Participant-reported effect of an Indigenous health continuing professional development initiative for specialists

Abstract

Background Health outcomes of Indigenous patients are impacted by culturally unsafe specialty care environments. The ‘Educating for Equity (E4E)’ program is a continuing professional development (CPD) intervention which incorporates skill-based teaching to improve Indigenous patient experiences and outcomes in healthcare interactions. Methods The E4E program was delivered to rheumatologists in two phases, each delivered as experiential learning workshops where participants engaged with and applied course content within an interactive format focusing on real-time feedback. The phase 1 workshop focused on skill development of E4E Framework concepts and principles. Phase 2 concentrated on building capacity for teaching of E4E content. Evaluation of the program’s effectiveness was through longitudinal responses to the Social Cultural Confidence in Care Survey (SCCCS), self-reported strategies employed to address social issues and improve therapeutic relationships, engagement with teaching others, and satisfaction with the program. Results Two cohorts of participants have participated in the program (n = 24 Phase 1, n = 10 Phase 2). For participants completing both phases of training, statistically significant improvements were observed in exploring social factors with patients, gaining knowledge and skills related to cultural aspects of care, improved communication and relationship building, and reflections on held stereotypes. Strategies to address social issues and build therapeutic relationships remained consistent throughout participation, while the training enhanced exploration and confidence to ask about cultural and traditional practices, and stronger communication strategies for exploring beliefs, expectations, social barriers, and residential school impacts on health. Participants reported feeling prepared to teach Indigenous health concepts to others and subsequently lead teaching with residents, fellows, and allied health professionals. Satisfaction with the delivery and content of the workshops was high, and participants valued interactions with peers in learning. Conclusions This CPD intervention had a beneficial impact on self-reported confidence and enhanced practice strategies to engage with Indigenous patients.

The First Nations experience of accessing rheumatology services in a metropolitan hospital: A qualitative study

“…33 Developing these skills requires clinician upskilling through educational programs run by First Nations peoples which have been delivered in Canadian settings and more recently Australia. 34,35 In Australia, there is evidence that 'yarning' is a helpful strategy for health professionals to reduce communication barriers with First Nations Peoples. 36,37 Participants suggested that culturally appropriate educational resources, including pamphlets and infographics, could also help bridge communication.…”

“…There has been increased emphasis placed on the cultural safety of health professionals ensuring they have the necessary communication skills to practice culturally‐safe care 33 . Developing these skills requires clinician upskilling through educational programs run by First Nations peoples which have been delivered in Canadian settings and more recently Australia 34,35 . In Australia, there is evidence that ‘yarning’ is a helpful strategy for health professionals to reduce communication barriers with First Nations Peoples 36,37 …”

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

“…Developed to improve HCP communication and clinical approaches when providing care to Indigenous persons with diabetes [ 11 ], the ‘Educating for Equity’ or ‘E4E’ framework outlines Indigenous-specific determinants of care. The E4E framework includes a comprehensive assessment of the social realities that contextualize an individual’s capacity to cope with their condition and has since been applied to arthritis care providers’ continuing medical education [ 17 ]. These realities include social and economic resource disparities, and the accumulation of adverse life experiences [ 11 ].…”

“…In the E4E Framework, facilitators are also recognized. “Culture framing knowledge” refers to knowledge contextualization and exchange in a manner that is effective in building a shared understanding with the patient [ 11 , 17 ]. Finally, recognizing “culture as therapeutic” is acknowledging that health is positively correlated with a secure cultural identity while having access to cultural resources, including traditional healing practices and medicine for Indigenous peoples [ 11 ].…”

Professional Development in Health Sciences: Scoping Review on Equity, Diversity, Inclusion, Indigeneity, and Accessibility Interventions

“…Previous literature has demonstrated that interactions with the health care system may be unsafe and emotionally difficult for health care workers and patients who belong to underrepresented and historically oppressed groups. [2][3][4][5] For example, an integrative review on the experiences of Black nursing students found that experiences of seclusion and prejudice were consistent across all institutions reviewed. 6 Critically, marginalized and historically oppressed populations are disproportionately affected by social determinants of health as patients.…”