Student Research Feature: Tammy Rogers: Decolonizing Frontline Healthcare in a Rural-Urban Indigenous Community Health Center
Decolonizing Frontline Healthcare in a Rural-Urban Indigenous Community Health Center
The School of Leadership Studies would like to extend our heartfelt congratulations to Tammy Rogers on the completion of a Master’s Thesis titled, Decolonizing Frontline Healthcare in a Rural-Urban Indigenous Community Health Center
This thesis is available through RRU’s library
We asked Tammy Rogers a few questions about this research and this is what they said:
1. What are some key takeaways from your thesis that would be helpful for other leaders?
Key takeaways from this thesis center on the importance of relationships, addressing systemic barriers, principles of anti-racism and cultural safety and addressing burnout. The study emphasizes that relationships are foundational to decolonial practice in healthcare. Building deep, meaningful connections with the people we serve and with colleagues is crucial for understanding individual and historical contexts, fostering trust, and providing safe, personalized care. Leaders should be aware of the systemic barriers that impede decolonizing practices. These include time constraints, regulatory pressures, and a focus on efficiency over personalized care, which often conflict with the goals of providing culturally safe and client-centered care. The integration of cultural safety and anti-racism principles is vital. This involves reimagining healthcare with Indigenous knowledge at its core, informed by the lived experiences and wisdom of Indigenous communities. Provider burnout is a significant issue that affects both the quality and safety of care for families and individuals as well as provider satisfaction and overall wellness. Developing comprehensive, systemic strategies to address burnout, including promoting wellness and resilience among healthcare providers, is essential for sustaining decolonizing efforts. These efforts require organizational commitments to systemic challenges and individual commitment to ensuring continued reflexivity and growth. This further emphasizes that healthcare education must include comprehensive cultural competency training, experiential learning opportunities with Indigenous communities, and ongoing self-reflection practices for providers to continually develop and build their decolonizing competencies.
How is the organization moving change forward based on your work?
CINHS has established and is continually refining its commitments to collaborative care models. CINHS and other healthcare organizations can enhance collaborative care by integrating Indigenous knowledge and traditional healing practices into all aspects of healthcare delivery. This requires a systemic shift from efficiency-driven models to those that value relationships and holistic care. CINHS centers inclusive decision-making by actively involving Indigenous leaders and clients in decision-making processes at all levels. CINHS seeks to ensure that healthcare services are reflective of and responsive to Indigenous perspectives and needs through the inclusion of its cultural guiding body, Dakelh Bughuni, through the teachings and guidance of Elder Lucy and through ongoing formal and informal consultation with clients. CINHS additionally seeks to create safe spaces for both the people it serves and its staff, providing access to traditional debriefing methods and continually seeking to ensure frontline leaders are equipped to support culturally safe practices, which are critical steps in moving change forward.
What surprised you about your experience of the thesis process?
I experienced profound personal growth through this project. Though I wrote in my original ethics proposal that this type of project may bring up challenging emotions and reactions for both researchers and participants, I was not quite prepared for the level of deep, personal sharing that occurred. Maintaining reflexivity as a researcher in a subject matter that is so deeply personal to me was much more difficult than I thought it might be, and it took me a lot longer to review the raw data than I had anticipated as I needed to take frequent, sometimes long breaks.
Participants highlighted significant personal growth through their engagement in the study, often in uncomfortable but transformative ways, bringing to light the importance of experiential learning and self-reflection in the decolonizing journey. The emotional toll of working in colonial healthcare systems was a recurrent theme, with many participants expressing distress over the lack of culturally safe practices and the systemic racism they encountered. The emotional toll of these impacts on providers was more pronounced than I had anticipated. I learned how much participants care about the people they serve, how impacted they are by time pressure, efficiency measures, and how much they want to provide high-quality care.
How are you applying lessons learned from your whole MA-Leadership journey?
The lessons learned here emphasized the importance of advocating for systemic reforms that align healthcare practices with decolonizing principles, challenging existing power structures and promoting policies that support culturally safe care. Applying the understanding of burnout and its impacts, as a healthcare leader, I focus on creating supportive work environments that promote true wellness, resilience, and a culture of continuous learning and self-reflection. In my leadership roles, I am actively working to integrate these principles across all areas of healthcare I am involved in.
I am implementing ongoing cultural competency training and reflexivity into organizational practices to ensure that healthcare providers continually develop their skills and understanding of providing culturally safe care. This includes facilitating immersive learning experiences with Indigenous communities and incorporating feedback mechanisms for continuous improvement.
I firmly articulate the value of collaborative decision-making processes that include Indigenous voices and perspectives. It is through developing meaningful partnerships and power-sharing arrangements with Indigenous Peoples and communities that inclusive and responsive healthcare systems are built. I am committed to ensuring that these collaborative efforts are integral to the fabric of healthcare delivery models. I am working to foster an environment where decolonizing practices are the norm, and where providers and patients are fully collaborative partners in care and health systems co-design.