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Diversity and Inclusion

A work-in-progress resource for faculty, students, and administrators on creating more inclusive and diverse classrooms.

The Development of an Indigenous Health Curriculum for Medical Students. Academic Medicine

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Lewis, M., & Prunuske, A. (2017). The Development of an Indigenous Health Curriculum for Medical Students. Academic Medicine, 92(5), 641-648. doi:10.1097/ACM.0000000000001482

Abstract:

Indigenous populations experience dramatic health disparities; yet, few medical schools equip students with the skills to address these inequities. At the University of Minnesota Medical School, Duluth campus, a project to develop an Indigenous health curriculum began in September 2013. This project used collaborative and decolonizing methods to gather ideas and opinions from multiple stakeholders, including students, community members, faculty, and administration, to guide the process of adding Indigenous health content to the curriculum to prepare students to work effectively with Indigenous populations. A mixed-methods needs assessment was implemented to inform the instructional design of the curriculum. In June 2014, stakeholders were invited to attend a retreat and complete a survey to understand their opinions of what should be included in the curriculum and in what way. Retreat feedback and survey responses indicated that the most important topics to include were cultural humility, Indigenous culture, social/political/economic determinants of health, and successful tribal health interventions. Stakeholders also emphasized that this content should be taught by tribal members, medical school faculty, and faculty in complementary departments (e.g., American Indian Studies, Education, Social Work) in a way that incorporates experiential learning.

Preliminary outcomes include the addition of a seven-hour block of Indigenous content for first-year students taught primarily by Indigenous faculty from several departments. To address the systemic barriers to health and well-being and provider bias that Indigenous patients experience, this project sought to gather data and opinions regarding the training of medical students through a process of Indigenizing research and education.

Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers (and peer commentary - 2016)

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Kotalik, J., & Martin, G. (2016). Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers. The American Journal Of Bioethics: AJOB16(5), 38-43. doi:10.1080/15265161.2016.1159749

Abstract:

Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge. As an example of an element of traditional knowledge that contains strong ethical guidance, we present the story of the Gifts of the Seven Grandfathers. We note a resemblance of this Ojibway teaching to virtue ethics in European traditions, but we suggest that there are also important differences in how these two traditions are currently presented. We hope that further engagement with a variety of indigenous moral teachings and traditions could improve health care involving Aboriginal patients and communities, and enrich the discipline of bioethics.

PEER COMMENTARY ARTICLES

Pullman, D., & Brunger, F. (2016). Acknowledging Diversity of Meaning: A Reflection on American Bioethics. The American Journal of Bioethics16(5), 44-46. DOI:10.1080/15265161.2016.1159758

McPherson, D. H., & Rabb, J. D. (2016). Further Reflections on the Seven Grandfathers: Bringing Native American Values to Bioethics. The American Journal of Bioethics, 16(5), 46-47. doi:10.1080/15265161.2016.1159757

Campbell, D. (2016). Relevance and Guidance: Two Questions for the Seven Grandfathers. The American Journal of Bioethics, 16(5), 48-49. doi:10.1080/15265161.2016.1161411

Bardill, J., & Garrison, N. A. (2016). New Words and Old Stories: Indigenous Teachings in Health Care and Bioethics. The American Journal of Bioethics, 16(5), 50-52. doi:10.1080/15265161.2016.1159762

Stevenson, S. A., & Murray, S. J. (2016). Aboriginal Bioethics as Critical Bioethics: The Virtue of Narrative. The American Journal of Bioethics, 16(5), 52-54. doi:10.1080/15265161.2016.1159752

Foster, C. (2016). Aboriginal Health Care: The Seven Grandfathers Trump the Four Principles. The American Journal of Bioethics, 16(5), 54-56. doi:10.1080/15265161.2016.1159751

Crowden, A. (2016). Indigenous Health Care, Bioethics and the Influence of Place. The American Journal of Bioethics, 16(5), 56-58. doi:10.1080/15265161.2016.1159754

Kelecevic, J. (2016). The Story Moved Me, But Will It Move Health Care Forward? The American Journal of Bioethics, 16(5), 58-59. doi:10.1080/15265161.2016.1159763

Toward a Narrative Ethics: Indigenous Community-Based Research, the Ethics of Narrative, and the Limits of Conventional Bioethics (2016)

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Stevenson, S. A. (2016). Toward a Narrative Ethics: Indigenous Community-Based Research, the Ethics of Narrative, and the Limits of Conventional Bioethics. Qualitative Inquiry, 22(5), 365–376. doi:10.1177/1077800415625689

Abstract

Drawing on experience of community-based health research with a First Nation population, I present a case for the incorporation of an ethics grounded in narrative, particularly within Indigenous community-based research (CBR). Viewing conventional bioethics’ emphasis on individual autonomy as increasingly insufficient in grappling with the complexities of research with Indigenous communities, with their often historically, socially, and culturally specific notions of kinship, intersubjectivity, and relationality, I suggest that an ethics of narrative has the potential to respond to a conventional bioethics of autonomy in ways that would be more commensurable with the ethical and lived experiences of Indigenous persons. Drawing on poststructuralist and Indigenous thought, I ultimately argue for the narrative competency to engage with and respond to the stories of sickness and health that may arise from cultural contexts other than those sedimented within Western Euro-American frameworks. Key to this endeavor is attention to and understanding of conceptions of self and community formation as multiple and diverse, marked by porosity and even the potential for ethical failure.

Staying connected: Native American women faculty members on experiencing success. (2010)

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Elliott, B., Dorscher, J., Wirta, A., & Hill, D. (2010). Staying Connected: Native American Women Faculty Members on Experiencing Success. Academic Medicine, 85(4), 675-679. http://dx.doi.org/10.1097/acm.0b013e3181d28101

Abstract: 

PURPOSE:

To document how medical school faculty who are Native American women describe their sense of personal and professional success, so that mentoring can be better informed and diversity increased.

METHOD:

This qualitative study was designed using snowball sampling methodology. Open-ended questions were developed with the authors' expertise and asked of five Native American women physician faculty participants until saturation was achieved. Transcripts were coded, organized, and interpreted to generate tentative themes and working hypotheses. The study was completed in 2006 and 2007.

RESULTS:

Native American women defined their place in the world through their primary culture. From analysis of the transcripts, three themes emerged as important in participants' sense of professional success: (1) Maintaining Native American values of belonging, connectedness, and giving back was essential, (2) success was perceived and experienced to have changed over time, and (3) mentoring relationships made success possible.

CONCLUSIONS:

Native American women faculty based their identity and definition of success in their primary culture's values, relationships, and expectations. Academic success can be accomplished with mentorship that honors the Native American woman's responsibility to her culture over time (with clinical and academic opportunities) while also assisting with development of appropriate academic skills and opportunities.