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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

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Abstract

Indigenous education curriculum has been implemented in health professional programs as a potential solution to addressing commonly held false beliefs, as well as negative social attitudes and behaviours. As such it is important to map and analyze the current literature on educational initiatives that teach about historical and ongoing colonialism as a determinant of health to identify commonly used theoretical frameworks and outcomes assessed, as well as the intended and unintended short- and long-term outcomes on health professional learner’s beliefs, attitudes and behaviours. This scoping review follows the framework by (Peters et al., JBI Evidence Synthesis 18:2119–2126, 2020). Six databases (MEDLINE, CINAHL, PsychInfo, Sociological Abstracts, ERIC, and ProQuest Dissertations and Theses) were searched with grey literature included through hand-searching of Indigenous journals and citation searching for papers published up until 2022 based on an established search criterion. Two reviewers independently screened articles. In total, 2731 records were identified and screened; full text was assessed for 72 articles; 14 articles were identified as meeting all the inclusion criteria and included in the final review. Commonly- used theoretical frameworks were transformative learning and cultural safety, with a variety of evaluation tools used and post-intervention outcomes measured across the studies (e.g., knowledge, beliefs, attitudes, behaviour and general learner feedback). Indigenous education interventions require longitudinal evaluation studies to address shortcomings in the design and evaluation of outcomes associated with teaching about colonialism as a structural determinant of health. It is critical that we identify and monitor the intended and unintended consequences of such curriculum as we look to develop solutions to changing health professional learners’ false beliefs and attitudes, in hopes to inform their future care practices.

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Acknowledgements

We would like to acknowledge Robin Parker, Dalhousie University, for peer reviewing the scoping review search strategy and Dr. Amy Bombay for mentorship in the development of this study.

Funding

The primary author is supported by a Social Science and Humanities Research Council of Canada and a Nova Scotia Graduate doctoral award.

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Authors and Affiliations

  1. Faculty of Health, Dalhousie University, 5869 University Avenue, P.O. Box 15000, Halifax, NS, B3H 4R2, Canada

    Carolyn M. Melro

  2. Department of Neuroscience, Carleton University, Ottawa, ON, Canada

    Jyllenna Landry & Kimberly Matheson

  3. The Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada

    Kimberly Matheson

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CMM: study conceptualisation, formal analysis, methodology, writing – original draft; writing -review and editing; project administration. JL: data interpretation and writing – reviewing and editing. KM: supervision; writing – review and editing.

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Correspondence to Carolyn M. Melro.

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Melro, C.M., 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 in Health Sci Educ 28, 1311–1331 (2023). https://doi.org/10.1007/s10459-023-10217-y

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