References

Babla K, Lau S, Akindolie O Allyship: an incremental approach to addressing microaggressions in medicine. Paediatrics and Child Health. 2022; 32:(7)273-275 https://doi.org/10.1016/j.paed.2022.04.006

Baxter C. Developing an agenda for promoting race equality in the nurse education curriculum. NT Research [Journal of Research in Nursing]. 1998; 3:(5)339-348 https://doi.org/10.1177/174498719800300503

Bell B. White dominance in nursing education: a target for anti-racist efforts. Nurs Inq. 2021; 28:(1) https://doi.org/10.1111/nin.12379

Bheenuck S, Miers M, Pollard K, Young P. Race equality education: implications of an audit of student learning. Nurse Educ Today. 2007; 27:(5)396-405 https://doi.org/10.1016/j.nedt.2006.06.003

Blanchet Garneau A, Browne AJ, Varcoe C. Drawing on antiracist approaches toward a critical antidiscriminatory pedagogy for nursing. Nurs Inq. 2018; 25:(1) https://doi.org/10.1111/nin.12211

Nurse retention and long-run NHS workforce challenges. 2021. https://ifs.org.uk/publications/nurse-retention-and-long-run-nhs-workforce-challenges (accessed 24 July 2023)

Burnett A, Moorley C, Grant J Dismantling racism in education: in 2020, the year of the nurse & midwife, ‘it's time’. Nurse Educ Today. 2020; 93 https://doi.org/10.1016/j.nedt.2020.104532

Nursing and racism: are we part of the problem, part of the solution, or perhaps both?. 2020. https://tinyurl.com/nhcadyzj (accessed 24 July 2023)

Time to talk take action: making race equality a reality for the NHS in London. 2020. https://tinyurl.com/j6fvxpfj (accessed 26 July 2023)

Coleman T. Anti-racism in nursing education: recommendations for racial justice praxis. J Nurs Educ. 2020; 59:(11)642-645 https://doi.org/10.3928/01484834-20201020-08

Cortis J, Law IG. Anti-racist innovation and nurse education. Nurse Educ Today. 2005; 25:(3)204-213 https://doi.org/10.1016/j.nedt.2005.01.008

Beyond BAME: rethinking the politics, construction, application, and efficacy of ethnic categorisation. Stimulus paper. 2021. https://tinyurl.com/yzykvns8 (accessed 24 July 2023)

Equality and Human Rights Commission. Racial harassment inquiry: survey of universities. Research report no 130. 2019. https://equalityhumanrights.com/en/publication-download/racial-harassment-inquiry-survey-universities (accessed 26 July 2023)

Saying ‘I don't see color’ denies the racial identity of students. 2020. https://tinyurl.com/387kbz8d (accessed 24 July 2023)

Foronda CL, Baptiste DL, Ockimey J. As simple as black and white: the presence of racial diversity in simulation product advertisements. Clin Simul Nurs. 2017; 13:(1)24-27 https://doi.org/10.1016/j.ecns.2016.10.007

Garland R, Batty ML. Moving beyond the rhetoric of social justice in nursing education: practical guidance for nurse educators committed to anti-racist pedagogical practice. Witness: the Canadian Journal of Critical Nursing Discourse. 2021; 3:(1)17-30 https://doi.org/10.25071/2291-5796.96

Godbold R, Brathwaite B. Minding the gap. Improving the Black Asian and minority ethnic student awarding gap in pre-registration adult nursing programmes by decolonizing the curriculum. Nurse Educ Today. 2021; 98 https://doi.org/10.1016/j.nedt.2020.104667

Golash-Boza T. A critical and comprehensive sociological theory of race and racism. Sociology of Race and Ethnicity. 2016; 2:(2)129-141 https://doi.org/10.1177/2332649216632242

Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005; 331:(7524)1064-1065 https://doi.org/10.1136/bmj.38636.593461.68

Hall JM, Fields B. Race and microaggression in nursing knowledge development. ANS Adv Nurs Sci. 2012; 35:(1)25-38 https://doi.org/10.1097/ANS.0b013e3182433b70

Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016; 113:(16)4296-4301 https://doi.org/10.1073/pnas.1516047113

Hollinrake S, Hunt G, Dix H, Wagner A. Do we practice (or teach) what we preach? Developing a more inclusive learning environment to better prepare social work students for practice through improving the exploration of their different ethnicities within teaching, learning and assessment opportunities. Social Work Education. 2019; 38:(5)582-603 https://doi.org/10.1080/02615479.2019.1593355

Hooks B. Teaching community: a pedagogy of hope.Abingdon: Routledge; 2003

Jones CP, Truman BI, Elam-Evans LD Using ‘socially assigned race’ to probe white advantages in health status. Ethn Dis. 2008; 18:(4)496-504

Krieger N. Discrimination and health inequities. Int J Health Serv. 2014; 44:(4)643-710 https://doi.org/10.2190/HS.44.4.b

Naming and addressing racism: a primer. 2015. https://aidph.org/resource-center/webinar-naming-and-addressing-racism-a-primer/ (accessed 26 July 2023)

Lester JC, Jia JL, Zhang L, Okoye GA, Linos E. Absence of images of skin of colour in publications of COVID-19 skin manifestations. Br J Dermatol. 2020; 183:(3)593-595 https://doi.org/10.1111/bjd.19258/

Maternal mortality—undoing systemic biases and privileges. 2019. https://tinyurl.com/458n3the (accessed 24 July 2023)

Marmot M, Allen JJ. Social determinants of health equity. Am J Public Health. 2014; 104:S517-519 https://doi.org/10.2105/AJPH.2014.302200

MBRRACE-UK. MBRRACE-UK: saving lives, improving mothers' care 2020: lessons to inform maternity care from the UK and Ireland Confidential Enquiries in Maternal Death and Morbidity 2016-18. 2020. https://tinyurl.com/225c8pyc (accessed 24 July 2023)

McChesney KY. Teaching diversity: the science you need to know to explain why race is not biological. SAGE Open. 2015; 5:(4) https://doi.org/10.1177/2158244015611712

McGibbon E, Mulaudzi FM, Didham P, Barton S, Sochan A. Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter-narrative. Nurs Inq. 2014; 21:(3)179-91 https://doi.org/10.1111/nin.12042

Elizabeth Anionwu: the ‘cool, black and exceptional’ woman who fought to make the NHS fairer. 2020. https://tinyurl.com/4eyrcfza (accessed 24 July 2023)

Moorley C, Darbyshire P, Serrant L, Mohamed J, Ali P, De Souza R. Dismantling structural racism: nursing must not be caught on the wrong side of history. J Adv Nurs. 2020; 76:(10)2450-2453 https://doi.org/10.1111/jan.14469

Mukwende M, Tamonty P, Turner M. Mind the gap. A handbook of clinical signs and symptoms in black and brown skin, 1st edn. : St George's, University of London; 2020

Nairn S, Hardy C, Harling M, Parumal L, Narayanasamy M. Diversity and ethnicity in nurse education: the perspective of nurse lecturers. Nurse Educ Today. 2012; 32:(3)203-7 https://doi.org/10.1016/j.nedt.2011.02.012

Noon M. Pointless diversity training: unconscious bias, new racism and agency. Work, Employment and Society. 2018; 32:(1)198-209 https://doi.org/10.1177/0950017017719841

Nowak AL, Anderson CM, Mackos AR, Neiman E, Gillespie SL. Stress during pregnancy and epigenetic modifications to offspring DNA: a systematic review of associations and implications for preterm birth. J Perinat Neonatal Nurs. 2020; 34:(2)134-145 https://doi.org/10.1097/JPN.0000000000000471

Office for Students. Associations between characteristics of students. How do outcomes differ when accounting for multiple student characteristics?. 2019. https://tinyurl.com/432uxnt9 (accessed 27 July 2023)

Social privileges as a counterpoint to social burdens. 2020. https://mentalhealthathome.org/2020/06/16/another-way-of-looking-at-social-privilege (accessed 24 July 2023)

Schmunk. BC investigating allegations ER staff played ‘game’ to guess blood-alcohol level of indigenous patients. 2020. https://tinyurl.com/ms3bnr9x (accessed 24 July 2023)

Singhal A, Tien YY, Hsia RY. Racial-ethnic disparities in opioid prescriptions at emergency department visits for conditions commonly associated with prescription drug abuse. PLoS One. 2016; 11:(8) https://doi.org/10.1371/journal.pone.0159224

Sommers MS. Defining patterns of genital injury from sexual assault: a review. Trauma Violence Abuse. 2007; 8:(3)270-280 https://doi.org/10.1177/1524838007303194

Spanakis EK, Golden SH. Race/ethnic difference in diabetes and diabetic complications. Curr Diab Rep. 2013; 13:(6)814-23 https://doi.org/10.1007/s11892-013-0421-9

Tengelin E, Dahlborg-Lyckhage E. Discourses with potential to disrupt traditional nursing education: nursing teachers' talk about norm-critical competence. Nurs Inq. 2017; 24:(1) https://doi.org/10.1111/nin.12166

Thorne S. Isn't it high time we talked openly about racism?. Nurs Inq. 2017; 24:(4) https://doi.org/10.1111/nin.12219

Thorne S. On privilege and fragility. Nurs Inq. 2020; 27:(4) https://doi.org/10.1111/nin.12386

Statement on race. Background paper 104.Paris: UNESCO; 1950

Van Bewer V, Woodgate RL, Martin D, Deer F. An indigenous and arts-influenced framework for anti-racist practice in nursing education. J Prof Nurs. 2021; 37:(1)65-72 https://doi.org/10.1016/j.profnurs.2020.11.002

Williamson EJ, Walker AJ, Bhaskaran K Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020; 584:(7821)430-436 https://doi.org/10.1038/s41586-020-2521-4

World Health Organization. Closing the health equity gap: policy operations and opportunities for action. 2013. https://apps.who.int/iris/handle/10665/78335 (accessed 24 July 2023)

Zappas M, Walton-Moss B, Sanchez C, Hildebrand JA, Kirkland T. The decolonization of nursing education. J Nurse Pract. 2021; 17:(2)225-229 https://doi.org/10.1016/j.nurpra.2020.11.006

Developing anti-racist undergraduate nursing education: themes and action

17 August 2023
Volume 32 · Issue 15

Abstract

The impact of racism on health is undeniable. However, undergraduate nurse education in the UK is not adequately addressing the racism within the profession. Literature on anti-racist nursing education was reviewed to uncover the most effective strategies for nurse educators to develop this approach. The literature describes a climate of denial and defensiveness among nurse educators. It urges nurse educators to develop racial literacy, and explores nursing curricula, recommending intersectionality as a way to teach about health disparities, with a move away from a culturalist perspective. There is growing recognition that institutions need to address issues around the retention of Black students, and robust reporting systems are required to respond to allegations of racism. Institutions also need to provide evidence-based anti-racist training for staff. The conclusion here is that, without institutional support, there is little nurse educators can do alone to change the culture of racism in nurse education. Thus, this review is a starting point for nurse educators interested in anti-racist nursing education.

Racism persists within the NHS and there is significant evidence that racial discrimination has negative consequences for those who experience it (Bheenuck et al, 2007; McChesney, 2015; Burnett et al, 2020). Krieger (2014) determined a direct relationship between racial discrimination and hypertension, premature labour and low birthweight, as well as other significant health conditions. In 2010, the World Health Organization explicitly identified racism as a social determinant of health (WHO, 2013).

Despite decades of research on the deleterious impact of racism on health, nurse educators rarely examine racism in healthcare. In fact, racism is often demonstrated and reinforced by health professionals and educators themselves (Burnett et al, 2020; Schmunk, 2020).

Nursing is a particular challenge because the profession is viewed as inherently non-judgemental, with a long-held commitment to the individual (Thorne, 2020). This presents as a barrier to critical scrutiny. Furthermore, while many nurses may practise anti-racist care, the nursing profession as a collective has upheld a culture of denial, silence and reluctance to address the issue of racism that pervades in healthcare education and practice (Hall and Fields, 2012; Bell, 2021).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content