Abstract
Indigenous Peoples are underrepresented in many of the Health and Human Services Educational Programs (HHSEP, e.g.: Nursing, Social Work). As various studies have reported the benefits of diversifying HHSEP, the barriers and facilitators of increasing the number of Indigenous Peoples in these professions must be identified. The purpose of this exploratory study is to identify and understand the barriers and facilitators Indigenous Peoples face when entering, learning or working in HHSEP. A narrative approach was used in the facilitation of culturally safe sharing circles with Indigenous students and staff to collect perspectives based on their individual experiences in HHSEP. Inductive thematic analysis was used to identify emerging themes in participant experiences and the impact of those experiences on participation in learning and working at the university in these educational programs. Results from this exploratory study identified current academic structures and ideologies rooted in colonialism, that act as barriers for engagement and inclusion of Indigenous students, staff, and clinical and academic faculty. These findings shaped the main themes of this study including negotiation of identity in different spaces, negotiating colonial structures in HHSEP, and negotiating changes and transitions in HHSEP. We anticipate these preliminary results will act as a catalyst for uncovering further changes to be made regarding attitudes, procedures, and practices present in an academic environment that limit the inclusion of Indigenous Peoples in HHSEP.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ackerman-Barger, K., Bakerjian, D., & Latimore, D. (2015). How health professions educators can mitigate underrepresented students’ experiences of marginalization: Stereotype threat, internalized bias, and microaggressions. Journal of Best Practices in Health Professions Diversity, 8(2), 1060–1070
Asmar, C., & Page, S. (2018). Pigeonholed, peripheral or pioneering? findings from a national study of indigenous Australian academics in the disciplines. Studies in Higher Education, 43, 1679–1691
Battiste, M., Bell, L., & Findlay, L. M. (2002). Decolonizing education in Canadian universities: an interdisciplinary, international, Indigenous research project. Canadian Journal of Native Education, 26, 82–95
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101
Brodt, E., Empey, A., Mayinger, P., Miller, M. F., Frutos, R., Bruegl, A. … Carney, P. A. (2019). Shifting the tide: innovative strategies to develop an American Indian/Alaska Native Physician Workforce. Hawai’i journal of health & social welfare, 78(12 Suppl 3), 21
Bond, C., Brough, M., Willis, J., Stajic, J., Mukandi, B., Canuto, C. … Lewis, T. (2019). Beyond the pipeline: A critique of the discourse surrounding the development of an indigenous primary healthcare workforce in Australia. Australian Journal of Primary Health, 25(5), 389
Campbell, B. E. (2018). Educators must mind tone policing. School Library Journal, 64(9), 17
Carpenter, C., & Suto, M. (2008). Qualitative research for occupational and physical therapists: A practical guide. Oxford, UK; Ames, Iowa;: Blackwell Pub
Caxaj, C. S. (2015). Indigenous storytelling and participatory action research: Allies toward decolonization? Reflections from the Peoples’ International Health Tribunal. Global Qualitative Nursing Research, 1–12
Coulthard, G. (2014). Red skin, white masks: rejecting the colonial politics of recognition. Minneapolis: University of Minnesota Press
Davis, A. L. (2018). Experiences of underrepresented minority students in health professions programs, and their journeys to the programs. Available from ProQuest Dissertations & Theses Full Text: The Humanities and Social Sciences Collection. Retrieved from https://search.proquest.com/docview/2085948236
Erasmus, G., & Dussault, R. (1996). Report of the Royal Commission on Aboriginal Peoples. The Royal Commission on Aboriginal Peoples
Gaudry, A., & Lorenz, D. (2018). Indigenization as inclusion, reconciliation, and decolonization: Navigating the different visions for indigenizing the Canadian academy. AlterNative:. An International Journal of Indigenous Peoples, 14(3), 218–227
Herrera, M. D. (2011). Red earth, brown earth: Walking in two worlds, the journey of indigenous women in academia (Order No. 3481819). Available from ProQuest Dissertations & Theses Global. (907247154). Retrieved from http://ezproxy.library.ubc.ca/login?url=https://search-proquest-com.ezproxy.library.ubc.ca/docview/907247154?accountid=14656
Karani, R., Varpio, L., May, W., Horsley, T., Chenault, J., Miller, K. H., & O’Brien, B. (2017). Commentary: racism and bias in health professions education: how educators, faculty developers, and researchers can make a difference. Academic Medicine, 92(11S), S1–S6
Kovach, M. (2021). Indigenous methodologies: Characteristics, conversations, and contexts. University of Toronto press
Matthews, R. (2017). The cultural erosion of Indigenous people in health care. CMAJ, 189(2), E78–E79
Mayeda, D. T., Keil, M., Dutton, H. D., & Ofamo’Oni, I. F. H. (2014). “You’ve Gotta Set a Precedent”: Māori and Pacific voices on student success in higher education. AlterNative: An International Journal of Indigenous Peoples, 10(2), 165–179
Marmot, M., & Allen, J. (2014). Social determinants of health equity. American Journal of Public Health, 104(S4), S517–S519. doi:https://doi.org/10.2015/AJPH.2014.302200
Oliver, R., Rochecouste, J., Bennell, D., Anderson, R., Cooper, I., Forrest, S., & Exell, M. (2013). Understanding Australian Aboriginal Tertiary Student Needs. International Journal of Higher Education, 2(4), 52–64
Prescod-Weinstein, C. (2019, December 5). Tone Policing & the Sound of Equality in STEM [blog post]. Retrieved from https://medium.com/@chanda/tone-policing-the-sound-of-cries-for-equality-in-stem-312e5a9d34f8/
Roberts, D. (2011). Fatal invention: How science, politics, and big business re-create race in the twenty-first century. New Press/ORIM
Rodríguez, J. E., Campbell, K. M., & Pololi, L. H. (2015). Addressing disparities in academic medicine: what of the minority tax? BMC Medical Education, 15(1), 1–5
Rothe, J. P., Ozegovic, D., & Carroll, L. J. (2009). Innovation in qualitative interviews: “sharing circles” in a First Nations community. Inj Prev, 15, 334–340
Russel, D. J., Zhao, Y., Guthridge, S., Ramjan, M., Jones, M. P., Humphreys, J. S., & Wakerman, J. (2017). Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013–2015. Human Resources for Health, 15(1), 1–12
Sánchez, J. P., Peters, L., Lee-Rey, E., Strelnick, H., Garrison, G., Zhang, K. … Castillo-Page, L. (2013). Racial and ethnic minority medical students’ perceptions of and interest in careers in academic medicine. Academic Medicine, 88(9), 1299–1307
Simpson, A. (2014). Mohawk Interruptus: Political life across the borders of settler states. Durham, BC: Duke University Press
Statistics Canada (2018, July 07). National Indigenous Peoples Day… By the Numbers. Retrieved from https://www.statcan.gc.ca/eng/dai/smr08/2018/smr08_225_2018
Statistics Canada (2019, May 02). Tables 14-10-0104-01 Employment by Aboriginal group and occupation (x 1,000). Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1410010401
Strickland, C. (1999). Conducting focus groups cross-culturally: experiences with Pacific Northwest Indian people. Public Health Nursing, 16(3), 190–197
Tachine, A. R., Bird, Y., E., & Cabrera, N. L. (2016). Sharing circles: an Indigenous methodological approach for research with groups of Indigenous Peoples. International Review of Qualitative Research, 9, 277–295
Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans – TCPS 2 (2018). https://ethics.gc.ca/eng/policy-politique_tcps2-eptc2_2018.html Accessed on October 1, 2019
Truth and Reconciliation Commission of Canada. (2015). Truth and Reconcilliation Commission of Canada: Calls to Action. Truth and Reconcilliation Commission of Canada
Tuhiwai Smith, L. (2012). Decolonizing methodologies. Research and Indigenous Peoples. 2nd edition. Dunedin, New Zealand: Otago University Press
Turpel-Lanford, M. E. (2020). In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care. https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Full-Report.pdf
US Department of Health and Human Services (2006). The rationale for diversity in the health professions: A review of the evidence.Health Resources and Services Administration, Bureau of Health Professions, ftp://ftp.hrsa.gov/bhpr/workforce/diversity.pdf..
Usher, K., Miller, M., Turale, S., & Goold, S. (2005). Meeting the challenges of recruitment and retention of indigenous people into nursing: Outcomes of the indigenous nurse education working group. Collegian, 12(3), 27–31
Wakerman, J., Humphreys, J., Russell, D., Guthridge, S., Bourke, L., Dunbar, T. … Jones, M. P. (2019). Remote health workforce turnovver and retention: what are the policy and practice priorities?.Human Resources for Health, 17(1)
Weaver, H. N. (2001). Indigenous nurses and professional education: Friends or foes? The Journal of Nursing Education, 40(6), 252
Yeo, M., Haggarty, L., Wida, W., Ayoungman, K., Pearl, C. M., Stogre, T., & Waldie, A. (2019). Unsettling Faculty Minds: A Faculty Learning Community on Indigenization. Teaching and Learning, 2019: 27–41
Zhao, Y., Russell, D. J., Guthridge, S., Ramjan, M., Jones, M. P., Humphreys, J. S., & Wakerman, J. (2019). Costs and effects of higher turnover of nurses and aboriginal health practitioners and higher use of short-term nurses in remote australian primary care services: An observational cohort study. BMJ Open, 9(2), e023906. doi:https://doi.org/10.1136/bmjopen-2018-023906
Acknowledgements
The success of cultural safety measures in lending to safe spaces for in-depth conversation could not have been done without the Indigenous members of our research team. Indigenous team members put in time and energy to educate non-Indigenous team members on appropriate land acknowledgements, how to share our vulnerabilities before asking the same of the participants, and how to word our questions in the most respectful way. The settler authors are grateful for the work and energy asked of Indigenous authors, they taught us the importance of a genuine expression of gratitude. We would like to acknowledge the contribution of all of the participants who so gracefully and generously gifted us with their stories to share in this paper. We would like to acknowledge Hannah Doyle’s help and support with revising the paper.
Author information
Authors and Affiliations
Contributions
KJC and EN contributed substantially to the study design, acquisition, analysis, and interpretation of data for the work, drafting the paper and revising it critically for important intellectual content. HBM and HM contributed substantially to the study design, acquisition, analysis, and interpretation of data for the work, and revising it critically for important intellectual content. AQ, YM and TJ contributed substantially to the study design, analysis, and interpretation of data for the work, revising it critically for important intellectual content and supervising all aspects of the study. All the authors provided final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Corresponding author
Ethics declarations
Conflict of interest
None of the authors has any relevant conflict of interest to declare.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Joy-Correll, K., Nevill, E., Bird-Matheson, H. et al. Barriers and facilitators for Indigenous students and staff in health and human services educational programs. Adv in Health Sci Educ 27, 501–520 (2022). https://doi.org/10.1007/s10459-022-10099-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10459-022-10099-6