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Record W4414081618 · doi:10.1111/medu.70028

Facing hard truths: Medical education's reckoning with settler colonialism in an era of reconciliation

2025· article· en· W4414081618 on OpenAlexafffund
Obinna Esomchukwu, Lisa Bishop, Libby Dean, Kori A. LaDonna, Sarah Burm

Bibliographic record

VenueMedical Education · 2025
Typearticle
Languageen
FieldSocial Sciences
TopicIndigenous Health, Education, and Rights
Canadian institutionsUniversity of OttawaDalhousie University
FundersRoyal College of Physicians and Surgeons of Canada
KeywordsPrivilege (computing)ColonialismMedical professionMEDLINECommon senseMedical practice

Abstract

fetched live from OpenAlex

INTRODUCTION: Medical schools are responsible for embedding Indigenous health education across the training continuum. Central to this work is recognising settler colonialism as an ongoing structure that privileges non-Indigenous peoples while producing and sustaining inequities for Indigenous communities. This paper explores key learning moments as non-Indigenous medical learners and faculty reflect on their experiences within systems that promote reconciliation yet remain largely rooted in colonial logic. METHODS: Data collection and analysis were informed by the principles of narrative inquiry. Five non-Indigenous medical students, a health research graduate student and 10 medical educators (MD and PhD) consented to participate in a narrative interview about how they positioned themselves and supported others engagement in ongoing reconciliatory efforts within their institution. Data were gathered over 2020-2022. RESULTS: Participants acknowledged their privileged position and aimed to leverage it to address educational or health disparities affecting Indigenous peoples. Yet intervening when they witnessed unfairness proved challenging. Although many attempted to adopt a proactive stance and advocate for systemic change, the prevailing tendency in such situations was to avoid disrupting the status quo due to perceived gaps in their knowledge or apprehension about professional backlash. CONCLUSION: Non-Indigenous medical learners and faculty struggle to navigate a system calling for transformation yet rife with historical and institutional barriers. This struggle often arises from the discomfort stemming from their privilege and a sense of limited influence within the medical hierarchy.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.017
metaresearch head score (Gemma)0.025
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesScience and technology studies
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.977
Threshold uncertainty score0.092

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0170.025
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0230.060
Scholarly communication0.0130.013
Open science0.0020.014
Research integrity0.0040.013
Insufficient payload (model declined to judge)0.0030.000

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.

Opus teacher head0.011
GPT teacher head0.348
Teacher spread0.338 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

Study designTheoretical or conceptual
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes2
Has abstractyes

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