Medicine Wheel Research Articles

Reconciliation and Diversity for Educators: The Medicine Wheel, Bloom's Taxonomy, and CanMEDS Competencies.

Reconciliation and Diversity for Educators: The Medicine Wheel, Bloom's Taxonomy, and CanMEDS Competencies.

Stepping Into the Circle: Inviting Spirit Through Medicine Wheel Teachings in the Expressive Therapies Continuum (Entrer dans le cercle : invitation de l’esprit à travers les enseignements de la roue médicinale dans le Continuum des Thérapies Expressives)

This article explores the intersections between colonial trauma and Indigenous identity as a centralizing factor of Indigenous wellness. Focusing on the Expressive Therapies Continuum theory, this author continues her research on using culturally significant materials and material interaction as a way to honor Indigenous knowledge. Taking a Two-Eyed Seeing approach, this author proposes changing the shape of the continuum from hierarchal to cyclical in order to invite clinicians to reflect on the role of Spirit and cultural identity as important elements when considering wholistic health. Using the teachings of the Medicine Wheel, the body, heart, mind, and Spirit are connected with the somatic/kinesthetic, perceptual/affective, cognitive/symbolic, and creative levels of the continuum.

Culturally Safe Practices in the Co-creation of Medical Education Curriculum with Indigenous Animators: Outcomes From an Indigenous Learning Circle.

To explore the experiences of Indigenous patient actors who co-created and enacted Indigenous patient scenarios in collaboration with medical school faculty. We critically examine the structures and systems in a medical school that mediate cultural safety for Indigenous patient actors. The Truth and Reconciliation Commission of Canada has called on medical schools and healthcare institutions to help address the intergenerational harms inflicted on Indigenous people by the Indian residential school (IRS) system. Institutions are striving to incorporate cultural competency, conflict resolution, human rights, and anti-racism education into their curricula. However, the structural inequities within undergraduate, postgraduate, and continuing medical education practices must be identified and challenged to ensure that medical education is authentic and culturally safe for those involved in the development and delivery of the Indigenous health curriculum. To explore potential structural inequities in the co-creation process of simulated cultural communication scenarios (SCCS), the Indigenous animators at Debajehmujig Storytellers and collaborating faculty and professional staff at the Northern Ontario School of Medicine University (NOSM U) examined cultural safety in their curriculum design and delivery process. We utilized the qualitative Indigenous research methodology of the Learning Circle to deconstruct the co-creation process and to explore the experience of cultural safety from the Indigenous animators' perspective throughout the curriculum design and delivery process. A framework for culturally safe co-creation practices with Indigenous people, rooted within Indigenous teachings of the Medicine Wheel, emerged from the qualitative data. This framework has the potential to guide the practice of culturally safe co-creation of Indigenous patient simulations in medical education and healthcare workplace learning. While the Medicine Wheel teachings are held by specific Indigenous nations, we anticipate that the results and recommendations of this study will apply to Indigenous co-creators and academic medical educators internationally.

Planting Seeds of Change: Voices of Indigenous Youth on Wholistic Health

Indigenous youth are key partners in improving our understanding of holistic health and identifying solutions to address health-related issues. The Urban Gardens Project was a community-based research partnership involving Indigenous youth co-researchers, Brandon University, Indigenous Knowledge Users, Elders, and Indigenous organizations in Winnipeg and Brandon, Manitoba. Using the Medicine Wheel as an analytic framework, the study identified key indicators of spiritual, mental, physical, and emotional wellbeing that Indigenous youth attributed to gardening. Findings illuminate the need for policies to foster Indigenous youth engagement, leadership, and urban gardening programs that advance Indigenous cultural practices to contribute to Indigenous health and wellbeing. The research was funded by the Canadian Institutes for Health Research (CIHR).

Implementation and evaluation of a two-eyed seeing approach using traditional healing and seeking safety in an indigenous residential treatment program in Northern Ontario

ABSTRACT Indigenous clients in need of residential care for substance use disorders (SUD) often present with the diagnosis of substance use disorder (SUD) combined with intergenerational trauma (IGT) or both. SUD is exceedingly prevalent amongst Indigenous peoples due to the health impacts of colonisation, residential school trauma, and IGT on this population’s health. We evaluated the effectiveness of a Two-Eyed Seeing approach in a four-week harm reduction residential treatment programme for clients with a history of SUD and IGT. This treatment approach blended Indigenous Healing practices with Seeking Safety based on Dr. Teresa Marsh’s research work known as Indigenous Healing and Seeking Safety (IHSS). The data presented in this study was drawn from a larger trial. This qualitative study was undertaken in collaboration with the Benbowopka Treatment Centre in Blind River, Northern Ontario, Canada. Patient characteristic data were collected from records for 157 patients who had enrolled in the study from April 2018 to February 2020. Data was collected from the Client Quality Assurance Survey tool. We used the qualitative thematic analysis method to analyse participants’ descriptive feedback about the study. Four themes were identified: (1) Motivation to attend treatment; (2) Understanding Benbowopka’s treatment programme and needs to be met; (3) Satisfaction with all interventions; and (4) Moving forward. We utilised a conceptualised descriptive framework for the four core themes depicted in the medicine wheel. This qualitative study affirmed that cultural elements and the SS Western model were highly valued by all participants. The impact of the harm reduction approach, coupled with traditional healing methods, further enhanced the outcome. This study was registered with clinicaltrials.gov (identifier number NCT0464574).

Seasons of research with/by/as the Keweenaw Bay Indian Community

In response to generations of inequitable research to/for Indigenous communities, many have and are developing research practices that center Indigenous priorities. In this paper, we share the Seasons of Research framework developed by the Keweenaw Bay Indian Community and University collaborators. First, we outline the scholarship that provides the foundations for research and being researchers in Keweenaw Bay. This section includes a comprehensive table that summarizes resources for building, strengthening, and sustaining equitable research partnerships with/by/as Indigenous communities. Next, we share the guidance for research partnerships we created together that uses the Medicine Wheel to illustrate an interconnected system of partnership teachings. The guidance aims for balance between and among four seasons of research: relationship building, planning and prioritization, knowledge exchange, and synthesis and application. Research partnerships with/by/as the Community demonstrate respect for each other's differences, honor reciprocity in actions, exemplify responsibility for differing commitments, and express reverence for shared lands, waters, and living beings. Personal reflections by lead author Emily Shaw are shared to demonstrate the process and practices associated with seasons of research, bridging Indigenous wisdom, social and natural sciences, and environmental engineering. We conclude with a few words on the transformation of the research landscape with Indigenous peoples at home and abroad.

Clinical Strategies to Develop Connections, Promote Health and Address Pain From the Perspectives of Indigenous Youth, Elders, and Clinicians

In this article we discuss findings from a community based, participatory action research study. The aim was to understand how Indigenous youth describe, experience, manage pain and hurt and how they seek care. A critical analysis guided by Two-Eyed Seeing and Medicine Wheel frameworks highlighted important clinical strategies for Indigenous youth to balance their health and reduce pain. This study is a partnership project with an Aboriginal Health Centre in Southern Ontario and the Canadian Institute of Health Research funded Aboriginal Children's Hurt and Healing Initiative (ACHH). The study gathered perspectives of Indigenous youth, Elders, and health clinicians using conversation sessions guided by a First Nations doctoral student and nurse researcher. Using the medicine wheel framework three main thematic areas emerged across the three groups and include (1) Predictors of Imbalance; (2) Indicators of Imbalance; and (3) Strategies to re-establish balance health in relation to pain. The main strategy includes considerations for clinicians using the acronym LISTEN (Language, Individual, Share, Teachable moments, Engage, and Navigate) approach that outlines strategies for clinicians that will be a safe guide to manage pain and hurt.

Native and Indigenous Populations and Gastric Cancer: A Worldwide Review.

Gastric cancer is a worldwide concern, particularly for Indigenous populations who face greater disparities in healthcare. With decreased access to screening and critical treatment delays, this group is experiencing adverse health effects. To determine what factors drive these disparities, a systematic review was performed in PubMed. This revealed a lack of research on gastric cancer specific to this population. The literature primarily focused on subset analyses and biological aspects with sparse focus on determinants of health. The results informed this presentation on factors related to Indigenous gastric cancer, which are influenced by colonialism. Indigenous populations encounter high rates of food shortage, exposure to harmful environmental agents, structural racism in the built environment, H. pylori, and compromised healthcare quality as an effect of colonialism, which all contribute to the gastric cancer burden. Putting gastric cancer into a cultural context is a potential means to respond to colonial perspectives and their negative impact on Indigenous patients. The objective of this manuscript is to examine the current state of gastric cancer literature from a global perspective, describe what is currently known based on this literature review, supplemented with additional resources due to lack of published works in PubMed, and to present a model of gastric cancer through the lens of a modified medicine wheel as a potential tool to counter colonial healthcare perspectives and to honor Indigenous culture.

Rethinking the Native American medicine wheel garden: from an outdoor classroom to celebration and land acknowledgement

The Native American Medicine Wheel is a powerful tool to bring alive curricular connections from science and history to mathematics and civics as part of schoolyard gardening initiatives. As a living lab these gardens also serve as valuable tools to reinforce lessons on habitat enhancement. However, deeper lessons connected to the cultures of Native Americans and land acknowledgement are embedded throughout and serve as a progressive investment to campus greening initiatives that raise awareness to contemporary social issues.

An exploration of the coaching approaches used by Mi’kmaw First Nation coaches

ABSTRACT This study explored the coaching approaches of Mi’kmaw First Nation coaches in Canada. Eight coaches from across six Mi’kmaw First Nation communities in Nova Scotia, Canada, participated in a semi-structured interview to discuss what it means to be an Indigenous coach. The interviews were audio-recorded and transcribed verbatim. Data were generated inductively using a reflexive thematic analysis. The findings were conceptualised to suggest three concurrent approaches to Mi’kmaq coaching: two-eyed seeing in coaching, multifaceted coaching, and medicine wheel coaching. These approaches highlight the perceived importance and desire to blend Indigenous and Western ideologies of coaching to ensure Indigenous customs and traditions are considered when participating within a pre-dominantly Western conception of sport.

Indigenous pedagogies and online learning environments: a massive open online course case study

This study is based on a massive open online course titled Aboriginal Worldviews in Education, which was created and instructed using various Indigenous pedagogies. Despite significant pedagogical differences between massive open online course and Indigenous pedagogical learning environments, this study builds the case that various Indigenous pedagogies can effectively be incorporated in a massive open online course. The study found that holistic pedagogies were effectively applied by centering course creation and instruction around Medicine Wheel teachings. The article details the various experiential and self-reflective activities that were applied to the massive open online course, and that were found to effectively address the spiritual, emotional, and physical quadrants of the Medicine Wheel that are normally overlooked in courses that stress intellectual learning. The article also suggests directions for the development and redevelopment of massive open online courses to better include Indigenous pedagogies.

Understanding Social Determinants of First Nations Health Using a Four-Domain Model of Health and Wellness Based on the Medicine Wheel: Findings from a Community Survey in One First Nation.

We examined the explanatory roles of social determinants of health (SDOH) for First Nations people using a four-domain model of health and wellness based on the Medicine Wheel (i.e., physical, mental, emotional, and spiritual health), including colonial-linked stressors (i.e., historical trauma, childhood adversities, racial discrimination) and cultural resilience factors (i.e., cultural strengths, traditional healing practices, social support). Data were collected in partnership with a First Nation in Ontario, Canada in 2013 through a community survey (n = 194). For each outcome (physical, mental, emotional, and spiritual health), a modified Poisson regression model estimated prevalence ratios for the SDOH, adjusting for age, sex, education, and marital status. Negative associations were found for historical trauma with physical, mental, emotional, and spiritual health; for childhood adversities with mental health; and for racial discrimination with physical, mental, and emotional health. Positive associations were found for cultural strengths with physical, mental, and emotional health and for social support with physical, mental, emotional, and spiritual health. We observed negative associations between use of traditional healing practices and mental and emotional health. Our findings suggest that these SDOH may play important roles in relation to wellness through associations with the domains of health modelled by the Medicine Wheel.

Holistic Health of Two Spirit People in Canada: A Call for Nursing Action.

Purpose: In response to item 7.1 from the Missing and Murdered Indigenous Women and Girls Report (2019), calling on health service providers to recognize the importance in inclusive services with and for Indigenous peoples including Two Spirit, lesbian, bisexual, transgender, queer, questioning, intersex, and asexual (2SLGBTQQIA) peoples, we undertook a review of the literature to identify the gaps in understanding and to better situate the health and resiliencies of Two Spirit people in Canada. Method: We conducted a review of 13 articles related to the health and wellness of the Canadian Two Spirit community. Overall, there was a dearth of Two Spirit specific health-related information. Results: Identified themes were grounded in the holistic Medicine Wheel teachings. These themes directly parallel holistic nursing in their demonstration that health is complex, and that there are many facets that make up an individuals' health. Conclusion: Assessing the impact that colonization has had on the intersections of gender, race, sexuality, class, culture, and spirituality, Two Spirit people face unique health concerns. Considering the intersections of identity and structural barriers in place for this community, more research led by and in collaboration with the Two Spirit community is needed.

Kincentricity and Indigenous Wellbeing

This manuscript explores the rhetorical coupling of food as a holistic health initiative across two Indigenous organizations—Indian Health Services (IHS) and the American Indian Cancer Foundation (AICF). Drawing upon contemporary literatures of rhetorical ecologies, I position “kincentricity” (Salmón, 2000, 2012) as a particularly provocative framework to reconceptualize the body as its own rhetorical ecosystem, contending that Indigenous dimensions of RHM offer radically creative ways to decolonize the body/body politic. My analysis demonstrates theways in which IHS and AICF engage in kincentric logics to repurpose rhetorics of food within the Native medicine wheel, most notably by emphasizing (1) pre-Columbian diets, (2) traditional harvesting and cooking methods, and (3) spiritual food-based rituals—all of which explicitly link tribal food(ways) to bodily wellbeing. Finally, this essay encourages RHM scholars to reorient rhetorical vocabularies and understandings toward more pluralistic and non-Western accounts of health, medicine, and collective wellness.

“Land is everything, land is us”: Exploring the connections between climate change, land, and health in Fort William First Nation

The myriad and cumulative impacts of climate change on land, communities, and health are increasingly evident worldwide. Throughout 2019 and 2020, Fort William First Nation and researchers at Lakehead University conducted a project to document and understand connections among climate change, land, and health from the perspective of Elders, knowledge keepers, and community members with close ties to the land. Fort William First Nation is an Anishinaabe community located on the shores of Lake Superior/Kitchigami in Northern Ontario and within Robinson-Superior Treaty territory. This paper describes the analysis of interviews with 22 community members. Two-Eyed Seeing, an approach that centers the working together of Indigenous and non-Indigenous knowledges and peoples and demands respectful relationship building, guided our project and analysis. Our analysis identified five themes: 1) observations and experiences of changes on the land, 2) lack of care and respect for Mother Earth as the root cause of climate change, 3) healthy land, healthy people, 4) youth and future generations, and 5) (re-)connecting with land and culture. 'All our Relations' is a thread woven across these themes emphasizing that climate change is understood and experienced through relationships and relationality. As concluding thoughts and reflections, we share three specific offerings of particular relevance to those engaging in climate change and health research and action with Indigenous peoples and communities. First, this research has highlighted the importance of explicitly centering land when exploring the links between climate change and health. Second, we reflect on the value of both the Two-Eyed Seeing approach and the Medicine Wheel in guiding climate change and health research. Third, we argue for an explicit focus on relationships and relationality in efforts aimed at understanding and addressing climate change.

Teaching for truth: engaging with difficult knowledge to advance reconciliation

ABSTRACT As a settler colonial state, Canada has used education to advance colonialism in an effort to erase the experiences of Indigenous peoples. Today, education has a critical role to play in advancing the truth of our shared history just as it has played a role in enacting colonial practices and violence on Indigenous peoples. This action research project considers the practices of truth and reconciliation education in Canadian high school classrooms and reveals the need for white settler teachers to engage unrelentingly with difficult knowledge as they encounter and respond to settler colonialism. The research revealed that truth and reconciliation efforts must reaffirm the presence and value of Indigenous peoples, experiences, and epistemologies through the creation of intentional learning opportunities to disrupt colonialism. Notably, this research demonstrates the need for holistic pedagogical approaches as described through the teachings of the medicine wheel and its spiritual, physical, emotional, and mental domains.

Building Bridges for Indigenous Children's Health: Community Needs Assessment Through Talking Circle Methodology.

ObjectiveThe Stollery Children’s Hospital in Edmonton, Alberta, introduced the Stollery Awasisak team to provide targeted support to Indigenous families and their children. Talking Circles were conducted across northern communities from 2017 to 2019 to better understand how Indigenous people perceive the current state of healthcare services delivered by the Stollery Hospital.MethodsThe 2019 Talking Circles were held in six cities: Grande Prairie, Slave Lake, High Level, Fort McMurray, Edmonton, and Cold Lake, which were the biggest circles held to date with an attendance of 160 participants. Participants included members of Treaties 6 and 8, and Metis Nations of Alberta, as well as healthcare professionals in those regions.ResultsTalking Circles identified challenges Indigenous (First Nation, Inuit and Metis) pediatric patients and their families experienced from accessing care to transitioning home to exploring their positive experiences with the Stollery Hospital and other frontline collaborates. Through these circles guided by Elders in ceremonies, priorities and recommendations were made to help support pediatric patients and their families.ConclusionMultiple perspectives provided rich data on how best to adhere to the Truth Reconciliation of Canada 19th mandate and ensure equitable healthcare access to all Indigenous children. Together, leaders, healthcare providers, service providers and community members reflected on the lessons of the Medicine Wheel quadrants and the Seven Sacred Teachings, and brought forward four priorities; capacity building, continuity of care, culturally responsive care and increased communication.

Empowering Indigenous Communities Through a Participatory, Culturally Responsive Evaluation of a Federal Program for Older Americans.

This article describes our experience of conducting a 5-year, culturally responsive evaluation of a federal program with Indigenous communities. It describes how we adapted tenets from "participatory evaluation models" to ensure cultural relevance and empowerment. We provide recommendations for evaluators engaged in similar efforts. The evaluation included stakeholder engagement through a Steering Committee and an Evaluation Working Group in designing and implementing the evaluation. That engagement facilitated attention to Indigenous cultural values in developing a program logic model and medicine wheel and in gathering local perspectives through storytelling to facilitate understanding of community traditions. Our ongoing assessment of program grantees' needs shaped our approach to evaluation capacity building and development of a diverse array of experiential learning opportunities and user-friendly tools and resources. We present practical strategies from lessons learned during the evaluation design and implementation phases of our project that might be useful for other evaluators.

A Framework for the Adaptation of Positive Psychological Interventions to North American Indigenous Populations.

Positive psychology research has led to the development of brief interventions designed to promote positive emotions: positive psychological interventions (PPIs). Randomized controlled trials examining PPIs have found them to be effective in increasing well-being and decreasing depressive symptoms. PPIs have been studied in samples consisting primarily of White Americans; however, PPIs may be useful for members of North American Indigenous groups. PPIs align well with Indigenous views on health, which tend to be strengths-based, holistic, and encompassing the whole body (including the medicine wheel's four dimensions of spirit, mind, heart, and body). This paper provides a framework for the adaptation of PPIs for Indigenous communities and a review of preliminary data on the relationships between positive psychological characteristics and health outcomes including substance use. Implications include the potential widespread impact of culturally adapted PPIs given their alignment with Indigenous thoughts on health and relative ease of administration.

Digital Storytelling as a Patient Engagement and Research Approach With First Nations Women: How the Medicine Wheel Guided Our Debwewin Journey.

When research is conducted from a Western paradigm alone, the findings and resultant policies often ignore Indigenous peoples’ health practices and fail to align with their health care priorities. There is a need for decolonized approaches within qualitative health research to collaboratively identify intersecting reasons behind troubling health inequities and to integrate Indigenous knowledge into current health care services. We engaged with First Nations women to explore to what extent digital storytelling could be a feasible, acceptable, and meaningful research method to inform culturally safe health care services. This novel approach created a culturally safe and ethical space for authentic patient engagement. Our conversations were profound and provided deep insights into First Nations women’s experiences with breast cancer and guidance for our future qualitative study. We found that the digital storytelling workshop facilitated a Debwewin journey, which is an ancient Anishinabe way of knowing that connects one’s heart knowledge and mind knowledge.