In an era marked by the Black Lives Matter movement and the COVID-19 pandemic,聽awareness of the inequities within health care is steadily growing. Research from the Centers for Disease Control and Prevention and the New England Journal of Medicine indicates that structural racism is a fundamental driver of health disparities.

Following the murder of George Floyd and worsening pandemic conditions in 2020,聽Nursing Outlook聽published an editorial by nursing school deans at the University of Pennsylvania and Duke University calling out racism as a disease that nurses and nurse educators must address to improve patient outcomes and create better workplaces. To meet its goal of creating classrooms where students learn how to promote health equity, the Connell School of Nursing (CSON) has been working to develop on-campus resources for students of color, and to make sure that both classroom content鈥攚hat is taught鈥攁nd pedagogy鈥攈ow it is taught鈥攅quip all students to address health disparities in their careers.

Expanding the Student Experience

Karen Aldana in a maroon top

When Karen Aldana 鈥�23 arrived at 天美传媒app as a first-year, she quickly became aware that the majority of her nursing school classmates were white. For Aldana, who believes representation is crucial in the field of nursing and at 天美传媒app, finding community on campus was a priority. 鈥淲hat made that easier was the Seacole Scholars Program that Julianna Gonz谩lez-McLean started our freshman year,鈥� Aldana says.

At the time, Gonz谩lez-McLean was CSON鈥檚 assistant dean of student services for diversity and inclusion. She co-created the Seacole Scholars Program as an intentional Living and Learning Community for first-year nursing students from underrepresented backgrounds, inspired in part by her own experience as a 天美传媒app undergraduate in the mid-2000s. Back then, her dream was to be a psychiatrist. 鈥淚 knew I could do it, but I didn鈥檛 make connections with faculty,鈥� she says. 鈥淪o I left pre-med after organic chemistry. Later, I wanted to be that mentor for the students who felt they were just getting by.鈥�

“Guiding faculty toward new teaching norms will create classrooms where both students and educators feel empowered to learn.”
Kim Humphrey, Instructional Designer, 天美传媒app鈥檚 Center for Teaching Excellence
Julianna Gonzalez-McLean

When Gonz谩lez-McLean returned to campus in 2013 to work at the Connell School, she made it her mission to nurture a supportive learning environment for all future health care workers. Although CSON鈥檚 existing Keys to Inclusive Leadership in Nursing (KILN) program provided support to some 60 students each year, she felt the school鈥檚 efforts to serve underrepresented students like Aldana could be more robust. She envisioned a residential community where nursing students of color could choose to live together, take classes together, and have meaningful, guaranteed dialogue with faculty and campus leaders. Today, Gonz谩lez-McLean is continuing this work at George Washington University School of Nursing as associate dean for diversity, equity, and inclusion, and Aldana is the resident assistant for the Seacole Scholars Program. Now an established community member and a mentor to boot, Aldana says the program has been essential to her 天美传媒app experience. 鈥淚t was helpful to have that community of individuals who identified similarly to me鈥攚ho I could be comfortable with and express my feelings around. I made more friends because of it.鈥�

Evaluating the Curriculum

Making education inclusive also means choosing the right course materials. The Connell School鈥檚 Baccalaureate Program Committee (BPC) has been partnering closely with Boston College鈥檚 Center for Teaching Excellence (CTE) to do exactly this. The committee is composed of nursing faculty, some of whom joined forces with the CTE鈥檚 Kim Humphrey to create a system for evaluating coursework.

Kimberly Humphrey

An instructional designer, Humphrey has been a key resource during the ongoing evaluation process. While CTE instructional designers are not subject matter experts, they are teaching specialists who provide confidential support to 天美传媒app faculty. Humphrey hopes to help teachers develop a critical eye toward their own biases (which can stem from class background, race, age, gender, and beyond) and expand their imagination of how various students might experience the classroom.

With this in mind, Humphrey created a curriculum review instrument to put faculty teaching under a microscope. This tool can, for example, help teachers have inclusive discussions about topics like disease processes that disproportionately impact non white populations. Framing health inequity as a product of systemic racism can both give students a more nuanced understanding of illness and help them connect with future patients on a more holistic level. The classroom, Humphrey says, is a place where oppression can either be reproduced or undone.

鈥淚nstructors ask different questions about inclusive teaching and come from different perspectives and backgrounds,鈥� Humphrey says. For this reason, their approaches to designing course materials vary. Ultimately, she hopes that guiding faculty toward new teaching norms will create classrooms where both students and educators feel empowered to learn.

Evolving Classroom Learning

In 2021, Dorean Behney Hurley, a clinical instructor and BPC member, requested that CTE audit her core Pathophysiology course, which she has taught for more than 10 years. 鈥淚t鈥檚 one of the very first classes that nursing students take, so I thought it was important that we should start from that perspective,鈥� Hurley says. Over the fall 2021 semester, Hurley met regularly with Humphrey, Gonz谩lez-McLean, and other CSON staff and faculty to comb through each section of her course material to update the course鈥檚 case studies and presentations to be as bias free as possible

Dorean Behney Hurley

One of Hurley鈥檚 goals was to make the images she shows to students more inclusive. 鈥淚f you look in a lot of the textbooks, a lot of the references are only shown on white skin,鈥� she says. Diversifying images is just one step in calibrating the nursing classroom toward inclusion, however. As the curriculum evaluation went on, Hurley began to talk about race and illness differently. This was particularly true during her unit on hypertension鈥攁 disease that disproportionately impacts non-white individuals.

鈥淲here in the past I may have said, 鈥楾his is what a person who has this disease looks like,鈥� I would now say, 鈥楾his is a product of structural racism,鈥欌�� she says. Her teaching is backed by the research of medical experts and by organizations like the American Heart Association, which cites structural racism as 鈥渁 fundamental cause of persistent health disparities in the United States.鈥� Hurley also adjusted her syllabus policies to be more inclusive, allowing greater flexibility for students given the effect the pandemic could have on their lives.

鈥淚 want to build relationships with students,鈥� she says. 鈥淚 want them to come to me if they need help.鈥�

Student course surveys are already reflecting positive feedback to the changes, she says鈥攁 promising start.

“We don鈥檛 exist in isolation here in Chestnut Hill. If we do better here, our alums will do better wherever they choose to practice.”
Katherine E. Gregory, Dean, Connell School of Nursing
Jacqueline Sly

Clinical Assistant Professor Jacqueline Sly, who is CSON鈥檚 former assistant department chair and a family nurse practitioner, credits much of her own teaching success to working with a largely non-white hospital population in Brockton, Massachusetts. Her work there motivates her to give students the curriculum they need to understand health disparities and improve patient outcomes. She cites CSON鈥檚 mission to educate nurses who provide scientifically based, humanizing health care as a reason to center health equity in the classroom. Like Hurley, Sly has worked with Gonz谩lez McLean and the CTE to identify where she can improve her teaching.

鈥淲hen you work on dismantling racism, you鈥檙e also stepping into racism, and that can feel like stepping into conflict,鈥� she says. 鈥淪ometimes it鈥檚 hard, emotional work.鈥�

While uncertainty is a natural part of the learning process, the payoff can be great. To Aldana, who was Sly鈥檚 Pharmacology student, the classroom felt more welcoming because of the open-minded environment. 鈥淲hether it related to the content or not, she gave us the space to talk about current events and how certain medications and drugs affect different populations,鈥� Aldana says. With a year to go in her CSON education, Aldana is excited about her professional future in pediatrics and supporting premature babies in the NICU. For her, Sly鈥檚 teaching brought the outside world in.

Charting a Path Forward

With the 2022 spring semester unfurling, Dean Katherine Gregory wants to keep expanding the conversation about inclusive teaching and inequity in nursing.

Dean Katherine E. Gregory

Gregory, who earned a Ph.D. in nursing from Boston College and served as a faculty member from 2006 to 2014, is intimately familiar with the learning environment at CSON. In July 2021, though, she became dean at an unprecedented time. 鈥淟ike any new leader, I have spent the majority of my time listening and learning to partner across the University to be effective,鈥� Gregory says.

Academic excellence is Gregory鈥檚 number one priority as dean, and she sees anti-racist education as a cornerstone of this goal. 鈥淎t the grassroots level, we have been very fortunate to have members of CSON lead book clubs, podcast groups, and reflection seminars to increase knowledge and competency with concepts related to diversity, equity, and inclusion,鈥� she says. Gregory credits the partnership with CTE as one of the most effective methods the school has of weaving anti-racism through the nursing curriculum. With that work ongoing, she is setting her sights on the global CSON network.

鈥淲e don鈥檛 exist in isolation here in Chestnut Hill,鈥� she says. 鈥淚f we do better here, our alums will do better wherever they choose to practice.鈥� She hopes alumni will reach out with ideas for enriching CSON鈥檚 mission and share their own experiences related to health inequities in the field.

鈥淚 don鈥檛 think there鈥檚 any wrong way to move forward. I think the key is moving forward together.鈥� 鈻�

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