What Works, Why, and How? The Effect of Educational Interventions on Health Professional Learners’ Causal Beliefs and Attitudes Towards Indigenous Peoples’ Experiences with Historical and Ongoing Colonialism

Abstract

Racism towards Indigenous Peoples continues to exist in the Canadian healthcare system, with potentially fatal outcomes. Given the historical and ongoing effects of colonialism in Canada, the Truth and Reconciliation Commission (TRC) specifically called for anti-racism and cultural competency as one pathway towards achieving health equity for Indigenous Peoples. Yet, we know little about the design, delivery and effectiveness of such strategies in terms of changing beliefs, attitudes and behaviours towards Indigenous Peoples. This dissertation is comprised of two integrated manuscripts, bookended by introduction and discussion chapters. The first manuscript evaluates the effect of an Indigenous health curriculum on health professional learners’ beliefs, attitudes, support for government assistance to reduce inequities, and professional responsibility to address inequities in Canada. The second manuscript scans the literature to map and analyze the current research landscape of educational interventions regarding the historical and ongoing effects of colonization in Canada, as well as in other countries that share similar colonial histories (i.e., the United States, Australia and New Zealand). It also reports on the common evaluation methods used and the short- and long-term outcomes of educational interventions in those countries. Together, these manuscripts contribute knowledge pertaining to the intended and unintended consequences of Indigenous-specific educational interventions on health professional learners’ beliefs and attitudes. They also contribute to the perceived need for change, as well as the theoretical and evaluation design considerations of educational interventions that focus on the root causes of Indigenous Peoples’ inequities given the Truth and Reconciliation Commission’s Calls to Action on anti-racism and cultural competency training.