Beliefs around the causes of inequities and intergroup attitudes among health professional students before and after a course related to Indigenous Peoples and colonialism

BACKGROUND

Addressing the Truth and Reconciliation Calls to Action on including anti-racism and cultural competency education is acknowledged within many health professional programs. However, little is known about the effects of a course related to Indigenous Peoples and colonialism on learners' beliefs about the causes of inequities and intergroup attitudes.

METHODS

A total of 335 learners across three course cohorts (in 2019, 2020, 2022) of health professional programs (e.g., Dentistry/Dental Hygiene, Medicine, Nursing, and Pharmacy) at a Canadian university completed a survey prior to and 3 months following an educational intervention. The survey assessed gender, age, cultural identity, political ideology, and health professional program along with learners' causal beliefs, blaming attitudes, support for social action and perceived professional responsibility to address inequities. Pre-post changes were assessed using mixed measures (Cohort x Time of measurement) analyses of variance, and demographic predictors of change were determined using multiple regression analyses. Pearson correlations were conducted to assess the relationship between the main outcome variables.

RESULTS

Only one cohort of learners reported change following the intervention, indicating greater awareness of the effects of historical aspects of colonialism on Indigenous Peoples inequities, but unexpectedly, expressed stronger blaming attitudes and less support for government social action and policy at the end of the course. When controlling for demographic variables, the strongest predictors of blaming attitudes towards Indigenous Peoples and lower support for government action were gender and health professional program. There was a negative correlation between historical factors and blaming attitudes suggesting that learners who were less willing to recognize the role of historical factors on health inequities were more likely to express blaming attitudes. Further, stronger support for government action or policies to address such inequities was associated with greater recognition of the causal effects of historical factors, and learners were less likely to express blaming attitudes.

CONCLUSION

The findings with respect to blaming attitudes and lower support for government social action and policies suggested that educational interventions can have unexpected negative effects. As such, implementation of content to address the Truth and Reconciliation Commissions Calls to Action should be accompanied by rigorous research and evaluation that explore how attitudes are transformed across the health professional education journey to monitor intended and unintended effects.

Intervention Tournaments: An Overview of Concept, Design, and Implementation

A large portion of research in the social sciences is devoted to using interventions to combat societal and social problems, such as prejudice, discrimination, and intergroup conflict. However, these interventions are often developed using the theories and/or intuitions of the individuals who developed them and evaluated in isolation without comparing their efficacy with other interventions. Here, we make the case for an experimental design that addresses such issues: an intervention tournament-that is, a study that compares several different interventions against a single control and uses the same standardized outcome measures during assessment and participants drawn from the same population. We begin by highlighting the utility of intervention tournaments as an approach that complements other, more commonly used approaches to addressing societal issues. We then describe various approaches to intervention tournaments, which include crowdsourced, curated, and in-house-developed intervention tournaments, and their unique characteristics. Finally, we discuss practical recommendations and key design insights for conducting such research, given the existing literature. These include considerations of intervention-tournament deployment, characteristics of included interventions, statistical analysis and reporting, study design, longitudinal and underlying psychological mechanism assessment, and theoretical ramifications.