Understanding Perceptions of Non-Indigenous Medical Educators’ Professional Competency for the Integration and Delivery of Indigenous Health Curriculum in Medicine

Abstract

The Canadian medical education system is to increase curricula on Indigenous health as outlined in the Truth and Reconciliation Commission’s (TRC) Call to Action #24; medical schools need instructors with cultural competency. As most instructors are non-Indigenous Medical Educators (NIMEs), medical educators urgently need to understand what it means to be culturally competent within Indigenous health and engage with the TRC Calls to Action #24, which states: “We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues... This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism (TRC, 2015, 3).” This research examines what constitutes competency in teaching Indigenous health curricula in medical education. Using critical race theory for analysis, three areas are explored: 1. understanding competency; 2. the role of Indigenous health in medicine; and 3. educator and learner perspectives. One-to-one interviews were conducted with Indigenous learners and medical educators, frontline non-Indigenous medical educators and senior leadership from across Canada’s medical schools. The data allowed for a robust understanding of what competency to teach Indigenous health means when the participants in systems of Indigenous health curricula share their views on NIMEs and account for how Indigenous and Western knowledge often difer in conceptualization and expression. The analysis provided recommendations for NIME training and a snapshot of NIME professional competencies from their perspectives and those of people receiving their teaching. From this research, an initial framework of ethical standards for the teaching of Indigenous health was developed. This framework can be instrumental in developing territorial-based standards between medical schools and local Indigenous communities in which medical schools are situated. It can also support medicine’s regulatory, policy, and academic bodies of medicine in addressing the TRC Call to Action #24.