Six ways to get a grip on teaching medical trainees on the convergence of Indigenous knowledges and biomedicine, within a culturally-safe Indigenous health curriculum

Abstract

As Indigenous knowledges and biomedicine come together in healthcare today, to improve health outcomes and strengthen cultural identity among Indigenous Peoples, it is vital for physicians to learn about this convergence during their training. This narrative review article aims to provide practical advice for educators when implementing teaching regarding this topic, using examples from the research literature, and pedagogical and practice-based methods used at the University of Toronto (UofT). The methodology on obtaining the research literature included a search of a computer database called Medline. Moreover, the medical school curriculum information specific to UofT, was obtained through the formal curriculum map and UofT’s Office of Indigenous Medical Education. The following six recommendations provide a way to successfully implement the teachings on Indigenous knowledges and biomedicine, within a culturally-safe Indigenous health curriculum.

Recreating the future—Indigenous research paradigms in health professional education research

“…19 Indigenous knowledge systems have existed for thousands of years and include conceptualisations of health and healing practices. 20 While there is great diversity within and between Indigenous populations across the globe, there are shared ontological approaches to Indigenous ways of knowing and being that centre relationships, interconnectedness with non-human beings and the land and connection to ancestors and spirituality. 7 In Australia, the seven domains of spirit, spirituality, ancestors; country and land; body and behaviours; mind and emotions; family and kinship; community; and culture underpin self-hood and experiences of health and well-being for First Nations peoples.…”

“…Another effective clinical practice example is the co-location of Indigenous knowledges and culture alongside biomedical approaches to improve health outcomes and strengthen the cultural identity of Indigenous peoples. 10,20 The successful co-location of Indigenous culture into health care delivery is evident in Indigenous primary health care services. 38 In these practices, service delivery is underpinned by Indigenous cultural values, customs, beliefs and traditional healing approaches 38 that address health needs at the individual, family and community level.…”

“…44 Sayal and colleagues favour the notion of 'wise practice' over 'best practice' as this approach considers the diversity of Indigenous peoples, removes hierarchical approaches to knowledge, and advocates against the translocation of one research approach into a different setting without local community consultation. 20 Wise practices represent the congruence of lived experiences that are resilient, adaptive and characterised by dynamic learning processes. 48 Such practices contrast with reductionist western concepts of science that value reproducibility, encourage structural sameness and discourage deviation from pre-determined norms.…”

“…Diverse ontological perspectives are urgently needed for future approaches in research, as the oppression of different ways of seeing reality can suppress alternative solutions and approaches 19 . Indigenous knowledge systems have existed for thousands of years and include conceptualisations of health and healing practices 20 . While there is great diversity within and between Indigenous populations across the globe, there are shared ontological approaches to Indigenous ways of knowing and being that centre relationships, interconnectedness with non‐human beings and the land and connection to ancestors and spirituality 7 .…”

Five ways to get a grip on the need to include clinical placements in Indigenous settings

“…For example, some leaders of Indigenous communities encourage working towards cultural humility over competency, as it is likely more pragmatic and attainable. 29 Cultural humility involves ongoing reflection and critique of individual biases and perceptions. 31 Placements in Indigenous settings could provide students with a deeper understanding of Indigenous values and beliefs, as well their own attitudes and orientation towards cultures outside their own.…”