Exploring first nations nursing and midwifery leadership development: an international scoping review

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Abstract
The development of First Nations nurses and midwives is crucial to addressing health inequities stemming from systemic injustices. However, this workforce is significantly underrepresented globally. Understanding the reasons for this underrepresentation and identifying key challenges and opportunities for leadership is necessary. This scoping review aimed to explore the challenges and opportunities in leadership development of First Nations nursing and midwifery professionals internationally. A scoping review was conducted following the framework developed by Arksey and O'Malley (2005). Six databases including PubMed, CINAHL, Scopus, PsychInfo, Proquest and Australian Indigenous HealthInfoNet were searched. The search was performed on 30 January 2024. Items were included if the research focus was on First Nations nursing and midwifery leadership. Full texts were then thematically analysed for overarching themes, and extracted data was charted. After charting, key findings were reviewed, and emerging themes were grouped into common categories. The scoping review identified a paucity in the contemporary literature, with only ten articles retrieved. Analysis revealed five main theses: (1) systemic injustices impacting leadership opportunities, (2) complex responsibilities beyond typical roles, (3) underrepresentation in leadership positions, (4) shifting from colonial leadership models and (5) effective methods for leadership development. Opportunities identified included promoting equitable leadership, fostering integrated relationships, building cultural resilience and emphasising community-orientated leadership approaches. Promoting adequate representation and developing culturally safe leadership models are essential steps towards empowering First Nations nurses and midwives in their leadership development. The study highlights the need for targeted leadership development strategies for First Nations nurses and midwives to enhance representation and impact within healthcare systems globally.

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