Alhgoh: A new online course advancing Indigenous cultural safety in primary care

I have participated in and supported Indigenous health initiatives for the past 20 years, focusing on increasing representation of Indigenous people in health professions and increasing awareness of Indigenous health among non-Indigenous professionals. I was driven to advance Indigenous health—and later cultural safety and Indigenous-specific anti-racism initiatives—because I grew up both in the inner city and on reserve experiencing the impacts of segregation and isolation. These impacts on health included lack of access, unsafe care, and poorer outcomes. I was driven to address the disparities faced by my community by becoming a physician; however, I quickly realized that to have a wider-reaching impact, I would need to support broader system change.

In the past few years, British Columbia has formally recognized Indigenous-specific racism and implemented new regulatory standards for Indigenous cultural safety, cultural humility, and anti-racism. This has included many health organizations, including Doctors of BC, health authorities, and the College of Physicians and Surgeons of BC (CPSBC), signing declarations of commitment to cultural safety; publishing the In Plain Sight report; developing the Health Standards Organization’s British Columbia Cultural Safety and Humility Standard; and publishing the CPSBC’s Cultural Safety, Cultural Humility and Anti-Racism practice standard.[1] This foundational regulatory framework has supported the shift from acknowledging harms experienced by Indigenous people in accessing care to implementing changes to address them.

This shift became evident when I started receiving feedback from physicians wanting to understand what this looks like at the bedside and in their practices. Their college standards called for them to be self-reflective, anti-racist, relational, and trauma informed, but many struggled with where and how to start. In my work in primary and community care, there seemed to be an even wider gap, with limited support available, few facilitators, and increasing pressures on clinicians and staff. Acknowledging this gap, in 2021, primary care teams from the First Nations Health Authority and the Ministry of Health developed a working group with representatives from across the system, including Doctors of BC, the Ministry of Health, the regulatory colleges, and leaders in cultural safety. The group identified the need for more clinical tools and skills to translate the standard into practice as the number one priority. The tools would need to be practical, accessible, and relevant to everyday scenarios that clinicians may encounter.

With this clarity of purpose, the group developed a proposal that led to the Cultural Safety, Humility, and Indigenous-Specific Anti-Racism Provincial Primary Care Project. In discussions with other cultural safety and anti-racism clinician educators, it became apparent that we were often presenting the same topics to similar groups. We determined that an asynchronous introductory course for clinicians would help expand the reach of this education. The target audience would be primary and community care clinicians, particularly those prescribing treatments. We thought it would also be helpful for those new to practice or British Columbia. The course would need to be open-access, free, and accredited to minimize barriers for busy clinicians. It would be rooted in translating practice standards into actionable bedside teaching using case studies and reflective exercises. The course would also provide resources and next steps to encourage clinicians to continue their cultural humility and anti-racist journeys.

After almost 2 years of development, the online course, Alhgoh Together as One, Together as Community: Pathway to Indigenous Cultural Safety, was released through the UBC CPD eLearning platform on 21 June 2026 in recognition of National Indigenous Peoples Day.[2] Alhgoh is a Dakelh word from the Lheidli T'enneh traditional territory, which encompasses Prince George, where the idea and development of the course began. Alhgoh represents the personal and collective responsibility we have as medical professionals to provide culturally safe, respectful, and anti-racist care. To learn more, please visit the course registration page.[3]

Providing leadership and content for this course has deepened my own understanding of the journey toward a safer, more inclusive health care system. I was able to work with a dedicated and inspiring team committed to promoting social justice in a way that heals and connects. The next step for the project team is to develop microlearnings that build on key concepts highlighted in the course and support the development of a provincial community of practice. There is no destination with this work; it is an ongoing journey, and I’m incredibly grateful and proud to be part of it.
—Terri Aldred, MD    

References

1.    College of Physicians and Surgeons of British Columbia. Indigenous cultural safety, cultural humility and anti-racism. Practice standard. Revised 1 April 2026. Accessed 12 August 2026. www.cpsbc.ca/files/pdf/CPSBC-PS-Indigenous-Cultural-Safety-Cultural-Humility-Anti-racism.pdf.

2.    First Nations Health Authority. Alhgoh learning pathway launched to advance Indigenous cultural safety [news release]. 25 June 2026. Accessed 12 August 2026. https://fnha.ca/alhgoh-learning-pathway-launched-to-advance-indigenous-cultural-safety/.

3.    UBC CPD. Alhgoh together as one, together as community: Pathway to Indigenous cultural safety. Accessed 12 August 2026. https://ubccpd.ca/learn/learning-activities/alhgoh-together-one-together-community-pathway-indigenous-cultural-safety.