Shifting Nursing Students' Attitudes towards Indigenous Peoples by Participation in a Required Indigenous Health Course

Background: Increasing evidence shows that Indigenous Peoples of Canada experience greater health disparities and receive lesser quality of health care services than non-Indigenous Canadian people. There is an important need to educate health care professionals to be knowledgeable about Indigenous culture, Canadian history, and culturally safe care. Purpose: This project aimed to evaluate if student perceptions of Indigenous Peoples, knowledge of Indigenous culture, and a student’s cultural competency improved through participation in a required Indigenous health course in the third year of one Canadian Bachelor of Nursing program. Methods: A pretest posttest design measured student self-reported Knowledge of Factors Impacting Indigenous Health, Interest in Indigenous Issues, and Perceptions of Indigenous People. Students wrote reflections on their learning throughout the course which were analyzed to understand the nature of how their thinking transformed through exposure to Indigenous history and its impact on the relationship between Indigenous populations and the health care system in Canada. Results: We used previously validated instruments in our study: Student Knowledge of Factors Impacting Indigenous Health, Interest in Indigenous Issues and Attitudes about Indigenous People. Student scores on all three measures improved from the beginning until the end of the course. Previous Indigenous education and experience working in a health care environment had minimal impact on students’ growth on these measures. The analysis of the student reflections rooted in a cultural competence framework showed the transformative nature of their learning. Conclusion: Increasing the knowledge of nursing students about historical factors in a colonial context impacting Indigenous Peoples’ health addresses a key call to action of the Truth and Reconciliation Commission of Canada. Indigenous Health courses within nursing curricula can stimulate the personal transformations needed within health care professionals to promote willingness to advocate with Indigenous populations and facilitate progress toward reducing health inequities and increasing health access in this population.

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