The current status of anti-racist and decolonial pedagogies in health sciences postsecondary education: a qualitative secondary analysis of a scoping review.

OBJECTIVES: The purpose of this qualitative secondary analysis is to explore the current practices and the ongoing challenges with implementing anti-racist and decolonial pedagogies in health sciences postsecondary education (HPSE).

METHODS: This study is a qualitative secondary analysis of HSPE focused studies (n=15) from an original qualitative scoping review on anti-racist and decolonial pedagogies within postsecondary education. The secondary analysis was informed by Critical Race Theory, anti-racist and decolonial pedagogical frameworks, and consideration of the Social Determinants of Health and Indigenous Social Determinants of Health. This study adopts a two-stage, sequential exploratory mixed-methods qualitative design, with the first stage involving the completion of the original qualitative scoping review and the second stage which encompasses the current qualitative secondary analysis of a subset of studies focused on HSPE. The included health sciences studies were categorized into the following disciplines: Medicine, Nursing, Health Policy, and Public Health. Thematic analysis was utilized to analyze the included studies and develop themes.

RESULTS: The key findings from this study include the importance of challenging current HSPE structures such as re-evaluating the biomedical model, moving beyond focusing on solely on grades, tokenism, and performativity and instead focusing on accountability, fostering critical learning, and genuine engagement. Current anti-racist and decolonial pedagogies utilized include reflexivity, ongoing open dialogue, deconstructing dominant discourses, inclusivity of Indigenous pedagogies, creative strategies, and developing safe spaces for learning. Barriers and facilitators were also discussed across student, educator, and institutional/systemic levels. Barriers included discomfort with the topic of anti-racist and decolonial pedagogies, lack of support, and overall resistance to change and facilitators included embracing change, conflict resolution, developing supportive partnerships, and the importance of ongoing learning. A discussion of how current pedagogies are being evaluated and gaps with this process (i.e., feedback methods) was also discussed as well as how white supremacy may present itself in HSPE.

CONCLUSIONS: The study findings provide critical insights to inform further work and strategies for educators within HSPE that will ultimately benefit HSPE students, future health care professionals (HCPs) and patients by encouraging improved safe learning environments and equipping HSPE students with foundational knowledge on anti-racist and decolonial pedagogies.

IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The relevancy of these findings for an international audience is evident as the strategies presented can be applied to HSPE more generally and aim to strengthen education for future HCPs regardless of contextual differences.