Innovations Impacts of Educating for Equity Workshop on Addressing Social Barriers of Type 2 Diabetes With Indigenous Patients Lynden (Lindsay) Crowshoe, MD, CCFP; Han Han, MA, PHD; Betty Calam, MD, CCFP, MClSc, FCFP; Rita Henderson, MA, PHD; Kristen Jacklin, MA, PHD; Leah Walker, BA; Michael E. Green, MD, MPH Introduction: Health education about Indigenous populations in Canada (First Nations, Inuit, and Me ´ tis people) is one approach to enable health services to mitigate health disparities faced by Indigenous peoples related to a history of colonization and ongoing social inequities. This evaluation of a continuing medical education workshop, to enhance family physicians’ clinical approach by including social and cultural dimensions within diabetes management, was conducted to determine whether participation in the workshop improved self-reported knowledge, skills, and confidence in working with Indigenous patients with type 2 diabetes. Methods: The workshop, developed from rigorous national research with Indigenous patients, diabetes care physicians, and Indigenous health medical educators, was attended by 32 family physicians serving Indigenous populations on three sites in Northern Ontario. A same-day evaluation survey assessed participants’ satisfaction with workshop content and delivery. Preworkshop and postworkshop surveys consisting of 5-point Likert and open-ended questions were administered 1 week before and 3 month after the workshop. Descriptive statistics and t test were performed to analyze Likert scale questions; thematic analysis was used to elicit and cluster themes from open-ended responses. Results: Participants reported high satisfaction with all aspects of the workshop. Reporting improved understanding of socioeconomic (P = .002), psychosocial, and cultural factors (P = .001), participants also described adapting their clinical approach to more actively incorporating social and cultural factors and focusing on patient-centered care. Discussion: The workshop was effective in shifting physician’s self-reported knowledge, attitudes, and skills resulting in clinical approach modifications within social, psychosocial, and cultural domains for their Indigenous patients with diabetes. Keywords: indigenous populations, diabetes, continuing medical education, cultural competency, cultural safety, structural competency DOI: 10.1097/CEH.0000000000000188 T he 2015 release of the report of the Truth and Reconcili- ation Commission of Canada (TRC) brings much needed attention to the adverse multigenerational impacts of the resi- dential school on Indigenous people that the TRC has termed “cultural genocide.” 1 The TRC defines reconciliation as “coming to terms with events of the past in a manner that overcomes conflict and establishes a respectful and healthy relationship among people, going forward.” 1(p6) In particular, the TRC Call to Action 24 highlights the need for Indigenous health education that provides critical intercultural skills. 2 The need for Cultural Competency and Cultural Safety training is an often-cited conclusion within the Indigenous health literature but evidence is lacking on effective Indigenous health learning approaches that improve learner and patient outcomes. 3 In Canada, health disparities experienced by Indigenous populations (ie, First Nations, Inuit, and Métis) arise from the complex history of colonization and contemporary social cau- ses, calling for a multisectoral approach to tackling underlying factors. Prevalence rates of type 2 diabetes are 2.5–5 times higher for Indigenous peoples than those in the general pop- ulation. 4,5 Studies revealed major care gaps, with Indigenous patients not achieving expected diabetes outcomes. 5–12 In addressing this gap, professional education for training a com- petent physician workforce is needed, especially one capable of addressing the specific needs for Indigenous patients and com- munities, where practice must be grounded in key political, social, and cultural constructs. 13–15 National Indigenous health learning strategies and resources have emerged at undergrad- uate and postgraduate levels 16,17 ; however, physicians continue to experience limited Indigenous health education throughout Disclosures: The authors declare no conflict of interest. The Canadian Institutes of Health Research funded this study through the International Collaborative Indigenous Health Research Partnership grant (#IDP- 103986, Grant no. RT735835), in partnership with the Health Research Council of New Zealand, and the Australian Government National Health and Medical Research Council. The funder had no role in the research. Dr. Crowshoe: Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. Dr. Han: Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada. Dr. Calam: Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada. Dr. Henderson: Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. Dr. Jacklin: University of Minnesota Medical School, Duluth, Minnesota. Ms. Walker: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Dr. Green: Departments of Family Medicine and Public Health Sciences, Queen’s University, Kingston, Ontario, Canada. Correspondence: Han Han, MA, PhD, Department of Family Medicine, Centre for Studies in Primary Care, Queen’s University, 220 Bagot Street, Kingston, Ontario, CA, Canada K7L 5E9; e-mail: han.han@dfm.queensu.ca. Copyright ª 2018 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education JCEHP n Month 2018 n Volume 0 n Number 0 www.jcehp.org 1 Copyright ª 2018 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education. Unauthorized reproduction of this article is prohibited.