A narrative inquiry into non‐Indigenous medical educators and leaders participation in reconcilatory work

Author:

Burm Sarah1ORCID,Dean Libby1,Alcock Danielle2,LaDonna Kori A.3ORCID,Watling Christopher J.4ORCID,Bishop Lisa1

Affiliation:

1. Continuing Professional Development and Medical Education, Faculty of Medicine Dalhousie University Halifax Nova Scotia Canada

2. Southwest Ontario Aboriginal Health Access Centre London Ontario Canada

3. Department of Innovation in Medical Education and Department of Medicine University of Ottawa Ottawa Ontario Canada

4. Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry Western University London Ontario Canada

Abstract

AbstractIntroductionGlobally, medical schools are operationalising policies and programming to address Indigenous health inequities. Although progress has been made, challenges persist. In Canada, where this research is conducted, Indigenous representation within medical schools remains low, leaving a small number of Indigenous advocates leading unprecedented levels of equity‐related work, often with insufficient resources. The change needed within medical education cannot fall solely on the shoulders of Indigenous Peoples; non‐Indigenous Peoples must also be involved. This work aims to better understand the pathways of those engaged in this work, with careful consideration given to the facilitators and barriers to ongoing engagement.MethodsData collection and analysis were informed by narrative inquiry, a methodology that relies on storytelling to uncover nuance and prompt reflection. In this paper, we focus on interview data collected from Canadian non‐Indigenous medical educators and leaders (n = 10). Participants represented different career stages, (early to late career) and occupied a mix of clinical, administrative and education roles.ResultsAlthough each participant's entry into reconciliatory work was unique, we identified common drivers actuating their engagement. Oftentimes their participation was tied to administrative work or propelled by experiences within their roles that forced them to confront the systemic inequalities borne by Indigenous Peoples in both academic and healthcare settings. Some admitted to struggling with understanding their appropriate role in Indigenous reconciliation; their participation often proceeded without firm support.ConclusionMedical schools have an obligation to ensure their faculty, including non‐Indigenous Peoples, are equipped to fulfil social accountability mandates regarding Indigenous health. Our findings generate a better understanding of the tensions inherent in this equity work. We urge others to reflect on their role in Indigenous reconciliation, or else medical schools risk generating a false sense of individual and institutional progress.

Funder

Royal College of Physicians and Surgeons of Canada

Publisher

Wiley

Reference52 articles.

1. Educating for Indigenous Health Equity

2. United Nations.United Nations declaration on the rights of indigenous peoples [Internet].2007. Available from:https://social.desa.un.org/sites/default/files/migrated/19/2018/11/UNDRIP_E_web.pdf

3. Health Canada.Social accountability—Health Canada Report: a vision for Canadian medical schools [Internet].2001. Available from:https://www.afmc.ca/wp-content/uploads/2022/10/sa_vision_canadian_medical_schools_en.pdf

4. Social Accountability Frameworks and Their Implications for Medical Education and Program Evaluation: A Narrative Review

5. Statistics Canada.First Nations people Métis and Inuit in Canada [Internet].2022. Available from:https://www150.statcan.gc.ca/n1/en/catalogue/11-627-M2022057

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