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BACKGROUND: Health equity curricula emphasizing critical pedagogy and centering perspectives of those with marginalized identities, both in curriculum design and execution, have yet to be described in interdisciplinary graduate medical education settings. AIM: The application of public health critical race praxis (PHCRP) in the redesign and evaluation of a social medicine immersion month (SMIM) curriculum. SETTING: A mandatory, 4-week course within the Residency Program for Social Medicine in the Bronx, NY. PARTICIPANTS: First-year residents in internal medicine, family medicine, pediatrics, and clinical psychology fellows between 2019 and 2020. PROGRAM DESCRIPTION: Residents and faculty underrepresented in medicine employed PHCRP to ground SMIM in critical pedagogy and structural competency with the goals of increasing critical consciousness, sensitizing trainees to structural barriers faced by patients, and promoting meaningful engagement in advocacy. PROGRAM EVALUATION: SMIM was evaluated pre- and post-curriculum using a validated critical consciousness and intersectionality survey, with additional questions to assess competency and behaviors. Participants also provided course feedback. Participants demonstrated significant increases across all domains of the measure (Racism + 1.62 (p < .01), Classism + 1.62 (p < .05), Heterosexism + 1.06 (p < .05)). Participant feedback was positive. DISCUSSION: PHCRP is a valuable model for designing health equity curriculum. SMIM provides insights for incorporating this framework into GME curricula.
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In the winter and spring of 2021, I-a White, female, graduate student-taught a six-month course surrounding the theme: Disrupting Systemic Racism at our University Through Action Research. I was challenged to lead a meaningful course in a two-dimensional virtual space, amidst rising death tolls of the COVID-19 pandemic and the rhythmic beat of calls for racial justice pulsing through our Zoom class periods. This experience opened my eyes as an educator, budding community psychologist, and an antiracist White accomplice. In this critical autoethnographic case study, I recount my experience adapting the community organizing principle of fractals into a pedagogical framework that guided my instructional practices in a community psychology course. In doing so, I echo the call for community psychologists to connect our work more tightly to Black, Indigenous, and people of Color social justice organizers and movements to fortify the field's relevance in the struggle for racial justice.
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Antirracismo , Racismo , Feminino , Humanos , Fractais , Pandemias , Pesquisa sobre Serviços de Saúde , Justiça SocialRESUMO
BACKGROUND: Four Black early-career faculty members, one Black doctoral student, and a Black senior faculty member, (herein referred to as scholars), previously engaged in cross-cultural mentoring with a White senior researcher to bolster their scholarship. PURPOSE: In the years following the 2020 racial reckoning, the scholars were motivated to reconvene by the realization that traditional scholarship activities of academia ignore historical educational oppression and fail to account for the contemporary effects of racism and discrimination rooted in American colonialism. METHODS: Collaborative autoethnography, a decolonizing qualitative approach to research, was used to explicate our journeys in academia. The tenets of Freire's critical pedagogy (conscientização, scholarship, praxis) framed our collective experiences. DISCUSSION: We describe resisting academic structures of power, discrimination, and disadvantage through reformation, crafting a vision statement, and utilizing positions of influence. CONCLUSION: To decolonize nursing academia, we implore the scholarly community to pursue liberation and contest structures that center Whiteness and marginalize collectivism and collaboration.
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Since the COVID-19 pandemic, ongoing reports have highlighted the urgency of addressing anti-Black racism within Canada's healthcare system. The paucity of research within a Canadian context has created growing concerns among Millennials and Generation Zs for healthcare to address growing health disparities and health inequities that are attributed to institutional and structural racism. Recognizing the paradigm shift that has occurred because of the pandemic and the sleuth of racial killings, the nursing classroom has witnessed a change and a need for nursing education to be relevant for the cohort of nursing students who are seeking answers. The scarcity of nursing literature addressing diverse forms of learning demonstrates the need for nursing education to explore new ways of being diverse, inclusive and innovative when teaching intergenerationally. In this paper, the author challenges nurse educators to revisit the student-educator relationship by introducing critical digital pedagogy to dismantle anti-Black racism and promote student-educator engagement for transformative learning to occur. As an educator, the author implements the use of digital illustration as a tool of resistance for students and educators to assess, engage, act and reflect on creating change within nursing education. Using Black feminist thought and culturally responsive learning, the author introduces an arts-based approach through the innovative design of an illustration, titled, 'Ain't I a Nurse. Combining historical stories with contemporary socio-political experiences, the author demonstrates how students and educators can enter a cognitive learning experience where they can connect mentally and emotionally, and in so doing re-envision and recreate a new world that centralizes equity, diversity and inclusivity through critical discourses. Through the illustration anti-Black racism is challenged and anti-Black racism resistance is discovered as an antidote in dismantling anti-Black racism within nursing education.
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Educação em Enfermagem , Racismo , Humanos , Racismo/psicologia , Educação em Enfermagem/métodos , Canadá , COVID-19 , Estudantes de Enfermagem/psicologiaRESUMO
Scientists in higher education institutions around the globe recognize the importance of engaging with public stakeholders to share their enthusiasm, explain their science, and encourage primary and secondary students to enter the sciences. However, without direct consideration of students' and teachers' perspectives and interests, scientists may design activities around their own goals, limiting the impact on school stakeholders (i.e., students, teachers, paraprofessional staff, students' parents, and other caregivers). We drew from natural and social science research to describe how expanding the conception of place beyond the biophysical can help engage school stakeholders in meaningful ways. We describe the multidimensional PLACE framework that we developed to integrate perspectives, knowledge, and values of all stakeholders in engagement programming. The framework is organized around topics that stakeholders should discuss early on to ensure successful partnerships. We recommend that scientists identify and use pedagogy that is inclusive; language framed around dialogic communication methods; aims and motivations centered on engagement; cultural funds of knowledge of place (i.e., disciplinary, personal, or experiential knowledge); and evaluation of engagement based on meaningful metrics. Two case studies are presented to illustrate how the PLACE framework components, when addressed, can lead to robust, successful partnerships between scientists and schools.
Pedagogía crítica del lugar para mejorar las actividades ecológicas participativas Resumen Alrededor del mundo, los científicos de las instituciones de educación superior reconocen lo importante que es involucrarse con los actores públicos para compartir su entusiasmo, explicar la ciencia que trabajan y alentar a los estudiantes de primaria y secundaria a formar parte de las ciencias. Sin embargo, si los científicos no consideran las perspectivas e intereses de los docentes y estudiantes, pueden terminar diseñando actividades para lograr sus propios objetivos, lo que limita el impacto sobre los actores escolares (estudiantes, docentes, personal para-profesional, familias y otros cuidadores). Partimos de las ciencias naturales y sociales para describir cómo la expansión del concepto de lugar más allá de lo biofísico puede ayudar a que los actores escolares se involucren de maneras significativas. Describimos el marco multidimensional PLACE que desarrollamos para integrar el conocimiento, las perspectivas y los valores de todos los actores dentro de la programación de la participación. El marco está organizado en torno a los temas que los actores deberían discutir al inicio para asegurar colaboraciones exitosas. Recomendamos que los científicos identifiquen y usen una pedogagía inclusiva; lenguaje enmarcado en los métodos de comunicación por diálogo; objetivos y motivaciones centradas en la participación; recursos culturales del conocimiento del lugar (conocimiento disciplinario, personal o por experiencias); y una evaluación de la participación con base en medidas significativas. Presentamos dos estudios de caso para ilustrar cómo, cuando se utilizan, los componentes del marco PLACE pueden resultar en colaboraciones sólidas y exitosas entre los científicos y las escuelas.
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Conservação dos Recursos Naturais , Estudantes , Humanos , Instituições Acadêmicas , Motivação , Ciências SociaisRESUMO
BACKGROUND: Researchers are increasingly being called upon to involve people with dementia in research that pertains to them. Participatory Action Research (PAR) has been one of the approaches that has been utilized to do this. How people understand and apply the ideas behind this approach however has often been atheoretical and diverse. This has implications for how purpose, power, voice and agency are conceived and actualized. OBJECTIVES: This paper will examine how theoretical construction of PAR can inform the process of meaningfully involving people living with dementia in research. Specifically, drawing on the work of Paulo Freire, this paper will articulate a way of conceptualizing PAR that is explicitly critical and then demonstrate how these ideas informed a PAR study focused on addressing stigma and discrimination with people living with dementia. CONCLUSION: The purpose of the paper is to engage researchers and people with lived expertise in critical reflection of what it actually means to involve people with dementia in research.
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Demência , Pesquisa sobre Serviços de Saúde , Humanos , Estigma SocialRESUMO
Faculty members must employ pedagogical practices that foster humanizing learning environments for graduate Students of Color who have been marginalized and othered in higher education. Methodologically using narrative inquiry, this paper describes graduate Students' of Color stories in higher education/student affairs hybrid graduate preparation programs to understand how faculty contribute to humanizing and critical pedagogy. The findings highlight three central pedagogical strategies faculty used in hybrid classrooms that graduate Students' of Color named as most effective: (1) taught to transgress against racism and oppression, (2) emphasized dialogic pedagogy strategies, and (3) encouraged collaboration inside and outside of the classroom. This study highlights critical pedagogies for student engagement and is a call-to-action for higher education to center humanizing praxis in hybrid learning environments and beyond.
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Critical reflection supports enactment of the social roles of care, like collaboration and advocacy. We require evidence that links critical teaching approaches to future critically reflective practice. We thus asked: does a theory-informed approach to teaching critical reflection influence what learners talk about (i.e. topics of discussion) and how they talk (i.e. whether they talk in critically reflective ways) during subsequent learning experiences? Pre-clinical students (n = 75) were randomized into control and intervention conditions (8 groups each, of up to 5 interprofessional students). Participants completed an online Social Determinants of Health (SDoH) module, followed by either: a SDoH discussion (control) or critically reflective dialogue (intervention). Participants then experienced a common learning session (homecare curriculum and debrief) as outcome assessment, and another similar session one-week later. Blinded coders coded transcripts for what (topics) was said and how (critically reflective or not). We constructed Bayesian regression models for the probability of meaning units (unique utterances) being coded as particular what codes and as critically reflective or not (how). Groups exposed to the intervention were more likely, in a subsequent learning experience, to talk in a critically reflective manner (how) (0.096 [0.04, 0.15]) about similar content (no meaningful differences in what was said). This difference waned at one-week follow up. We showed experimentally that a particular critical pedagogical approach can make learners' subsequent talk, ways of seeing, more critically reflective even when talking about similar topics. This study offers the field important new options for studying historically challenging-to-evaluate impacts and supports theoretical assertions about the potential of critical pedagogies.
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Currículo , Aprendizagem , Teorema de Bayes , HumanosRESUMO
Significant global events in recent years have had a substantial impact on the nursing profession. The COVID-19 pandemic, climate change, and systemic racism are a few of the many complex issues that create a landscape of disruption and uncertainty in healthcare. With the aims of protecting both people and the planet, the United Nations' Sustainable Development Goals offer a road map to combat these global concerns, yet require more widespread consideration as a way forward. Education on the Sustainable Development Goals is recognised as a key aspect for healthcare professionals to take action towards achieving the targets of the goals. For student nurses, the undergraduate curriculum offers an opportunity to enculturate future nurses on the important role they play in the global agenda to transform our world. Brazilian pedagogue Paulo Freire's theoretical approach to education, critical pedagogy, espouses transformation with conscientization, dialogue and liberation, which may create a paradigm shift toward global action. This discussion paper seeks to provide an argument for embedding the Sustainable Development Goals into nursing curricula using the philosophies of Freire's critical pedagogy. It will argue that a critical approach to education is required to create the transformation needed for student nurses to be educated on the Sustainable Development Goals.
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COVID-19 , Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Desenvolvimento Sustentável , Pandemias , COVID-19/prevenção & controle , CurrículoRESUMO
Drawing on a historical ethnography of how Brazil's post-dictatorial psychiatric reforms have shaped young people's lives, this paper builds on Eve Sedgwick's analysis of the hermeneutics of suspicion to show that narrow applications of Foucault's biopower concept nurture forms of resistance to bio-reductionism centred primarily on epistemic deconstruction. To unsettle this hermeneutic, I put young people's theories of power into conversation with Georges Canguilhem's concept of the milieu and with feminist scholars' work on prefigurative politics. I introduce the concepts of threading and unthreading to consider how one subject of biopower, the child-like biobehavioural figure, was continuously being threaded within a specific milieu and in relation to another key figure: the elite angst-ridden 'storm-and-stress' adolescent. Young people's subsequent unthreading and reweaving politics, flourishing in co-construction with what I call the politicizing clinic, illustrate how decolonial pedagogies can incrementally change the patterning of social life.
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How do ordinary citizens, activists and urban practitioners learn to become agents of change for a socially just habitat? The paper explores this question through the experiences of eight grassroots schools of popular urbanism working under the umbrella of the Habitat International Coalition (HIC) in Latin America. Building on a process of self-documentation and collective pedagogic reflection driven by the protagonists of these schools, the analysis explores the core pedagogic practices identified across the schools to enact popular urbanism as a collective and intentional praxis: to weave, sentipensar, mobilize, reverberate and emancipate. We argue that, put in motion, these pedagogic practices transgress the rules and boundaries of the formal classroom, taking participants to and through other sites and modes of learning that host significant potential to stimulate collectivizing and alternative ways of seeking change towards urban equality.
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This paper is based on an online experiment, conducted with bachelor students of educational sciences during the COVID-19 lockdown period in the spring of 2020. The experiment, which took place on a daily basis for a whole workweek, consisted of a series of what we have come to call "artistic-scientific interventions". These constituted a pedagogical praxis in which over a longer period of time students are challenged to collect and 'think with' artistic media as alternative ways of experiencing, studying, and evaluating the corona crisis. Our paper describes the structure and proceedings of this experiment against the background of efforts to develop a new philosophical idea of what it means to do pedagogy. This idea, inspired by philosophers of science like Bruno Latour, contests some of the classical divides that run through the educational sciences, and that we believe pose a great threat to their relevance in current times of crisis: empirical/speculative, quantitative/qualitative, natural/social, facts/meaning, object/subject, etc. What our experiment shows, beyond all obsession with validating hypotheses or consistency of results, is that art, as an education of the senses, can afford science with a much needed platform for (re)creating and/or (re)arranging circumstances in which those problematic divides may be overcome. However, what it also shows is that often this only works when art is approached, not through the lens of predominantly respresentationalist aesthetics, but as a full-fledged part of a scientific (c.q. pedagogical) discipline. Especially in a diffuse digital environment, this entails a need for transindividual, impersonal protocols which allow for both repetition, variation, and feedback, and instil a strong sense of transformative gathering and study.
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Policy Points Despite the pandemic's ongoing devastating impacts, it also offers the opportunity and lessons for building a better, fairer, and sustainable world. Transformational change will require new ways of working, challenging powerful individuals and industries who worsened the crisis, will act to exploit it for personal gain, and will work to ensure that the future aligns with their interests. A flourishing world needs strong and equitable structures and systems, including strengthened democratic, research, and educational institutions, supported by ideas and discourses that are free of opaque and conflicted influence and that challenge the status quo and inequitable distribution of power.
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Saúde Global , Equidade em Saúde , Indústrias/ética , Saúde Pública/tendências , COVID-19/epidemiologia , Governo , Humanos , Pandemias/ética , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
Disaster education outcomes are highly dependent on the political context of that education. Based on a rich, in-depth case study of the creation of community monitors in a landslide and flood-prone city in southeast Brazil, this paper demonstrates how developmental and political environments add much additional nuance to existing theories of behaviourist and transformative education for disaster preparedness and mitigation. Beyond identifying the benefits of education, it argues that disaster risk reduction outcomes are reliant on governance frameworks that alter over time. The study reveals the political complexity associated with programme implementation and cites the perspectives of a number of participants. Disaster education is shown to be the necessary yet underappreciated twin of the militarised and technical approaches that dominate disaster response in Brazil. Understated, however, is education's situatedness: how it can become an arena of conflict between government and civil actors over matters of state and society in increasingly hazardous urbanisation settings in Latin America.
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Planejamento em Desastres , Desastres , Inundações , Política , Populações Vulneráveis , Brasil , Educação , Política Ambiental , Humanos , Risco , Gestão da Segurança , Meio SocialRESUMO
Nursing programs are complex systems that articulate values of relationality and holism, while developing curriculums that privilege metric-driven competency-based pedagogies. This study used an interpretive approach to analyze interviews from 20 nursing students at two Canadian Baccalaureate programs to understand how nursing's educational context, including its hidden curriculums, impacted student writing activities. We viewed this qualitative data through the lens of activity theory. Students spoke about navigating a rigid writing context. This resulted in a hyper-focus on "figuring out" the teacher with minimal focus on the act of writing. Students used a form of behavioral "code-switching" to maximize their grade while considering how their "valuing" of the assignment fit within their writing motives. Hidden curriculum messages taught students that academic success was assured whether their writing mirrored instructor preferences. Instructional practices of rigidity reinforced unequal social conditions for some minority students. Faculty can counteract the impact of the hidden curriculum through encouragement of choice and independent thinking about writing activities. Acknowledging power relationships and their influence on how students navigate writing assignments and nursing discourse may relieve pressures on students who fear penalties for countering norms and result in a more flexible learning environment.
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Currículo/tendências , Bacharelado em Enfermagem/métodos , Estudantes de Enfermagem/psicologia , Redação , Canadá , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Estudantes de Enfermagem/estatística & dados numéricosRESUMO
While online learning resources are proliferating in all education delivery modes, from traditional classes to distance learning, institutions may have not recognized their potential for addressing diverse student populations, providing them online with learning experiences according to their individual needs. If teachers embrace online learning and customize their approaches to make online resources accessible to students, the interactive and collaborative nature of online learning may help reduce the lack of interaction in large classes and isolation in distance education. Research reports the need to examine the accessibility of online learning through the lenses of the digital divide dependence on factors related to physical access, skills and motivational factors. The circumstances of the pandemic have revealed inequality in access to education caused by access to technology and online delivery in which teaching approaches may not necessarily address the student voice with appreciation of their culture. Discussion address Kuo and Belland (Educ Technol Res Dev 64:661-680, 2016) article which reports experiences of minority students (e. g., African-American) in continuing education indicating that there has been little study of minority students' use of online learning resources. Authentic learning is highlighted by critical pedagogy as a means of engaging students in real-life problems and giving meaning to their real-life contexts as sources of learning and among which digital spaces play a prominent role in students' meaning-making.
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Data visualizations have proliferated throughout the COVID-19 pandemic to communicate information about the crisis and influence policy development and individual decision-making. In invoking exponential growth, mathematical modelling, statistical analysis, and the like, these data visualizations invite opportunities for mathematics teaching and learning. Yet data visualizations are social texts, authored from specific points of view, that narrate particular, and often consequential, stories. Their fundamental reliance on quantification and mathematics cements their social positioning as supposedly objective, reliable, and neutral. The reading of any data visualization demands unpacking the role of mathematics, including how data and variables have been formatted and how relationships are framed to narrate stories from particular points of view. We present an approach to a critical reading of data visualizations for the context of mathematics education that draws on three interrelated concepts: mathematical formatting (what gets quantified, measured, and how), framing (how variables are related and through what kind of data visualization), and narrating (which stories the data visualization tells, its potential impacts and limits). This approach to reading data visualisations includes a process of reimagining through reformatting, reframing and renarrating. We illustrate this approach and these three concepts using data visualizations published in the New York Times in 2020 about COVID-19. We offer a set of possible questions to guide a critical reading of data visualizations, beyond this set of examples.
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Developing an understanding of the social and political basis of marginalization is an important educational task for health education guided by frameworks of social justice. With the intention of developing an evaluative framework for use in further research, the aim of this review article is to present a synthesized framework of critical consciousness development, developed from a systematic search and qualitative synthesis of empirical studies that have examined the processes by which individuals come to critically reflect upon and act on oppressive social relations. A systematic search was conducted examining English-language literature produced between January 1970 and May 2017 within databases of PsycINFO, SCOPUS and ProQuest. A total of 20 articles were selected following a two-stage screening process and an assessment of methodological quality. Thematic analysis of findings from these texts produced a framework of critical consciousness development consisting of six qualitative processes and the relationships between them, including the priming of critical reflection, information creating disequilibrium, introspection, revising frames of reference, developing agency for change and acting against oppression. This synthesized framework of critical consciousness development is presented as a useful tool for assessing learning within critical pedagogies, albeit requiring some modification to suit specific cultural contexts and epistemologies.
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Estado de Consciência , Aprendizagem , Pesquisa Empírica , Humanos , Pesquisa QualitativaRESUMO
This qualitative systematic review examined the context-specific factors that influence the implementation of youth participatory action research (YPAR) projects in high schools within the United States. Thematic synthesis was conducted to identify and analyze the YPAR implementation factors that were present in 38 peer-reviewed studies. Results indicate the following two analytic themes concerning YPAR implementation in high schools: (a) pedagogical strategies and (b) stakeholder dynamics and needs. The themes provide support for existing ecological frameworks of implementation factors and demonstrate that adult researchers' project-specific decisions are nested within educational power structures. This paper will discuss the implications of these YPAR implementation themes in executing YPAR projects in high schools.
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Pesquisa Participativa Baseada na Comunidade , Relações Comunidade-Instituição , Pesquisa sobre Serviços de Saúde , Instituições Acadêmicas , Adolescente , Pesquisa Participativa Baseada na Comunidade/métodos , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Formulação de Políticas , Pesquisa Qualitativa , Participação dos Interessados , Estados UnidosRESUMO
Violence against women constitutes a significant public health problem affecting an estimated 35% of women worldwide (WHO, 2013); the scale of the problem and its ongoing intransigence indicate the need for critical and transformative approaches that confront the cultures that support gender violence and lead to change. The present paper analyses a program run in Scottish primary schools for 10-12 year olds called RESPECT that was successful in making pupils alert to and critical of gendering norms and practices. Analysis reveals that the teaching plans and activities of RESPECT are highly consistent with a critical pedagogical approach (Freire, 2005; Matthews, 2014), and indicates the value of combining the theoretical approaches of critical pedagogy, feminism and critical health literacy in public health campaign materials aimed at challenging the cultural bases of gender violence in ways that promote health in an educational setting.