2023-2024 Diversity, Equity, and Inclusion/Anti-Racism Updates

Diversity, equity, and Inclusion work continued through the 2023-2024 academic year and included development/educational activities, strategic objectives under the People and Culture Goal, and the Diversity Action Plan led by the SON Diversity Advisory Group.

Below is a summary on activities related to the 2020 OHSU School of Nursing Anti-Racism statement and actions taken to Advance the Culture of the School of Nursing:

“Create an anti-racism repository of resources for faculty, staff, and students, including multicultural curriculum resources.”

Completed and Ongoing: This repository has been created and further development continues.  Information resources related to DEI for students, staff, and faculty is available. Links to OHSU Center for Learner Diversity & Inclusion and OHSU Library are included along with their resources/podcasts on anti-racism and racial equity to expand one’s knowledge in this area.  Links to resources on race, racism, and health disparities are also included, as well as Trauma Informed Educational Practices.  Information and best practices for faculty on how to create a culturally inclusive and responsive learning environment are also provided through the Foster Respectful and Equitable Education (FREE) OHSU education website resource.

“Listen to our students about their observations of racism, provide opportunities for dialog and processing of observations in classes and clinical, and potential responses and interventions.”

Ongoing:  Meetings have occurred with various students and faculty members to discuss their concerns and to work with them on addressing concerns and finding potential solutions. Informal mentoring has also occurred with some students and there are continued discussions about having more formal mentoring in the future.  Informal mentoring also has occurred with some faculty members. Dialogue with the School of Nursing Deans continues to occur once a term for undergraduate and graduate nursing students.  These sessions are designed to offer connection and the opportunity to ask questions of SON mission leaders.

“Listen to faculty and staff about racism and anti-racism efforts and seek to provide opportunities for dialog and action.” 

Ongoing: Leadership Council members have read The Sum of Us: What Racism Costs Everyone And How We Can Prosper Together, and subsequent discussions are planned about this book for 2025.  The School of Nursing Staff Anti-Racism study group, formed in 2022, now has a new leaders, Mel Tennyson and Eric Vecchi.  Members of this group read and discussed Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, a book by Linda Villarosa, Between the World and Me, a book by Ta-Nehisi Coates, and will next read My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies, by Resmaa Menakem.  This group’s multi-media focused sessions will continue to provide a safe space for staff to learn more about what it means to be anti-racist. 

“Examine clinical course outcomes and rubrics, add language regarding system biases/racism and incorporate more opportunity for students to pay attention to the racism that exists in microsystems of care.”

Ongoing: A few of our campuses across the state previously reviewed courses as part of a pilot study and another campus reviewed course activities. Other campuses are considering learning activities and one incorporated clinical patient bias scenarios.  One 400 level course created and incorporated a stand-alone module on equitable leadership. Another course has incorporated inclusive language along with simulation cases that reflect diversity.  In a 200 level course, discussions have occurred regarding diversity and social justice.  Inclusive and anti-racist resources are also included in this course. 

“Consider program outcomes to incorporate social justice.”

Ongoing: Continued participation of one of the campuses with an NAACP annual event is helping to raise social justice awareness. This campus is also working with their Justice, Equity, Diversity & Inclusion group to further social justice awareness.

“Conduct a review of cases, exam questions, assignments, and simulations across the undergraduate and graduate curricula to ensure accuracy, lack of bias, diversity and multicultural examples.”

Ongoing: A Photo Diversity Repository was created by Linda Felver, a SON faculty member, and OHSU librarian Pam Pierce to help students more accurately visualize pathophysiological conditions of diverse populations, increase awareness of issues related to health & diversity, and help prepare students for more effective interactions with their future patients.  With the collaboration of Pam Pierce, M.N., M.L.S., OHSU Library, the OHSU Educational Use Photo Diversity Repository continues to be maintained for OHSU faculty.

• Two LibGuides, linked from the OHSU Library website are available to anyone in the world who has Internet access, making an impact beyond OHSU and beyond Oregon:
• The OHSU LibGuide: Journal Articles with Photographs of Visible Diseases and Conditions in People with Skin of Various Colors (https://libguides.ohsu.edu/visible-diseases) provides citations and links to journal articles with photos that people can use in teaching and learning. Dr. Felver continues to update this resource, which currently has at least 40 topics with links to approximately 100 articles.
• The OHSU LibGuide: Diverse Images and Audiovisuals for Educating Health Professionals (https://libguides.ohsu.edu/diverse-images) is a compilation of open access and no-cost sites with images and audiovisuals to increase inclusive representation in teaching and learning. Dr. Felver continues to update this resource, which currently includes links to inclusive photos involving body size, gender identity and expression, people with disabilities, newborns, older adults, and people of color living their lives.
• Plans were made last year for continuing training/developing select undergraduate faculty and staff in the use of didactic and simulation-based strategies to deliver culturally responsive, affirming, and anti-racist LGBTQIA+ care in a variety of healthcare contexts. Stage 1 workshops were completed and the next step was to look at the curriculum and modify/design simulation-based learning experiences, before finally integrating and measuring the outcomes of the activities. For last year's work, we had a change in project leadership, so the original work, as intended and designed, could not move forward beyond the initial stage.  However, significant elements of the work have been carried forward.  The SON undergraduate simulation team, in partnership with OHSU Simulation, has made significant strides in enhancing diversity and inclusion within our SON simulation program. By reviewing case objectives and outcomes, edits were made regarding patient and family names, pronouns, and ages to better reflect the diverse populations that our learners may encounter in their communities.

“Offer courses for student unconscious bias training in specific undergraduate and graduate courses beginning summer 2020.”

Completed and Ongoing: All SON students have the opportunity to participate in this training at the start of their academic program.

“Encourage a personal anti-racism individual goal for SON employees in the coming year.”

Completed and Ongoing: Individual goals are presented and discussed during each employee’s annual review.  This is now an annual requirement.

“Consider a personal anti-racism goal in the Faculty Performance Review – this work will be led by the Faculty Affairs Council.”

Completed and Ongoing: Voted on by faculty May 2021. Personal anti-racism goals are now part of the annual Faculty Performance Review.

“Support an Interprofessional Education focus on anti-racism.”

Ongoing:  The author of the “The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together”, Heather McGhee, was considered for an on-site presentation , but we were unable to successfully arrange this.  Other authors may be considered for the upcoming academic year.

“ Health System & Organizational Leadership program racism course series of 3 started fall 2020 and includes seats for other students.”

Completed and Ongoing: Three racism courses were created in 2020 and 2021 and continue to be offered during fall, winter, and spring terms. In winter term 2024, these courses were offered to all OHSU university students.  In fall 2024, Oregon State University will be listing these courses for students as electives.

Courses

• Clarifying Racism – Institutional Racism –initiated Fall Term, 2020
• Clarifying Racism – Foundational Concepts of Bias- initiated Winter Term 2021  
• Clarifying Racism – Unequal Treatment – initiated Spring Term 2021

“Update the statement on diversity, equity, and inclusion for the SON catalog.”

Completed: 7/2020

“Create several pre- and post-conferences for undergraduate clinical faculty to support faculty in addressing racism and opening conversation about it.”

Ongoing: Initial work related to patient bias in clinical settings has occurred with some SON faculty members and students. This pilot work was presented at the September, 2022 Las Vegas, Nevada NLN Healthy Planet, Healthy People: Leading The Way Through Education, Practice, and Policy conference by Dr. Ginger Keller, Dr. Karen Reifenstein, and Kathy Criswell.  Discussions are underway to help plan/understand the application of what has been learned by faculty to this point.

“Create a safe place for faculty to bring situations forward and discuss how to address and learn from them.”

Completed: The Diversity Science Company provided 4-months of workshops in support of our People/Culture objectives, which included developing multi-cultural and inclusive curricula, prevention of bias, anti-racism education, and offering learning opportunities for inclusive teaching/learning strategies. These workshops occurred during winter and spring term 2023.  Many SON faculty and staff participated in this educational training, and post evaluations were overall very positive with over 80% of faculty indicating that the training was both useful and effective.   Staff evaluation was even more positive. 

Workshop topics included: Creating the conditions for positive DEI outcomes; understanding ourselves to bring out the best in ourselves; neuroscience of bias and bias-prevention, best practices for constructive disagreement and discussions about stressful topics; bringing out the best in each other and students; understanding and reducing stereotype threat, psychological injury, and trauma; creating inclusive meetings and classrooms; talking about inequities and bias; and targeted applications.  Initial discussions occurred previously in the SON- Academic Practice Collaborative regarding safe spaces for faculty discussions, but further discussions continue to be needed.

• Additionally, An Introduction to the Antiracism & Multiculturalism Continuum: Institutional Racism in Healthcare Settings asynchronous online course is available.  This course provides  participants (faculty, staff, and students) with a foundational learning experience to acquire the language and concepts to prepare for more in-depth discussions related to structural, institutional, and systemic racism. 
• The LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Queer and /or Questioning, Intersex, Asexual, Two-Spirit) Cultural Humility & Allyship training is available, and explores the differences of sexual orientations and gender identities, strategies for holding trauma informed discussions with people from marginalized groups, how to improve health disparities in the LGBTQIA2S+community, and creating a culture of inclusivity for LGBTQIA2S+ community at OHSU & beyond.  This training is not designed as medical education, but rather to increase knowledge, awareness and confidence in LGBTQIA2S+affirming behaviors.

“Create safe spaces for students and staff for dialog, being together, and learning.”

Started and Ongoing: An Introduction to the Antiracism & Multiculturalism Continuum: Institutional Racism in Healthcare Settings asynchronous online course is available.  This course provides participants (faculty, staff, and students) with a foundational learning experience to acquire the language and concepts to prepare for more in-depth discussions related to structural, institutional, and systemic racism. 

Meetings have been hosted for students and staff for dialog, being together, and learning.   Karen Reifenstein met previously individually with several students. This space created an opportunity for informal mentoring as well, and Karen Reifenstein is informally mentoring a recent graduate from the SON.

• Two student interest groups-LatinX Nursing Student Association (LANSA) and Black Student Nurses-Umoja were created in 2021.  Men Embracing Nursing Diversity (MEND) student interest group was created in fall 2022.  An Asian Alaskan Pacific Islander (AAPI) student interest group was created in winter 2024.
• The LGBTQIA2S+ (Lesbian, Gay, Bisexual, Transgender, Queer and /or Questioning, Intersex, Asexual, Two-Spirit) Cultural Humility & Allyship training is available, and explores the differences of sexual orientations and gender identities, strategies for holding trauma informed discussions with people from marginalized groups, how to improve health disparities in the LGBTQIA2S+community, and creating a culture of inclusivity for LGBTQIA2S+ community at OHSU & beyond.  This training is not designed as medical education, but rather to increase knowledge, awareness and confidence in LGBTQIA2S+affirming behaviors

Strategic Objectives under People & Culture

• Identify a framework to guide DEI work – exploration and affirmation of the Trauma-Informed Systems Change Framework occurred during the 2021-2022 academic year. Two-day initial training with Dr. Alisha Moreland-Capuia was completed for DEC, Leadership Council, and DAG members.
  • Dr. Moreland-Capuia completed a comprehensive review of SON policies. She recommended we consider a number of changes to language and process.  Dr. Alicia Moreland-Capuia’s trauma-informed updates to our School of Nursing  policies were forwarded earlier to all councils for review and further discussion. Faculty policies that were fully approved earlier in 2023 include Academic Program Initiation and Review, Faculty Appointment Renewal, and Faculty Enrollment into degree programs.  All policies that underwent review by Dr. AMC have been addressed by SON Governance and are posted to the SON Policy Website.  The Equity Impact Assessment Tool was presented at Faculty Assembly earlier in 2023, and has been vetted by all councils. This tool will be used for any new policies and updating any policies.
  • The implementation of a trauma-informed framework into the curriculum and organizational culture has begun.  Notably, development stage 1 of the Trauma Informed Education Practices (TIEP) modules, including 4 sections and 7 modules has been completed.  Additionally, coordination with DAG was done to revise the Equity Impact Assessment Tool, and there was collaboration regarding recommended use.  Pre- and post- module surveys were also developed. Group norms and modeling trauma informed practices in workgroups were developed. 
• Advance the culture of the School of Nursing community by cultivating respect for diversity and fostering equity, inclusion, and well-being.
  • The Diversity Science Company provided 4-months of workshops in support of our People/Culture objectives, which included developing multi-cultural and inclusive curricula, prevention of bias, anti-racism education, and offering learning opportunities for inclusive teaching/learning strategies. These workshops occurred during winter and spring term 2023.  Many SON faculty and staff participated in this educational training, and post evaluations were overall very positive with over 80% of faculty indicating that the training was both useful and effective.   Staff evaluation was even more positive.