Implementation and impact of indigenous health curricula: a systematic review

Abstract

Systemic barriers acting on and within educational networks have limited the developmental capacity of indigenous health curricula, supported and sustained hidden curricula, and led to insufficient institutional investment to support a comprehensive curriculum. Future research in health professional education should explore these political and network intermediaries acting on cultural competence curricula and how they can be overcome to achieve cultural competency learning outcomes.

Two‐eyed seeing: A useful gaze in Indigenous medical education research

“…Medical curricula can be delivered formally through stated learning objectives and scheduled activities, informally with unscheduled, unplanned conversations and interactions, or in a hidden manner, under the influence of institutional norms, policies and morals, which themselves are ever‐changing. The maintenance of a colonial agenda is an identified limitation to the effective implementation of Indigenous medical education and can be found with the reinforcement of negative stereotypes and blaming of individual choices rather than a critique of the ongoing impacts of colonisation . This agenda often exists within the bounds of the hidden curriculum and potentially influences curriculum acceptability and learner knowledge.…”

“…The maintenance of a colonial agenda is an identified limitation to the effective implementation of Indigenous medical education and can be found with the reinforcement of negative stereotypes and blaming of individual choices rather than a critique of the ongoing impacts of colonisation . This agenda often exists within the bounds of the hidden curriculum and potentially influences curriculum acceptability and learner knowledge.…”

“…9 This can impact the safety of incorporating Indigenous perspectives into research as previous applications of two-eyed seeing have required researchers to challenge Western concepts of time and research timeframes in addition to advocating for resources that maximise Indigenous contributions to knowing. 8 As some Indigenous health curricula rely solely on the goodwill of Indigenous communities, 48 the appropriate resourcing of research and education activities would enable more effective and safer knowledge translation. 48 Successful implementation of two-eyed seeing requires a critically conscious and reflexive research team as transparency around individual positioning provides a lens through which we can better understand our responsibilities and how we relate to others and our research practices.…”

“…8 As some Indigenous health curricula rely solely on the goodwill of Indigenous communities, 48 the appropriate resourcing of research and education activities would enable more effective and safer knowledge translation. 48 Successful implementation of two-eyed seeing requires a critically conscious and reflexive research team as transparency around individual positioning provides a lens through which we can better understand our responsibilities and how we relate to others and our research practices. 49 Such a skill, of being able to critically reflect on one's own positioning, is essential in all facets of Indigenous health practice, 50 but it has its origin in the praxis of medical educators themselves, with reference to both their educative and research roles.…”

Developing Graduate Medical Education Partnerships in American Indian/Alaska Native Communities

“…However, to our knowledge, formal GME curricula for rotations in AI/AN communities in the United States have not been published. 14,15 In this article, we describe 4 topics useful in directing the development of GME curricula in partnership with rural AI/AN communities, and discuss the unique relevance of each topic in the context of AI/ AN health. The topics are intended to align with international consensus recommendations for health equity education in Indigenous populations and with Accreditation Council for Graduate Medical Education Clinical Learning Environment Review Program objectives to improve health disparity education for trainees.…”