Employing Indigenous methodologies to transform dental and medical education


  • Cathryn Forsyth Faculty of Medicine and Health, The University of Sydney
  • Peter Malouf Faculty of Medicine and Health, The University of Sydney
  • Stephanie Short Faculty of Medicine and Health, The University of Sydney
  • Michelle Irving Faculty of Medicine and Health, The University of Sydney
  • Marc Tennant International Research Collaborative, Oral Health and Equity, The University of Western Australia.
  • John Gilroy Faculty of Medicine and Health, The University of Sydney




Indigenous methodologies, dental, medical, Indigenous health outcomes


Indigenous people in Australia experience considerably more dental and medical ill-health than non-Indigenous people. Cultural competence of dental and medical teams is crucial in the delivery of services to address these health disparities. Traditionally, cultural training has been incorporated later in health education curricula, resulting in students perceiving Indigenous health to be less important, relevant or useful in their future careers. Higher education institutions struggle to incorporate Indigenous culture into curricula to improve educational outcomes for Indigenous peoples and to increase cultural competence of staff and students. This study explores how a team of Indigenous and non-Indigenous researchers navigated the cultural interface to develop an Indigenous curricula model for dental and, potentially, medical programs in Australia. A team of Indigenous and non-Indigenous oral health, dental and social science researchers, together with a Cultural Competence Curriculum Review Reference Group comprising Indigenous and non-Indigenous members, successfully navigated the cultural interface. Collaborations between the reference group and research team at each phase of this research ensured authentication and validity of the data. This study highlights the importance of employing Indigenous methodologies when conducting Indigenous research to improve dental and medical health outcomes for Indigenous peoples.


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Author Biographies

Cathryn Forsyth, Faculty of Medicine and Health, The University of Sydney

Cathryn Forsyth is a registered dental therapist, educator and qualitative researcher. Cathryn implemented the Indigenous strategy and Oral Health in Society curricula in the Bachelor of Oral Health program, School of Dentistry, University of Sydney, for many years. Her research interests include Indigenous student recruitment and retention, cultural competence, community engagement and oral health promotion.

Peter Malouf, Faculty of Medicine and Health, The University of Sydney

Peter Malouf is an Aboriginal (Wakka Wakka and Wuli Wuli) public health researcher and health system executive with experience in research and evaluation focusing on health service, primary care and mental health in Aboriginal and Torres Strait Islander communities. His expertise and skills are in quantitative research methods, systematic review and meta-analysis, mixed method, and evaluation.

Stephanie Short, Faculty of Medicine and Health, The University of Sydney

Stephanie Short is an experienced health sociologist and researcher, skilled in consulting, administration and education in Australia, Europe, North America, the Middle East and Asia.

Michelle Irving, Faculty of Medicine and Health, The University of Sydney

Michelle Irving is a Senior Advisor for the Centre for Evidence and Implementation and an Adjunct A/Prof with the Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney. She has a PhD in implementation of evidence-based practice in chronic kidney disease and was an NHMRC Post-Doctoral Fellow in Translating Research into Practice (TRIP Fellow). Michelle’s research interests include translational research and evaluation, Indigenous health, cultural competence and improving oral health.

Marc Tennant, International Research Collaborative, Oral Health and Equity, The University of Western Australia.

Marc Tennant has been a member of The University of Western Australia academic staff since the early 1990s and is now Deputy Chair of Academic Board. He is Director and Founder of the International Research Collaborative – Oral Health and Equity (formally the Centre for Rural and Remote Oral Health). The collaborative (for over 20 years now) is a global leader in driving reform particularly focused on marginalisation and addressing health inequality.

John Gilroy, Faculty of Medicine and Health, The University of Sydney

John Gilroy is an Aboriginal (Yuin) sociologist in Indigenous health, specialising in disability and ageing research and community development with Indigenous communities, government and non-government stakeholders. John is passionate about Aboriginal-owned and -driven research as a means to influence policy, having led many research projects in urban and rural/remote Indigenous communities.


Aboriginal Health and Medical Research Council of New South Wales. (2013). AH&MRC guidelines for research into Aboriginal health: Key principles. https://www.ahmrc.org.au/wp-content/uploads/2019/07/AHMRCGuidelinesforResearchKeyPrinciples.pdf

Australian Government. (2016). Aboriginal and Torres Strait Islander health curriculum framework. Department of Health. https://www1.health.gov.au/internet/main/publishing.nsf/Content/aboriginal-torres-strait-islander-health-curriculum-framework

Australian Health Ministers’ Advisory Council. (2017). National strategic framework for Aboriginal and Torres Strait Islander peoples’ mental health and social and emotional wellbeing 2017–2023. Department of the Prime Minister and Cabinet. https://www.niaa.gov.au/sites/default/files/publications/mhsewb-framework_0.pdf

Australian Human Rights Commission. (n.d.). Aboriginal and Torres Strait Islander social justice. https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice

Betancourt, J. R., Green A. R., Carrillo J. E., & Ananeh-Firempong II, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302. DOI: https://doi.org/10.1016/S0033-3549(04)50253-4

Betancourt, J. R., Green A. R., Carrillo J. E., & Park E. R. (2005). Cultural competence and health care disparities: Key perspectives and trends. Health Affairs, 24(2), 499–505. DOI: https://doi.org/10.1377/hlthaff.24.2.499

Brondolo, E., Gallo, L., & Myers, H. (2009). Race, racism and health: Disparities, mechanisms and interventions. Journal of Behavioral Medicine, 32(1), 1–8. DOI: https://doi.org/10.1007/s10865-008-9190-3

Brookfield, S. (1995). Becoming a critically reflective teacher. Jossey-Bass Inc.

Chun, M. (2010). Pitfalls to avoid when introducing a cultural competence training initiative. Medical Education, 44, 613–620. DOI: https://doi.org/10.1111/j.1365-2923.2010.03635.x

Connell, R. (2007). Southern theory: The global dynamics of knowledge in the social sciences. Allen & Unwin. DOI: https://doi.org/10.22459/AHR.44.2008.04

Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Georgetown University Child Development Center. https://spu.edu/-/media/academics/school-of-education/Cultural-Diversity/Towards-a-Culturally-Competent-System-of-Care-Abridged.ashx

Downing, R., Kowal, E., & Paradies, Y. (2011). Indigenous cultural training for health workers in Australia. International Journal for Quality in Health Care, 23(3), 247–57. DOI: https://doi.org/10.1093/intqhc/mzr008

Dudgeon, P., Bray, A., Darlaston-Jones, D., & Walker, R. (2020). Aboriginal participatory action research: An Indigenous research methodology strengthening decolonisation and social and emotional wellbeing [Discussion paper]. The Lowitja Institute. https://www.lowitja.org.au/page/services/resources/Cultural-and-social-determinants/mental-health/aboriginal-participatory-action-research-an-indigenous-research-methodology-strengthening-decolonisation-and-social-and-emotional-wellbeing

Dudgeon, P., Bray A., D’Costa, B., & Walker, R. (2017). Decolonising psychology: Validating social and emotional wellbeing. Australian Psychologist, 52(4), 316–325. DOI: https://doi.org/10.1111/ap.12294

Dudgeon, P., Milroy, H., & Walker, R. (2014). Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2nd ed.). Commonwealth of Australia. https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/working-together-aboriginal-and-wellbeing-2014.pdf

Durey, A. (2010). Reducing racism in Aboriginal health care in Australia: Where does cultural education fit? Australia and New Zealand Journal of Public Health, 34(S1), S87–92. https://doi:10.1111/j.1753-6405.2010.00560.x DOI: https://doi.org/10.1111/j.1753-6405.2010.00560.x

Esgin, T., Hersh, D., Rowley, K., Gilroy, J., & Newton, R. (2018). Indigenous research methodologies: Decolonizing the Australian sports sciences. Health Promotion International, 34(6), 1231–1240. DOI: https://doi.org/10.1093/heapro/day076

Farrelly, T., & Carlson, B. (2011). Towards cultural competence in the justice sector [Current initiatives paper 3]. Indigenous Justice Clearinghouse.

Farrelly, T., & Lumby, B. (2009). A best practice approach to cultural competence training. Aboriginal and Islander Health Worker Journal, 33(5), 14–22.

Foley, D. (2006). Indigenous standpoint theory: An acceptable academic research process for Indigenous academics. International Journal of the Humanities, 3(4), 25–36. DOI: https://doi.org/10.18848/1447-9508/CGP/v03i08/41775

Forsyth, C. J., Irving, M. J., Short, S. D., Tennant, M., & Gilroy, J. A. (2018). Strengthening Indigenous cultural competence in dentistry and oral health education: Academic perspectives. European Journal of Dental Education, 23(1). https://doi.org/10.1111/eje.12398 DOI: https://doi.org/10.1111/eje.12398

Forsyth, C. J., Irving, M. J., Short, S. D., Tennant, M., & Gilroy, J. A. (2019). Students don’t know what they don’t know: Dental and oral health students’ perspectives on developing cultural competence regarding Indigenous peoples. Journal of Dental Education, 83(6), 679–686. DOI: https://doi.org/10.21815/JDE.019.078

Forsyth, C. J., Irving, M. J., Tennant, M., Short, S. D., & Gilroy, J. A. (2016). Teaching cultural competence in dental education: A systematic review and exploration of implications for Indigenous populations in Australia. Journal of Dental Education, 81(8), 956–968. DOI: https://doi.org/10.21815/JDE.017.049

Forsyth, C. J., Irving, M. J., Tennant, M., Short, S. D., & Gilroy, J. A. (2017). Indigenous cultural competence: A dental faculty curriculum review. European Journal of Dental Education, 23(1). https://doi.org/10.1111/eje.12320 DOI: https://doi.org/10.1111/eje.12320

Forsyth, C. J., Short, S. D., Gilroy, J. A., Tennant, M., & Irving, M. J. (2020). An Indigenous cultural competence model for dentistry education. British Dental Journal, 228(9), 719–725. DOI: https://doi.org/10.1038/s41415-020-1480-3

Ganesharajah, C. (2009). Indigenous health and wellbeing: The importance of country. Australian Institute of Aboriginal and Torres Strait Islander Studies. https://aiatsis.gov.au/sites/default/files/research_pub/ganesharajah-2009-indigenous-health-wellbeing-importance-country_3.pdf

Gilroy, J. (2009). The theory of the cultural interface and Indigenous people with a disability in NSW. Balayi: Culture, Law and Colonialism, 10, 44–59.

Gilroy, J., & Donelly, M. (2016). Australian Indigenous people with disability: Ethics and standpoint theory. In S. Grech & K. Soldatic (Eds.), Disability in the global south: The critical handbook (pp. 545–566). Springer. DOI: https://doi.org/10.1007/978-3-319-42488-0_35

Gilroy, J., Donelly, M., Colmar, S., & Parmenter, T. (2013). Conceptual framework for policy and research development with Indigenous people with disabilities. Australian Aboriginal Studies, 2, 42–58.

Goode, T., Haywood, S., Wells, N., & Rhee, K. (2009). Family-centered, culturally, and linguistically competent care: Essential components of the medical home. Pediatric Annals, 38(9). https://doi.org/10.3928/00904481-20090820-04 DOI: https://doi.org/10.3928/00904481-20090820-04

Johnston, M. (2020). Locating Human Rights in the Cultural Competence Context. In: Frawley et al., (eds.), Cultural Competence and the Higher Education Sector. Springer, Singapore. https://doi.org/10. 1007/978-981-15-5362-2_4 DOI: https://doi.org/10.1007/978-981-15-5362-2_4

Larson, A., Coffin, J., Gilles, M., & Howard, P. (2007). It’s enough to make you sick: The impact of racism on the health of Aboriginal Australians. Australia and New Zealand Journal of Public Health, 31(4), 322–328. DOI: https://doi.org/10.1111/j.1753-6405.2007.00079.x

Latulippe, N. (2015). Bridging parallel rows: Epistemic difference and relational accountability in cross-cultural research. International Indigenous Policy Journal, 6(2). DOI: https://doi.org/10.18584/iipj.2015.6.2.7

Marino, R., Morgan, M., & Hopcraft, M. (2012). Transcultural dental training: Addressing the oral health care needs of people from culturally diverse backgrounds. Community Dentistry and Oral Epidemiology, 40(S2), 134–140. DOI: https://doi.org/10.1111/j.1600-0528.2012.00733.x

Martin, K. (2003). Ways of knowing, being and doing: A theoretical framework and methods for Indigenous and Indigenist re-search. Journal of Australian Studies, 27(76), 203–214. DOI: https://doi.org/10.1080/14443050309387838

Moreton-Robinson, A. (2004). Whiteness, epistemology and Indigenous representation. In A. Moreton-Robinson (Ed.), Whitening race: Essays in social and cultural criticism (pp. 75–88). Aboriginal Studies Press.

Moreton-Robinson, A., Casey, M., & Nicoll, F. (2008). Transnational whiteness matters. Lexington Books.

Nakata, M. (1998). Anthropological texts and Indigenous standpoints. Australian Aboriginal Studies, 2, 3–12.

Nakata, M. (2004). Indigenous knowledge and the cultural interface: Underlying issues at the intersection of knowledge and information systems. Post Press.

Nakata, M., Nakata, V., Keech, S., & Bolt, R. (2012). Decolonial goals and pedagogies for Indigenous studies. Decolonization: Indigeneity, Education & Society, 1(1), 120–140.

National Center for Cultural Competence. (2004). A guide to infusing cultural & linguistic competence in health promotion training. Georgetown University Center for Child & Human Development. https://nccc.georgetown.edu/video-infusing-clc/continuum.pdf

National Health and Medical Research Council. (2003). Values and ethics: Guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research. Australian Government Publishing. https://www.nhmrc.gov.au/about-us/publications/values-and-ethics-guidelines-ethical-conduct-aboriginal-and-torres-strait-islander-health-research

National Health and Medical Research Council. (2018). Ethical conduct in research with Aboriginal and Torres Strait Islander peoples and communities: Guidelines for researchers and stakeholders. Commonwealth of Australia. https://www.nhmrc.gov.au/about-us/resources/ethical-conduct-research-aboriginal-and-torres-strait-islander-peoples-and-communities

Paradies, Y., Ben, J., Denson, N., Elias, A., Priest, N., Pieterse, A., Gupta, A., Kelaher M., & Gee, G. (2015). Racism as a determinant of health: A systematic review and meta-analysis. PLoS ONE, 10(9). https://doi.org/10.1371/journal.pone.0138511 DOI: https://doi.org/10.1371/journal.pone.0138511

Ramsden, P. (2003). Learning to teach in higher education (2nd ed.). Routledge Falmer. DOI: https://doi.org/10.4324/9780203507711

Reconciliation Australia. (n.d.). What is reconciliation? https://www.reconciliation.org.au/what-is-reconciliation/

Rigney, L-I. (1999). Internationalization of an Indigenous anticolonial cultural critique of research methodologies: A guide to Indigenist research methodology and its principles. Wicazo Sa Review, 14(2), 109–121. DOI: https://doi.org/10.2307/1409555

Salmon, M., Doery, K., Dance, P., Chapman, J., Gilbert, R., Williams, R., & Lovett, R. (2018). Defining the undefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing. Aboriginal and Torres Strait Islander Health Team, Research School of Population Health, Australian National University. https://www.lowitja.org.au/page/services/resources/Cultural-and-social-determinants/culture-for-health-and-wellbeing/defining-the-indefinable-descriptors-of-aboriginal-and-torres-strait-islander-peoples’-cultures-and-their-links-to-health-and-wellbeing

Satur, J., Forsyth, C., Bolton, J. (2021). Joining the dots: A dental Aboriginal and Torres Strait Islander cultural safety curriculum, The University of Melbourne Dental School for the Australasian Council of Dental Schools.

Sherwood, J. (2009). Who is not coping with colonization? Laying out the map for decolonization. Australasian Psychiatry, 17(S1), s24–s27. DOI: https://doi.org/10.1080/10398560902948662

Sherwood, J. (2013). Colonisation – It’s bad for your health: The context of Aboriginal health. Contemporary Nurse, 46(1), 28–40. DOI: https://doi.org/10.5172/conu.2013.46.1.28

Sherwood, J., & Edwards, T. (2006). Decolonisation: A critical step for improving Aboriginal health. Contemporary Nurse, 22(2), 178–190. DOI: https://doi.org/10.5172/conu.2006.22.2.178

Thackrah, R., & Thompson, S. (2013). Refining the concept of cultural competence: Building on decades of progress. Medical Journal of Australia, 199(1), 35–38. DOI: https://doi.org/10.5694/mja13.10499

Tuhiwai-Smith, L. (1999). Decolonising methodologies: Research and Indigenous peoples. University of Otago Press.

Universities Australia. (2011a). Guiding principles for developing Indigenous cultural competence in Australian universities. https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/Guiding-Principles-for-Developing-Indigenous-Cultural-Competency-in-Australian-Universities.pdf

Universities Australia. (2011b). National best practice framework for Indigenous cultural competence in Australian universities. https://www.universitiesaustralia.edu.au/wp-content/uploads/2019/06/National-Best-Practice-Framework-for-Indigenous-Cultural-Competency-in-Australian-Universities.pdf

Watt, R. (2007). From victim blaming to upstream action: Tackling the social determinants of oral health inequalities. Community Dentistry and Oral Epidemiology, 35(1), 1–11. DOI: https://doi.org/10.1111/j.1600-0528.2007.00348.x

Wilkinson, R., & Marmot, M. (2003). Social determinants of health: The solid facts. World Health Organization Regional Office for Europe. https://apps.who.int/iris/handle/10665/326568

Williamson, J., & Dalal, P. (2007). Indigenising the curriculum or negotiating the tensions at the cultural interface? Embedding Indigenous perspectives and pedagogies in a university curriculum. The Australian Journal of Indigenous Education, 36(S1), 51–58. DOI: https://doi.org/10.1017/S1326011100004701

World Health Organization. (2008). Closing the gap in a generation: Commission on social determinants of health final report. https://www.who.int/publications/i/item/WHO-IER-CSDH-08.1




How to Cite

Forsyth, C., Malouf, P., Short, S., Irving, M., Tennant, M., & Gilroy, J. (2022). Employing Indigenous methodologies to transform dental and medical education. The Australian Journal of Indigenous Education, 51(2). https://doi.org/10.55146/ajie.v51i2.47




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