The American Association of Colleges of Nursing (AACN, 2017) recently called on academic nursing programs to advance diversity, equity, and inclusion (DEI) to (a) improve the quality of nursing education and (b) prepare nurses to effectively care for an increasingly diverse American population. Specifically, the AACN (2017) states that:
When diversity is integrated within inclusive educational environments… assumptions are challenged, perspectives are broadened, and socialization across a variety of groups occurs, resulting in intellectual and cognitive benefits for all learners.
However, creating truly inclusive learning environments for a diverse group of students with a wide range of experiences is difficult. This is especially true for large courses with content that many students consider dry or challenging, such as research methods courses. The objective of this project was to incorporate DEI topics into a large (N = 96) undergraduate nursing research methods course to (a) create a more inclusive learning environment for a diverse student body through readings and discussions on various DEI topics (e.g., transgender health, racism) and (b) encourage critical self-reflection on the experiences of marginalized populations through self-reflection activities in the context of research and health care.
Broad DEI topics of interest were first identified (e.g., transgender health, the effect of race in health care), relevant research articles pertaining to the DEI topics were chosen (e.g., qualitative study on the experience of transgender adolescents seeking health care, randomized control trial of BiDil [isosorbide dinitrate/hydralazine HCL]), and the articles were matched to appropriate weekly research topics (e.g., study design, data analysis). Research articles were then used to discuss both the weekly research topic (e.g., study design) and the DEI topic (e.g., the experience of transgender adolescents seeking health care). DEI-specific learning activities included in-class discussions about how the DEI topic affects health care and/or health outcomes, which included questions such as:
- What can we do as nurses to provide more inclusive care for transgender adolescents?
- There is considerable discussion surrounding race as a social versus biological construct; thus, if race is socially constructed (e.g., there is more genetic variation within racial groups than between them), what does it mean to say a medication is more effective for a certain racial group?
In addition, students participated in online after-class reflection activities such as:
- Listening to any episode of the “How to Be a Girl” podcast (Mack, 2018).
- Viewing any three of the “A Conversation on Race” short films (New York Times, 2017), then participating in related discussion board posts (e.g., “What surprised you about the pod-cast/videos?” and “What do you want to know more about?”).
- In-class debriefs on the DEI-related discussion board posts at the beginning of the following class.
On research course evaluations, students expressed gratitude for creating a more inclusive learning environment (“Thank you for advocating for under-represented groups!”), shared experiences of personal reflection and growth (“We talked about a lot of issues that encouraged us to think outside of our biases and consider all potential perspectives”), and provided positive feedback on two questions focused on inclusivity (“The instructor showed respect for all students in this course,” and “The instructor provided an environment in which I felt comfortable discussing issues about diversity”). The mean rating was 4.7 of 5.0 for each question.
The AACN, the National Academy of Medicine, and others have recently highlighted the need to promote diversity and inclusivity throughout health sciences education to address persistent inequities in health, health care, and associated educational programs. Thus, DEI topics should be integrated throughout all nursing curricula—including research courses. The above method is one way to successfully incorporate DEI topics into a research course that results in a more inclusive learning environment and promotes personal reflection regarding the experiences of others. Future projects are needed to provide educators with additional examples of how DEI can be successfully integrated throughout nursing curricula to promote inclusive learning environments and critical self-reflection among learners.
Rebecca O'Connor, PhD, RN
University of Washington School of