scholarly journals Barriers to Including Indigenous Content in Canadian Health Professions Curricula

Author(s):  
Nicole Doria ◽  
Maya Biderman ◽  
Jad Sinno ◽  
Jordan Boudreau ◽  
Michael P. Mackley ◽  
...  

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

2006 ◽  
Vol 36 (1) ◽  
pp. 79-102 ◽  
Author(s):  
Vernon R. Curran ◽  
Lisa Fleet ◽  
Diana Deacon

Canadian governments and various stakeholder groups are advocating greater interprofessional collaboration amongst health care providers as a fundamental strategy for enhancing coordination and quality of care in the health care system. Interprofessional education for collaborative patient-centred practice (IECPCP) is an educational process by which students/learners (or workers) from different health professions learn together to improve collaboration. The educational system is believed to be a main determinant of interprofessional collaborative practice, yet academic institutions are largely influenced by accreditation, certification and licensure bodies. Accreditation processes have been linked to the continuous improvement of curricula in the health professions, and have also been identified as potential avenues for encouraging educational change and innovation. The purpose of this paper is to summarize the characteristics of the national accreditation systems of select Canadian health professional education programs at both the pre- and post-licensure educational levels and to show how these systems support and/or foster IECPCP. A review of the educational accreditation systems of medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy was undertaken through key informant interviews and an analysis of accreditation process documentation. The results of this comparative review suggest that accreditation systems are more prevalent across the health professions at a pre-licensure level. Accreditation at the post- licensure level, particularly at the continuing professional education level, appears to be less well established across the majority of health professions. Overall, the findings of the review also suggest that current accreditation systems do not appear to promote nor foster interprofessional education for collaborative patient-centred practice in a systematic manner through either accreditation processes or standards. Through a critical adult learning perspective we argue that in order for traditional uni-professional structures within the health professional education system to be challenged, the accreditation system needs to place greater value on interprofessional education for collaborative patient-centred practice.


2019 ◽  
Vol 6 ◽  
pp. 233339361986897 ◽  
Author(s):  
Marilyn Ballantyne ◽  
Laurie Liscumb ◽  
Erin Brandon ◽  
Janice Jaffar ◽  
Andrea Macdonald ◽  
...  

Children with cerebral palsy (CP) require ongoing rehabilitation services to address complex health care needs. Attendance at appointments ensures continuity of care and improves health and well-being. The study’s aim was to gain insight into mothers’ perspectives of the factors associated with nonattendance. A qualitative descriptive design was conducted to identify barriers and recommendations for appointment keeping. Semi-structured interviews were conducted with 15 mothers of children with CP. Data underwent inductive qualitative analysis. Mothers provided rich context regarding barriers confronted for appointment keeping—transportation and travel, competing priorities for the child and family, and health services. Mothers’ recommendations for improving the experience of attending appointments included virtual care services, transportation support, multimethod scheduling and appointment reminders, extended service hours, and increased awareness among staff of family barriers to attendance. The results inform services/policy strategies to facilitate appointment keeping, thereby promoting access to ongoing rehabilitation services for children with CP.


Author(s):  
Mirian Benites Falkenberg ◽  
Helena Eri Shimizu ◽  
Ximena Pamela Díaz Bermudez

ABSTRACT Objective: to analyze the social representations of health care of the Mbyá-Guarani ethnic group by multidisciplinary teams from the Special Indigenous Health District in the south coast of Rio Grande do Sul state (Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul), Brazil. Method: a qualitative method based on the theory of social representations was used. Data were collected via semi-structured interviews with 20 health workers and by participant observation. The interviews were analyzed with ALCESTE software, which conducts a lexical content analysis using quantitative techniques for the treatment of textual data. Results: there were disagreements in the health care concepts and practices between traditional medicine and biomedicine; however, some progress has been achieved in the area of intermedicality. The ethnic boundaries established between health workers and indigenous peoples based on their representations of culture and family, together with the lack of infrastructure and organization of health actions, are perceived as factors that hinder health care in an intercultural context. Conclusion: a new basis for the process of indigenous health care needs to be established by understanding the needs identified and by agreement among individuals, groups, and health professionals via intercultural exchange.


2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.


2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i107-i114
Author(s):  
Ana Lucia de M Pontes ◽  
Ricardo Ventura Santos

Abstract Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.


Author(s):  
Stephen Harfield ◽  
Carol Davy ◽  
Anna Dawson ◽  
Eddie Mulholland ◽  
Annette Braunack-Mayer ◽  
...  

Abstract Aim: In the crowded field of leadership research, Indigenous leadership remains under-researched. This article explores the Leadership Model of an Aboriginal Community Controlled Primary Health Care Organisation providing services to the Yolngu people of remote northern Australia: the Miwatj Health Aboriginal Corporation (Miwatj). Background: The limited research which does exist on Indigenous leadership points to unique challenges for Indigenous leaders. These challenges relate to fostering self-determination in their communities, managing significant community expectations, and navigating a path between culturally divergent approaches to management and leadership. Methods: Guided by Indigenous methodology and using a mixed methods approach, semi-structured interviews, self-reported health service data, organisational and publicly available documents, and literature were analysed using a framework method of thematic analysis to identify key themes of the Miwatj Leadership Model. Findings: The Miwatj Leadership Model is underpinned by three distinctive elements: it offers Yolngu people employment opportunities; it supports staff who want to move into leadership positions and provides capacity building through certificates and diplomas; and it provides for the physical, emotional, and cultural wellbeing of all Yolngu staff. Furthermore, the model respects traditional Yolngu forms of authority and empowers the community to develop, manage and sustain their own health. The Miwatj Leadership Model has been successful in providing formal pathways to support Indigenous staff to take on leadership roles, and has improved the accessibility and acceptability of health care services as a result of Yolngu employment and improved cultural safety. Conclusions: Translating the Miwatj Leadership Model into other health services will require considerable thought and commitment. The Miwatj Leadership Model can be adapted to meet the needs of other health care services in consideration of the unique context within which they operate. This study has demonstrated the importance of having a formal leadership model that promotes recruitment, retention, and career progression for Indigenous staff.


2016 ◽  
Vol 9 (1) ◽  
pp. 28-48 ◽  
Author(s):  
David Sjorberg ◽  
Dennis McDermott

The ‘deconstruction exercise’ aims to give non-Indigenous health profession students the ability to recognise language that is imbued with power imbalance, so as to avoid the perpetuation of racialised ways of interacting with Indigenous peoples in the health system. Informed by Ngarrindjeri and Malak Malak perspectives, this is a measured anti–racism strategy, one able to address unexamined, racist language in a manner that avoids the emotive or combative nature of unstructured discussions around the impacts of racism. ISSN: ISSN 1837-0144 © International Journal of Critical Indigenous Studies 29 We argue that once a health care professional is able to exhibit decolonised language, together with a re-orientation towards decolonised practice, a door opens; one vital for the development of a more-effective, culturally-safe practitioner. In an academic setting, this ‘Ngarrindjeri way’ has shaped the deconstruction exercise, which ensures that students are ‘having the hard conversations’ in a pragmatic manner that challenges ‘whiteness’, whilst honouring each student’s dignity, on a learning journey that is informed by Indigenous methodologies.


2021 ◽  
Vol 10 (1) ◽  
pp. 237-244
Author(s):  
Flávia Carvalho dos Santos Batista ◽  
Firmina Hermelinda Saldanha Albuquerque ◽  
Karla Maria Carneiro Rolim ◽  
Manoel Viana Xavier ◽  
Mirian Calíope Dantas Pinheiro ◽  
...  

The objective was to describe, through key points of indigenous health care, what has changed after the implementation of the National Health Care Policy for Indigenous Peoples. For this, the research method chosen was the literature review with a qualitative approach of the results. The studies that composed the sample were retrieved from the SciELO and PubMed databases, from May to August 2018. The results point to the deficiency of training of professionals of the Multidisciplinary Team of Indigenous Health (EMSI) in the context of interethnic relations; the need to define the functions of Indigenous Health Agents (IHA) within EMSI; the good acceptance by indigenous peoples and EMSI regarding biomedical and traditional indigenous treatments, respectively; in addition to the food deficiency of the Indigenous Health Care Information System. That said, there should be trainings in the scope of interethnic action for EMSI and IHA with clear definition of each one’ roles within EMSI, especially the IHA.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Madeleine Kétéskwēw Dion Stout ◽  
Cornelia (Nel) Wieman ◽  
Lisa Bourque Bearskin ◽  
Becky C. Palmer ◽  
Lauren Brown ◽  
...  

Racism toward Indigenous Peoples continues to permeate throughout the health care system, a reality the authors know all too well in their shared and yet unique personal and professional experiences. Although acknowledging and speaking up against racial injustice is daunting, and is often met with disregard or inaction, the authors contend that this is a necessary undertaking to redress the ongoing harms of colonialism. Correspondingly, those who do not speak up must not have their voices silenced. Instead, the perspectives that Indigenous Peoples have regarding their own experiences of racism must be heeded seriously and produce real and tangible solutions. In narrating their own encounters of confronting and challenging racism, the authors juxtapose activism and resistance with the preservation of Indigenous Knowledge as a catalyst for propelling the necessary changes forward within health care to end racism. To be truly impactful, all efforts taken to address racism must occur alongside advancing equity of care and human rights for and by Indigenous Peoples at individual, community, and systemic levels. Changes are not needed after more evidence. The time to act is now.


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