The lived experiences of racial bias for Black, Asian and Minority Ethnic students in practice: A hermeneutic phenomenological study.

AIM: This study explored the lived experiences of racial bias for Black, Asian and Minority Ethnic students undertaking an undergraduate or post-graduate degree in nursing, midwifery and allied health courses in the United Kingdom. BACKGROUND: Previous research indicates that students from Black, Asian and Minority Ethnic groups have fewer opportunities to succeed at university and this has brought about a race awarding gap in their degree attainment. The reasons for this awarding gap are complex and multi-factorial and it is crucial that the lived experiences of racial bias are explored from the student perspective. DESIGN: A hermeneutic phenomenological approach was adopted to elicit individual and collective experiences in the practice environment, a mandatory component of the student's degree. METHODS: A focus group and individual semi-structured interviews were conducted to collect data from sixteen participants and analysed using thematic analysis RESULTS: Three encompassing themes were identified which included a sense of not belonging, trauma impact on mental health and understanding covert and overt racism. Participants reported incidences of racism and appeared to be traumatised by their experiences within practice and the university. They also reported poor mental health and well-being as shared experiences and a lack of confidence in the university and practice to mitigate racial issues. CONCLUSIONS: Meaningful action must be taken by universities and practice partners to advance racial inequality initiatives by having robust anti-racism action plans and processes. These should be co-created with students and staff to reduce the race awarding gap.

A mixed-methods evaluation of unconscious racial bias training for NHS senior practitioners to improve the experiences of racially minoritised students.

OBJECTIVE: The degree awarding gap indicates that racially minoritised higher education students receive lower degree classifications relative to their white peers. While the reasons for this are complex, research suggests that educator and practitioner attitudes and behaviour towards racially minoritised students are a significant contributing factor. This preregistered study evaluates the effectiveness of unconscious racial bias training (URBT) to enhance National Health Service senior practitioner's recognition of how racial inequalities negatively impact racially minoritised students. DESIGN: A mixed-methods study with a pretest and post-test design was conducted in the higher education and healthcare practice environment. METHODS: Forty-nine NHS senior practitioners completed a 4-hour URBT workshop with activities focusing on activating stereotypes, exploring differences between unconscious and implicit bias, discussing the development of bias, and reflecting on student experiences of prejudice, harassment and discrimination. They completed pre- and post- quantitative measures that assessed the effectiveness of URBT and changes in racial competency, awareness and perceptions of unconscious racial bias. Qualitative measures explored the usefulness and perceived applications of URBT, and a 1-month follow-up assessed further how it had been applied within practice. RESULTS: Participants reported positive evaluations of URBT, higher perceived racial competency, awareness and perceptions of racial bias (ps<0.001, dz>0.35). After 1 month, key themes from qualitative responses suggested that participants had increased self-awareness and were exploring how to set up mentoring and working groups, change recruitment and progression processes, and diversify the taught curriculum. CONCLUSIONS: URBT may be one effective strategy to enhance awareness and encourage reflections of racial bias. We discuss how reducing racial inequalities requires a multifaceted approach that affords upfront conversations about systemic racism, implements effective initiatives, policies and procedures, and engages in continuous evaluation.