Scholarship - ART Praxis: Evidence-Based Strategies for Antiracist Teaching in Nursing

This episode of the NLN Nursing EDge Unscripted Scholarship track features guest Danica Sumpter. Learn more about her work, "ART Praxis: Evidence-Based Strategies for Antiracist Teaching in Nursing."

Sumpter, Danica; Thurman, Whitney; Wright, Michelle; Johnson, Karen; Duplechain, Danielle; Abbyad, Chris. ART Praxis: Evidence-Based Strategies for Antiracist Teaching in Nursing. Nursing Education Perspectives 44(5):p 273-278, 9/10 2023. | DOI: 10.1097/01.NEP.0000000000001171 

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Transcript

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[Music] Welcome to this episode of the podcast Nursing EDge Unscripted the Scholarship track. I'm your  host Dr. Steven Palazzo, a member of the editorial board of Nursing Education Perspectives. Nursing  EDge Unscripted and our track entitled Scholarship celebrates the published work of select nurse  educators from the NLN's official journal Nursing Education Perspectives and the NLN Nursing EDge  blog. The conversations embrace the author's unique perspectives on teaching and learning  innovations and the implications for nursing program development and enhancement. In this  episode we will discuss effective teaching and learning strategies for teaching about racism.  We will discuss the perspectives of my guest today, Dr. Danica Sumpter who is a clinical  associate professor at the University of Texas Austin School of Nursing and authored ART Praxis:  Evidence-Based Strategies for Antiracist Teaching in Nursing. The article can be found  in our current September-October special issue of Nursing Education Perspectives. Dr. Sumpter,  welcome. Thank you Steven. I'm happy to be here. We are very happy to have you here and I want to  start off by first asking you to just describe the process of anti-racist teaching and learning and  why it's imperative to dismantle the structures and systems that support a white narrative in  nursing education and very specifically I guess for the audience that have no experience in this  area and are very hesitant or unsure of how to move forward. Yeah that's a great question  and I'm going to take a page from Simon Sinek and start with the why first. I think even within the  question this idea of the white narrative or some authors have labeled it kind of the white racial  frame is so normative within society in general but nursing as sort of this microcosm of society  and it is so normative that it's invisible and so unless we are very intentional about making the  invisible visible the status quo is never going to change because we can't change what we can't  see. And so this idea of white dominance or the centrality or the supremacy of whiteness within  nursing that's what keeps us from being able to diversify the workforce, which we know is required  to be able to eliminate health inequities. And so when whiteness is the standard for everything  that's considered good and right and beautiful and you name it, why would it be surprising if those of  us who are racialized as Black would feel like we don't belong, would feel like our experiences or  our ways of knowing, our ways of being within the world don't count as real knowledge, that don't  count as real experiences? And so to experience this constant state of feeling like you don't  belong and you don't matter, that takes a lot of emotional energy, a lot of intellectual energy.  That's energy that our our white counterparts don't have to expend and that they can apply  towards the rigors of nursing school if you're you know a nursing student or within  the promotion and tenure if you're a faculty and even within the staff realm. So for us to be  able to acknowledge and to see that that's got to be kind of our starting or the why and then  I'll kind of transition to the first part of the question, the how. The how we do that, and I borrow  a metaphor from Emily Style with the SEED Project. She uses it the window and the mirror. She uses it  to refer to curriculum but I like to just use it as I think about this work. And so she talks about  the need for us to look in the mirror first, so this introspection. I heard a great quote  that revolution begins with the self, in the self. so this idea of examining ourselves, reflecting  on these everyday moments when thoughts, words, actions manifest that are reflective of these  narratives about dominant culture the way that I've been socialized to believe. When those things  pop up, like, I've got to become more aware of them in my everyday life and so anti-racism is not this  checklist but it's this transformation process. It's about my becoming and so with me, like it's  a daily battle to resist anti-Blackness within myself and so I gave myself grace, but meanwhile  I also continue to do the hard, uncomfortable introspection that's necessary when I see it  pop up within myself. So when I can begin to see it within myself more readily then I can see it  outside. So I've looked in that mirror, I've gained some insight, and that has improved my  quote unquote eyesight if you will so that I can see it outside of me more readily. So  I can then be more open and solicit feedback from others during those times when maybe I don't see  it and so that's kind of the why and a little bit about the how. Wow, that's great and there's a lot  there to analyze, right, or to think about from a perspective of an educator in nursing. I think  all of us, depending on our frame of reference, our upbringing, our where we're at in our process of  education, whether we're a novice or experienced, all fall along this continuum of self-reflection, self-analysis, understanding, you know your place in the world and how it came  to be and how your experience is different, so different than many other people's experiences. But  we tend to view it through a certain lens like you mentioned, right, this kind of normalized lens  of white culture and how that affects everything we do in the classroom and subconsciously for many  people, unless you learn how to to recognize it, which kind of brings me to the  next question, and how does a nurse educator and I've had experiences as in the  past as a novice educator where I did it very poorly and an experienced educator where I did  it better of course not you know in a perfect way, but I've done it better, but how does the  nurse educator start this process of examining their own, let's say you have a course  that you've taken on or you've been teaching for a while, you know opportunities to implement and  strategies of encountering, reflecting, discussing, and taking action which was the framework  you used in your article when discussing anti-racist teaching in the context of their  course. Yeah, I think so it sort of dovetails into the first question. So when I start that process  of introspecting and reflecting I'm going to see my world differently, so my frame starts to shift  and change and so I start to view my curricula, I start to view my teaching strategies, I start to  even view my interactions within the classroom differently. I would also say that students are  a great repository of ideas. I think they are so ready for this and are waiting on us as faculty to  hop on board so soliciting and talking with them, how can you even like relinquishing some of that  power is an anti-racist strategy, dismantling that hierarchy within the classroom space that I talk  about, we talk about in the article. So co-creating some assignments like they are often aware and  they're doing community work, community activism. What are they aware of? What are those local issues  that maybe they're aware of that you're not? Who can we partner with within the community? What  are the needs that are there that the students can galvanize around to take action? I mean there's so  like that is the role of the university to improve the health, the wellness, the well-being  of the communities within which we find ourselves. It's not just about knowledge generation for the  sake of, but in the service of, and so how do we truly partner with? But there are some taken for  granted assumptions that have to be addressed when we're working with community members. So how do we  help our students privilege the knowledge and the experience that the community members are bringing  to the table? It's not just me, I've read all this stuff in an article or in a book and so  I know what's best, but understanding from the get-go that communities typically already know  what they need and so they don't need us to swoop in and tell them. A matter of access to  power and resources - that's the issue, not access to knowledge and experience. And so how do we  again come alongside communities as co-learners and co-laborers? So we're role modeling that  for our students within the classroom space and then taking them out into the community and  then often in nursing we're good about teaching the what, kind of the statistics, the stats, but we  neglect the how and the why. So how did this certain inequity come to be? What's the  historic policy or law that might have been the initial historical insult that led us here?   One of the classes I taught, a graduate elective, it was called Race, Power, Privilege and Health and  we had an assignment it was called throughline and I got it from the NPR Podcast Throughline,  where they take a contemporary issue and sort of trace it back through time like how do we get here?  And so thinking about that like how did we come to these disproportionate rates of asthma within  the Black area of town. I love that idea. Within the city where you are well. Let's trace it back. So you  know, in 1928, 1929 Austin had a city plan and they intentionally placed all of the Black  and brown folks on a certain part of the city. So how do we how do we trace that? Thinking about the  why this happened and the how it continues and so that kind of it takes, it gives some more context  to it and then also thinking about the biases, the assumptions, the stereotypes about this population.  Where do those come from? Why do I have them? Why do they persist and what are  the consequences of that? You mentioned we go into to health care because we want to care  and we have this caring ethos and this identity and so realizing that we can care and we can also  perpetuate harm like those two things can coexist. So helping our learners kind of become okay with  the complexity of that, we've got to incorporate more personal introspection and reflection  and I think the shift to CBE there is a huge emphasis on self-reflection and the metacognition  piece. So I think that will help facilitate this as well. I talk with my colleagues in social  work and they are big about sort of situating the practitioner as a part of the therapeutic  equation and I think often times in nursing we sort of pretend that we're just a part of the  wall, we're just kind part of the backdrop and we're not really impacting the encounter in  substantial ways, but like we're bringing our own stuff, you know, our own baggage of course, right  into this own bias our own perspectives. Exactly and I think Christine Tanner's kind of revision  of her clinical judgment model takes that into account too and so I think we're shifting, we're  heading in these good directions but thinking about encounters that we already have within  our classes and how do we then pull and tease out the systems and structures of oppression,  racism being one. Reflect on those intentionally, bring those into discussion and then how can we  take action around them? That's great. I've been using the framework of Raymond Wlodkowski  and Margery Ginsburg for probably 15 to 20 years now, which is about really about adult motivation  through cultural responsiveness and they always start with you have  to create this safe and inclusive environment before any learning can take place and I've  used that as part of my strategies always going forward so thinking about that how do we create  this kind of space for students and faculty to feel, I mean you know you can't  make everybody feel safe and not vulnerable, right? But you can create an atmosphere where safety and  and vulnerability are recognized in a way that can make people feel more comfortable coming  forward and having these type of discussions. Yeah I'll have to look into that framework. It's  really, yeah, I would recommend it. It's really great. They do great work. I think when we  think about safe space so it depends like largely on how we define and consider safety like safe for  whom? So often when conversations about classroom safety especially as it relates to conversations  about race oftentimes the safety of the white students is what centered and so we have to be  mindful and intentional about centering the margins so sometimes safety and comfort are  conflated and learning new things is inherently uncomfortable so it upsets something that  we held to be true and sometimes it refutes or negates things that we thought to be so and  turns them on their head. And so I'm thinking about this book that I bought for my son, Lies  My Teacher told Me. It just is unsettling and so I have to think about that, how the things that maybe I think I should have known, especially as a Black person like when  I learned things about racism. It's like, why didn't I know that? And so that can be unsettling and  uncomfortable but I think about the article by Clemens and Arai that talk about brave spaces  rather than safe spaces and so our organizations and hence our classrooms are not race neutral.   So we should not presume that they're safe for all learners or really all faculty for  that matter who are racialized as Black or brown or really lots of marginalized identities and so  I think when we talk about centering the margins, if you're not sure like to ask so creating  anonymous polling. Stephen Brookfield has this critical questionnaire is a good way to think  about asking those questions to make sure again, because I'm coming in with my view, my frame,  my thinking and I'm thinking everything is good, but I've got students who are coming in with lots  of different identities and it may not be so good and so unless I ask, I may not know and so  anonymous polling is a good way to do that. Again, that critical questionnaire to ask at the end of  each class but it doesn't even have to be super formalized. I've done check-ins as a  way of building community. I think that's another huge tenant of anti-racist practice is building  community. We within our capitalist society or competition and it's about that piece and  sometimes students come into nursing school with that competitive sort of nature within  them so unless we are intentional about building community and helping us see that we are stronger  together and so that is checking in with each other at the beginning of class. How  are folks doing is just simple, easy way to do that. That time that you have when we are  face to face at the lectern at the end so letting students know I'm here for you  during break, kind of just checking in and asking them how they're doing with life outside of  class is a good way that they know that you care about them. Again, this is not the default so  being intentional, ice breakers, introductory discussion boards where you have a video  of yourself as the instructor sharing yourself, role modeling, transparency, vulnerability.  As vulnerable as I'm willing to be is generally the tone that the students will take. They'll match  me, so I think about bell hooks like us not expecting students to do and to go where we're  not willing to go ourselves. So, so much of what I do as a faculty it reminds me of parenting and  I had this moment when I was a clinical instructor. I would just grab a bag of salad because it was  easy and quick on my way out the door and I would eat salad with my students for lunch and I  remember the students remarking about, oh you eat so healthy and I'm thinking I didn't even  know y'all were looking at what I was eating, right? But the power of just our actions and  role modeling what is that what message does that send to students and so we are teaching by what  we say we're teaching by what we don't say when we ignore and kind of go over conversations like  a bump in the road and don't address issues when they come up in the moment. We're role modeling by  what we do and what we don't do and so again I think creating a community agreement at the  beginning of class is a good way to sort of have these conversations and to be explicit. What  do students perceive as respectful, disrespectful? It may be very different from what I as a faculty  think and so let's put that out there. What do we hope gets accomplished within our time together?  What are we afraid of happening? How do we create a community agreement so that we ensure  that our hopes are actualized and our fears are minimized and then holding each other accountable  to that each time we meet is a good way. That's something I've done in in classes as well as with  faculty within book clubs. Another sort of way of building community is social annotation.  I've used Hypothesis, but there are lots of different platforms out there but just ways  to help students to get inside of each other. Curiosity I think is this...I keep coming back  to in all of my readings it is this lost kind of dying art within our society at large but just  becoming curious about one another's thinking. Not trying to prove a point, not try trying to win an  argument, but truly trying to understand and become curious about what one another is thinking and so  social annotation can help with that as well. I'm not sure if I even answered the question. I think  you answered it. I think you gave us a lot to think about, right, and I hear   we do a lot of thinking or talk about doing a lot of thinking but we really need to start moving  to action. These discussions have been around a long time and are we moving  the needle forward it seems, but I think the action piece is where people get stuck. The discussion piece is the easier part amongst each other, but then moving forward and what do  you actually do is what becomes difficult for most educators. And I also add to that.  So Glenn Singleton in his creative conversations about race he uses this compass to sort of locate  yourself within conversations about race and so it's divided into four quadrants and on the  left side there is kind of the moral or the beliefs that you have and on the left bottom it  is the affective or the feeling then on the right side it's the thinking or the head quadrant and  then on the right at the bottom it's the do and so I think within the academic space we spend  a lot of time thinking and then doing within conversations about racism there is often  a like oh, this is a problem, this is really bad. Okay, what can I do? And there is a rush to action  which it needs to happen, however, I think we don't necessarily spend enough time on the left  side of that quadrant examining our feelings, the affect, the emotion especially as these  conversations can generate. And that's data. We have emotions for a reason. Often  time I think they're seen as pejorative within the academic space but that is our compass,  that is what kind of guides us in terms of ethics and what is right, what is wrong. So how do we teach  students? How do we teach ourselves to be in tune like when my heartbeat starts to elevate.  Why did that happen? Why did I flush? Why did my breathing just get shallow? What's happening here?  Why am I experiencing this way right now? And then leaning into that. What does that tell me  about my morals and my beliefs about  a certain group of people, a certain population?  Where did that come from? And so I think spending some time interrogating that intentionally, the pedagogy of just the affective is huge and then helping sit with that, those uncomfortable  emotions can inform our actions a little bit so that we don't rush and then end up causing  more harm than good because I've seen that from well-intended people. Well, I want to thank you for  joining us this is a great important conversation. I appreciate your time and the expertise you  brought to the conversation and broadening our understanding of this work and how we can even  just think about more intentionally introducing this into our specific classroom our course and  at the very least, for those who may not have any experience, start getting them thinking about how we can do this in the classroom. So for that, we really appreciate it. To our listeners,  if you have not had the opportunity to read about this work, you will find the manuscript  published in Nursing Education Perspectives and you'll find it in our current special issue, this September October issue and I want to thank you again for joining us. Absolutely. It was my pleasure.