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

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Τίτλος: Facing hard truths: Medical education's reckoning with settler colonialism in an era of reconciliation.
Συγγραφείς: Esomchukwu O; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Bishop L; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Dean L; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., LaDonna KA; Department of Innovation in Medical Education and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Burm S; Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Πηγή: Medical education [Med Educ] 2026 Mar; Vol. 60 (3), pp. 317-325. Date of Electronic Publication: 2025 Sep 08.
Τύπος έκδοσης: Journal Article; Research Support, Non-U.S. Gov't
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 7605655 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2923 (Electronic) Linking ISSN: 03080110 NLM ISO Abbreviation: Med Educ Subsets: MEDLINE
Imprint Name(s): Publication: Oxford : Wiley-Blackwell
Original Publication: Oxford, Blackwell Scientific Publications.
Ιατρικοί όροι (MeSH): Education, Medical*/organization & administration , Students, Medical*/psychology , Faculty, Medical*/psychology , Health Services, Indigenous*/organization & administration , Colonialism*, Schools, Medical/organization & administration ; Humans ; Qualitative Research ; Indigenous Peoples
Περίληψη: 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.
(© 2025 The Author(s). Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
References: BMJ Open. 2023 Feb 22;13(2):e063178. (PMID: 36813494)
Perspect Med Educ. 2022 Dec;11(6):325-332. (PMID: 36417160)
J Gen Intern Med. 2022 Jul;37(9):2291-2296. (PMID: 35710656)
Perspect Med Educ. 2021 Aug;10(4):222-229. (PMID: 33914288)
Med Educ. 2023 Oct;57(10):903-909. (PMID: 37199083)
BMC Med Educ. 2023 Apr 22;23(1):277. (PMID: 37085777)
Med Educ. 2025 Jan;59(1):114-123. (PMID: 38992874)
Int J Qual Health Care. 2020 Jun 4;32(4):240-250. (PMID: 32232323)
Med Educ. 2015 Jun;49(6):612-22. (PMID: 25989409)
Adv Health Sci Educ Theory Pract. 2020 Dec;25(5):1107-1126. (PMID: 33136279)
Med Educ. 2026 Mar;60(3):317-325. (PMID: 40921427)
Acad Med. 2022 May 1;97(5):649-654. (PMID: 35020611)
BMC Public Health. 2019 Dec 5;19(1):1637. (PMID: 31805907)
Healthc Manage Forum. 2023 Jul;36(4):228-234. (PMID: 37194453)
Soc Sci Med. 2019 Sep;237:112363. (PMID: 31421460)
Med Teach. 2019 May;41(5):525-531. (PMID: 30299183)
Can Med Educ J. 2025 May 01;16(2):6-16. (PMID: 40365587)
J Racial Ethn Health Disparities. 2019 Feb;6(1):37-45. (PMID: 29736617)
Med Educ. 2023 Jun;57(6):556-565. (PMID: 36495548)
Can Med Educ J. 2021 Apr 30;12(2):e94-e99. (PMID: 33995726)
Med Educ. 2024 Oct;58(10):1215-1223. (PMID: 38385616)
Grant Information: 19/MERG-1 Royal College of Physicians and Surgeons of Canada
Entry Date(s): Date Created: 20250908 Date Completed: 20260217 Latest Revision: 20260813
Update Code: 20260813
PubMed Central ID: PMC12913239
DOI: 10.1111/medu.70028
PMID: 40921427
Βάση Δεδομένων: MEDLINE
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  Data: 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.<br />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.<br />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.<br />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.<br /> (© 2025 The Author(s). Medical Education published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)
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  Data: BMJ Open. 2023 Feb 22;13(2):e063178. (PMID: <searchLink fieldCode="PM" term="%2236813494%22">36813494)</searchLink><br />Perspect Med Educ. 2022 Dec;11(6):325-332. (PMID: <searchLink fieldCode="PM" term="%2236417160%22">36417160)</searchLink><br />J Gen Intern Med. 2022 Jul;37(9):2291-2296. (PMID: <searchLink fieldCode="PM" term="%2235710656%22">35710656)</searchLink><br />Perspect Med Educ. 2021 Aug;10(4):222-229. (PMID: <searchLink fieldCode="PM" term="%2233914288%22">33914288)</searchLink><br />Med Educ. 2023 Oct;57(10):903-909. (PMID: <searchLink fieldCode="PM" term="%2237199083%22">37199083)</searchLink><br />BMC Med Educ. 2023 Apr 22;23(1):277. (PMID: <searchLink fieldCode="PM" term="%2237085777%22">37085777)</searchLink><br />Med Educ. 2025 Jan;59(1):114-123. (PMID: <searchLink fieldCode="PM" term="%2238992874%22">38992874)</searchLink><br />Int J Qual Health Care. 2020 Jun 4;32(4):240-250. (PMID: <searchLink fieldCode="PM" term="%2232232323%22">32232323)</searchLink><br />Med Educ. 2015 Jun;49(6):612-22. (PMID: <searchLink fieldCode="PM" term="%2225989409%22">25989409)</searchLink><br />Adv Health Sci Educ Theory Pract. 2020 Dec;25(5):1107-1126. (PMID: <searchLink fieldCode="PM" term="%2233136279%22">33136279)</searchLink><br />Med Educ. 2026 Mar;60(3):317-325. (PMID: <searchLink fieldCode="PM" term="%2240921427%22">40921427)</searchLink><br />Acad Med. 2022 May 1;97(5):649-654. (PMID: <searchLink fieldCode="PM" term="%2235020611%22">35020611)</searchLink><br />BMC Public Health. 2019 Dec 5;19(1):1637. (PMID: <searchLink fieldCode="PM" term="%2231805907%22">31805907)</searchLink><br />Healthc Manage Forum. 2023 Jul;36(4):228-234. (PMID: <searchLink fieldCode="PM" term="%2237194453%22">37194453)</searchLink><br />Soc Sci Med. 2019 Sep;237:112363. (PMID: <searchLink fieldCode="PM" term="%2231421460%22">31421460)</searchLink><br />Med Teach. 2019 May;41(5):525-531. (PMID: <searchLink fieldCode="PM" term="%2230299183%22">30299183)</searchLink><br />Can Med Educ J. 2025 May 01;16(2):6-16. (PMID: <searchLink fieldCode="PM" term="%2240365587%22">40365587)</searchLink><br />J Racial Ethn Health Disparities. 2019 Feb;6(1):37-45. (PMID: <searchLink fieldCode="PM" term="%2229736617%22">29736617)</searchLink><br />Med Educ. 2023 Jun;57(6):556-565. (PMID: <searchLink fieldCode="PM" term="%2236495548%22">36495548)</searchLink><br />Can Med Educ J. 2021 Apr 30;12(2):e94-e99. (PMID: <searchLink fieldCode="PM" term="%2233995726%22">33995726)</searchLink><br />Med Educ. 2024 Oct;58(10):1215-1223. (PMID: <searchLink fieldCode="PM" term="%2238385616%22">38385616)</searchLink>
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