The tools at their fingertips: How settler colonial geographies shape medical educators’ strategies for grappling with Anti-Indigenous racism

Settler colonialism implicates settler and Indigenous populations differently within ongoing projects of settlement and nation building. The uneven distribution of benefits and harms is a primary consequence of settler colonialism. Indeed, it is a central organizing feature of the settler state's governance of Indigenous societies and is animated, in part, through pervasive settler ignorance and anti-Indigenous racism, which has manifested in persistent health disparities amongst Indigenous peoples. This broader socio-political context surrounding medical schools, which are seeking to develop teaching and learning about Indigenous health presents a significant challenge. Understanding the cognitive and affective tools that settler educators use when grappling with questions of race, racialization, and Indigenous difference is an important step in addressing anti-Indigenous racism in health care provision. This paper reports on findings from in-depth semi-structured interviews with educators at one Canadian medical school. Our intent was to elicit respondents' understandings, experiences, and attitudes regarding Indigenous-settler relations, Indigenous health and healthcare, and the inclusion of Indigenous health in the curriculum as a means of identifying facilitators and barriers to improving Indigenous health and health care experiences. Respondents were generally sympathetic and evinced an earnest desire to include more Indigenous-related content in the curriculum. What became clear over the course of the data collection and analysis, however, was that most respondents lacked the tools to engage critically with questions of race and racialization and how these are manifested in the context of asymmetrical settler colonial power. We argue that this inability, at best, limits the effectiveness of much needed efforts to incorporate more content relating to Indigenous health, but worse yet, risks re-entrenching anti-Indigenous racism and settler dominance.