File of Uncertainties: Exploring student experience of applying decolonizing knowledge in practice

Abstract

It is critical that nurse education programs in Canada respond to the Truth and Reconciliation Commission’s call to develop a course about the documented impacts of Indigenous-specific racism on the health outcomes of Indigenous people. Initiatives such as San’yas Anti-racism Indigenous Cultural Safety Education, courses on trauma-informed care, and required Indigenous health and history classes in nursing programs are providing a solid beginning. However, the effectiveness of this education requires interrogation. The assumption that education results in changes in nursing practice behavior or uptake of critical knowledge may not be completely accurate in complex environments. To this end, this mixed methods study aimed to explore nursing student experience with incorporating decolonizing and antiracist knowledge into nursing practice with Indigenous patients/clients. Fourth-year baccalaureate program nursing students at a Canadian university who had completed a core course on the impacts of colonization and Indigenous-specific racism on Indigenous health in Canada were surveyed regarding their experience of applying this knowledge during their clinical rotations. Sixteen participants responded to an anonymous online survey consisting of three short-answer open-ended questions and six Likert-style questions about their experiences. The emergent narrative themes and Likert-scale data indicate that although the students valued the information provided in the class, they continued to experience some uncertainty when caring for Indigenous clients. Prominent areas of uncertainty included applying knowledge to practice, student confidence in disrupting racist treatment of Indigenous patients by their healthcare colleagues, and knowing how to approach sensitive client situations to avoid re-traumatization. This article discusses these student responses and implications for nursing education and future research.