Indigenous strengths-based approaches to healthcare and health professions education – Recognising the value of Elders’ teachings

Abstract

Background A strengths-based lens is essential for the pursuit of health equity among Indigenous populations. However, health professionals are often taught and supported in practice via deficit-based approaches that perpetuate inequity for Indigenous peoples. Deficit narratives in healthcare and health education are reproduced through practices and policies that ignore Indigenous strengths, disregard human rights, and reproduce structural inequalities. When strengths are recognised it is possible to build capacities and address challenges, while not losing sight of the structural factors impacting Indigenous peoples’ health. Objective In this paper, we examine Indigenous strengths-based approaches to policy and practice in healthcare and health professions education when delivered alongside teachings shared by Elders from the Cree, Blackfoot and Métis Nations of Alberta, Canada. Method Literature and Elders’ teaching were used to shift strengths-based approaches from Western descriptions of what might be done, to concrete actions aligned with Indigenous ways. Results Four pointers for future action adopting a strengths-based approach are identified: enacting gifts – focusing on positive attributes; upholding relationality – centring good relationships; honouring legacy – restoring self-determination; and reconciling truth – attending to structural determinants of health. Conclusion Identified directions and actionable strategies offer a promising means to advance Indigenous health equity through strengths-based actions that change existing narratives and advance health equity.

Indigenous gender and wellness: a scoping review of Canadian research

“…Accordingly, our review highlights the need for health researchers to centre Indigenous strengths and assets. Although challenges and deficits undoubtedly exist, there is a need to present a balanced picture of both limitations and strengths in order to avoid contributing to the deficit-based narrative that has typically characterised Indigenous health research [ 45 ].…”

Patient complexity assessment tools containing inquiry domains important for Indigenous patient care: A scoping review

“…PCATs for Indigenous patients should identify how social injustices rooted in a colonial legacy have shaped the health outcomes of Indigenous peoples while not hyper-focusing on where deficiencies exist but rather recognizing the resilience and strengths of Indigenous peoples [ 78 , 80 ]. By incorporating an assessment of resilience and protective factors that prevent complexity, a PCAT for Indigenous patients may provide an avenue for HCPs to recognize the rich legacy of Indigenous strengths, work alongside the patient to advance Indigenous health equity, and acknowledge the dominance of Western health models [ 81 ].…”

Meeting Together in a Good Way: A Discussion on the Educational Mapping Activity of Indigenous Content in a Nurse Practitioner Program

“…Knowing the centrality of Elders and knowledge keepers within the Action Calls where healing and medicinal traditions are prioritized, a strengths-based approach related to health professions education was selected (Kennedy et al 2022). This may be a challenge for health care practitioners who tend to rely more on statistics with respect to disease, an approach that focuses on dysfunction and illness (Allan & Smylie, 2015).…”

“…This may be a challenge for health care practitioners who tend to rely more on statistics with respect to disease, an approach that focuses on dysfunction and illness (Allan & Smylie, 2015). Involving Elders shifts this perspective to a strengths-based perspective where one's being and ancestry is consistent with pride in identity, healthful living in spiritual harmony and balance with the land (Allan & Smylie, 2015, Kyoon-Achan et al, 2018Kennedy et al, 2022).…”

“…Elders, Indigenous faculty, and students as well as faculty and students who have a vested interest in allyship (Bourke, 2020;Nixon, 2019) and improving health through cultural humility and safety are imperative to the overall process. In addition, involving Elders to foster learning of traditional protocols and Indigenous ways of being and knowing is to be prioritized (Kennedy et al, 2022). Elders need to be compensated generously for the time they invest.…”