Payestewa-Picazo Kristin, Godfrey Timian M, Sowicz Tim Joseph, Llanque-White Sarah M, Michalec Barret
Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ, USA.
The University of Arizona College of Nursing, Tucson, AZ, USA.
Creat Nurs. 2025 Aug;31(3):254-262. doi: 10.1177/10784535251359691. Epub 2025 Jul 22.
The underrepresentation of American Indian and Alaska Native (AI/AN) professionals in health care exacerbates health disparities and limits culturally relevant care. The AI/AN students in health professions face challenges such as financial barriers, cultural isolation, and systemic discrimination. This review examines the barriers and facilitators influencing the success of AI/AN students in health professions education, identifying strategies for improvement. A synthesis of 14 peer-reviewed studies examined factors affecting the success of AI/AN students, with a focus on challenges, interventions, and outcomes. Key challenges include academic structures that do not incorporate Indigenous knowledge, a lack of AI/AN faculty and mentors, and the struggle to balance professional training with cultural identity. Interventions such as culturally tailored mentorship, financial support, and retention programs have improved retention and graduation rates. The findings underscore the need for institutional reforms, including the integration of Indigenous perspectives into curricula and the strengthening of partnerships with tribal colleges and universities. While short-term programs offer vital support, addressing systemic issues requires long-term structural change. Future research should focus on longitudinal studies, policy evaluations, and holding institutions accountable for advancing equity in health-care education.
美国印第安人和阿拉斯加原住民(AI/AN)专业人员在医疗保健领域的代表性不足,加剧了健康差距,并限制了具有文化相关性的护理。从事健康职业的AI/AN学生面临着经济障碍、文化孤立和系统性歧视等挑战。本综述探讨了影响AI/AN学生在健康职业教育中取得成功的障碍和促进因素,并确定了改进策略。对14项同行评审研究进行的综合分析,考察了影响AI/AN学生成功的因素,重点关注挑战、干预措施和结果。关键挑战包括未纳入本土知识的学术结构、缺乏AI/AN教师和导师,以及在平衡专业培训与文化身份方面的困难。诸如量身定制的文化指导、经济支持和留校计划等干预措施,提高了留校率和毕业率。研究结果强调了进行机构改革的必要性,包括将本土观点纳入课程,以及加强与部落学院和大学的伙伴关系。虽然短期项目提供了至关重要的支持,但解决系统性问题需要长期的结构性变革。未来的研究应侧重于纵向研究、政策评估,以及要求机构对促进医疗保健教育公平负责。