Anti-Black Medical Gaslighting in Healthcare: Experiences of Black Women in Canada.

BACKGROUND: Stereotype about Black people contribute to nurses and healthcare providers gaslighting and dismissing of their health concerns. Despite the popularity of the term medical gaslighting in mainstream literature, few studies have explored the experiences of Black women during pregnancy and childbirth. PURPOSE: This paper aims to provide an in-depth insight into Black women's experiences of anti-Black medical gaslighting when accessing care during pregnancy and childbirth. METHODS: Utilizing qualitative methods, we conducted 24 semi-structured interviews with Black women in the Greater Toronto Area. We used thematic analysis to ground the data analysis and to generate insight into Black women's experiences. RESULTS: Three overarching themes: 1) Not Being Understood: Privileging of Medical Knowledge Contributing to the Downplaying of Health Concerns, 2) Not Being Believed: Stereotypes Contributing to Dismissive Healthcare Encounters and 3) Listen to Us: Turning off the Cycle of Medical Gaslighting. These themes highlight ways anti-Black medical gaslighting manifests in Black women's healthcare encounters to create differential access to treatment and care. CONCLUSIONS: Anti-Black medical gaslighting contributes to differential access to treatment and care. Improving equitable access to treatment and care must involve addressing structural and epistemic biases in healthcare and fostering a culture of listening to humanize the experience of illness.

Disproportionate Rates of COVID-19 Among Black Canadian Communities: Lessons from a Cross-Sectional Study in the First Year of the Pandemic.

BACKGROUND: Racialized communities, including Black Canadians, have disproportionately higher COVID-19 cases. We examined the extent to which SARS-CoV-2 infection has affected the Black Canadian community and the factors associated with the infection. METHODS: We conducted a cross-sectional survey in an area of Ontario (northwest Toronto/Peel Region) with a high proportion of Black residents along with 2 areas that have lower proportions of Black residents (Oakville and London, Ontario). SARS-CoV-2 IgG antibodies were determined using the EUROIMMUN assay. The study was conducted between August 15, 2020, and December 15, 2020. RESULTS: Among 387 evaluable subjects, the majority, 273 (70.5%), were enrolled from northwest Toronto and adjoining suburban areas of Peel, Ontario. The seropositivity values for Oakville and London were comparable (3.3% (2/60; 95% CI 0.4-11.5) and 3.9% (2/51; 95% CI 0.5-13.5), respectively). Relative to these areas, the seropositivity was higher for the northwest Toronto/Peel area at 12.1% (33/273), relative risk (RR) 3.35 (1.22-9.25). Persons 19 years of age or less had the highest seropositivity (10/50; 20.0%, 95% CI 10.3-33.7%), RR 2.27 (1.23-3.59). There was a trend for an interaction effect between race and location of residence as this relates to the relative risk of seropositivity. INTERPRETATION: During the early phases of the pandemic, the seropositivity within a COVID-19 high-prevalence zone was threefold greater than lower prevalence areas of Ontario. Black individuals were among those with the highest seroprevalence of SARS-CoV-2.

Anti-Black racism: Gaining insight into the experiences of Black nurses in Canada.

The call to address anti-Black racism in workplaces resonates across several organizations and institutions in Canada. But specifically, the coronavirus disease 2019 pandemic shed further light on how health inequities negatively impact the Black community. After conducting a literature review of the experiences of Black nurses in Canada, a deeper understanding of their plight was gained. In healthcare, the findings from the Black Nurses' Task Force report conclude that anti-Black racist practices are pervasive in nursing, and there remains a paucity of research in this area. This study builds off the report by exploring how Black nurses experience anti-Black racism while working in Canada's healthcare system. Inspired by critical race theory and Black feminist thought, an exploratory qualitative research study was conducted, using semistructured interviews to gather data. The study concludes that Black nurses experience anti-Black racism within the workplace, and it manifests itself through some of the attitudes of colleagues, patients, and nurses in leadership roles. Despite policies and statements that were in place to protect them, anti-Black racism continues to occur systematically. The findings point to the need for change in the overall workplace culture, which includes a fair representation of Black nurses in leadership roles, further research to identify best practices for tackling anti-Black racism within Canada's healthcare system, and mandatory training on anti-Black racism for healthcare leaders, educators, and service providers.

Equity, diversity, and inclusion in open educational resources: An interpretive description of students' perspectives.

BACKGROUND: Although often assumed as objective, texts in nursing education are value-laden artifacts. Not unlike many educational materials, nursing texts are socially situated and often reflect dominant discourses of white supremacy, patriarchy, colonialism, cis/heteronormativity, gender binaries, and ableism. In addition to conveying what institutions and educators value, the discourses that are mediated through text socialize students in their ways of thinking and acting. There is a collective responsibility to critically examine how and why particular discourses persistently permeate texts used in nursing education. Open educational resources, as one type of text in nursing, are often touted as symbols of social justice because they are accessible for use by diverse learners and can be adapted to suit educators' needs. OBJECTIVES: With a focus on better understanding how equity, diversity, and inclusion can inform the design and production of open education resources, our guiding research question was: How do students perceive and envision equity, diversity, and inclusion in nursing-related open educational resources? DESIGN: Guided by a social justice framework, we used interpretive description methodology informed by participatory action research values to answer this question. SETTING, PARTICIPANT AND METHODS: Sixteen students participated from a post-secondary year-one nursing course in two focus groups and thirty-three students completed an open-ended survey. RESULTS: Data analysis yielded four themes: representation, learning, identities, and self. CONCLUSION: Nurse educators have the opportunity to design open educational resources in ways that empower students and elevate social justice. Thus, a more nuanced and critical approach towards social justice is needed to better integrate diversity in nursing-related resources.

Apoiando a educação em pesquisa dos graduandos de enfermagem / Apoyando la educación para la investigación de los estudiantes de enfermería de pregrado / Sustaining undergraduate nursing students' research education

Resumo Objetivos Descrever a experiência da implementação de um programa de treinamento de assistente de pesquisa voluntário para graduandos canadenses de Enfermagem, objetivando o desenvolvimento de habilidades de comunicação verbal e escrita, métodos de pesquisa e análise de dados, pensamento crítico e resolução de problemas, assim como o planejamento de suas carreiras e o avanço de seus papéis relacionados à pesquisa e às oportunidades administrativas e de liderança. Método Estudo descritivo com relato de experiência sobre o processo de treinamento para um novo papel profissional relativo ao engajamento dos graduandos em 11 oficinas, cada uma com duração de uma hora e o processo de apoiá-los para assumir papéis profissionais e de liderança. Resultados Os graduandos demonstraram comprometimento em todas as fases do treinamento. Destaca-se, ainda, o interesse por assumirem a liderança em atividades práticas que redefinem seu perfil profissional. Essa experiência contribuiu para construir e nutrir relações intelectuais docentes-graduandos. Os graduandos expandiram suas redes profissionais e a relação com o mentor de carreira, estão desenvolvendo suas habilidades práticas e relataram confiança em se candidatar para cargos de assistentes de pesquisa. Conclusão e implicações para a prática O treinamento pode instrumentalizá-los para escolhas de planos de carreira, ingresso no mercado de trabalho e a construção de plano para desenvolvimento profissional. O desejo genuíno dos docentes de Enfermagem, apoiando uma nova geração de enfermeiros, culminou nessa experiência de empoderamento mútuo.

Resumen Objetivos Informar sobre la experiencia de un equipo de profesionales de enfermería y desarrollo profesional en la implementación de un programa de asistente voluntario de investigación para estudiantes universitarios canadienses de pregrado en enfermería con el objetivo de desarrollar la comunicación escrita y verbal, métodos de investigación, análisis de datos, pensamiento crítico y habilidades de resolución de problemas, así como en su planificación y avance profesional para funciones relacionadas con la investigación y oportunidades de empleo administrativo y de liderazgo. Método Un diseño descriptivo con el informe de la experiencia de los investigadores de enfermería y desarrollo profesional sobre el proceso de apoyo para la formación de los estudiantes para un nuevo rol profesional. La experiencia se refiere a 11 talleres que durarán una hora sobre los temas relacionados con la investigación. Resultados Los estudiantes demostraron compromiso con la capacitación. Relevante es su interés en liderar actividades prácticas para redefinir su perfil profesional. Esta experiencia contribuyó a construir y fomentar relaciones significativas e intelectuales entre los profesores y los estudiantes. Los estudiantes amplían sus redes profesionales y obtienen una relación con un mentor de carrera. Conclusión e implicaciones para la práctica La capacitación puede equipar mejor a los estudiantes para elegir trayectorias profesionales, entrar en el mercado laboral y elaborar un plan para el avance profesional. Fue el deseo genuino de los profesores de enfermería de apoyar a una nueva generación de enfermeras que culminó en esta experiencia de empoderamiento mutuo.

Abstract Objective To describe the experience of implementing a research assistant program for Canadian undergraduate nursing students, which aimed to develop written and verbal communication, critical thinking and problem-solving skills, as well as knowledge of various research methods. Engagement in this program was intended to support students' career planning and advancement in research related roles, including administrative and leadership employment opportunities. Method A descriptive design with the report of experience of nursing researchers and career advisers pertaining to: engagement in an 11 one-hour research focused workshop; and the process of supporting students to assume professional and leadership roles. Results Students demonstrated commitment to the training program throughout its phases. They expressed interest in leading practical activities to redefine their professional profile. This experience contributed to building and nurturing intellectual teacher-student relationships. Students are expanding their professional networks and a relationship with a career mentor, while demystifying the research assistant role. Students are developing practical skills and reporting confidence in applying for research assistant positions. Conclusion and Implications for practice Participating in the training program better equips students for choosing their career path, entering the job market, and building a plan for further career advancement. Nursing faculty's genuine desire for and purposeful actions to support a new generation of nurses informed this mutually empowering experience.

Women's Experiences of Intimate Relationships While Living With Irritable Bowel Syndrome.

Irritable bowel syndrome is a chronic digestive disorder that commonly affects women. Research has shown that the illness experience of irritable bowel syndrome can disrupt social relationships. However, the area of intimate relationships has yet to be explored despite the deep involvement that intimate partners often have in the experience of living with chronic illness. Using a critical feminist lens, a narrative methodology was employed to explore women's experiences of intimate relationships while living with irritable bowel syndrome. Data collection methods included semistructured interviews and an arts-informed activity. The women's narrative accounts and artistic pieces reflected the emotional, physical, and interpersonal aspects of intimacy while living with irritable bowel syndrome. The findings indicated that women's experiences were deeply emotional and involved laborious and gendered emotion work. Their body concept complicated their relationship experiences. Women's emotional and social well-being was fostered by their partners' provision of acceptance, understanding, and support. The findings highlighted the need to implement and further explore the inclusion of emotional support and counselling as well as dyadic and gendered approaches to irritable bowel syndrome management.

Mentors' and mentees' intellectual-partnership through the lens of the Transformative Learning Theory.

In this paper we report reflections about the scholarly mentoring experiences of undergraduate nursing students (mentees) and faculty members (mentors) involved in an intellectual partnership at a Canadian university. The paper specifically recounts the impacts of the transformative process experienced by 18 mentees and three mentors, based on their in-depth written critical reflections. In this collaborative initiative, the constructivist framework of Shor and Freire, and Mezirow's Transformative Learning Theory, served as foundations for all interactions between mentees and mentors, and guided the analysis and interpretation of their written self-reflections. Mentees and mentors were motivated by complementary goals for the intellectual relationships. Their combined contexts, self-reflective, critical dialogue, shared assumptions and ideas worked to ignite a critical awareness of their potential and self in their professional world. Sharing new ways of thinking and points of view stimulated their transformation on various levels -emotional, cognitive, and spiritual.

Taking action on violence through research, policy, and practice.

BACKGROUND: Violence is a critical public health problem associated with compromised health and social suffering that are preventable. The Centre for Global Health and Health Equity organized a forum in 2014 to identify: (1) priority issues related to violence affecting different population groups in Canada, and (2) strategies to take action on priority issues to reduce violence-related health inequities in Canada. In this paper, we present findings from the roundtable discussions held at the Forum, offer insights on the socio-political implications of these findings, and provide recommendations for action to reduce violence through research, policy and practice. METHODS: Over 60 academic researchers, health and social service agency staff, community advocates and graduate students attended the daylong Forum, which included presentations on structural violence, community violence, gender-based violence, and violence against marginalized groups. Detailed notes taken at the roundtables were analyzed by the first author using a thematic analysis technique. FINDINGS: The thematic analysis identified four thematic areas: 1) structural violence perpetuates interpersonal violence - the historical, social, political and economic marginalization that contributes to personal and community violence. 2) social norms of gender-based violence-the role of dominant social norms in perpetuating the practice of violence, especially towards women, children and older adults; 3) violence prevention and mitigation programs-the need for policy and programming to address violence at the individual/interpersonal, community, and societal levels; and 4) research gaps-the need for comprehensive research evidence made up of systematic reviews, community-based intervention and evaluation of implementation research to identify effective programming to address violence. CONCLUSIONS: The proceedings from the Global Health and Health Equity Forum underscored the importance of recognizing violence as a public health issue that requires immediate and meaningful communal and structural investment to break its historic cycles. Based on our thematic analysis and literature review, four recommendations are offered: (1) Support and adopt policies to prevent or reduce structural violence; (2) Adopt multi-pronged strategies to transform dominant social norms associated with violence; (3) Establish standards and ensure adequate funding for violence prevention programs and services; and (4) Fund higher level ecological research on violence prevention and mitigation.

Building a scholar in writing (BSW): A model for developing students' critical writing skills.

Several authors have highlighted the importance of writing in developing reflective thinking skills, transforming knowledge, communicating expressions, and filling knowledge gaps. However, difficulties with higher order processing and critical analysis affect students' ability to write critical and thoughtful essays. The Building a Scholar in Writing (BSW) model is a 6-step process of increasing intricacies in critical writing development. Development of critical writing is proposed to occur in a processed manner that transitions from presenting simple ideas (just bones) in writing, to connecting ideas (connecting bones), to formulating a thesis and connecting key components (constructing a skeleton), to supporting ideas with evidence (adding muscle), to building creativity and originality (adding essential organs), and finally, developing strong, integrated, critical arguments (adding brain). This process symbolically represents the building of a scholar. The idea of building a scholar equates to progressively giving life and meaning to a piece of writing with unique scholarly characteristics. This progression involves a transformation in awareness, thinking, and understanding, as well as advancement in students' level of critical appraisal skills.

The mediating role of social support, cognitive appraisal, and quality health care in black mothers' stress-resilience process following loss to gun violence.

Although much attention has been granted to the perpetrators and victims of gun violence, limitations exist in our understanding of the psychological well-being of parents grieving children lost to gun violence. The purpose of this study was to examine the mediating effects of social support, cognitive appraisal, and quality health care on the relationship between traumatic stress and resilience among Black mothers bereaving children to gun violence. A cross-sectional design and network sampling method were used to recruit 48 Black mothers living in a large Canadian city. Participants completed a survey either by phone or in person. Social support and positive appraisal were found to be protective factors of resilience for study participants. The traumatic stress experienced by the sample decreased with increased social support (beta = -.291, p = .045), leading to an increase of their resilience (beta = .297, p = .032). With positive appraisal of the loss, the stress levels of study participants decreased (beta = -.334, p = .023), leading to increased resilience (beta = .441, p = .003). Quality health care showed a significant positive relationship with the resilience of the women (beta = .313, p = .023) but did not mediate the relationship between their stress and resilience. For Black mothers who experience loss of a child to gun violence, policy and social change efforts should focus on strengthening their access to formal and informal supports and improving their abilities to find meaning in their loss.