Pharmacy lab builds students' Indigenous health knowledge

Cloé Lafleur was among the first University of Toronto students to participate in a novel lab at the Leslie Dan Faculty of Pharmacy that focused on counselling Indigenous patients on medication and health issues – and says she got so much out of the initiative last year that she decided to get involved.

“The response from my cohort was so overwhelmingly positive," says Lafleur, a Doctor of Pharmacy (PharmD) student. “Even this small bit of exposure from one lecture and lab made people so much more aware of Indigenous health, and it allowed us to have so many more productive conversations, even in casual settings.

“I saw the ripple effect that it had on students and how they wanted to branch out a bit more and learn more about it.”

The medication therapy management lab is organized by Jaris Swidrovich, an assistant professor at the Leslie Dan Faculty of Pharmacy who is the faculty’s Indigenous Engagement Lead.

Swidrowich says the idea is not to teach students everything about Indigenous health and cultures, but help them learn to navigate different knowledge systems and communicate respectfully with Indigenous patients.

“We want to give them some strategies to navigate those intercultural conversations without talking down about a particular knowledge system, ensuring that they build trust with their Indigenous patient and providing a safe environment,” says Swidrowich, a Two Spirit Saulteaux First Nations and Ukrainian man and pharmacist from Yellow Quill First Nation.

“There's no secret right answer. But it’s important to be able to have a good, respectful conversation that recognizes the importance of Indigenous knowledge systems, traditions and ceremonies to have a positive therapeutic relationship.”

For this year’s lab, which took place in early February, LaFleur helped train the Indigenous standardized patients – the people who play the role of patients for educational purposes.

“We’re so grateful for the First Nations, Inuit and Métis standardized patients because we couldn't run this lab without them,” says Lafleur. “They offered up their time and lived experiences with the health-care system to help make us better practitioners.”

The lab, a partnership between the Leslie Dan Faculty of Pharmacy and the Indigenous Pharmacy Professionals of Canada, was developed in part to respond to several of the Truth and Reconciliation Commission of Canada’s calls to action to address the ongoing impacts of residential schools and advance reconciliation with Indigenous Peoples – specifically the call to action to develop skills-based training in intercultural competency for students in health-care fields.

Prior to the lab, Swidrovich gave a lecture that provided students with sufficient information to effectively and respectfully work through cases with Indigenous patients.

Then, as part of the lab, the students practised applying their knowledge with the standardized patients who were scripted to ask the students about issues highly specific to Indigenous Peoples centred around a common health condition: high blood pressure.

For example, one scenario involved a patient asking whether they could attend a sweat (also known as a sweat lodge) while taking blood pressure medication, while in another scenario the patient asked about potential interactions between their prescription medication and an Indigenous traditional medicine.

Swidrovich says the lab was an overwhelmingly positive experience for everyone who participated.

Students said they felt more confident in their knowledge and skills, while the standardized patients said they felt the students created a respectful, safe environment and that they learned and appreciated more about pharmacy practice.

Swidrovich is now working with other pharmacy programs across the country to develop their own Indigenous-focused labs.

Lafleur, for her part, says that she hopes that the students who participated in the lab this year will – like her cohort – continue learning about how they can improve the care that they provide to Indigenous patients.

“Even if something is not your area of expertise, the more you have conversations about it, the more you're able to respond appropriately,” she says. “When you're interacting with patients who might have different views on medicine than you do, you can still have a respectful and positive interaction, and that patient is more likely to feel comfortable coming back to you in the future.”