Informing critical indigenous health education through critical reflection: A qualitative consensus study

Objective: To examine experiences of anti-Indigenous racism in a Canadian medical school and inform the development of critical and action-oriented Indigenous health education necessary to pave the way for reconciliation within health systems. Design: A qualitative study conducted within a constructivist paradigm which involved (1) semi-structured interviews with students, faculty and staff at a Canadian medical school and (2) consensus-building/collaborative analytical sessions with an Indigenous advisory group and a non-Indigenous working group. Setting: Twenty-three semi-structured interviews were completed with students, staff and faculty working across a Canadian medical school. Results: Inductive coding generated 211 codes that were grouped into seven overarching thematic domains. By engaging in an iterative dialogue with the advisory and working groups, we deductively aligned the thematic analysis with faculty-level and institution-level Indigenous education strategies to ensure local relevance. Self-reflective statements were developed with the advisory group to guide areas for action and resulted in 18 statements with five-point Likert-type-style response options. Conclusion: The results of this study suggest that promoting self-reflexivity in health professional education can prompts educators to engage with Indigenous health curriculum and pedagogy; mentorship and role modelling; and accountability. Critically evaluating systemic injustices at an individual level enables educators to resist systemic oppression and create change in the spaces where they work.