Modelling change and cultural safety: A case study in northern British Columbia health system transformation
Bibliographic record
Abstract
The relationship that Indigenous Peoples have to the Canadian healthcare system makes the system's weaknesses and complexities obvious. The long-standing lack of consideration to the historical and contemporary realities of Indigenous Peoples has resulted in miscommunication, misunderstanding, mistrust and racism. Health leaders, including health authorities, across the province are thus challenged to ensure that culturally safe environments are available and culturally safe practices are being used. This article begins with an overview of contemporary social political contexts in which Indigenous individual and collective realities are situated. Following is a conceptual discussion focused on health system change and the experiences of Indigenous Peoples. Change at structural, systemic and individual levels is the focus of the change model presented in this article. Throughout this exploration, examples of concrete actions currently underway in a health authority are offered. The article concludes with visions for future change.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.021 | 0.009 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".