HealthJune 14, 2023

Video: How to advance health equity in nursing education

Health equity in nursing education creates learning environments that are racially affirming, mitigate bias, and meet the needs of all learners.

While most educators support the need for health equity in nursing education, going about it can present sensitive challenges, even for the most dialed-in of faculty. In this video, Lisa Bonsall, Senior Clinical Editor for Lippincott® NursingCenter®, probes Kenya Beard, Associate Provost for Social Mission and Academic Excellence at Chamberlain University, on what it takes to instill health equity into today’s nursing classroom.

Bonsall opens the conversation by asking Beard, EdD, AGACNP, CNE, ANEF, FAAN, how educators can create learning environments that promote and are racially affirming, mitigate bias, and meet the needs of all learners. "It starts", says Dr. Beard, "by focusing on your student’s strengths and capabilities rather than emphasizing weaknesses and failures. To promote self-efficacy,” she explains, “the learning environment must be one that believes and ensures all students can achieve academic success. Negative assumptions about the intellectual skills of a student have no place in education.”

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Along with assuming the best, Dr. Beard adds that educators must strive to teach in a relevant and racially-affirming way. What does that look like? For starters, educators should consider the context of teaching materials such as case studies. “Do I provide a case study that perpetuates stereotypes?” she posits, “or do I integrate content that illuminates the upstream factors that contribute to sickness and disease? Do I teach toward a philosophy that uses race as a social construct?” If so, “Is it a social construct that uses it as a structural and biological factor?”

Along with being mindful of context, Dr. Beard also emphasizes that it is important to “teach in a way that helps individuals create a habit of inquiry.” For example, “Are students encouraged to consider how stress hormones play a role in disease?” she suggests. What about “how poverty, social determinants of health (SDoH), and racism impact health equity?” Unfortunately, says Beard, “some of our textbooks still foster beliefs and attitudes that condition some to subliminally believe that race rather than racism is the root cause of health disparities.”

As part of the discussion, Dr. Beard notes that the Centers for Disease Control and Prevention (CDC) has declared that racism is a fundamental cause of health disparities and inequities, which the American Association of Colleges of Nursing (AACN) Essentials has also amplified. When these actions were taken to identify the need to discuss racism and SDoH in the classroom, she explains that it “caught some educators flat-footed. They weren’t ready, and you might ask, ‘How can that be?’” which begs a larger question: “Who is facilitating the collegial discourse that strengthens one’s ability to safely engage in race-related conversations or even construct learning environments that support health equity?”

Ultimately, Beard emphasizes that equity is all about “ensuring that every individual has an opportunity to achieve their highest level of health,” which “requires the mitigation of bias.” She cautions that “we cannot pretend that bias isn’t real. We have to recognize how our biases show up. We have to avoid a blaming or shaming culture. We have to be able to reflect and demonstrate humility, work to build and support difference, and cultivate a sense of belonging.”

Bonsall next probes Dr. Beard on equity pedagogy, which she defines as “teaching methods that contribute to the academics and students” and which subscribe to “a variety of teaching methods that include reflection, pair/share, narrative pedagogy, and unfolding case studies,” all taught with relevance. “For example, I would ask the student, ‘Tell me why you care about diabetes,’” Dr. Beard explains. “Tell me, ‘What’s important to you about diabetes?’” In these cases, she notes that “the learning environment must help students find their voice,” adding, “With equity pedagogy, we create learning environments that support those critical concepts.”

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