Centering First Voice in Indigenous Ways of Knowing in a Foundational Indigenous Health Course

Abstract

In Fall 2024, the University of Calgary Faculty of Nursing launched its inaugural Indigenous health course within the new Bachelor of Science in Nursing curriculum. Rather than simply providing a stand-alone course, this first-year course provides the foundation for ongoing learning and transformation needed to prepare nursing students to provide culturally safe care to Indigenous peoples. In this article, we will share the curriculum design process and implementation of the first iterations of the course. We will highlight the long-standing relationships and trust built over years that made it possible for a group of women (a Mi’kmaw/Irish/English settler scholar, a Scottish/German settler nurse scholar, and a Lakota/Dakota Elder, and scholar) to work together from course design to implementation and validation. Through the embodied practice of “first voice” as eloquently articulated in the epilogue by Graveline, we are leading change through stories of lived experiences that enable us to forefront Indigenous ways of knowing, being, doing, and connecting from our unique locations.

Implications for Knowledge Transfer

Indigenous Elder and community engagement in curriculum design, teaching, and validation are rooted in long-standing, trusting relationships and require time, resources, and relational accountability.

When teaching about Indigenous health, it is important to start with the pre-contact history of Indigenous peoples and to come from a strengths-based approach.

Truth-telling about the formation of settler-colonial nations must problematize colonial systems of power and privilege that impact Indigenous people's health and well-being.

Transformational learning through Indigenous ways of knowing, being, doing, and connecting involves self-reflection and meaning-making that prioritize relationality

. . . Embrace First Voice . . . “the Voice of Experience”

Rooted in Identity.

The Authority of Lived Experience.

Particular . . . Specific . . . Detailed

Embedded . . . Imbued with meaning

Our Personal . . . Structural

Political Cultural Locatedness.

First Voice.

Opportunity for previously spoken for people

To become Included . . . Part of the curriculum.

We First Voices

Embodied Teachers.

The Artifact on display

All eyes on We teach.

With our Experiences . . . with our Voices

Our Heart-felt Voices . . . with our Lives.

Reaching Inside our Everyday Lived Experiences

We Gift to others our “Voice of Experience”

The Pain . . . Loss . . . Anger

Strength to Heal . . . cost of Resistance

In ourselves, our families, our communities

To Earth Mother.

First Voice Cries Out at Me . . . Screams out at Me

Sorrow lodges in my Heart

Anger pumps through my veins

Resistance inspires me . . . tickles my Funny Bone

Awakening my conscience . . . Enlightening my consciousness

I learn . . . learned . . . am learning

From you . . . of you . . . through you

Through me . . . of me . . . from me.

Whether we speak them to your ears or

We enter through your eyes from a page

Our words Echo in your brain.

What can you learn through our stories?

(Graveline, 1998, p. 117)

In Fall 2024, the University of Calgary, Faculty of Nursing launched its inaugural Indigenous health course within the new Bachelor of Science in Nursing curriculum (There are three distinct Indigenous people groups in Canada: First Nations, Métis, and Inuit). Rather than simply providing a stand-alone course, this first-year course provides the foundation for ongoing learning and transformation needed to prepare nursing students to provide culturally safe care to Indigenous peoples. In this article, we highlight the long-standing relationships and trust built over years that made it possible for a group of women: (a Mi’kmaw/Irish/English settler scholar, a Scottish/German settler nurse scholar, and a Lakota/Dakota Elder and scholar), to work together from course design to implementation and validation. We forefront the ways relationality, strengths-based approaches, and Indigenous ways of knowing have enlivened our course development in the first iterations of the course.

This foundational course provides students with a compassionately curated curricular arc that begins with Indigenous pre-contact histories and uncovers the ongoing disruption of settler colonial violence that continues to shape the lives of Indigenous peoples in Canada. We help students understand the impacts of systems of power and privilege that benefit dominant society and harm Indigenous peoples. Through the embodied practice of “first voice” (Graveline, 1998), we are leading change through stories of lived experiences that enable us to forefront Indigenous ways of knowing, being, doing, and connecting from our unique locations.

To address the pressing need to prepare future nurses to provide ethical care to Indigenous peoples, we draw on cultural safety, an educational model and pedagogy first developed by a Maori nurse, Dr. Irihapeti Ramsden (Hunter et al., 2021; Ramsden, 2002). Within the Canadian context, a First Nations-led health governance organization, the First Nations Health Authority (FNHA), describes cultural safety as a relational outcome based on respectful engagement across difference where health professionals recognize and redress power imbalances informed by the socio-historical context of colonial violence. Importantly, cultural safety has been achieved when the Indigenous person affirms it and it results in an environment free of racism and discrimination (FNHA, n.d.; Hunter et al., 2021; Ramsden, 2002). Cultural humility involves an ongoing process of self-reflection and self-critique combined with a willingness to humbly learn from others and to position them as experts of their own experience. Cultural humility enables cultural safety.

Background

The Faculty of Nursing's Indigenous health course aligns with the nation's response to the truth about Canada's historic and ongoing colonial violence against Indigenous peoples. The Truth and Reconciliation Commission of Canada (TRC) (2015) released its final report in response to the stories of more than 6,000 survivors of the Indian Residential School (IRS) system, a deeply problematic outworking of the nation's assimilatory policies from the 1880s to 1990s. The report contained 94 Calls to Action to guide systemic change within sectors of society complicit in the IRS system and responsible for ongoing harms impacting Indigenous peoples. Call to Action #24 requires all nursing schools in Canada to provide an Indigenous health course to teach about:

The history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism. (TRC, 2015, p. 7)

As a faculty, we recognize that Indigenous-specific racism remains embedded in the health-care system and acts of discrimination by health professionals continue to harm Indigenous peoples (Canadian Indigenous Nurses Association and Canadian Association of Schools of Nursing, 2025). We have a responsibility to prepare future nurses to understand the impacts of colonialism and to equip them with the knowledge and skills required to enact anti-racist and culturally safe nursing care. When asked for her advice on what we should teach our students, Bonnie Healy, a Blackfoot nurse leader urged us to, “teach your students to stop harming our people” (B. Healy, personal communication, January, 2024). We strive to go beyond this call to prepare future nurses with the requisite knowledge, skills, and attitudes to disrupt systems of harm and promote the health and wellbeing of Indigenous peoples.

Development Process

While different nations and communities will have different protocols that define who an Elder in their community is, we offer this definition by The Aboriginal Healing Foundation (2005) as “[S]omeone who is considered exceptionally wise in the ways of their culture and the teachings of the Great Spirit. They are recognized for their wisdom, their stability, their humor and their ability to know what is appropriate in a particular situation. The community looks to them for guidance and sound judgment. They are caring and are known to share the fruits of their labours and experience with others in the community” (p. 4).

To ensure that the Indigenous health course is grounded in the knowledge, stories, and particular context(s) of Calgary, Alberta, Canada, where we offer our nursing program, we consulted Elders with long-standing connections to place. In the spirit of reciprocity, and following local protocols, we offered traditional tobacco and honoraria to ask for their guidance. We held two talking circles with these invited Elders with whom we have relationships where we sought their guidance about how best to teach nursing students about Indigenous health and the impacts of colonization. They advised us to begin with pre-contact history to provide students a foundational understanding of the beauty and long-standing sustainability of traditional ways of knowing, being, doing, and connecting. It is important, they told us, to point out the health systems, education systems, natural laws, spirituality, and justice systems that had existed for millennia before colonization. We also offered tobacco and honorariums and invited practicing Indigenous nurses to sit in circle with us and tell us what they had learned in nursing school about Indigenous health (most said they learned little to nothing), and what they wish they had learned, so that we could include it in our curriculum. At the top of their list was the true history of settler-colonial violence in Canada and its ongoing legacy that structures the lives of Indigenous peoples.

In response to the guidance of Indigenous nurses and Elders, our course connects historical colonial policies to Indigenous peoples’ present-day health outcomes. Specifically, we teach about the historical/political/social context of colonization, beginning with the papal bull, Inter Caetera, that informed the creation of the Doctrine of Discovery which justified the stealing of Indigenous lands and subjugation of Indigenous peoples in what was known as the new world (Alexander VI, 1493). From the Doctrine of Discovery to the Indian Act, we trace Canada's assimilationist policies that continue to control, define, and directly impact the health and well-being of First Nations peoples today. In Canada, the Indian Act of 1876 and subsequent amendments (Indian Act, RSC 1985, c. I-5, 2025) apply only to First Nations peoples with status. The Indian Act defines who is First Nations, and thereby their relationship to the Crown.

Over the course of the following year, we (Michelle, Heather, and Evelyn) met frequently to co-design and compassionately curate the course description, learner outcomes, weekly readings, and assignments. Drawing on the work of LaFever (2016) about creating learner outcomes that support Indigenous ways of knowing, we pushed against a Western model of conceptualizing learner outcomes as solely psychomotor, affective, and cognitive domains. We included the spiritual domain to make space for learner outcomes that support Indigenous ways of knowing, being, doing, and connecting. Given that our goal is student transformation, we privileged meaning-making in our assessment of student learning, with a focus on self-reflection and positionality as a necessary first step toward cultural humility and cultural safety (FNHA, n.d.; Ramsden, 2002).

Recognizing the importance of Elder validation in the implementation and teaching of this course, we prioritized Evelyn's time and first voice contributions with ongoing discussions and adjustments to the course through the fall and winter semesters. In countering the tendency to seek Elder approval as a “check box,” we honored Indigenous ways of doing in the validation process by cultivating relational accountability in our curriculum development process (Taylor Institute for Teaching and Learning, 2022).

The Four Elements Indigenous Framework

Through the curriculum development process, four core themes emerged: self-in-relation, service and reciprocity, relationships to land, and anti-Indigenous racism. We connected these curricular themes to the four elements: air (understand self-in-relation to settler colonialism and systems of power and privilege), fire (practice principles of service and reciprocity for the benefit of Indigenous peoples, communities, and land), earth (unlearn colonial constructs and renew and repair relationships to land), and water (recognize the ways that anti-Indigenous racism shows up in health care and develop skills to disrupt racism and create cultural safety through cultural humility). We introduce students to the Four Elements in this foundational course through group discussion assignments with curated readings, videos, and reflection prompts. These curricular apertures are also taken up by the broader Faculty of Nursing as the Four Elements Indigenous Framework and will be further developed as curated curriculum resources to be integrated into every term throughout the BScN program.

A Different Approach

To understand the health disparities experienced by Indigenous peoples in Canada, it is important to problematize settler colonialism. Rather than being an event of the past, settler colonialism is a structure that continues to affect the lives of Indigenous peoples through systems of colonial violence and ongoing structures of harm (Tuck & Yang, 2012; Wolfe, 2006). Settler colonialism is a system predicated on the replacement of Indigenous peoples by settlers who structure society according to their own logics, laws, and culture, centered around the accumulation, ownership, and exploitation of land and resources (Tuck & Yang, 2012; Wolfe, 2006). Settler society flourishes because it is built upon the colonial logic of the erasure and replacement of Indigenous peoples. According to the definition provided by the United Nations Convention on the Prevention and Punishment of the Crime of Genocide (1948) and further documented by the National Inquiry into Missing and Murdered Indigenous Women and Girls (2019), such actions/policies/atrocities can be defined as genocide. The outworking of genocidal policies results in significant health disparities between Indigenous and non-Indigenous peoples in Canada (Allan & Smylie, 2015; Browne, 2017). These differences are linked to structural racism and power and privilege embedded within society and the health-care system. By reflecting on the effects of colonialism and the ways it is structured to erase and harm Indigenous peoples while benefiting dominant society, we gain a more truthful creation story about Canada (Bensler, 2022; Donald, 2009). Truth-telling is a fundamental first step toward transformation (Regan, 2010).

Through colonialism and genocide, Indigenous peoples were removed from their land and separated from their families, languages, and cultures (McIvor, 2013). In a guest lecture, Blackfoot epidemiologist Chyloe Healy (C. Healy, personal communication, October 2024) shared with our class how cultural, spiritual, land-based, and community connections support health. Healy challenged students to consider how Blackfoot ways of knowing, being, doing, and connecting foster a sense of connection to the land, to ceremonies, community, language, and traditional knowledge. Through first voice teachings, she emphasized the importance of embodying Blackfoot values and teachings to counter the colonial interruptions that displace and disrupt Indigenous health. What is needed, she urged us, is the measurement of health indicators that align with community strengths as defined by each nation. When health is measured solely by Western standards, what is often measured is the impact of colonial disruption on Indigenous peoples rather than Indigenous understandings of health and well-being, which focus on the strengths of Indigenous culture, spirituality, and language.

When introducing Indigenous health within curricula, many educators focus on Indigenous sickness rather than Indigenous wellness. To counter this tendency to problematize Indigenous communities for these health inequities, we heeded the teachings of Elders who encouraged us to start our course with pre-contact Indigenous history in Canada. It is important, they told us, for students to understand that Indigenous peoples had longstanding education, health, economic, and justice systems to support their health and wellbeing over millennia. As Indigenous health scholars Askew et al. (2020) say,

A strengths-based approach in Indigenous health demands a radical rethink of Indigenous peoples, communities and capabilities to enable this different way of working with. Within health, we typically learn ‘about’ Indigenous peoples and therefore miss out on the opportunity to become with – to be in relationship with and thereby learn with and from – acquiring in the process a different disposition or way of being. (Askew et al., p. 105)

To address this demand, we prioritized first voice accounts and a relational pedagogy.

Relational Pedagogy as Theory and Meaning Making

One way we are working to dismantle oppressive structures within nursing education is to make visible our relationships as female-identifying educators to settler colonialism, systems of power and privilege, the land, and each other. Co-developing and co-teaching an Indigenous health course grounded in Indigenous ways of knowing demands that we bring our whole selves to this work. To do so requires trust among us and a belief in our ability to lead transformation and change. Rather than being led by theory, we witness the emergence of theory and meaning making within our relational pedagogy. We align with Nishnaabeg scholar Leanne Simpson's (2017) articulation of theory:

Theory isn’t just an intellectual pursuit. It is woven within kinetics, spiritual presence, and emotion. It is contextual and relational. It is intimate and personal with individuals themselves holding the responsibilities for finding and generating meaning within their own lives. (Simpson, p. 151)

Who we are matters. Where we come from matters. The stories that form us matter. As Evelyn reminds us, the goal is to become fully human, which means we need to know where we come from to know our responsibilities and the way forward. Within an Indigenous context, locating ourselves is of utmost importance; where we are from and who claims us tells the story of how we know the world, our experiences, and our interpretations of them (Absolon & Willet, 2004). We invite you to witness, dear reader, as we introduce ourselves and the ways our stories have intersected to form the necessary foundation for this work. From within a relational paradigm (Kovach, 2009; Wilson, 2008), we describe in detail the formation of our relationships, making visible Indigenous ways of knowing, being, and doing.

Elder Evelyn Good Striker

Evelyn is Lakota Dakota from Standing Buffalo First Nation in southern Saskatchewan and the Cheyenne River Sioux Tribe in South Dakota. Her maternal Lakota ancestors journeyed to Canada after annihilating the American Seventh Cavalry at the Battle of Little Big Horn in what is now southern Montana in 1876. She is a descendant of Chief Black Moon and a relative of Chief Sitting Bull, who led thousands of Lakota families to settle in southern Saskatchewan. Lakota descendants of this migration continue to live there today on a small reserve called Wood Mountain. Her paternal Dakota ancestors came to Canada after the Dakota uprisings of 1862, which had the most casualties on both the settler/newcomer side and the Dakota. This war was caused by many factors stemming from settler encroachment on Dakota territory, including starvation, removal from traditional lands, wild game extinction, and disease (University of Minnesota, n.d.). The people were led by Chief Standing Buffalo to the Fort Qu’Appelle area in southern Saskatchewan, where the Standing Buffalo First Nation now sits. Evelyn attributes her character, her personality, and her strength to these courageous acts of service for the survival of her nations, her family, and herself.

Growing up on the reserve in Saskatchewan was difficult without running water, central heating, or electricity. Evelyn's family survived through the hard work of both her parents; her father was a carpenter and farmer, and her mother worked local seasonal jobs and sold her crafts of quillwork and beadwork. In the summertime, the family grew a large garden. Hunting and fishing often supplemented the food supply. In the loving support of family and her large extended kinship network, she was raised in spirituality, language, traditions, and social order of the cultures of the Lakota/Dakota, Peoples of the Plains.

Evelyn grew up under the colonial assimilative education policies of the Canadian government, forced to attend Indian Day School, Indian Residential School, and public school away from her community. Such displacements and removals separated Evelyn from her loving family, culture, and language. Despite this, Evelyn went on to complete her graduate degree and embark on her reclamation journey of healing and re-connection to her culture, spirituality, and language. Evelyn knows who she is as a Lakota/Dakota woman living with the strength and teachings of her ancestors. Evelyn had a long career as a classroom teacher and administrator and served as the first Indigenous Director of Education for the Province of Alberta. She has served on many committees and boards as an education and cultural advisor. Evelyn serves as an Elder and advisor to Indigenous research, curriculum development, and teaching and learning practices in several faculties at the University of Calgary.

Michelle Scott Paul

Michelle Scott Paul is Mi’kmaw on her dad's side, the Paul family who had hunted, fished, and trapped in the area now known as Badger, and were the first permanent inhabitants that made the banks of the Exploits River and the Badger River their home in the interior of Newfoundland (Ktaqmkuk). The Roberts family on her mom's side, also from Badger, trace roots and routes back to Ireland and England from the late 1700s to mid-1800s. Newfoundland was the point of first contact for the European colonizers, starting with the Vikings in 1000 AD, and then Giovanni Caboto in the late 1400s. The long history of colonization on the island of Newfoundland has been brutal. With the genocide of the Beothuk, often misunderstood as the only people Indigenous to the island of Newfoundland. The mercenary myth (Wetzel, 1995), espousing that the Mi’kmaq were brought over to the island to help the British fight the Beothuk, forwards the settler colonial narrative that the Irish/English immigrants-cum-Newfoundlanders are the “rightful” inhabitants of the land. The Mi’kmaq and all other Indigenous peoples in Newfoundland and Labrador were not recognized as Indigenous to place in the terms of the agreement between Canada and the newly formed province when they joined the Canadian confederation in 1949 (Hanrahan, 2003; Neary, 2012). While the government recognized there were Indigenous peoples in both Newfoundland (Mi’kmaw), and Labrador (Innu), they asserted that the Mi’kmaw and Innu peoples had already assimilated and were “enjoying” all of the rights and privileges of citizenship. Therefore, by not recognizing them under the Indian Act, they were enfranchised without consent.

Following decades of fighting for recognition as First Peoples, the Mi’kmaq of Newfoundland now have two bands that are recognized by the Canadian Government. This colonial process, however, continues to be filled with contention. It is within this fractured story that Michelle grew up with her Mi’kmaw great grandfather, William John Paul, who joined her and her parents in the suburbs of Toronto in the early 1970s and shared stories of hunting and trapping on their traditional territory all of his life, and raising her dad, George, along the shores of the Exploits River to do the same. Michelle's journey of reclamation and responsibility to her Mi’kmaw kinship ties, as well as to her responsibilities to Calgary, where she has lived for the past 25 years, is at the forefront of Michelle's work and life (Scott, 2023). Michelle has worked in the Indigenous community in post-secondary education since 2014 and at the University of Calgary since 2023. She currently serves as an assistant professor (teaching) and is the associate dean for Indigenous education within the Faculty of Nursing.

Heather Bensler

Heather is a settler of Scottish and German heritage whose family immigrated to Canada in the late 1800s and homesteaded in Northern Alberta and British Columbia. Born and raised in Calgary, Heather completed her Bachelor of Nursing degree at the University of Calgary in the 1990s, though she did not begin to learn a more truthful narrative about Canada's colonial history until she was in graduate school. Troubled by the revelations about Indian Residential Schools, she questioned her parents about their knowledge of Canada's hidden past and soon learned that her paternal grandparents worked at the Port Alberni Indian Residential School, a school known for experiments on children (Bensler, 2023). Rather than turning away from the truth, Heather continues to lean into the discomfort required for transformation and seeks to share her learning with others. Her research focuses on white settler identity formation and how to build the capacity of nursing students to recognize and disrupt anti-Indigenous racism in health care. Heather is an associate professor (teaching) and the assistant dean for academic partnerships, where she oversees the development of the faculty's rural and Indigenous nursing programs.

How We Met

Michelle and Evelyn

Michelle and Evelyn met at a Truth and Reconciliation Forum in Calgary in June 2014, facilitated by Chief Robert Joseph Sr, in Michelle's second month in her new role as the First Nations, Métis, and Inuit Liaison Specialist at St. Mary's University in Calgary, Alberta. Evelyn was there as the Co-Chair of the Calgary Urban Aboriginal Affairs Committee and a residential school survivor. Having enjoyed each other's company, Evelyn invited Michelle to visit her the following month at the Kainai Nation Pow Wow and Rodeo. Thus began a 10+ year relationship that has spanned course curation and co-teaching at St. Mary's University and the University of Calgary. Evelyn supported Michelle through her doctoral journey as a Wisdom Guide and traveled to Michelle's home community in Ktaqmkuk for her ceremonial Give-Away. Their relationship is characterized by love, trust, and a deep sense of kinship (and always laughter).

Heather and Michelle

Heather and Michelle met at an Indigenous event in 2017 and then reconnected in 2019 when they enrolled in the same Doctor of Education program through the University of Calgary. They paired up for group work, and their relationship grew over their joint interest in interrogating the role that colonial violence had in shaping their respective lives. For their doctoral work, they each embarked on self-in-relation journeys taking up Indigenous Métissage (Donald, 2012) to try to understand, unlearn, and relearn how to be good relatives to each other and to their other-than-human kin. Centering an Indigenous worldview upholds the interdependency of relationships that include animals, insects, plant and tree-life, the land, bodies of water, and the cosmos. When Michelle joined the Faculty of Nursing, after being recruited and championed by Heather, Evelyn was invited to join for curriculum development and now is at the heart of Indigenous education in the faculty.

Problematizing Settler Colonialism Through Personal Stories

We believe it is important for each of our voices and stories to be shared in the classroom as an intentional relational pedagogy. As Papaschase Cree scholar Dwayne Donald (2019) reminds us, “Stories that give life emerge from people sitting together in the spirit of good relations and thinking carefully on their shared future as human beings” (p. 121). To illustrate the differences between imperialism and settler colonialism, Heather shared photographs and stories of her British ancestor, General Alexander Dirom, who led imperial conquests into both India and Jamaica during the late 1700s before his descendants immigrated to Canada and homesteaded in British Columbia She draws connections with the imperial hubris that informed her ancestors’ journeys, which culminated in her grandparents’ employment in the Indian Residential School System. The process of uncovering these ancestral stories through her research was unsettling and was part of her healing journey that moved her towards responsibility and action rather than shame and blame. Because many of the nursing students identify as Canadian and/or white, it is instructive to have the first voice perspective of a white settler Canadian who is willing to share the difficult truths of the ways their family has benefited from colonial violence.

To make visible the ways colonial violence has impacted her sense of belonging to land and family connections to Ktaqmkuk, Michelle animates stories related to her conceptualization of “colonial shrapnel” that emerged through her doctoral research:

I envision colonial shrapnel as a curricular aperture. I am coming to know it as the ways in which colonial violence is embedded within our bodies through generations of spiritual, emotional, and blood and bone memory. I envision it as the shards of bullet fragments that came showering down through systems of colonial violence since colonization. I believe that, as a concept we can animate, define, and trace the ways in which these shards live in each of us as individuals with the collective root of colonial violence embedded in the settler colonial project. Colonial shrapnel then, is a composite of the different ways that systems: education systems, health systems, legal systems, pass down through family systems to create unique and damaging fragments that live in our bodies, and at the same time inhibit our movements, cloud our thoughts - entrench, and limit our beliefs. (Scott, 2023, pp.13–14)

Michelle brings first voice stories of reclamation and re-membering herself as a Mi’kmaw woman, demonstrating how connections to kinship ties, land, language, and ceremony have contributed to her own sense of health and wellbeing. While it is easy to see how these stories may be instructive for Indigenous students who are on their own journey of reclamation, we have also witnessed how students from other colonized nations are inspired to take up their own journey of reclamation.

In our course, Evelyn embodies a strengths-based perspective of Indigenous cultures, languages, and spirituality within the classroom. Invited to share in every class, her stories exemplify Indigenous survivance and the beauty of Indigenous ways of knowing, being, doing, and connecting. Evelyn's presence as an Elder and teacher counters the negative stereotypes and colonial logics of erasure common in Canadian discourse and health care. These first voice teachings provide the foundational understanding for why nurses should promote Indigenous health and wellbeing, through supporting individual and system-wide access to culture, language, and spirituality.

Student Transformation

Canada's settler colonial history remains hidden from dominant society (Regan, 2010), and many students are learning about its impacts for the first time. While we are concerned about the risk of vicarious trauma, particularly for Indigenous students, we regularly check in with students and provide trigger warnings before sharing disturbing content to mitigate harm. Many Indigenous students shared that learning the truth about colonial violence has transformed their understanding of their own lived experiences.

In our course, we draw on Dwayne Donald's (2021) understanding of colonization as multiple sites of relationship denial and invite students to unlearn colonialism by seeking to repair and renew their relationships to land, to Indigenous peoples, to themselves, to each other, and to their other-than-human kin. At the completion of our third iteration of teaching the course, we have been buoyed by the transformations we have witnessed in the students.

Through a land photo journal assignment, we invited students to spend intentional time on the land in their same chosen spot and to reflect on their evolving relationship with the land over time. As Shivneet Toor, a first-year student, reflected, “I now see the land as a living, interconnected sacred space which holds history, sustains life, and calls for my respect, responsibility and continuous acts of reciprocity” (Toor, 2025). Another way we see transformation at work is in the students’ growing understanding of themselves as nurses. Because our program does not include a clinical component in the first year, students have often shared that they do not feel a connection to nursing until their second year. However, we have found that, through this course, students are starting to see themselves as nurses and are beginning to articulate their responsibilities to practice in a culturally safe manner, to disrupt anti-Indigenous racism, and to cultivate cultural humility. One surprising way students have grown in their self-in-relation journeys is through their desires to re-member and reclaim their unique cultural inheritances that have been disrupted by colonial violence. For instance, several students have reclaimed their non-English names and have felt comfortable wearing cultural clothing or regalia at school. Through unlearning colonialism, they are repairing their relationships first and foremost to themselves.

Sustainability and Lessons Learned

The human and financial resources required to design and implement this course in a good way have been substantial. We received significant financial support from the faculty's leadership to provide honoraria for Evelyn's weekly contributions to the course, from conception to teaching and validation. Ongoing discussions were required to help the faculty leadership and curriculum team understand and value an Indigenous approach to curriculum design and implementation within the Western academy. We privileged a relational approach throughout the process, even when it was in direct conflict and countered expectations and university processes. For the first three iterations of the course, Michelle and Heather chose to co-teach even when our teaching assignments did not reflect this commitment. It took considerable mental, physical, emotional, and spiritual labor, yet all felt it was necessary to spend concentrated time together preparing and refining the course as it was being implemented.

Due to human resource and financial constraints within the faculty, we acknowledge that it is not feasible to have a three-person teaching team moving forward, so our next steps are to create video resources to support our first voice contributions to the course. We have found value in having each of our voices and lived experiences present in the classroom, and all agree to have recordings of our stories available to contribute to ongoing course offerings. In addition, to maintain the integrity of the course, which we poured our hearts into, we are also recording the entire lectures from our online version of the course. We want to support future instructors with resources so they can draw on them and, most importantly, can understand the intention behind our curriculum choices.

Conclusion

We offer this story of how we privileged relationality, Indigenous ways of knowing, and first voice stories in the co-creation and implementation of a first-year Indigenous health course within a Bachelor of Science in Nursing program in Canada. The curriculum fostered self-reflection, empathy, and understanding by integrating Indigenous pre-contact histories, addressing the ongoing impacts of settler colonial violence, and sharing first voice stories. By bringing our whole selves to the creation and implementation of this course, we welcomed students into the vulnerable work of deep learning and transformation needed to foster cultural humility. We made visible how we could not have accomplished this work without the longstanding, trusting relationships that underpin our collaborative efforts and characterize our ongoing commitment to educate culturally safe nurses. We invite you, dear reader, to consider how this approach to curriculum design and implementation might serve as a path toward transformational change for both educators and students.