Abstracts
Abstract
Background: In response to the Truth and Reconciliation Commission of Canada Calls to Action 22 to 24 around health, the Department of Family Medicine at the University of Calgary piloted a novel Indigenous Health Longitudinal Elective (IHLE) to give first year residents longitudinal experiences in Indigenous healthcare environments. The purpose of this evaluation was to capture the successful qualities and identify areas for improvements to ensure feasibility of the IHLE pilot program.
Methods: Between November 2022 and April 2023, semi-structured interviews were completed with seven participants of the IHLE and included a mix of residents, preceptors, and clinic staff members. Qualitative thematic analysis was used to gain an in-depth understanding of the IHLE program experiences of all participants.
Results: Benefits of the IHLE program include a deeper understanding of the values and priorities critical to working in healthcare with Indigenous peoples in Southern Alberta. Areas for improvement include clarity around IHLE program structure; clearly defining roles and responsibilities for preceptors; increased opportunities for reciprocity and relationality; and a deeper self-reflection process.
Conclusion: Recommendations for future iterations of the IHLE include ensuring preceptors are trained and engaged, while providing residents more opportunities for relationality and peer debriefing. Results from this study may also help inform future Indigenous health programming in family medicine.
Résumé
Contexte : En réponse aux appels à l'action 22 à 24 de la Commission de vérité et de réconciliation du Canada concernant la santé, le département de médecine familiale de l'Université de Calgary a piloté un nouveau stage à option longitudinal en santé autochtone (SOLSA) afin de procurer aux résidents de première année des expériences longitudinales dans des environnements de soins de santé autochtones. L'objectif de cette évaluation était d'identifier les compétences atteintes et les points à améliorer pour assurer la faisabilité du programme pilote de SOLSA.
Méthodes : Entre novembre 2022 et avril 2023, des entretiens semi-structurés ont été menés avec sept participants au SOLSA, dont des résidents, des superviseurs et des membres du personnel clinique. Une analyse thématique qualitative a été utilisée pour comprendre en profondeur les expériences de tous les participants dans le cadre du programme de SOLSA.
Résultats : Les avantages du programme de SOLSA comprennent une meilleure compréhension des valeurs et des priorités essentielles pour travailler dans le domaine des soins de santé avec les populations autochtones dans le sud de l'Alberta. Les points à améliorer sont la clarté de la structure du programme de SOLSA, une définition claire des rôles et des responsabilités des superviseurs, une augmentation des possibilités de réciprocité et de relationnalité, et un processus d'auto-réflexion plus approfondi.
Conclusion : Les recommandations pour les versions ultérieures du SOLSA consistent à s'assurer que les superviseurs sont formés et mobilisés, tout en offrant aux résidents davantage d'occasions de relationnalité et de débreffage entre collègues. Les résultats de cette étude peuvent également aider à améliorer de futurs programmes sur la santé autochtone en médecine familiale.
Appendices
Bibliography
- Truth and Reconciliation Commission of Canada. Truth and Reconciliation Commission of Canada: Calls to Action. Winnipeg MB; 2015. Available from: https://ehprnh2mwo3.exactdn.com/wp-content/uploads/2021/01/Calls_to_Action_English2.pdf. [Accessed Sept 2, 2023].
- Anderson M, Crowshoe L, Linda M, et al. Joint commitment to action on Indigenous health as approved by the AFMC Board of Directors prepared by writing working group on behalf of the Indigenous Health Network. 2019. Available from: https://www.afmc.ca/wp-content/uploads/2022/10/AFMC_Position_Paper_JCAIH_EN.pdf. [Accessed Aug 30, 2023].
- Kitty D, Funnell S, eds. CanMEDS-FM Indigenous Health Supplement. The College of Family Physicians of Canada. Mississauga, ON; 2020. Available from https://www.cfpc.ca/CFPC/media/PDF/CanMEDS-IndigenousHS-ENG-web.pdf. [Accessed Sept 28, 2023].
- Rashid M, Nguyen J, Foulds JL, Dennett L, Cardinal, N, Forgie, SE. A scoping review of Indigenous health curricular content in graduate medical education. J Grad Med Educ. 2023;15(1):24–36. https://doi.org/10.4300/JGME-D-22-00180.1
- Clarke V, Braun V, Terry G, Hayfield N. Thematic analysis. Handbook of research methods in health and social sciences. In: P. Liamputtong, ed. 2019: 843-860.
- Pitama SG, Palmer SC, Huria T, Lacey C, Wilkinson, T. Implementation and impact of Indigenous health curricula: a systematic review. Med Educ. 2018;52(9):898–909. https://doi.org/10.1111/medu.13613
- Aggarwal, M, Abdelhalim, R. Are early career family physicians prepared for practice in Canada? A qualitative study. BMC Med Ed. 2023;23 (1): 370. https://doi.org/10.1186/s12909-023-04250-z
- Laine-Gossin J, DeKoven S, Bordman R. Making connections: exploring residents' perspectives on a virtual World Café as a novel approach for teaching Indigenous health issues. Can Med Educ J. 2022;13(2):92-95: https://doi.org/10.36834/cmej.73098
- Rame A, Kelly-Turner K, Roze des Ordons A, et al. Informing critical Indigenous health education through critical reflection: a qualitative consensus study. Health Educ J. 2023;82(5):569–582. https://doi.org/10.1177/00178969231174872
- Vogel L. Residency programs grapple with new Indigenous cultural safety training requirements. CMAJ. 2018;190(25):e778-e779. https://doi.org/10.1503/cmaj.109-5616
- Melro CM, Landry J, Matheson, K. A scoping review of frameworks utilized in the design and evaluation of courses in health professional programs to address the role of historical and ongoing colonialism in the health outcomes of Indigenous Peoples. Adv Health Sci Ed. 2023. https://doi.org/10.1007/s10459-023-10217-y
- Melro CM, Matheson K, Bombay. Beliefs around the causes of inequities and intergroup attitudes among health professional students before and after a course related to Indigenous Peoples and colonialism. BMC Med Ed. 2023;23(277):1-14. https://doi.org/10.1186/s12909-023-04248-7