous health: a simulation to educate residents about the social determinants of health faced by Indigenous Peoples in Canada. Acad Med. 2022;97(4):518-523. doi:10.1097/ACM.0000000000004570.
Strasser R, Hogenbirk J, Jacklin K, et al. Community engagement: a central feature of NOSM's socially accountable distributed medical education. Can Med Educ J. 2018;9(1):e33-e43. doi:10.36834/cmej.42151.
Anderson M, Lavallee B. The development of the First Nations, Inuit and Métis medical workforce. Med J Aust. 2007;186(10):539-540. doi:10.5694/j.1326-5377.2007.tb01033.x.
Young ME, Razack S, Hanson MD, et al. Calling for a broader conceptualization of diversity: surface and deep diversity in four Canadian medical schools. Acad Med. 2012;87(11):1501-1510. doi:10.1097/ACM.0b013e31826daf74.
Povey R, Trudgett M, Page S, Coates SK. Where we're going, not where we've been: Indigenous leadership in Canadian higher education. Race Ethn Educ. 2022;25(1):38-54. doi:10.1080/13613324.2021.1942820.
Mohamed T, Beagan BL. ‘Strange faces’ in the academy: experiences of racialized and Indigenous faculty in Canadian universities. Race Ethn Educ. 2018;22(3):338-354. doi:10.1080/13613324.2018.1511532.
Henry F, Dua E, James CE, et al. The equity myth: racialization and indigeneity at Canadian universities. UBC Press; 2017. doi:10.59962/9780774834902.
Krusz E, Davey T, Wigginton B, Hall N. What contributions, if any, can non-indigenous researchers offer toward decolonizing health research? Qual Health Res. 2020;30(2):205-216. doi:10.1177/1049732319861932.
Burm S, Deagle S, Watling CJ, Wylie L, Alcock D. Navigating the burden of proof and responsibility: a narrative inquiry into Indigenous medical learners' experiences. Med Educ. 2023;57(6):556-565. doi:10.1111/medu.15000.
McGuire M, Denis JS. Unsettling pathways: how some settlers come to seek reconciliation with Indigenous peoples. Settler Colonial Stud. 2019;9(4):505-524. doi:10.1080/2201473X.2019.1598701.
Doria N, Biderman M, Sinno J, Boudreau J, Mackley MP, Bombay A. Barriers to including Indigenous content in Canadian health professions curricula. Can J Educ Rev Canadienne de l'éducation. 2021;30(3):648-675. doi:10.53967/cje-rce.v44i3.4611.
Soklaridis S, Lin E, Black G, et al. Moving beyond “think leadership, think white male”: the contents and contexts of equity, diversity and inclusion in physician leadership programmes. BMJ Leader. 2022;6(2):146-157. doi:10.1136/leader-2021-000542.
Roger E, Prager C, Govier T. We are all treaty people: history, reconciliation, and the ‘settler problem’. In: Dilemmas of reconciliation: cases and concepts. Wilfrid Laurier University Press; 2004.
Regan P. Unsettling the settler within: Indian residential schools, truth telling, and reconciliation in Canada. UBC Press; 2010. doi:10.59962/9780774817790.
Younging G. Elements of Indigenous style: a guide for writing by and about Indigenous peoples [Internet]. Brush Education; 2018. (Indigenous Collection). Available from: https://books.google.ca/books?id=7a5uAQAACAAJ.
Connelly FM, Clandinin DJ. Stories of experience and narrative inquiry. Educ Res. 1990;19:12-14.
Clandinin DJ, Cave MT, Berendonk C. Narrative inquiry: a relational research methodology for medical education. Med Educ. 2017;51(1):89-96. doi:10.1111/medu.13136.
Josselson R. The ethical attitude in narrative research: principles and practicalities. Handbook of narrative inquiry: mapping a methodology. Sage Publications, Inc; 2007:537-566. doi:10.4135/9781452226552.n21.
Clandinin DJ. Engaging in narrative inquiry [Internet]. Left Coast Press, Incorporated; 2013. (Developing qualitative inquiry). Available from: https://books.google.ca/books?id=SGDRNAEACAAJ.
Josselson R. Interviewing for qualitative inquiry [Internet]. 2013. Available from: https://www.guilford.com/books/Interviewing-for-Qualitative-Inquiry/Ruthellen-Josselson/9781462510009/reviews.
Riessman CK. Narrative methods for the human sciences. SAGE Publications; 2008.
Austen I, Bilefsky D. Hundreds more unmarked graves found at former residential school in Canada. The New York Times [Internet] 2021 Jun 24; Available from: https://www.nytimes.com/2021/06/24/world/canada/indigenous-children-graves-saskatchewan-canada.html.
Cecco L. ‘Dead because she was Indigenous’: Québec coroner says Atikemekw woman a victim of systemic racism. The Guardian [Internet] 2021 Oct 6; Available from: https://www.theguardian.com/world/2021/oct/06/joyce-echaquan-coroner-indigenous-systemic-racism-death.
LaDonna KA, Artino ARJ, Balmer DF. Beyond the guise of saturation: rigor and qualitative interview data. J Grad Med Educ United States. 2021;13(5):607-611. doi:10.4300/JGME-D-21-00752.1.
Nixon SA. The coin model of privilege and critical allyship: implications for health. BMC Public Health. 2019;19(1):1637. doi:10.1186/s12889-019-7884-9.
Sylvestre P, Castleden H, Denis J, Martin D, Bombay A. The tools at their fingertips: how settler colonial geographies shape medical educators' strategies for grappling with Anti-Indigenous racism. Soc Sci Med. 2019;237:112363. doi:10.1016/j.socscimed.2019.112363.
Wylie L, McConkey S, Corrado AM. It's a journey not a check box: indigenous cultural safety from training to transformation. Int J Indig Health. 2021;16(1):314-332. doi:10.32799/ijih.v16i1.33240.
Kluttz J, Walker J, Walter P. Unsettling allyship, unlearning and learning towards decolonizing solidarity. Stud Educ Adults. 2020;52(1):49-66. doi:10.1080/02660830.2019.1654591.
Burleigh D, Burm S. Doing duoethnography: addressing essential methodological questions. Int J Qual Meth. 2022;21:160940692211408. doi:10.1177/16094069221140876.
Anderson M. Indigenous health research and reconciliation. CMAJ. 2019;191(34):E930-E931. doi:10.1503/cmaj.190989.
Tuck E, Yang KW. Decolonization is not a metaphor. Decolon Ind Educ Soc. 2012;1(1):1-40.
Gaudry A, Lorenz D. Indigenization as inclusion, reconciliation, and decolonization: navigating the different visions for indigenizing the Canadian Academy. AlterNative: Int J Ind Peoples. 2018;14(3):218-227. doi:10.1177/1177180118785382.
Corntassel JJ. Re-envisioning resurgence: Indigenous pathways to decolonization and sustainable self-determination. Decolon Ind Educ Soc. 2012;1(1):86-101.
Bishop A. Becoming an ally: breaking the cycle of oppression [Internet]. Bloomsbury Academic; 2009. Available from: https://books.google.ca/books?id=6K7ZAAAAMAAJ.
Smith GH, Smith LT. Doing Indigenous work: decolonizing and transforming the academy. In: McKinley EA, Smith LT, eds. BT - Handbook of Indigenous Education. Springer Singapore; 2019:1075-1101. doi:10.1007/978-981-10-3899-0_69.
Sukhera J, Watling CJ, Gonzalez CM. Implicit bias in health professions: from recognition to transformation. Acad Med. 2020 May;95(5):717-723. doi:10.1097/ACM.0000000000003173.
Zaidi Z, Rockich-Winston N, Chow C, Martin PC, Onumah C, Wyatt T. Whiteness theory and the (in)visible hierarchy in medical education. Med Educ. 2023;57(10):903-909. doi:10.1111/medu.15124.
معلومات مُعتمدة: 19/MERG-1 Royal College of Physicians and Surgeons of Canada
تواريخ الأحداث: Date Created: 20240222 Latest Revision: 20240222
رمز التحديث: 20240222
DOI: 10.1111/medu.15360
PMID: 38385616
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-2923
DOI:10.1111/medu.15360