Indigenous Elders and Academic Leaders' Perspectives on Training Residents to Work With Indigenous Populations: A Constructivist Grounded Theory Study

Abstract

Introduction

Indigenous populations continue to experience healthcare inequities due in large part to the ongoing impacts of colonization. A literature review revealed that postgraduate educational interventions can help reduce inequities, including cultural safety training and formal Indigenous training curricula for residents. However, it was noted that these interventions are not part of many training programmes, and the voices of Indigenous communities were often absent in the creation of cultural safety curricula. This study aimed to explore ways to improve postgraduate training and better prepare residents to care for Indigenous patients from the perspectives of Indigenous elders and academic leaders.

Methods

A constructivist grounded theory approach was employed to organize and interpret the data. Interviews employed conversational methods, including open-ended, semistructured interview questions, to facilitate conversation with the study participants. Theoretical sampling was used to recruit Indigenous elders (n = 4) and academic leaders (n = 16) across two provinces in Canada. Data were transcribed and subsequently entered as verbatim transcripts to facilitate data analysis.

Results

The analysis revealed the following themes with numerous subthemes: (1) Helping faculty on their journey of truth, reconciliation and unlearning; (2) leading by example and with humility; (3) compensation for Indigenous curriculum-related activities acknowledges the value of Indigenous colleagues; and (4) clinical practice is enriched by the integration of Indigenous approaches.

Discussion

Residency programmes should ensure that the necessary supports are available for faculty and academic leaders who aim to develop and implement Indigenous curricula. Providing resources to academic leaders is vital for the successful implementation of Indigenous curricula.