This article delineates specific issues relating to health literacy for Indigenous Australians. Drawing on the extensive experience of the authors' work with Yolnu people (of north-east Arnhem Land) and using one model for health literacy described in the international literature, various components of health literacy are explored, including fundamental literacy, scientific literacy, community literacy and cultural literacy. By matching these components to the characteristics of Yolnu people, the authors argue that language and worldview form an integral part of health education methodology when working with Indigenous people whose first language is not English and who do not have a biomedical worldview in their history. Only through acknowledging and actively engaging with these characteristics of Indigenous people can all aspects of health literacy be addressed and health empowerment be attained.
Introduction: General practitioners (GPs) and family medicine clinicians should respond to Indigenous peoples' health needs. However, medical graduates feel underprepared for this work. The foundational elements of racism, white privilege and cultural self-reflexivity remain conspicuously absent from medical education in general practice programmes, despite inclusion in curriculum frameworks. This study explored the perception and experiences of Australian GP educators in teaching this content. Methods: We undertook a qualitative study that gathered data through semi-structured interviews with GP educators (n = 12) at a medical school in Victoria, Australia. We utilised the Reflection learning domain of the Aboriginal and Torres Strait Islander Health Curriculum Framework to shape interview questions on racism, white privilege and cultural self-reflexivity. Data were analysed from constructivist and Critical Indigenous Theory paradigms to formulate key themes. Results: General practitioner educators were challenged by Reflection content, struggled to articulate a refined pedagogy for provision of anti-racist, self-reflexive learning and felt poorly qualified to teach Indigenous health, articulating preference for delegation of teaching to Indigenous peoples. They simultaneously stated the importance of inclusion of Reflection teaching in general practice, alongside expressing beliefs that appeared to devalue its perceived relevance. Students were perceived as being either disinterested or incapable of Reflection learning, or conversely, more engaged than previous generations with these topics. Discussion: The results call into question how skilled are GP educators to teach elements of Indigenous health education such as racism, white privilege and cultural self-reflexivity. Unskilled educators can reinforce colonialism in curricula, including through minimisation of content. Stronger anti-racist pedagogy is urgently required in medical education. Vital to this is active research on educator preparedness, evidence-based teaching models and accountable curriculum accreditation.
In this latest contribution to the 'When I say … ' series, Vass and Adams explore the pervasive impact of colonisation as an under-recognised and poorly addressed context of medical education.Reflecting on the term 'situation' in the context of Medical Education's 'State of the Science' issue we are less inclined to worry about the definition of the term 'situation' and more inclined to worry about how the state of our field is defined by its situation. In settler-colonial countries, such as Australia, New Zealand, Canada, and the United States, it is self-evident that the 'situation' of medical educa-
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