Background/Purpose: Arthritis conditions are highly prevalent in Indigenous populations in Canada and patients experience severe outcomes. Patients avoid specialty care health systems due to experiences of racism, stereotyping and culturally unsafe environments. The ‘Educating for Equity’ program was designed as a continuing medical education (CME) intervention to incorporate skill-based teaching to re-center relationships and engage patient social realities, and was adapted as an educational intervention for rheumatologists.

Methods: Following introductory exposure to Indigenous health competency training, a half-day interactive workshop was delivered to 9 rheumatologists who were recruited through the Canadian Rheumatology Association membership. This half-day workshop provided content knowledge and skill practice through role playing case studies with instantaneous feedback on performance. Participants completed a pre-workshop survey which was repeated 3 months following the workshop to identify the strategies they used to address social issues and enhance therapeutic relationships, as well as a 15 question Likert-scaled Social Cultural Confidence in Care Survey (SCCCS). They were asked about the perceived impact of the intervention on their practice.

Results:

Prior to the workshop, strategies to address social issues were primarily to involve allied health staff or local primary care providers, with few offering they would ask patients about social situations themselves. Strategies they used to enhance the therapeutic relationship were being open, available, and flexible, encouraging family participation in decision making, and sharing expectations for treatment effects while working to reach common ground and earn trust. Following the workshop, they were more likely to focus on relationship building with patients and their families, had enhanced awareness and confidence to explore the context of patient social reality in decision making, were serving as advocates for access to treatment, enquired about residential school experiences and patient cultural practices, and had changed their practices to be more patient-centered, with attention paid to space and time in the care environment. They valued the developing community of practice and were motivated to learn more about Indigenous health. There was no statistical improvement in the SCCCS ratings, but trends to improvement in rankings were noted in this small group. Interactive group discussion and role playing were reported as the most effective part of the intervention.

Conclusion: This CME intervention had beneficial impact on self-reported confidence and enhanced practice strategies to engage with Indigenous patients. The next phase will incorporate reinforcement of principles and skills while providing training in facilitation to expand the community of practice.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/participant-reported-effect-of-an-indigenous-health-continuous-professional-development-education-initiative/