Theory analysis and evaluation of emancipatory nursing praxis: A theory of social justice in nursing.

PURPOSE: The aim of this paper was to analyze and evaluate the middle-range theory, emancipatory nursing praxis (ENP): a theory of social justice in nursing. METHODS: Peterson and Bredow's method was utilized to complete the theory evaluation. The theory was evaluated systematically to ensure the appropriateness of application for research in nursing education and transforming nursing students into social justice allies. FINDINGS: The ENP theory has not been widely used since its introduction in 2017, although it is even more relevant today after the revelation of profound societal inequities during the pandemic. The theory lacks testing and empirical indicators for utilization in nursing practice. CONCLUSION: ENP addresses the mandate from the American Association of Colleges of Nursing for nurse educators to foster the development of students as social justice leaders and competent caregivers across the life span. This theory provides a framework to apply in nursing education to improve the professional competency in social justice and disparities. However, further research is needed to develop tools to measure outcomes and generalizability. IMPLICATIONS FOR NURSING PRACTICE: ENP middle-range theory could support nursing educators and nursing programs to develop learning strategies and curricula to facilitate nursing students' knowledge and application in social justice advocates, allies, and leaders, thus improving individual, community, and global health outcomes.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies.

BACKGROUND: The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts. OBJECTIVE: The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course. DESIGN/METHODS: Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting. CONCLUSION: Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Social justice in medical education: a student-led approach to addressing COVID-19 vaccine equity in the Hispanic/Latinx community.

The current healthcare system disproportionately affects vulnerable populations, leading to disparities in health outcomes. As a result, medical schools need to equip future physicians with the tools to identify and address healthcare disparities. The University of Nevada, Reno School of Medicine implemented a Scholarly Concentration in Medical Social Justice (SCiMSJ) program to address this issue. Three medical students joined the program and pioneered a project to address the equitable vaccine distribution within the local Hispanic/Latinx community. After identifying the disparity in vaccine uptake and high levels of vaccine hesitancy, they collaborated with local organizations to address vaccine misinformation and accessibility. They organized outreach events, provided vaccine education, and hosted a vaccine clinic at a Catholic church with a high Hispanic/Latinx congregation. Through their efforts, they administered 1,456 vaccines. The estimated economic and societal impacts of their work was 879 COVID-19 cases avoided, 5 deaths avoided, 45 life years saved, and $29,286 in economic value. The project's success highlights the effectiveness of a student-led approach to promote skill development in social justice training. Leadership skills and coalition building were crucial in overcoming resource limitations and connecting organizations with the necessary volunteer force. Building trust with the Hispanic/Latinx community through outreach efforts and addressing vaccine hesitancy contributed to the well-attended vaccine clinic. The project's framework and approach can be adopted by other medical students and organizations to address health disparities and improve health outcomes in their communities.

Looking within: Elevating Black scholarly contributions to empirical approaches in developmental science.

Over the past century, Black American scholars have designed, applied, and promoted conceptual frameworks and research models that propose nuanced understandings of psychological development. This article highlights examples of their contributions to understanding the differential impact of diverse contextual and situational factors. Through examinations of the psychological effects of Blackness on the development of cognition, competence, identity, and social functioning, Black psychologists outline pathways and provide tools for ecological culturally rooted methodologies. These multidisciplinary approaches run in contrast to dominant trends in the field and thus broaden developmental science's reach and influence. In the 1950s, developmental research by Black psychologists was instrumental to the fight for civil rights. Today, it continues to provide a basis for advancing diversity, equity, inclusion, and justice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social justice attitudes of undergraduate nursing students: The impact of praxis.

BACKGROUND: Social justice is a foundational concept in nursing, yet studies on how best to impact change in nursing students' attitudes toward social justice are few. OBJECTIVES: The intent of this work was to quantify the impact on attitudes of undergraduate nursing students toward social justice, after extended interactions with adults living in poverty. METHODS: Undergraduate nursing students from three programs, university medical center, private university, and community college were given a validated survey of social justice attitudes before and after a clinical rotation with low-income adults in an inner-city neighborhood. All students did home social visits through the same social service agency. Students from the medical center were also involved with active care coordination for assigned clients. RESULTS: Each group showed significant increases in social justice attitudes following their experience. Students doing care coordination did not have significantly greater changes in overall scores but did show significant improvement in subtests others did not. CONCLUSION: Clinical opportunities placing nursing students in direct interaction with marginalized populations are recommended to increase social justice awareness.

Teaching transformation: Fostering critical awareness through transformative justice organizing frameworks.

The following article explores how the curricular adaptation of seminal and contemporary definitions of and approaches to transformative justice frameworks can foster student's critical reflection from identity awareness toward critical action informed by collectivist perspectives of social change. Applications in the social work curriculum are presented.

Preparing Medical Students to Address Health Disparities Through Longitudinally Integrated Social Justice Curricula: A Systematic Review.

PURPOSE: The education of health care professionals is a contributing factor to persistent health disparities. Although medical students are expected to understand racism, classism, and other social and structural drivers of health (SDH), standardization and best practices for teaching these concepts are lacking. Some medical schools are adopting social justice curricula (SJC) that prioritize health equity in teaching students to recognize SDH and preparing them to address the consequent health disparities. This systematic review sought to evaluate how these schools have integrated SJC into their core teaching; the criteria they have used to measure success and to what extent these criteria are met; and best practices in planning, implementing, and evaluating SJC. METHOD: The authors searched 7 databases for English-language studies published between January 2000 and April 2020, reporting on longitudinally integrated SJC at U.S. medical schools intended for all students. Quantitative and qualitative outcomes were synthesized and summarized. RESULTS: Searches identified 3,137 articles, of which 11 met inclusion criteria. Results demonstrated schools use a variety of teaching methods over a wide range of didactic hours to teach SJC concepts. Surveys and objective tests indicated students in SJC are generally satisfied and demonstrated improved knowledge and skills related to understanding and mitigating SDH, although findings related to changes in attitudes were equivocal. Evaluations at graduation and in residency demonstrated students who experience SJC are more prepared than their peers to work with patients who are underserved. Best practices in SJC included addressing the hidden curriculum, considering medical mistrust, and using tools like the Racial Justice Report Card and Tool for Assessing Cultural Competence Training. CONCLUSIONS: These findings indicated SJC can prepare students to better address the root causes of health disparities. Future research should consider the long-term influences of these curricula on students, patients, and the community.

Impact of a Social Justice Course in Graduate Nursing Education.

BACKGROUND: Social justice and health equity are foundational concepts to the graduate-prepared nurse's role. However, the integration of these concepts into graduate nursing education has been unclear. PURPOSE: This study examined the impact of a newly created social justice course in a graduate nursing program. METHODS: The impact of the Health Equity and Social Justice course on students' values and attitudes toward social justice was investigated through analysis of quantitative and qualitative data generated in the course. RESULTS: Data were collected from 41 graduate nursing students. Findings demonstrated that students who completed the course had an increased endorsement of social justice values, goals, and behaviors. Students universally found the course to be transformational. CONCLUSIONS: A social justice course in graduate education can be transformational in shaping students' values and attitudes toward health equity and social justice.

Critical Perspectives to Advance Educational Equity and Health Justice.

A robust body of research supports the centrality of K-12 education to health and well-being. Critical perspectives, particularly Critical Race Theory (CRT) and Dis/ability Critical Race Studies (DisCrit), can deepen and widen health justice's exploration of how and why a range of educational inequities drive health disparities. The CRT approaches of counternarrative storytelling, race consciousness, intersectionality, and praxis can help scholars, researchers, policymakers, and advocates understand the disparate negative health impacts of education law and policy on students of color, students with disabilities, and those with intersecting identities. Critical perspectives focus upon and strengthen the necessary exploration of how structural racism, ableism, and other systemic barriers manifest in education and drive health disparities so that these barriers can be removed.

Integrating equity and social justice for indigenous peoples in undergraduate health professions education in Canada: a framework from a critical review of literature.

Understanding how to create structural change by actively counteracting racialized ways of interacting with Indigenous peoples at an individual and organizational level within health care systems and health professions education is essential for creating a more inclusive, equitable, and healthier society. In health professions education, the primary means of teaching about health inequities has been to frame them as stemming from culturally or ethnically based issues. While attention to culturally specific practices can be valuable to health and healing in some contexts, education that solely focuses on Indigenous cultures risks perpetuating cultural stereotypes and othering, rather than focusing on how Eurocentric systems continue to exert oppressive effects on Indigenous peoples. We present an organizational transformation framework grounded in equitable partnerships from a comprehensive critical review of the literature on the integration of equity and social justice in undergraduate health professions education with a focus on Indigenous health. We did a thematic analysis of the results and discussions presented in the 26 selected articles to identify promising practices and challenges associated with the integration of equity and social justice in undergraduate health professions education. The framework resulting from this analysis is composed of three interrelated components: 1) adopt critical pedagogical approaches that promote Indigenous epistemologies; 2) partner with Indigenous students, educators and communities; 3) engage educators in critical pedagogical approaches and health equity issues. This framework could guide the development of contextually tailored interventions that contribute to decolonizing health professions education.

To sing the songs of pride: Creating an anthem of inclusion.

In this season of public health crises and profound social unrest, we can draw inspiration from those who survived hard times and celebrated the American spirit. Here three students in an accelerated nursing program, poised for graduation in the coming year, join their insights and observation on the challenges facing this country with that of the famed troubadour of the Great Depression, Woody Guthrie. As nurses and public health practitioners, we commit to anthems of inclusion and justice for all.

Nursing strategies for environmental justice: A scoping review.

OBJECTIVE: To describe types of strategic actions nurses take to promote environmental justice (EJ) through research, education, advocacy, and practice (REAP) reported in peer-reviewed literature. DESIGN AND SAMPLE: A scoping review of literature was conducted that described EJ nursing strategies and included nurses listed as authors, subjects, partners, or organizational members. The sample consisted of 35 articles, representing 24 primary research studies and 11 nonresearch articles. Data were separately analyzed by research and nonresearch articles for a clearer understanding of evidence-based strategies within domains of REAP. RESULTS: Articles in the sample highlighted the importance of authentic community partnership and represented diversity of nursing strategies that addressed a range of environmental exposures and subsequent health and racial inequities. Climate justice, a concept that emerged from the EJ movement and intersects with planetary health, is a recent focus in professional nursing. CONCLUSIONS: This scoping review establishes an understanding of the extent of nursing knowledge and research in EJ and lays the groundwork for further research on effective EJ nursing strategies. Community-Based Participatory Research/Participatory Action Research methods are fundamental for EJ research, and further theoretical development is needed to guide evaluation of EJ nursing strategies for education, advocacy, and practice.

The Missing Chapter: The Education of Surgery and Anesthesiology Trainees as Civic Advocates.

The SARS-CoV-2 pandemic has highlighted existing systemic inequities that adversely affect a variety of communities in the United States. These inequities have a direct and adverse impact on the healthcare of our patient population. While civic engagement has not been cultivated in surgical and anesthesia training, we maintain that it is inherent to the core role of the role of a physician. This is supported by moral imperative, professional responsibility, and a legal obligation. We propose that such civic engagement and social justice activism is a neglected, but necessary aspect of physician training. We propose the implementation of a civic advocacy education agenda across department, community and national platforms. Surgical and anesthesiology residency training needs to evolve to the meet these increasing demands.

Anti-Racism in Nursing Education: Recommendations for Racial Justice Praxis.

BACKGROUND: Studies link racism to higher mortality rates, earlier onset of more severe diseases, and higher comorbidity and impairment. This article explores nursing education as an upstream intervention to addressing racial inequities. METHOD: Six recommendations were created to guide the praxis of anti-racism in nursing education. The recommendations were based on examination of nursing literature and draw on experiences of the author. RESULTS: These recommendations include the following: adopt an explicitly anti-racist position, include everyone, institute a power and privilege course for all incoming students, implement intersectionality as a core competency, foster community-academic partnership, and utilize transdisciplinary resources. CONCLUSION: There are no quick fixes to health inequities; they are rooted in racism and discrimination that have been woven into the fabric of American society. However, by implementing the outlined recommendations, schools of nursing, and their nurse educators, can prepare the future workforce to be change agents.[J Nurs Educ. 2020;59(11):642-645.].

Rapid transition of a preclinical health systems science and social justice course to remote learning in the time of coronavirus.

As the coronavirus pandemic started, we rapidly transitioned a preclinical social justice and health systems sciences course at our medical school to asynchronous, remote learning. We describe processes, curricular innovations, and lessons learned. Small groups were converted into independent learning modules and lectures were given live via videoconferencing technology. We started with a simplified approach and then built technological capabilities over time. Current events were incorporated into curriculum and assessment. Our course ran from 16 March-3 April 2020 for the 155-person first-year class. Student attendance for optional, synchronous remote sessions was higher than in-person attendance in previous years. Completion rates for assignments were high but with minimal student collaboration. Faculty office hours were underutilized. Focus group and formal evaluations were largely positive, with numerical ratings for quality of the course and faculty teaching higher than the 2 years prior. Student engagement with social justice topics in aremote format was successful through modifications to small groups and lecture structure. Students, faculty, and administrative staff appreciated the consistency of session format throughout the course. Students exam performance was similar to prior years. Attention should be paid to what can be learned via self-study as opposed to small group learning. Better methods of soliciting real-time student feedback, and encouraging engagement with each other and with faculty in aremote environment are needed.