Updates and Recommendations After Implementing an Indigenous Health Curriculum Into a Medical School Curriculum

outside longhouse

This is the Evergreen Longhouse Education and Cultural Center, at Evergreen State College, called sgʷigʷialʔtxʷ, which means “The House of Welcome” in Salish. While there is not a medical school here, there are several programs that place Indigeneity in the forefront whether it be course content, building and classroom architecture and design, or Indigenous learning methods. Not only do students meet and learn in a traditional Salish structure, but their course content and learning techniques are influenced by tribal community members and contemporary Indigenous issues.

By: Melissa Lewis, PhD
M. Lewis is assistant professor, Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, Missouri.

In our recent Academic Medicine article, my coauthor and I described the development and reported preliminary outcomes of an Indigenous health curriculum for first-year medical students at the University of Minnesota Medical School, Duluth campus (UMMSD). Here I’d like to provide an update on the program and recommendations for other universities attempting to update their curricula to include similar content.

Update
The UMMSD has been delivering this curriculum to medical students for three years now (2013–2016). We asked students what they thought of this content via an anonymous, informal survey; and they had the following to say:

“I absolutely loved these sessions. As an institution that values Native American health, I thought it was appropriate and well worth the time to learn more about Native American health and history.”

“The professors were very knowledgeable about the topics they presented and were genuinely passionate about them.”

But, of course, we wanted to know more so we polled the first two cohorts (2013 and 2014) that received the updated curriculum about what they learned. We collected data on their Indigenous knowledge, ethnocultural empathy, cultural intelligence, social justice beliefs, and their multiethnic identity before the new curriculum was delivered, immediately afterward, and six months later. The results are very exciting, and we are preparing to submit them for publication in the upcoming months!

For more information about the Indigenous health curriculum at UMMSD, please contact Dr. Ruth Westra at rwestra@d.umn.edu.

alter

Located between the University of Hawai‛i (UH) at Mānoa medical school campus and the UH cancer center is a traditional medicine garden and altar. The native and medicinal plants are labeled and described for visitors to learn about. The garden and altar also provide a Native-specific place for prayer and solace.

Recommendations
In preparation for adding Indigenous health content to the medical school curriculum, I was privileged to travel the world to research what other universities, health centers, and Indigenous-focused programs were doing. I was able to see beautiful medical school campuses tailored for Indigenous patients, faculty, and staff; sit in on groundbreaking Indigenous health and research electives, and traditional medicine preceptorships; and visit traditional healers and structures on medical school campuses in Hawaii, Alaska, Washington, and New Zealand. I did my best to listen and learn along the way. Here is my (current, yet, ever-changing) dream list for preparing medical students to work with Indigenous patients as a result of my travels and experiences implementing the UMMSD’s Indigenous health curriculum:

  1. Create, implement, track, and train (new faculty on) Indigenous health, including core competencies, student learning objectives, and core pedagogical principles (see Leaders in Indigenous Medical Education [LIME] for an example).
  2. Create and implement a basics course for all students such as Introduction to Indigenous Health (10–12 hours) (see UMMSD for an example).
  3. Evaluate and track student learning of Indigenous-focused content via quizzes, tests, and experiential activities (see the Lewis forthcoming manuscript mentioned above for an example).
  4. Create an Indigenous Health Pathway for advanced learning composed of an advanced course, an experiential activity, summer research, and service learning (see University of Washington for an example).
  5. Purposefully integrate regionally specific Indigenous lifeways and traditional Indigenous knowledge
    1. Into the university curriculum by
      1. Implementing an Indigenous Elder-in-Residence Program as a faculty, staff, and student resource (see University of Alberta for an example),
      2. Creating, implementing, and making decisions in collaboration with a Community Advisory Board, and
      3. Engaging the community in developing the Indigenous health curriculum and creating an Indigenous-friendly environment.
    2. Into the medical school environment, including
      1. The classroom (see Evergreen State College for an example),
      2. Medicine Gardens (see Southcentral Foundation for an example), and
      3. Sacred sites/Places for prayer (see University of Hawai‛i [here and here] for an example).

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All photographs in this blog post were taken by Melissa Lewis.

For additional images, please visit https://www.southcentralfoundation.com, https://evergreen.edu/longhouse, and http://manoa.hawaii.edu/tropicalmedicine/?page_id=1332.

 

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  1. MU Professor First in Nation to Develop Medical Curriculum Tailored to Native Americans – School of Medicine
    February 17, 2017 at 10:22 AM Reply

    […] University of Minnesota Medical School’s Duluth campus implemented the new curriculum for medical students in 2014. Lewis recently gave an update on the success program and recommendations for other universities attempting to update their curricula to include similar content, in a new blog post by Academic Medicine. […]

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