"Spinning Their Wheels … "-Influences That Shape How Nurse Educators Teach Social Justice

"They bring the topic [of social justice] but stop there": Nursing students' perceptions of teaching practices that develop awareness and engagement with social justice

BACKGROUND

Pedagogical frameworks grounded in social justice, such as decolonizing and anti-racist educational practices, are essential in nursing programs. While scholars have begun to examine nurse educators' conceptualizations of social justice, there remains a lack of knowledge about student perspectives regarding nurse educators' approaches to incorporating social justice in education.

OBJECTIVE

To understand nursing students' perceptions about educational strategies that develop critical awareness and engagement with social justice and positively influence professional practice.

DESIGN

A qualitative study informed by Critical Feminist Pedagogy and guided by Interpretive Description methodology.

SETTINGS

A school of nursing in Western Canada.

PARTICIPANTS

Ten undergraduate and graduate nursing students recruited through convenience sampling.

METHODS

Students participated in one-on-one semi-structured interviews. A set of questions developed to facilitate data analysis allowed the deconstruction of the data to identify broad-based inductive categories. Contrast and comparison methods were also used. Members of the research team provided analytic insights into the categories, and subsequently, all members discussed the findings and developed the interpretive frame.

RESULTS

Student participants reported that educational strategies promoting awareness and engagement with social justice need to go beyond superficial engagement and awareness of social justice. Researchers' analysis suggests that cohesiveness between awareness and action in social justice is urgently needed within academia to adopt a decolonizing and anti-racist pedagogy in nursing and better prepare students for professional practice. From the data analysis, teaching strategies that enhance cohesiveness include: embracing personal development, creating community spaces and disrupting knowledge and curriculum hierarchies.

CONCLUSIONS

Understanding students' perceptions and incorporating their suggestions is critical to integrating socially just teaching practices that embrace a learner-centred pedagogy. Our findings offer suggestions for teaching strategies that foster critical awareness and engagement with social justice. Combined, these contribute to our understanding of signature pedagogies in nursing with the intention of increasing the adoption of anti-racist and decolonizing approaches.

Advancing health equity in prelicensure nursing curricula: Findings from a critical review

Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well-integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula.

Student Perception of Diversity, Equity, and Inclusion Curricular Threads on Nursing Practice

BACKGROUND

Compassionate, inclusive, and equitable nursing care begins with integrating concepts of diversity, equity, and inclusion (DEI) and social determinants of health (SDOH) into curricula.

PROBLEM

Little is known about RN to BSN students' perception of applying these concepts in practice. The purpose of this pilot project was to assess RN to BSN students' perceptions of DEI-SDOH curricular threads in their nursing practice.

APPROACH

Students were surveyed to assess their perceptions about the impact DEI-SDOH curricular content had on their ability to assess and address DEI-SDOH in practice, level of confidence in talking about DEI-SDOH, addressing breaches in DEI, and the influence of DEI-SDOH in nursing.

OUTCOMES

Respondents indicated DEI-SDOH curricula promoted self-examination, critical examination of health care systems, and increased DEI-SDOH competence.

CONCLUSION

DEI-SDOH curricula build upon professional experiences, strengthen assessment and application competence, and equip nurses with confidence to address DEI-SDOH as an effective strategy to reduce health disparities.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies

BACKGROUND

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts.

OBJECTIVE

The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course.

DESIGN/METHODS

Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting.

CONCLUSION

Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Culturally Responsive Teaching in Nursing Education

Culturally responsive teaching is a vital skill for nurse educators. A diverse nursing workforce is needed in the US to represent the population’s demographics. Recruiting, retaining, and engaging a diverse student body is critical to addressing issues of disparities and cultural sensitivity in health care. In a project to promote success among diverse nursing students, nurse educators collaborated to create and present faculty development programs to build culturally responsive teaching skills. This article includes examples of culturally responsive teaching and describes the project and the faculty development curriculum and teaching materials produced.

Defusing Land Mines: Keywords About Race in Nursing Education

BACKGROUND

The call for nurse educators to facilitate conversations about racism with learners has become inescapable. Yet, nurse educators in the United States indicate they feel unprepared or uncomfortable leading classroom conversations about race.

METHOD

Keyword analysis maps the multiple meanings of vocabulary, creating a common foundation for productive dialogue. Selection of keywords is subjective, but each keyword must meet three criteria: a term that is in common use, definitions that change according to time and perspective, and use that illuminates larger phenomena.

RESULTS

Five keywords when teaching about racism are Caucasian, colorblind, diversity, reverse racism, and underrepresented minority. Each keyword carries connotations that may be perceived as upholding egalitarian ideals without acknowledging the pernicious mechanisms of racism itself.

CONCLUSION

Familiarity with keywords provides educators with solid ground for engaging in often ambiguous and troubling dialogues about racism. [J Nurs Educ. 2022;61(7):408-412.].

Challenges Facing Public Health Nursing Faculty in the United States: COVID-19 as a Catalyst for Change

We present an analysis of challenges facing public health nursing faculty members (PHNF) in the United States and their broader societal implications. The COVID-19 pandemic has exacerbated these challenges, making them untenable. Current academic structures-influenced by the broader sociopolitical climate-are problematic for PHNF: they disincentivize PHNF from researching social determinants of health and public health systems, teaching systems-level content that may be deemed "controversial" and that is not included on licensure exams, and engaging in service through advocacy and community partnerships. The fault lines within health care, public health systems, and higher education indicate that it is time to reevaluate how to incentivize socially just and equitable outcomes. Toward this goal, we propose that collective action and systemic change, including the perspectives of PHNF, is needed to better realize our shared goals. The analysis serves as a catalyst for conversations about academic structures, health care systems, the role of public health, and the kind of society we envision for ourselves and future generations. (Am J Public Health. 2022;112(S3):S314-S320. https://doi.org/10.2105/AJPH.2022.306819).

Global Health in Swedish Nursing Curricula: Navigating the Desirable and the Necessary

Global health challenges are likely to be aggravated in the coming years by rapid climate change and environmental degradation. To address the resulting health inequities, nurses need an integrated understanding of environmental and social determinants of health. This study adopts an explorative inductive approach to examine how global health and sustainability are expressed the course syllabi of undergraduate nursing programmes (n = 24) in Sweden. After excluding biomedical and other unrelated content, 67 syllabi were selected for a thematic analysis. Results indicate that global health, the social determinants of health and sustainability tend to appear in a fragmented manner in the syllabi. Global health content is often limited, relegated to elective courses, or altogether missing. A theoretical framework is lacking, and focus lies on an individual rather than structural perspective. Based on international policy, earlier studies on undergraduate nursing education and theoretical work, suggestions are made for how global health and sustainability content could be integrated into nursing education, notably by using a structural competency approach.

"He just teaches whatever he thinks is important": Analysis of comments in student evaluations of teaching

Student evaluations of teaching are ubiquitous in higher education; however, most prior research has focused on the numeric ratings, with little systematic attention given to the qualitative comments. In this study, written comments were collected as part of the regular evaluation of a community health nursing course over four semesters. Taken as a whole, student comments were strikingly consistent and mostly negative. Students emphasized the authority of the textbook and framed the course as preparation for the National Council Licensure Examination (NCLEX). Instructor efforts to focus on critical analysis of social issues were met with confusion, suspicion, and resistance. Student comments were further analyzed in relation to 3 levels of discourse: the student/teacher level, the nursing-education level, and the social-historical level. For each level, the comments reveal problems, but not the ones suggested by a conventional reading of student evaluations. If students and teachers have conflicting expectations about goals and methods for learning, formal student evaluations may be less useful as a measure of teaching effectiveness. This study also raises troubling concerns about current practices in nursing pedagogy, particularly the emphasis on standardized testing and highly structured didactics, and the overlap between student evaluation systems and the technologies of neoliberalism.

Resisting the muddy notion of the 'Inclusionary Other': A re/turn to the philosophical underpinnings of Othering's construction

The notion of 'Inclusionary Othering,' in garnering uptake within diverse nursing spheres, muddies a critical understanding of Othering by obscuring the colonial production, exploitation and perpetuation of the Other for economic and political gain. The ongoing genocide of Indigenous women and girls in Canada is a direct manifestation of the Othering process and in response to the report's Calls for Justice, it is an apt time to re-enliven the conversation of the process of Othering's philosophical construction. The purpose of this article is to re/turn to the philosophical underpinnings of the process of Othering in hopes of enlivening a new wave of resistance within nursing and elsewhere to the means by which the Other is constructed as well as to the notion of Inclusionary Othering itself. Perhaps this re/turn to the philosophy of Edward Said and Sylvia Wynter can result in further thwarting the Othering construct by highlighting its colonial construction and usher in a pragmatic shift, increasing critical engagement with the construct as well as inspiring a re/newed resistance toward Othering in nursing practice.

Structural Competency in Conflict Zones: Challenging Depoliticization in Israel

Structural competency is the trained ability to discern and acknowledge how health care outcomes are shaped by larger political, social, economic, policy, and legal forces and structures. Although structural competency has become an increasingly known framework for training and teaching, especially in the United States, it has usually not been used in nursing and nursing education. Moreover, very little is known about how to implement structural competency programs in conflict zones. Due to depoliticization that often prevails in both the higher education system and the health care system, the political conflict and the structural violence that significantly impact people's health are rarely discussed in these systems. This article examines the potential contribution of structural competency training programs for nurses and nursing students in conflict areas by analyzing a program that has emphasized the impact of the Israeli-Palestinian conflict on the health of Jerusalem's Palestinian residents. The article explains how this program has challenged the denial and silencing of conflict-related sociopolitical issues. At the same time, this program has created heated disagreements and friction. We suggest that structural competency training programs that are adapted to the political context in question may help nurses become organic intellectual leaders and agents of social change for those whose voices are not heard.