Aboriginal Health Consumers Experiences of an Aboriginal Health Curriculum Framework

Abstract

Introduction In settler colonised countries medical education is situated in colonist informed health systems. This form of colonisation is characterised by overt racism and contributes to the significant health inequities experienced by Indigenous peoples. Not surprisingly, medical accreditation bodies in these countries have mandated the curriculum include content relating to Indigenous peoples. However, what is absent is the Indigenous health consumer worldview of health care and their nuanced lived experience of the delivery of medical care. Methods Yarning methods, integral to Aboriginal peoples’ ways of understanding and learning, were utilised. A Yarning guide was constructed with Social Yarn and Research Topic Yarn questions to understand Aboriginal health consumer experiences of the five learning domains within the Aboriginal and Torres Strait Islander Health Curriculum Framework. Data were analysed using Framework Analysis. Results Seventeen Aboriginal adults from urban and rural areas participated in the Yarns during 2018 and 2019. Coding and mapping data identified medical practitioner enacting practices that either perpetuated racism and the settler colonial ideology or facilitated anti-racist health care. Unwanted care included three racism themes described as the practitioner perpetuating and being unresponsive to racism; assimilation and an inability to consider impacts of settler colonialism. Desired care included four anti-racist themes expressed as responsiveness to racism and settler colonialism; advocating within the settler colonial health system; engaging with diversity of Aboriginal ways of knowing, being and doing and lifelong learning and reflection. Conclusion Medical practitioners are promoting ill health through racist practices with Aboriginal health consumers. Aboriginal people’s experiences of racism via continued settler colonial processes and anti-racism in the Australian health system, are critical to meaningful curricula. However, there is a risk for tokenism if the academy continues its coloniality by privileging the biomedical model of illness and health over other models of health.