Towards culturally relevant nursing education for aboriginal students Em M. Pijl-Zieber ⁎, Brad Hagen 1 The Faculty of Health Sciences, The University of Lethbridge, 4401 University Drive, Lethbridge, Alberta T1K 0N1 Canada summary article info Article history: Accepted 8 October 2010 Keywords: Nursing education Indigenous peoples Cultural diversity Aboriginal Aboriginal nursing students face numerous challenges in North American nursing educational programs, as reflected in the relatively high attrition rate of these students. In this paper, the authors argue that nurse educators need to create more culturally relevant curriculum and instructional approaches for Aboriginal students. Such approaches would help nursing educators to ensure that current aboriginal nursing programs— which are largely assimilative in nature—can be more successful and transformative in nature. © 2010 Elsevier Ltd. All rights reserved. Aboriginal students—a term to be used in this article to denote persons of First Nations, Metis, Inuit, and American Indian heritage— often encounter significant barriers in many North American nursing programs (Canadian Association of Schools of Nursing [CASN], 2007; Manifold & Rambur, 2001). Nursing educators have traditionally tried to enhance the success of Aboriginal students by offering transition and support programs, in which instructors assist students in adapting to the North American academic environment, or through curricular add-ons that introduce Aboriginal content. However, such measures are generally premised upon Eurocentric approaches to knowledge, and Aboriginal students continue to experience high rates of attrition. The purpose of this article is to articulate why current nursing educational models may not be supportive of Aboriginal students, and to propose nursing educational models that the authors believe are more likely to position Aboriginal nursing students for success. While the authors believe that the issues discussed are likely to be relevant for many industrialized countries with Aboriginal populations, the authors’ experiences lie within North America, and as such, many of the examples cited will be from North America, specifically Canada. The problem of high attrition rates among aboriginal nursing students Aboriginal students are underrepresented in Canadian nursing programs (Canadian Association of Schools of Nursing [CASN], 2007; Health Canada, 2002), and experience the highest attrition of any ethic group in North America (Manifold & Rambur, 2001). CASN (2007) has reported that while the intake of Aboriginal students into nursing programs has increased over time, the attrition rates remain high, at between 10% and 50%. Nursing educators often try to address the high attrition rates of Aboriginal nursing students from the perspective of concrete challenges such as funding, travel from remote areas, tutoring, childcare, academic assistance, and racism (Martin & Kipling, 2006). Other countries, such as Australia, are also grappling with similar challenges when offering nursing education to Aboriginal students (Usher et al., 2005). However, the issue of Aboriginal nursing student attrition remains largely unstudied from a pedagogical and curricular perspective. In one of these few studies, Manifold and Rambur (2001) found that a sample of American Aboriginal nursing often struggled with language and mathematical skills, which in turn significantly and negatively influenced their success in nursing school. Other documents in the literature, particularly from the Australian literature, have commen- ted on the issue of high Aboriginal nursing student attrition, and have offered various shorter-term options for how best to address it (Australian Nursing Federation and Royal College of Nursing, 2006; Goold, 2006; Usher et al., 2005). Fleet and Kitson (2009), however, in their report on an Australian study on assessment approaches in an Indigenous specific program, offer broader-sweeping changes that address the fundamental premises upon which mainstream profes- sional education curricula are based, and note that the existing challenges of Aboriginal students are “…intensified when elements of Indigenous knowledge and institutional power intersect” (p. 398). Furthermore, Fleet and Kitson suggest that mainstream faculty are not even necessarily aware of how curricular and pedagogical practices are immersed in “whiteness” (p. 398). Due to the relative lack of research in this area, CASN (2007) has concluded that nurse educators simply do not know enough about the possible causes of high attrition rates of Aboriginal nursing students. Consequently, nurse educators have little quality evidence to help them improve retention rates. Without such evidence, nurse educators may often resort to implementing “band-aid” solutions, Nurse Education Today 31 (2011) 595–600 ⁎ Corresponding author. Tel.: +1 403 332 5232; fax: +1 403 329 2668. E-mail addresses: em.pijlzieber@uleth.ca (E.M. Pijl-Zieber), brad.hagen@uleth.ca (B. Hagen). 1 Tel.: +1 403 329 2299; fax: +1 403 329 2668. 0260-6917/$ – see front matter © 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2010.10.014 Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/nedt