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First Nations, Mi'kmaq-led research leads to cultural safety curriculum for clinicians

Six smiling people send in front of banner

A research project out of the IWK offers health care providers an opportunity to learn from Indigenous Peoples about working in a health partnership and creating a culturally safe environment. To Know Better is to Do Better: Translating Indigenous Knowledge to Health Practice draws from nearly 15 years of community engagement, relationship-building, research, and validation with the Mi'kmaq and their health leadership teams.  

“It is critical that folks who provide care also understand why implementing Indigenous worldview into cultural safety is part of improving care for Indigenous People,” says John Sylliboy, Co-Principal investigator, and a L’nu Educator & Researcher. “Improving care practices for Indigenous People, improves their health.”  

The project has created an Indigenous-led innovative cultural safety curriculum relevant for health clinicians. The six modules are informed by research with several First Nations communities in Mi’kma’ki and a partnership with Tajikeimɨk, Dalhousie University and IWK Health.   

We know racism and lack of culturally safe environments in healthcare occur, and can be harmful for Indigenous People,” said Sharon (Paul) Rudderham, Director of Health Transformation for Tajikeimɨk. “People ask what they can do to engage in reconciliation and the Truth and Reconciliation Commission Calls to Action. This is one step they can take: participate in the course and incorporate the understandings learned into their work and everyday lives. 

“Our Mi'kmaw communities have invested many, long hours of engagement, research, coordination, and community validation with the goal of collaborating in a Two-Eyed Seeing way to enhance care for Indigenous People,” says Sylliboy. “We believe this is the first one using an integrated approach using the strengths of Indigenous worldview and western practices.”  

Indigenous knowledge of health, amassed over thousands of years can significantly enhance Western-based healthcare practices using a Two-Eyed seeing approach. Two-Eyed seeing invokes two sets of eyes representing the convergence of perspectives to support Indigenous People’s worldview on health.  

“Racism exists in our healthcare system, and we have to actively address it through education, policy and Indigenous-led initiatives,” says Dr. Margot Latimer, Co-Principal investigator, CIHR Research Chair in Indigenous Health Nursing, Faculty at Dalhousie and IWK affiliate scientist. “Landmark documents such as the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), Canada’s Truth and Reconciliation Commission Calls to Action, and Missing and Murdered Indigenous Women, Girls and Two-Spirit People(MMIWG2S) Calls to Justice all highlight the imperative for improvements in health care.” 

This project will invite 375 health clinicians from IWK, NSH and Mi’kmaw community health settings in Nova Scotia to participate in a  six-module cultural safety course with the plan to roll out more broadly across the province. The aim is to determine the course impact on clinician attitudes, knowledge and behavioural outcomes meant to positively impact the experiences of Indigenous people seeking care in the healthcare system.  

“Indigenous Peoples who have participated in our research have shared with us a better way forward,” says Latimer. “The course provides content such as history of Indigenous People, the impact of that history on Indigenous Peoples health, anti-racism and trauma-informed clinical practices as well as the strengths and knowledge that communities have shared in the ways that support wellness.” 

Funding for the course development and research has come from CIHR grants including Chronic Pain Network, Research Chair in Indigenous Health Nursing, Research Nova Scotia, Dalhousie and the IWK Foundation.

Pictured from left to right: Julie Francis, Mi’kmaw Registered Nurse, L’nu Health Chair, Cape Breton University. Athanasius Sylliboy, NP Millbrook First Nation, Dr. Margot Latimer, Professor Dalhousie Faculties of Health & Medicine, CIHR Chair, Indigenous Health Nursing, Dr Brent Young, Academic Director of Indigenous Health, Dalhousie Medical School, Elder Clarke Paul, Eskaoni First Nation, Sharon (Paul) Rudderham, Director of Health Transformation, Tajikeim?k. Missing from photo John R Sylliboy, L’nu Educator & Researcher.