RESUMEN
BACKGROUND: A conceptual, methodological, and theoretical framework is needed in Nursing Education to center racism, in the curriculum, as a root cause of health inequity. PURPOSE: To provide Nursing and health professions' educators with a comprehensive unifying framework to fundamentally conceptualize and deliver a curriculum which positions racism's impact as a root cause of health inequities. METHODS: Critical race theory is the underpinning for a historical analysis of racism and a critique of scientific racism, whiteness, and white supremacy ideologies that perpetuate harmful and lethal outcomes for racialized individuals and communities. RESULTS: This framework conceptualizes learning, unlearning, relearning, and reflective practice as the fundamental process needed to transformative nursing education and advance health equity. DISCUSSION: Methodological application is given for 1) unlearning harmful white supremacy ideology 2) learning that racism as it is embedded in every sector of American life and racial inequities are inherent in the health care system 3) relearning the importance of counternarratives and building structural competency and 4) engaging in reflective practice to challenge deficit paradigms assigned to racialized people and their communities. CONCLUSION: The Antiracism Framework provides foundational principles, guiding steps, and rationale for curricula that acknowledges the critical role of racism as a barrier to achieving health equity.
Asunto(s)
Curriculum , Educación en Enfermería , Racismo , Humanos , Racismo/prevención & control , Estados Unidos , AntiracismoRESUMEN
Background: In 2012, the Muhimbili University of Health and Allied Sciences (MUHAS) embarked on structured competency-based curricula (CBC) for its programmes. Other health profession training institutions continued with their traditional way of teaching and thus causing variability in the competencies of the graduates. We aimed to analyze the experiences of different stakeholders on the implementation of CBC specifically on biomedical sciences by MUHAS to inform the development of harmonized competency-based curricula in three health professional training institutions in Tanzania. Methods: We adopted an exploratory case study to analyse the implementation of CBC in programmes of Medicine and Nursing involving MUHAS graduates, immediate supervisors at the employment sites, faculty, and continuing students at MUHAS. Kiswahili guides were used to conduct the in-depth interviews (IDIs) and focus group discussions (FGDs). Qualitative content analysis was adopted for analysis. Results: From the 38 IDIs and 15 FGDs, four categories of human resources teaching and learning environment; curriculum content; and support systems emerged. Human resources were attributed to the shortage of an adequate number of faculty and teaching skills variation. The curriculum content category was linked to the redundancy of courses or topics, poor sequencing of some topics or courses, and limited time for teaching some essential courses or topics. Training and practice area mismatch, accommodation to students, teaching space, and library were the sub-categories linked to teaching and learning environment. Lastly, support systems related to teaching methods and opportunities for improving teaching and learning were revealed. Conclusion: The findings of this study highlight the challenges and opportunities for the implementation of CBC. The solutions to the revealed challenges are beyond the training institutions' capacity. The latter call for multi-stakeholder engagement including those from the public and private sectors in health, higher education and finance for common and sustainable solutions.