Education and Scholarship focuses on the academic core and the scholarly focus of a school of nursing. As a discipline, the center of nursing's focus is the whole person (body, mind, and spirit) with the influence of the environment on an individual's health and recovery being of utmost importance. Moreover, as an academic discipline nursing recognizes that students must not only be introduced to the knowledge and values of the discipline, but they must also appreciate how the social, political, and economic environment influences health.
In his book Diversity Explosion, William Frey (2018) used data from the U.S. Census Bureau to examine population projections through 2050. The data supported the expansion of minority groups over the next 30 years where each group will more than double. Racially and ethnically diverse individuals contributed more than three quarters of the nation’s population growth in the past decade, and this trend will accelerate in the future. By 2050, the federal government projects that racially and ethnically diverse persons will comprise 53 percent of the United States population (U.S. Census Bureau, 2019). This indicates that the future population of students entering schools of nursing will come from more diverse backgrounds. However, when we examine the outcomes of higher education graduation rates, we see gaps in race and ethnicity among those who graduate and those who do not.
According to the National Center for Education Statistics, the 6-year graduation rate for first-time, full-time undergraduate students who began their pursuit of a baccalaureate degree at a 4-year degree-granting institution in fall 2010 was highest for Asian students (74 percent), followed by White students (64 percent), students of two or more races (60 percent), Hispanic students (54 percent), Pacific Islander students (51 percent), Black students (40 percent), and American Indian/Alaska Native students (39 percent).
Table 326.20 (Digest of Education Statistics 2017) Graduation rate from first institution attended within 150 percent of normal time for first-time, full-time degree/certificate-seeking students at 2-year postsecondary institutions, by race/ethnicity, sex, and control of institution: Selected cohort entry years, 2000 through 2013
Diversity, like technology, represents a powerful change in our environment. Similar to technology, we must actively engage in the area of DEI to be successful in a society that is ever more pluralistic and diverse. Diversity offers strategic opportunities to fulfill an organization’s mission and advance institutional excellence. However, diversity offers some challenges. Faculty development has been a central part of diversity work, and faculty must be involved in the curriculum transformation that is required. These efforts have been more successful when the approach is linked to the academic mission and values of the institution. Efforts are less successful where curriculum change seems to be superficial effort to transform the appearance of the syllabus rather than engage the substantive perspectives that diversity raises for scholarship and pedagogy. By embracing a diversity framework, institutions can move toward inclusive excellence.
“The demographic and economic imperatives for racial equity are oriented toward the future: the projected racial-ethnic makeup of the American population and the economic prospects of the country. Racial inequity, however, is a problem that was born in the past and that has endured over time. It was born out of slavery and subsequent Jim Crow laws that legalized segregation and limited opportunity for Blacks. It was born out of genocide and land-grabbing that diminished the population and territories of Native Americans, as well as out of the colonization and assimilation projects that sought to “civilize” the “savage natives.” It was born out of waves of Asian, Latinx, and Pacific Islander migration, some of which was sanctioned by the American government (e.g., through the Immigration Act of 1965 and asylum seeking) and some of which was not. For all people of color, racial inequity was born from policies and practices that were designed to benefit the dominant population of whites and to directly and/or indirectly exclude, marginalize, and oppress people of color. Addressing racial inequity is therefore an act of justice that requires explicit attention to structural inequality and institutionalized racism, and demands system-changing responses.” Source: Center for Urban Education. (2020). Laying the groundwork: Concepts and activities for racial equity work. Rossier School of Education, University of Southern California.
Previous research provide evidence about what college students want from their professors: accessibility (Case, 2013), warmth (Morrow & Ackerman, 2012), organizational detail (Weaver & Qi, 2005), and compassion (O’Keeffe, 2013) are among the characteristics reported in the literature. Students want to know that they can reach out to faculty when they need support or encouragement (Booker, 2016). Students also expect faculty to be sensitive to their feelings and maintain a respectful environment that is not hindered by disrespect and antagonism. Booker (2018) concluded in her study How faculty create learning environments for diversity and inclusion, that faculty who want to develop an inclusive environment are tasked with supporting student connections with their teacher, their peers, and the course content.
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Creating inclusive teaching and learning environments involves developing critical skills that include managing microaggressions, conflicts, charged conversations, and discrimination in respectful, psychologically safe ways. Josiah Macy Jr. Foundation. (2020). Addressing harmful bias and eliminating discrimination in health professions learning environments.
Mindful and Learner-Centered Checklist
https://www.celt.iastate.edu/teaching/creating-an-inclusive-classroom/inclusive-teaching-resources/inclusive-pedagogy/
Murray, T, A. (2017). Inclusive excellence in nursing education. Journal of Nursing Education, 56(10), 579-580. https://doi.org/10.3928/01484834- 20170918-01
Critical pedagogy encompasses how one teaches, what is being taught, and how one learns. It is a way of thinking about, negotiating, and transforming the relationship among a) classroom teachings, b) the production of knowledge, c) the institutional structures of the school, and the social and material relation of the wider community and society
Breunig, M. C., (2016). Critical and social justice pedagogies in practice. Encyclopedia of Educational Philosophy and Theory, DOI 10.1007/978- 981-287-532-7_234-1
Centered in democracy and the freedom to exercise one full humanity, social justice pedagogy practices seeing students for who they are, where they come from, and their valuable contribution to the teaching and learning environment.
https://www.edweek.org/teaching-learning/opinion-what-is-social-justiceeducation-anyway/2019/01
An approach that reveals the structural inequalities within U.S. society, while fostering students’ critical analysis skills and their critical self-reflection.
https://ctl.columbia.edu/resources-and-technology/resources/anti-racistpedagogy/
A student-centered approach to teaching and learning where the student’s unique cultural strength is nurtured to promote student achievement and a sense of well-being about the student’s cultural place in the world.
https://www.theedadvocate.org/what-is-culturally-responsive-pedagogy/
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Transforming Your Teaching for the Virtual Environment. The Harvard Macy Institute. https://harvardmacy.org/index.php/hmi-courses/ttve
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Faculty are responsible for preparing the future nursing workforce that will provide care for a population that is rapidly increasing in diversity. To provide high-quality, equitable care and reduce health disparities, nurses must be skillful in cultural awareness in order to practice cultural humility. Cultural competence has been a common term to describe how to improve cultural understanding, but it is important to distinguish that cultural humility and awareness is a continuous process fueled by change and ongoing learning.
Cultural Humility in health care describes a lifelong commitment to self-evaluation and critique, to re-dressing power imbalances and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations. [Source: Tervalon, M., & Murray-Garcia, J. (2014). The concept of cultural humility, Health Affairs, 33(7)]
Cultural Humility is a reflective process of understanding one’s biases and privileges, managing power imbalances, and maintaining a stance that is open to others in relation to aspects of their cultural identity that are most important to them. Cultural competency includes the commitment to practicing cultural humility.
Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. 'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. 'Competence' implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities. (Adapted from Cross, 1989)
Health Equity: Health equity is achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment.
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Adopted from Thorton, M., & Persaud, S. (2018). Preparing today’s nurses: Social determinants of health and nursing education. The Online Journal of Issues in Nursing.
View Social Justice Resources [PDF]
View Health Disparities and Inequities Resources Resources [PDF]
View Social and Structural Determinants of Health Resources [PDF]
View Structural Racism Resources [PDF]
Since the publication of the 2002 Institute of Medicine Report, Unequal Treatment, there has been considerable momentum in research to address health disparities and to discover ways to improve health care provided to minority groups. Reducing disparities requires attention to the essential components of equitable, patient-centered, culturally appropriate high-quality care (Institute of Medicine: In the Nation’s Compelling Interest, 2003). Campinha-Bacote (2002) developed The Process of Cultural Competence in the Delivery of Healthcare Service model of care. The constructs of the model included cultural desire, cultural awareness, cultural knowledge, cultural skill, and cultural encounters. Cultural desire is the desire to know and be skillful in cultural encounters.
Cultural awareness is the recognition of ethnocentrism and the potential for cultural imposition. Cultural knowledge includes information about health beliefs and practices, disease incidence and prevalence, and treatment efficacy. One develops skill using awareness and knowledge in providing holistic and culturally appropriate care. Nursing faculty are charged with educating the future. The following recommendations reflect those observable behaviors representing culturally appropriate care.
Cultural competence in practice is defined not by a discrete endpoint but as a commitment and active engagement in a lifelong process that individuals “enter into on an ongoing basis with patients, communities, colleagues and with themselves” (Tervalon & Murray-Garcia, 1998). Tervalon and Murray-Garcia posit that cultural humility is a more suitable goal than cultural competence.
The strategies and tools introduced in this section offer nursing faculty options in developing cultural competencies in order to practice with cultural humility. The nine cultural competency/humility statements serve as pathway in providing more culturally appropriate nursing care for a diverse population.
Apply knowledge of socioeconomic, environmental, and cultural, political, and technologic factors that affect nursing practice and healthcare across multiple contexts.
Integrate knowledge of perspectives, values, and practices of culturally diverse individuals, families and communities regarding healing traditions and systems.
Engage with community stakeholders to work toward achieving equity in health and wellbeing.
Integrate fully, throughout the curriculum, evidence to provide just care.
Promote safe, equitable, and quality outcomes of care inclusive of diverse populations
Integrate the core principles of social justice into interprofessional practice as evidenced by engagement toward the elimination of health disparities and the attainment of health equity for all.
Recognize how the distribution of power, knowledge, and resources affect clients' ability to fully access and utilize complex systems of health care.
Engage in critical self-assessment and reflection of one’s own values and beliefs to increase awareness of the impact on nursing care delivery.
Engage in lifelong learning and leadership development to support principles of diversity, equity, and inclusion.
The Education and Scholarship section offers not only tools and strategies, but provides more in-depth readings for preparation, pedagogical development, personal growth, and self-reflection. This section will support nurse educators as they address diversity, equity, and inclusion in teaching and learning environments.
Click on the links below to navigate throughout the section.