Centering diversity, equity, and inclusion in a regional professional nursing organization.

BACKGROUND: Professional nursing organizations can respond to threats to social justice by strengthening structures to support diversity, equity, and inclusion (DEI). PURPOSE: Describe implementation strategies and outcomes to advance DEI from the Western Institute of Nursing (WIN). METHODS: In 2019, WIN committed to prioritizing DEI by updating its vision and mission. A taskforce was assembled to conduct member surveys, focus groups, and open forums to generate recommendations on developing and implementing organizational change. DISCUSSION: These initiatives culminated in centralized efforts that include the formation of a standing committee, ongoing member surveys, selection of diverse conference topics and speakers, adoption of inclusive practices, and ongoing assessments to make recommendations to the Board to advance DEI. CONCLUSION: The work of the Committee ensures the organization remains committed to DEI. These strategies inform other nursing organizations as they advance DEI to impact research, education, policy, and practice.

Follow-Up of a Program to Improve Undergraduate and Graduate Nursing Student Diversity.

BACKGROUND: Underrepresented student recruitment is critical to resolve persistent gaps in workforce diversity in the United States. PURPOSE: Prenursing and nursing students participated in a nursing workforce diversity program designed to recruit and graduate underrepresented students, which provided academic and student support, financial support, and mentoring. A follow-up study was conducted to identify the impact of the program. METHODS: Participants were surveyed about educational and employment information, perceptions about factors that contributed to success, benefits of the program, and educational experience. Descriptive summaries of data and thematic analysis of qualitative comments occurred. RESULTS: Financial support, program quality, mentoring, career guidance, and meeting basic security needs were the strongest factors contributing to success. Program benefit themes included: feeling empowered, encouraging success, building confidence, and easing financial strain. Negative experiences with discrimination and bias were reported. CONCLUSIONS: Cocurricular support can help facilitate belonging. Scholarship awards communicate belief in student success, which impacts confidence and achievement.

Addressing Diversity, Equity, and Inclusivity Contributions in Academic Review.

BACKGROUND: The nursing profession and academic environments are increasingly calling for nurse educators to incorporate diversity, equity, and inclusion (DEI) goals and actions into their professional practice. Such work aligns with institutional and professional missions of social justice and antiracism. PROBLEM: Historically, there has been an undervaluing and lack of recognition in academia of DEI contributions and qualitative or community-based research focused on health equity. This lack of recognition may disproportionately impact faculty who focus their scholarship and research on marginalized communities. APPROACH: The current state of the academic review of DEI contributions for appointment, promotion, and tenure is presented. Examples for teaching, research and scholarship, practice, and service are provided. OUTCOMES: Recommendations include expanding recognition and evaluation of academic scholarship and advocacy against efforts to dismantle social justice and antiracism advances within academia. CONCLUSION: Examining hegemonic norms is vital to promote more equitable power structures in academic environments.

Creating Structures to Support Quality Matters Certification Within a School of Nursing.

BACKGROUND: Best practices for online course design aim to improve teaching and learning by emphasizing the relationship between a course's learning outcomes and all other parts of the course, from assessments to technology to student interaction with peers and instructors. The transition and expanded opportunities to online or hybrid learning in nursing education demonstrate the need for quality online learning experiences. METHOD: A university initiative to ensure high quality remote courses focused on expanding Quality Matters (QM) certification of hybrid and online courses, which ensures that a course has been developed according to standards for online learning. RESULTS: Currently, 20 courses within a school of nursing are QM certified with 4 more actively preparing for formal review this academic year. CONCLUSION: This experience can aid schools to develop faculty competencies in evidence-based, online navigation and course design, and systematically improve the online learning experiences for all students. [J Nurs Educ. 2024;63(4):205-211.].

Supporting an Inclusive Environment Through Correct Name Pronunciation.

BACKGROUND: The Future of Nursing 2020-2030 Report recommends eliminating practices within nursing education that contribute to racism and discrimination. PROBLEM: Name mispronunciation has been identified as a microaggression that can interfere with an inclusive learning environment and a sense of belonging. APPROACH: The faculty development approach used a TEDx talk of a story about personal naming, followed by a discussion on appropriate and inappropriate responses to name mispronunciation. Tools and strategies to promote correct name pronunciation were shared. OUTCOMES: Participants reported (1) the training and video were meaningful and impactful; (2) increased understanding that name mispronunciation may be considered a microaggression; and (3) increased awareness of their response to correct name pronunciation. CONCLUSIONS: A just and equitable learning environment free of discrimination is integral to achieving inclusion and belonging in nursing education. Correct name pronunciation tools and techniques can engender a sense of inclusion.

Reflections on the Process of Implementing Trauma-Informed Education Lunch and Learns.

BACKGROUND: The trauma-informed education (TIE) framework can help create an equitable learning environment supportive of all learners. PROBLEM: Stress and trauma can be impediments to academic success for students, particularly from backgrounds historically excluded from nursing. APPROACH: This article shares the initial steps of a training program on implementing a series of Lunch and Learns (LLs) on TIE in a school of nursing to introduce TIE to faculty and staff and obtain their feedback on facilitators and barriers to implementing recommended approaches. OUTCOMES: The series was well attended, averaging 33 participants per session. Using experts in TIE positively impacted the learning but contributed to inconsistencies in presentation style and scaffolding of content across sessions. CONCLUSION: Purposeful recruitment and engagement of faculty during the development of the LLs were effective in increasing attendance. Multiple sessions require early planning and meetings with team and presenters to ensure consistency and better use of resources.

Regional delivery in graduate nursing programs for students living in rural communities.

Oregon has a lack of primary care providers in rural areas. To address this issue, employers have indicated they plan to hire greater numbers of advanced practice registered nurses (APRNs). Oregon Health & Science University (OHSU) School of Nursing (SoN) responded to this need by developing a statewide delivery model to educate APRN students in their communities. A performance improvement work group including practice faculty, statewide academic leaders, and staff created a project charter with scope of work, timelines, and outcomes with the goal of improving the systems supporting APRN education. An initial distance APRN education delivery model emerged from this effort and was refined over the following year. Strategies were implemented to address identified challenges using small cycles of change. The final model has three main principles: being learner-centered, equitable, and sustainable. The central outcome is graduating students committed to practicing in rural and urban underserved communities to meet workforce needs in Oregon.

Influence of a poverty simulation on nursing student attitudes toward poverty.

This study aimed to determine a poverty simulation's influence on nursing students' attitudes toward poverty. Five cohorts of baccalaureate nursing students participated in the study; two cohorts (experimental group, n = 103) participated in the simulation and three did not (control group, n = 75). The Attitudes Towards Poverty Short Form was administered before the simulation and 6 weeks later; higher scores indicated more positive attitudes toward poverty. Experimental group pretest scores were higher. Higher pretest global scores were negatively correlated with religious affiliation (Spearman's rho = -0.294, p = 0.000) and positively correlated with prior poverty exposure (Spearman's rho = 0.284, p = 0.000) and liberal political views (Spearman's rho = 0.444, p = 0.000). Controlling for pretest differences, posttest mean scores for the experimental group (78.73) were significantly higher (p = 0.007). The poverty simulation is an engaging learning experience providing an opportunity for students to gain sensitivity in working with this population.

Preparing Nurse Educators to Teach Social Determinants of Health Using Backward Design.

BACKGROUND: Recent national recommendations have been developed to ensure nurse educators are prepared to teach about health equity and social determinants of health. Nurse educators may not have had formal or professional development in teaching these concepts, which may pose a barrier to implementing recommendations. METHOD: This article outlines a graduate course focused on social determinants of health to prepare future nurse educators with the knowledge, skills, and ability to address these concepts in future teaching. RESULTS: A backward design approach facilitated the alignment of learning outcomes, assessments, and activities that resulted in Quality Matters certification in this online graduate-level course. Topics include health equity and implicit bias, and learners evaluate educational resources and develop an educational presentation of health inequities in a selected population. CONCLUSION: This course supports the development of nurse educators to increase their skill in understanding and teaching social determinants of health and health equity. [J Nurs Educ. 2022;61(9):511-515.].

Advancing Diversity in Nursing Education: A Groundwater Approach.

There have been increased calls for a diverse nursing workforce to resolve health inequities. While the diversity of the nursing workforce slowly improves, it lags in comparison to the diversity of the United States population. The lack of diversity in academic nursing is the root cause of the lack of a diverse nursing workforce. A groundwater approach, as developed by the Racial Equity Institute, is used to analyze systemic barriers in nursing education that hinder achieving student diversity. Using this approach, recommendations are offered to educators and regulatory organizations to change policies and practices. Inclusive educational policies and teaching practices should be adopted to recruit and retain diverse students and faculty. Nursing education accrediting bodies must implement standards requiring programs to adopt holistic admission reviews and measurable diversity outcomes for students, faculty, and staff. The National Council of State Boards of Nursing must establish a common national licensure passing standard that is based either on graduation date or upon the first attempt and includes multiple attempts within a given time frame. A groundwater approach requires a mindset shift to focus on the environment and changes in practice and policy to overcome the current structural barriers in nursing education if there is ever to be a diverse nursing workforce.

Minimizing Unconscious Bias in Nursing School Admission.

BACKGROUND: The potential exists for unconscious bias to influence decisions throughout the admission process to nursing school and derail holistic admission review processes. Although little is known about unconscious bias in nursing school admissions, unconscious bias has been demonstrated in nurse educators at levels similar to the general population. METHOD: This article examines concepts of unconscious bias, factors that may interfere with accurate and fair assessment of applicants to nursing school, and ways to mitigate unconscious bias in the application and admission decision processes. RESULTS: Interventions that have shown success in reducing unconscious bias center on increased awareness of the presence of unconscious bias and cognitive strategies that include motivation and effort to counter the unconscious bias. CONCLUSION: Creating structures in the admission process that promote fairness and reduce the risk of relying on automatic judgments can minimize the influence of unconscious bias on admission decisions. [J Nurs Educ. 2021;60(6):317-323.].

The impact of a service-learning foot soak experience on nursing students' attitudes towards the homeless.

BACKGROUND: Opportunities for meaningful engagement with the homeless can alter negative attitudes. The purpose of this study was to assess changes in attitudes towards the homeless among undergraduate nursing students participating in a service-learning foot soak experience. METHODS: This was a prospective, pretest and posttest interventional study. Student attitudes were measured through: (a) the attitudes toward homelessness inventory and (b) thematic analysis of a guided reflection on the experience. RESULTS: Mean posttest total scores (mean = 50.06; standard deviation = 7.004) were significantly (P = .001) higher from mean pretest scores (mean = 47.06; standard deviation = 5.455), indicating more positive attitudes towards the homeless (n = 47) after the clinic. Three categories of themes that reflected student experiences are as follows: (a) benefits, (b) context, and, (c) potential consequences. CONCLUSIONS: A foot soak clinic can increase students' understanding of experiences faced by homeless persons through genuine human interaction, and has benefits to community members and learners.

Nursing workforce diversity: Promising educational practices.

BACKGROUND: Nursing workforce diversity is a national priority for providing culturally competent care and contributing to improved health equity. While nurses from underrepresented populations are increasing in the nursing workforce, the distribution of nurses in the United States is still not representative of the population. PURPOSE: The purpose of this paper is to describe the current state of workforce diversity in Western states and identify promising practices from programs located in Arizona, California, Colorado, and Oregon that are focused on improving nursing workforce diversity. METHODS: Four innovative programs to address nursing workforce diversity are presented. Each project has unique situations and approaches to improving admission, retention, and graduation of students underrepresented in nursing. Similar approaches each project used include holistic admission review, academic and student support, financial support, and mentoring. CONCLUSIONS: These projects contribute to knowledge development related to improving nursing workforce diversity for other colleges, universities, and states to consider. Improving nursing workforce diversity is a priority issue that could lead, through collective impact, to resolving health inequities nationally.

Teaching to the three apprenticeships: designing learning activities for professional practice in an undergraduate curriculum.

The Carnegie Foundation for the Advancement of Teaching recently completed a series of comparative studies that examined components and best practices in professional education and practice across five professions (clergy, law, medicine, nursing, and engineering). Across these disciplines, three apprenticeships were identified as necessary components of education for professional practice: an intellectual or cognitive apprenticeship, a skill-based apprenticeship related to clinical judgment and practice, and an apprenticeship to the ethical comportment or behavior of the profession. Although nursing education has a strong theory and clinical practice base historically, the comparative study of nursing education by the Carnegie Foundation found limited integration of the apprenticeships. Using an exemplar, this article discusses intentional design of learning objectives and activities to integrate learning across the three apprenticeships with an emphasis on key elements for professional practice in nursing.

Spiraling evidence-based practice and outcomes management concepts in an undergraduate curriculum: a systematic approach.

Preparing undergraduate nursing students to practice nursing in the 21st century requires a focus on the development of evidence-based practice and outcomes management knowledge and skills throughout the nursing curriculum. To this end, seven learning activities were created that spiral and increase in complexity while building on previously acquired skills. Working in teams and practicing team-building techniques, students learned how to develop a clinical question, search the literature, synthesize the current knowledge, identify the significance of the issue in an ecological model, decipher existing quality data and compare that data to national benchmarks, investigate a health care quality issue using quality improvement methods, and draft a proposal for implementation of a continuous quality improvement initiative. Work was presented in both written and oral presentation formats, with emphasis on engaging various audiences in a compelling health care issue.

Creating a Community of Writers: Participant Perception of the Impact of a Writing Retreat on Scholarly Productivity.

An important component of the academic faculty role is dissemination of knowledge through manuscript publication. Ways to facilitate this scholarship are important to academic career progression. One approach is a writing retreat, which is a structured time to write and receive peer review of writing occurring over multiple, sequential days. This paper reports on an annual multi-day writing retreat originally consisting of five days and four nights. This was a mixed method descriptive evaluation. Fifty-three of the 56 participants from the seven writing retreats from 2010 to 2016 were contacted via email to complete an on-line quantitative and qualitative survey. Thirty-one responded for a response rate of 59%. Eleven participants from the 2017 writing retreat participated in a focus group discussion. Qualitative comments were analyzed using thematic analysis procedures. The majority of participants agreed that the writing retreat enhanced their overall scholarly activity and reported their knowledge and motivation to write increased as a result of participation. Participants valued the dedicated time for writing, peer review of writing, and structured time for discussions about writing and publishing. This was especially true for participants who attended two or more times. A writing retreat has value in supporting faculty to complete dissemination of research and to accomplish academic promotions.

Fostering Global Health Practice: An Undergraduate Nursing Student Exchange and International Service-Learning Program.

BACKGROUND: Nurses increasingly are identified as key health care members on global health initiatives, and nursing curricula should address this competency to prepare students to work in a global environment. This article will share how processes and structures were established for an international undergraduate nursing student exchange and service-learning experience between two schools of nursing. METHOD: The goals of the project were to (a) implement an annual nursing student exchange of approximately 3 weeks in length; (b) select eight students from each school, accompanied by a faculty member, to participate; and (c) provide opportunities for students to participate in service-learning assessments in identified communities. RESULTS: To date, an annual exchange is in its fourth year of existence. CONCLUSION: An international service-learning opportunity is one way to improve nursing students' ability to provide culturally competent health care. [J Nurs Educ. 2019;58(4):235-239.].