Using simulation-based education to enhance anti-racism learning in nursing

Authors

DOI:

https://doi.org/10.17267/2317-3378rec.2024.e5770

Keywords:

Racism, Anti-Racism, Simulation, Simulated Participant, Undergraduate Nursing Students

Abstract

OBJECTIVE: To determine whether simulation-based education promotes anti-racism learning among nursing students. METHODS: This descriptive qualitative study explored how simulation-based education could support anti-racism education in undergraduate nursing curricula. The study consisted of three parts: (a) journal entries, (b) anti-racism workshops and (c) simulation-based education.  The three anti-racism workshops were part of the simulation pre-work to prepare students to actively participate in four simulated participant anti-racism scenarios. Content analysis of journal entries using the Sensitizing, Taking Action, and Reflection (STAR) framework suggests that the anti-racism workshops raised awareness of self and others, as well as racism and anti-racism strategies among the participants. Fourteen participants were recruited. Ten provided consent and participated in at least one component of the study, six participated in the simulations, and five completed all 8 journal entries. RESULTS: Our findings indicated the participants engaged in a continuous cycle of sensitization and reflection, which broadened their awareness in four categories: self, others, racism, and anti-racism strategies.  As a result, the anti-racism workshops increased awareness of racism among participants. In addition, both were willing and able to address racism and advocate for political change during the simulations. The student participants found the simulated scenarios gave them a greater sense of authenticity when confronting racism. CONCLUSIONS: Anti-racism workshops and SBE are effective ways to support anti-racism learning in undergraduate nursing students. We recommend academic institutions explore ways to integrate antiracism SBE into curricula to support antiracism praxis.

 

Downloads

Download data is not yet available.

References

(1) Adib-Hajbaghery M, Sharifi N. Effect of simulation training on the development of nurses and Nursing Students’ Critical Thinking: A Systematic Literature Review. Nurse Education Today. 2017;50:17–24. https://doi.org/10.1016/j.nedt.2016.12.011 DOI: https://doi.org/10.1016/j.nedt.2016.12.011

(2) Bahreman NT, Swoboda SM. Honoring diversity: Developing culturally competent communication skills through simulation. Journal of Nursing Education. 2016;55(2):105–8. https://doi.org/10.3928/01484834-20160114-09 DOI: https://doi.org/10.3928/01484834-20160114-09

(3) Cant RP, Cooper SJ. The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis. Nurse Education in Practice. 2017;27:45–62. https://doi.org/10.1016/j.nepr.2017.08.012 DOI: https://doi.org/10.1016/j.nepr.2017.08.012

(4) Orr Z, Machikawa E, Unger S, Romem A. Enhancing the structural competency of nurses through Standardized Patient Simulation. Clinical Simulation in Nursing. 2022;62:25–30. https://doi.org/10.1016/j.ecns.2021.09.005 DOI: https://doi.org/10.1016/j.ecns.2021.09.005

(5) Ozkara San E. Using clinical simulation to enhance culturally competent nursing care: A review of the literature. Clinical Simulation in Nursing. 2015;11(4):228–43. https://doi.org/10.1016/j.ecns.2015.01.004 DOI: https://doi.org/10.1016/j.ecns.2015.01.004

(6) Dordunoo D, Abernethy P, Kayuni J, McConkey S, Aviles-G ML. Dismantling “race” in health research. Canadian Journal of Nursing Research. 2022;54(3):239–45. https://doi.org/10.1177/08445621221074849 DOI: https://doi.org/10.1177/08445621221074849

(7) Dordunoo D. Race is not pathological bur racism is. RBE. 2020;13;34. https://doi.org/10.18471/rbe.v34.34990 DOI: https://doi.org/10.18471/rbe.v34.34990

(8) Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: Evidence and interventions. The Lancet. 2017;389(10077):1453–63. https://doi.org/10.1016/S0140-6736(17)30569-X DOI: https://doi.org/10.1016/S0140-6736(17)30569-X

(9) Williams DR, Lawrence JA, Davis BA. Racism and health: Evidence and needed research. Annual Review of Public Health. 2019;40(1):105–25. https://doi.org/10.1146/annurev-publhealth-040218-043750 DOI: https://doi.org/10.1146/annurev-publhealth-040218-043750

(10) Turpel-Lafond, ME. In plain sight: Addressing indigenous-specific racism and discrimination in B.C. Health Care [Internet]. 2021. Available from: https://www.bcpharmacists.org/readlinks/plain-sight-addressing-indigenous-specific-racism-and-discrimination-bc-health-care

(11) Coalition of African, Caribbean and Black Nurses in British Columbia. [Internet]. Available from: https://www.cacbn.ca/

(12) Dordunoo D, Villeneuve M, Hamz A, Guest T, Etowa J, Bearskin MLB, et al. Racism and Discrimination Among Nurses in Canada and the Impacts of the COVID-19 Pandemic - A Scoping Review. Ottawa: Canadian Nurses Association; 2024. Available from: https://www.casn.ca/wp-content/uploads/2024/07/CNA_Racism_Discrimation_Nurses_E.pdf

(13) Waddell-Henowitch CM, Kruth ML, Stephen HM. Reiterating a need for antiracism praxis in nursing and Psychiatric Nursing Education. Journal of Nursing Education. 2022;61(8):439–46. https://doi.org/10.3928/01484834-20220602-04 DOI: https://doi.org/10.3928/01484834-20220602-04

(14) Coleman T. Anti-racism in nursing education: Recommendations for racial justice praxis.Journal of Nursing Education. 2020;59(11):642–5. https://doi.org/10.3928/01484834-20201020-08 DOI: https://doi.org/10.3928/01484834-20201020-08

(15) Thorne S. Isn’t it high time we talked openly about racism? Nursing Inquiry. 2017;24(4). https://doi.org/10.1111/nin.12219 DOI: https://doi.org/10.1111/nin.12219

(16) Garland R, Batty ML. Moving beyond the rhetoric of Social Justice in nursing education. Witness: The Canadian Journal of Critical Nursing Discourse. 2021;30;3(1):17–30. https://doi.org/10.25071/2291-5796.96 DOI: https://doi.org/10.25071/2291-5796.96

(17) Blanchet Garneau A, Browne AJ, Varcoe C. Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for Nursing. Nursing Inquiry. 2017;25(1). https://doi.org/10.1111/nin.12211 DOI: https://doi.org/10.1111/nin.12211

(18) Bell B. White dominance in nursing education: A target for anti‐racist efforts. Nursing Inquiry. 2020;3;28(1). https://doi.org/10.1111/nin.12379 DOI: https://doi.org/10.1111/nin.12379

(19) Hassen N, Lofters A, Michael S, Mall A, Pinto AD, Rackal J. Implementing anti-racism interventions in healthcare settings: A scoping review. International Journal of Environmental Research and Public Health. 2021;15;18(6):2993. https://doi.org/10.3390/ijerph18062993 DOI: https://doi.org/10.3390/ijerph18062993

(20) Cordes CC. Developing antiracist integrated health professionals. Families, Systems, & Health. 2021;39(2):404–7. https://doi.org/10.1037/fsh0000625 DOI: https://doi.org/10.1037/fsh0000625

(21) Barton AJ. What does it mean to be an ally? Journal of Nursing Education. 2020;59(10):543–4. https://doi.org/10.3928/01484834-20200921-01 DOI: https://doi.org/10.3928/01484834-20200921-01

(22) Miller JL, Bryant K, Park C. Moving from “safe” to “Brave” conversations. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2021;(4):231–2. https//doi.org/10.1097/sih.0000000000000605 DOI: https://doi.org/10.1097/SIH.0000000000000605

(23) Oh P-J, Jeon KD, Koh MS. The effects of simulation-based learning using standardized patients in nursing students: A meta-analysis. Nurse Education Today. 201535(5). https://doi.org/10.1016/j.nedt.2015.01.019 DOI: https://doi.org/10.1016/j.nedt.2015.01.019

(24) Lewis C, Reid J, McLernon Z, Ingham R, Traynor M. The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision. BMC Palliative Care. 2016;15(1). https://doi.org/10.1186/s12904-016-0143-2 DOI: https://doi.org/10.1186/s12904-016-0143-2

(25) Vora S, Dahlen B, Adler M, Kessler DO, Jones VF, Kimble S, et al. Recommendations and guidelines for the use of simulation to address structural racism and implicit bias. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2021;(4):27584. https://doi.org/10.1097/sih.0000000000000591 DOI: https://doi.org/10.1097/SIH.0000000000000591

(26) Mezirow J. Transformative dimensions of adult learning. San Francisco: Jossey-Bass; 1991.

(27) Mezirow J. Learning as transformation: critical perspectives on a theory in progress. San Francisco: Jossey-Bass; 2000.

(28) McAllister M. Star: A Transformative Learning Framework for Nurse Educators. Journal of Transformative Education. 2011;(1):42–58. https://doi.org/10.1177/1541344611426010 DOI: https://doi.org/10.1177/1541344611426010

(29) INACSL. Healthcare simulations standards of best practiceTM. https://www.inacsl.org/healthcare-simulation-standards

(30) Downe‐Wamboldt B. Content analysis: Method, applications, and issues. Health Care for Women International. 1992;(3):313–21. https://doi.org/10.1080/07399339209516006 DOI: https://doi.org/10.1080/07399339209516006

(31) Elo S, Kyngäs H. The qualitative content analysis process. Journal of Advanced Nursing. 2008;62(1):107–15. https://doi.org/10.1111/j.1365-2648.2007.04569.x DOI: https://doi.org/10.1111/j.1365-2648.2007.04569.x

(32) Truth and Reconciliation – Commissioner of Canada. Truth and Reconciliation Commission of Canada: Call to action. Manitoba; 2015. Available from: https://ehprnh2mwo3.exactdn.com/wp-content/uploads/2021/01/Calls_to_Action_English2.pdf

(33) Darley JM, Latané B. Bystander intervention in emergencies: diffusion of responsibility. Journal of personality and social psychology. 1968;8(4p1):377-383. https://doi.org/10.1037/h0025589 DOI: https://doi.org/10.1037/h0025589

(34) Hortensius R, de Gelder B. From Empathy to Apathy: The Bystander Effect Revisited. Curr Dir Psychol Sci. 2018;(4):249-256. https://doi.org/10.1177/0963721417749653 DOI: https://doi.org/10.1177/0963721417749653

(35) Lo KWK, Ngai G, Chan SCF, Kwan KP. How Students' Motivation and Learning Experience Affect Their Service-Learning Outcomes: A Structural Equation Modeling Analysis. Front Psychol. 2022;825902. https://doi.org/10.3389/fpsyg.2022.825902 DOI: https://doi.org/10.3389/fpsyg.2022.825902

(36) Lewis L, Fabersunne CC, Lacopetti CL, Retta GN, McBride D, Irving P, et al. Racial Affinity Group Caucusing in Medical Education - A Key Supplement to Antiracism Curricula. N Engl J Med. 2023;388(17):1542-1545. https://doi.org/10.1056/NEJMp2212866 DOI: https://doi.org/10.1056/NEJMp2212866

(37) McGibbon EA, Etowa JB. Anti-racist health care practice. Toronto: Canadian Scholars’ Press; 2009.

(38) Warner NS, Njathi-Ori CW, O’Brien EK. The grit (gather, restate, inquire, talk it out) framework for addressing microaggressions. JAMA Surgery. 2020;155(2):178. https://doi.org/10.1001/jamasurg.2019.4427 DOI: https://doi.org/10.1001/jamasurg.2019.4427

Published

11/28/2024

Issue

Section

Original Articles

How to Cite

1.
Epp H, Dordunoo D, Dompierre K-A, Cundiff V, McBride C, Magassa M. Using simulation-based education to enhance anti-racism learning in nursing. Rev Enf Contemp [Internet]. 2024 Nov. 28 [cited 2024 Dec. 22];13:e5770. Available from: https://www5.bahiana.edu.br/index.php/enfermagem/article/view/5770

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>