Teaching Indigenous health within an anti-racist, anti-colonial pedagogical framework: using Indigenous resurgence to explore the experiences of medical school instructors

Abstract

Anti-Indigenous racism in Canada creates numerous barriers that restrict access to safe, effective, and timely health care for Indigenous people. In the wake of the Truth and Reconciliation Commission of Canada (TRC) and growing reports of anti-Indigenous racism in the health care system, medical schools have been tasked with changing how they prepare students to work with Indigenous communities. Using a critical approach to teaching that seeks to transform systems of colonial-based oppression is relatively new in Canadian medical education, and how medical educators navigate this terrain remains largely unexamined. The central purpose of this qualitative study was to explore and uncover the relational aspects of teaching Indigenous health issues using an anti-racist and anti-colonial approach. Using an emerging framework informed by Indigenous resurgence, the stories of the medical educators were considered in relation to the evolving social discourse concerning Indigenous-settler relations in Canada. Knowledge was gathered using a combination of Kovach’s (2010) conversational method, which is grounded in an Indigenous worldview that aligns with my nêhiyawak identity, and a mobile research approach called guided walks. The gathered knowledge was translated into condensed stories which were further analyzed to identify a set of meta-stories that recovered key lessons and knowledge shared by the educators. In sharing their stories, medical educators situated themselves and their work within the relational dynamics of settler colonial society. While their work was at times met with resistance, the educators found ways to address the challenges that included self-reflective learning and peer mentoring. The entrenched Western ideologies in medicine continue to act as a formidable barrier to transforming medical learners’ perspectives about the lived realities of Indigenous peoples’ ongoing colonial oppression. However, the stories in this study as viewed through the lens of Indigenous resurgence reveal that facilitating discussions that provoke critical dialogue on issues of colonialism can create movement forward in a way that is safe, respectful, and potentially transformative for all concerned. The lessons identified could inform the work currently underway to meet the TRC’s call to implement a mandatory anti-racist Indigenous health course in all Canadian medical schools.