Predictors of medical student interest in Indigenous health learning and clinical practice: a Canadian case study

Sharon Yeung,Amy Bombay,Debbie Martin,Paul Sylvestre,Heather Castleden,Jeff Denis,Chad Walker

doi:10.1186/s12909-018-1401-1

Sharon Yeung, Amy Bombay + Show 5 more

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https://doi.org/10.1186/s12909-018-1401-1

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Abstract

BackgroundIncluding content on Indigenous health in medical school curricula has become a widely-acknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada. However, little is known about what levels of awareness and interest medical students have about Indigenous peoples when they enter medical school. Additionally, it is unclear whether current Indigenous health curricula ultimately improve students’ beliefs and behaviours.MethodsA total of 129 students completed a 43-item questionnaire that was sent to three cohorts of first-year medical students (in 2013, 2014, 2015) at one undergraduate medical school in Canada. This survey included items to evaluate students’ sociopolitical attitudes towards Indigenous people, knowledge of colonization and its links to Indigenous health inequities, knowledge of Indigenous health inequities, and self-rated educational preparedness to work with Indigenous patients. The survey also assessed students’ perceived importance of learning about Indigenous peoples in medical school, and their interest in working in an Indigenous community, which were examined as outcomes. Using principal component analysis, survey items were grouped into five independent factors and outcomes were modelled using staged multivariate regression analyses.ResultsGenerally, students reported strong interest in Indigenous health but did not believe themselves adequately educated or prepared to work in an Indigenous community. When controlling for age and gender, the strongest predictors of perceived importance of learning about Indigenous health were positive sociopolitical attitudes about Indigenous peoples and knowledge about colonization and its links to Indigenous health inequities. Significant predictors for interest in working in an Indigenous community were positive sociopolitical attitudes about Indigenous peoples. Knowledge about Indigenous health inequities was negatively associated with interest in working in an Indigenous community.ConclusionsStudents’ positive sociopolitical attitudes about Indigenous peoples is the strongest predictor of both perceived importance of learning about Indigenous health and interest in working in Indigenous communities. In addition to teaching students about the links between colonization, health inequities and other knowledge-based concepts, medical educators must consider the importance of attitude change in designing Indigenous health curricula and include opportunities for experiential learning to shape students’ future behaviours and ultimately improve physician relationships with Indigenous patients.

Highlights

Introduction[10] the study of medical students’ specific knowledge of Indigenous health topics is sparse, Zhou et al (2011) [11] recently identified that medical students tend to be aware of various Indigenous health issues, but their understanding of the effect of sociocultural and economic factors on Indigenous peoples’ health is more limited
Including content on Indigenous health in medical school curricula has become a widelyacknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada
In addition to teaching students about the links between colonization, health inequities and other knowledge-based concepts, medical educators must consider the importance of attitude change in designing Indigenous health curricula and include opportunities for experiential learning to shape students’ future behaviours and improve physician relationships with Indigenous patients

Summary

Introduction

[10] the study of medical students’ specific knowledge of Indigenous health topics is sparse, Zhou et al (2011) [11] recently identified that medical students tend to be aware of various Indigenous health issues, but their understanding of the effect of sociocultural and economic factors on Indigenous peoples’ health is more limited Their knowledge may be rooted in stereotypical conceptions and portrayals of Indigenous peoples, in part borne from negative views encountered through the media, as well as throughout their education and in medical school from peers and teachers. Beagan (2003) [18] reported that medical students at one Canadian University believed that learning about social and cultural issues was “all very nice to talk about in theory, but it makes no difference [on the wards].” More recently, Bullen et al [15] suggested that positive attitudes are more significantly associated with self-perceived preparedness to work with Indigenous Australians, further bringing into question the adequacy of current knowledge-focused cultural safety curricula

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