Do indigenous health curricula in health science education reduce disparities in health care outcomes?

Objective: To undertake a systematic literature review to determine the scope, rationales, and evaluation foci of indigenous health curricula included in university-based professional training of health care service providers. Study design: Systematic review. Data sources: We searched the Australasian Medical Index, ATSIhealth (Aboriginal and Torres Strait Islander Health Bibliography), CINAHL PLUS, MEDLINE, SCOPUS version 4, and Web of Science databases using relevant keywords. Our initial search identified 1247 articles and our refined search identified 57 articles. Thirty-six articles published between 1999 and 2011 that referred to indigenous health-related curricula within university health science courses were selected for review. Data synthesis: While almost all the articles were explicit that improving indigenous health was an aim of their curriculum, none evaluated the impact of curricula on patient outcomes. Conclusion: There appears to be a widespread assumption in the literature that improving practitioner skills, knowledge and attitudes will lead to improvements in indigenous health outcomes. The literature showed evidence of efforts towards evaluating learner (student) outcomes, but no evidence of evaluation of patient outcomes. We need to begin to design methods that focus on evaluating the impacts of indigenous health curricula on patient outcomes, while continuing to investigate the impact of curricula on learner outcomes.Shaun C Ewen, David J Paul and Gina L Bloo