Evaluating in Person Curriculum for Educating Obstetrical Residents on Better Caring for 2 Spirit Metis Patients Using and AI Assisted OSCE.

Overview

Two-Spirit (2S) Métis individuals often encounter significant barriers and discrimination in healthcare settings. This multisite randomized controlled feasibility trial evaluates a novel artificial intelligence (AI)-assisted Objective Structured Clinical Examination (OSCE) designed to assess and improve Obstetrics and Gynecology (Ob/Gyn) residents' competencies in delivering culturally safe, trauma-informed, and identity-affirming care to 2S Métis patients. Up to 90 Ob/Gyn residents across three Canadian academic sites (University of Alberta, University of Manitoba, and University of Saskatchewan) will be randomized 1:1 to complete either a 2S Métis Academic Half Day paired with AI-assisted OSCE evaluation or standard institutional anti-racism training with AI-assisted OSCE evaluation. The primary focus is to evaluate study feasibility (recruitment, retention, and delivery fidelity) and resident performance on clinical communication, trauma-informed care, and cultural humility evaluated using a 2S Métis co-developed scoring rubric.

Two-Spirit (2S) Métis people experience systemic discrimination, exclusion, and culturally unsafe care, particularly in reproductive, perinatal, and gender-affirming healthcare contexts. In response to the Truth and Reconciliation Commission's Call to Action #24, this study introduces an innovative educational model integrating artificial intelligence, Indigenous governance, and culturally specific evaluation frameworks to strengthen resident physician competency. The AI system serves two primary functions: 1. Co-developing culturally grounded assessment rubrics in collaboration with 2S Métis Elders, Knowledge Keepers, and community members. 2. Standardizing patient portrayal during OSCE clinical encounters to ensure consistency, eliminate human actor variability, and avoid the emotional burden associated with repeated standardized patient portrayals. Study Design \& Methods: Ob/Gyn residents (PGY1-PGY5) across three participating universities will undergo 1:1 prospective randomization: * Intervention Arm: 2S Métis Academic Half Day (AHD) + AI-assisted OSCE evaluation. * Control Arm: Standard institutional anti-racism and Indigenous cultural safety training + AI-assisted OSCE evaluation. AI Encounter Flow: Participants undergo a 5-minute pre-encounter briefing, a 15-20 minute real-time interaction with the AI-simulated 2S Métis patient, and a 5-minute post-encounter reflection. Recorded encounters will be independently scored by two blinded raters (including at least one 2S Métis community member) using the co-developed structured rubric. Ethics and Data Sovereignty: All algorithms, datasets, and cultural representations are governed by principles of Indigenous Data Sovereignty (OCAP®) and UNDRIP, ensuring community oversight and authority over cultural content, rubric criteria, and data ownership