Participating in a recent meeting of the UCSF School of Nursing’s Diversity in Action, are, from left, Zina Mirsky, Harvey Brody, Judy Martin-Holland, Michael Adams and Howard Pinderhughes.
A cadre of UCSF School of Nursing faculty members is leading the way to create a more welcoming environment for all people.
Over the past decade, representatives from the nursing school have been meeting not only to discuss the difficult issues that arise on a multicultural campus, but also to create and share tools to nurture diversity.
Called Diversity in Action (DIVA), the group is currently chaired by Glenna Dowling, RN, PhD, professor and chair of Physiological Nursing, and Holly Kennedy, PhD, associate professor of nursing. DIVA is a training initiative with a mission to create a climate in which everyone feels welcome and can participate and learn.
To date, the initiative has created six training modules, one of which is available online, according to Zina Mirsky, RN, EdD, associate dean of the nursing school. This training is mandatory for all new faculty, she points out.
Originally conceived as the UCSF Faculty Mentoring Group in 1994 under the direction of then Dean Jane Norbeck, RN, DNSc, the group came as a response to the need to support underrepresented faculty, who bore the responsibility of mentoring underrepresented students.
Led by Howard Pinderhughes, PhD, associate professor and chair, Social and Behavioral Sciences, Michael Adams, director of Affirmative Action, Equal Opportunity and Diversity, and Susan Kools, RN, PhD, associate professor in the School of Nursing, DIVA examined the changes that might be needed in the school’s classroom climate and curriculum to promote a feeling of inclusion and develop an optimal environment for learning.
It was during DIVA meetings that the difficult questions surrounding diversity came to the surface. Issues of how to deal with classroom incidents of insensitivity or bias were addressed. Eventually, the group broadened the definition of diversity to look at the variety of factors that contribute to a sense of inclusion.
“There is an ethos in nursing that takes social justice into account,” said Pinderhughes. “Historically, it’s a profession that’s worked closely with underrepresented groups, and there is often a commitment to want to work from a proactive standpoint.”
Identifying Weaknesses
The School of Nursing conducted a full survey of faculty and students that was led by Kennedy, who has a background in qualitative research. Every course in the nursing school was analyzed and compared with the campuswide definition of diversity. Other data sources included meetings with students, a study of schoolwide syllabi, student evaluations of diversity content in the curriculum and faculty responses to the presentation of the findings.
During this study, an online survey of 2006 graduates revealed that nursing students needed more support from faculty on issues of diversity. As one online comment stated, “Largely, nursing faculty here do not know how to talk about race and ethnicity factors, except when speaking about disease prevalence. They are uncomfortable with discussion of stigma, racism, discrimination and unequal treatment.”
At a fall 2006 retreat, the survey’s comprehensive findings were presented to the faculty. It was during a discussion led by Adams at the retreat that a breakthrough occurred.
“What was truly moving and commendable was the way in which faculty responded to the findings and criticisms,” recalled Adams. “They remained open and during the retreat were able to examine themselves in a very difficult and honest way and communicate where they felt like they were falling short in meeting student needs.”
During the breakthrough discussion, many faculty said they felt uncomfortable and ill-equipped to deal with issues surrounding diversity. Many said they felt personal discomfort and anxiety about saying the wrong thing, and more than half of the faculty at the retreat identified challenges to increasing diversity in course content.
The discussion, which included faculty and staff, is an example of UCSF’s commitment to creating a more diverse environment, a goal identified in the UCSF Strategic Plan.
Training Teachers
In response to faculty requests to address the issues raised at the retreat, DIVA representatives developed a six-module training series. The objective of the training is to develop a culture of humility within the learning environment in the school and to ensure that all faculty have the tools and skills to handle the sometimes sensitive issues of diversity.
The idea of cultural humility builds from the culture found in the School of Nursing, as demonstrated in the retreat. According to an article in the Journal of Health Care for the Poor and Underserved, “Cultural humility incorporates a lifelong commitment to self-evaluation and critique, to redress the power imbalances.”
The training modules include:
- Module 1: Facilitate discussions within the classroom
- Module 2: Design syllabi and courses to engage issues of diversity
- Module 3: Classroom management: Creating a respectful and inclusive environment
- Module 4: Encourage a culturally humble approach in the clinical setting and encourage students to be culturally humble
- Module 5: Teach future faculty to engage in issues of diversity
- Module 6: Research: Manage a multiethnic team, incorporate issues of difference into research projects and comply with NIH mandates
Faculty are given tools to encourage cultural humility when faced with difficult situations. One example used during the training is an actual case study of a classroom incident of bias against a homeless person.
“There was a classroom incident in which someone made a comment that ‘homeless people are frequent flyers in the emergency room,’” said Judy Martin-Holland, PhD, assistant dean of the School of Nursing. “The student commented that homeless people are just looking for a place to stay.”
The DIVA training encourages faculty to ask questions such as “Why are you making this assumption?” and to engage other students in the discussion by asking them to share their own experiences about the bias.
The case study revealed that the discussion spearheaded by faculty led to an analysis in which students concluded that perhaps it is the system that doesn’t have a way to meet the needs of homeless individuals. In allowing for an engaging discussion, faculty were able to access what was really embedded in the comment. In this case, it was a student’s feelings of frustration about the health care delivery system.
Improving Communications
In addition to training faculty to better address issues of diversity in the classroom, the DIVA Recruitment and Retention Committee, coordinated by Martin-Holland, is leading the way to bring more diverse populations into the application process.
One way the University is addressing issues of increasing the pool of applicants is through an ambassador program, in which representatives of UCSF travel to meetings around the country in an effort to recruit diverse faculty.
Harvey Brody, DDS, professor emeritus in the School of Dentistry, who recently conducted a training session for Democratic presidential candidate Barack Obama’s staff on community organizing, was invited by DIVA on June 13 to conduct a workshop at UCSF. The workshop, titled “Strategies and Resources to Increase Faculty Diversity in the School of Nursing,” presented specific strategies to use so that a conversation about diversity could be sustained effectively throughout the search process.
During the workshop, longtime DIVA representative Kools referenced a difficult incident that occurred when she was trying to cultivate a relationship with a potential faculty member from an underrepresented group. The workshop is designed to help faculty handle situations just like that one.
“We want to allow the DIVA representatives, many of whom will serve on search committees, to feel empowered to have those difficult conversations around diversity and not be embarrassed about them,” said Brody.
