Student Perspectives on Indigenous Health Content in Pre-Clinical Medical Education

Abstract

Introduction: In 2015, the Truth and Reconciliation Commission of Canada released 94 calls to action. These calls were intended to redress harms inflicted on Indigenous peoples as a result of the Indian Residential School system and to advance the process of reconciliation of Canada. Several of these calls to action are directed specifically toward educating health-care providers as a means to actively eliminate racism in health-care experiences for Indigenous peoples. Objectives : To identify the learning needs of pre-clerkship medical students with respect to Indigenous health content and curriculum, and to explore the perspectives of pre-clerkship medical students on existing gaps in the medical curriculum regarding Indigenous health. Methods: This study involved semi-structured interviews with 14 first- and second-year (pre-clinical/pre-clerkship) medical students at one medical school. Thematic analysis was performed using NVivo data management software to identify common themes, and then considered within the context of the existing literature. Results: Three main themes were identified: (a) Familiarity with Indigenous culture prior to medical school, (b) constructive criticism about Indigenous education in medical school, and (c) pervasive lack of education about Indigenous health issues in the program. Discussion: Participants felt they needed more time devoted to learning about Indigenous peoples’ health, as there are many topics to explore. Most participants felt that their understanding of health issues impacting Indigenous peoples has not been sufficient in their primary, secondary, and post-secondary education to date and offered suggestions for improving the Indigenous health content in the medical school curriculum. These suggestions included providing the education earlier in the program, having Indigenous peoples involved in content creation and delivery, and ensuring all learners have sufficient opportunity to learn more about Indigenous peoples and their health. Conclusion: Through this research we gain a glimpse of how future medical providers are interpreting Indigenous health curriculum, and whether and how they intend to apply this education to their own future practice. NOTE: While the term Aboriginal has been used in Canada and Australia, the term Indigenous is used in this paper as an all-encompassing term to speak of the diverse cultures and peoples who are the original inhabitants of Canada, as it is used globally (Indigenous Foundations, 2009).