Curriculum & Learning
“In order to attract students of color and create a safe learning environment, participants recommended embracing multiculturalism and incorporating cultural competence throughout the curriculum.” - Yamasaki McLaughlin p. 48
“Theoretical and empirical discussions of race and racism must be central throughout all programs. Perpetuating a color-blind ideology of midwifery not only ignores the raced experience of education programs but also does not equip all midwifery practitioners with the tools to best support all [pregnant persons].”
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"Much of the dialogue around diversity and inclusion in higher education suggests that curricula to which students are exposed can greatly impact the way in which they view and engage the world. Research suggests this begins with institutions’ orientation and induction of new students into the campus environment. Many institutions of higher education include cultural competency training in new student orientation, and also require that students take coursework in diversity as freshmen." (USDE, 2016, p.42-43)
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Schroeder & DiAngelo (2010) connect their critique of the UW SON to the “failure of so many efforts to ‘improve diversity’ within institutions” citing that their curriculum “included required content on cultural competence and issues of ‘cultural difference,’ but issues of power, white privilege, and racism/antiracism were not systematically addressed.” (p. 246)
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“Studies have shown that while minority students can be resilient and bear some prejudice before feeling alienated, this resiliency does not apply when students experience prejudice or discrimination in the classroom.
Multiple studies have found that negative experiences in the classroom can spill over into minority students’ overall perceptions of inclusiveness on campus.” (Taylor, Milem & Coleman, 2016, p.26)
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"Attention to diversity in the curriculum and cocurriculum, particularly in the first two years of college, results in student development along many dimensions of complex thinking and social cognitive growth." (Hurtado, 2005)
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The Case for Inclusive Teaching. (2018). The Chronicle of Higher Education.
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Effland, K. J., & Hays, K. Beyond cultural competence: Equity and social justice in midwifery education. Midwifery Matters, 5(2), 11-17.
EXAMPLES of Midwifery Student Antiracism
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Social identity; defining racism
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History of racism in the US
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Institutional racism
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White race privilege
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Theories of racial, ethnic and social identity development
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Intersectionality
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Microaggressions
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The dynamics of racism in communities
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Clinical work in a cross-racial context
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Putting it into action
"At Emory, I teach a master’s level course for midwives and other nurse practitioner students on developing cultural humility. What began years ago as a course on cultural competence has transformed to a course that examines both one’s own biases, as well as the structural patterns in healthcare that have perpetuated social inequality and health disparities. Students are asked to explore compassionate and thoughtful leadership-for-change to promote genuine health equity for all."
“Respondents also encouraged creative thinking about the practice models for which students were being prepared.”
See Also, EXAMPLES >>>
BOOKS:
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Racism in the United States: Implications for the Helping Professions. Springer Publishing Company. (Miller, J., & Garran, A. M., 2017).
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Brooke Barnett and Peter Felten, eds., Intersectionality in Action: A Guide for Faculty and Campus Leaders for Creating Inclusive Classrooms and Institutions (Sterling, VA: Stylus, 2016).
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Cia Verschelden, Bandwidth Recovery: Helping Students Reclaim Cognitive Resources Lost to Poverty, Racism, and Social Marginalization (Sterling, VA: Stylus, 2017).
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Kathleen A. Ross, Breakthrough Strategies: Classroom-Based Practices to Support New Majority College Students (Cambridge, MA: Harvard Education Press, 2016).
ARTICLES:
VIDEOS:
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See Videos/Webinars
SLIDES:
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Maternal-Child Health Disparities: Breaking Down the Barriers (AMSA, AAFP)
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The New Science of Unconscious Bias: Workforce & Patient Care Implications (Critical Measures)
CLEARINGHOUSES:
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Annotated Resources regarding the need to Shift Health Professions Curricula so graduates develop structural competency
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A Resource List to Educate Yourself on Why Black Women and Babies are Dying in the USA
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Implicit Bias Resources (UCSF)
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Historical Trauma and Cultural Healing (UMN Extension)
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Resource List compiled by AROM (Anti-Racism & anti-Oppression in Midwifery)
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LGBT Issues in Higher Education Guide (American Library Association, 2016)
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National LGBT Health Education Center Resources and Suggested Readings
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Online Diversity Related Learning Opportunities (OSU College of Nursing)
"Several participants recommended that cultural competence should be woven throughout the curriculum and not covered solely in a single course.”
"Students report that it is important for them to see themselves reflected in the faculty and curriculum to which they are exposed to create a sense of belonging and inclusiveness”
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Checklist designed for midwifery course revisions with an equity lens
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HPM Inclusion Checklist for the Classroom (UNC – Chapel Hill)
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Syllabus Checklist for Diversity and Inclusiveness (Portland State University)
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Checklist of Inclusive Excellence (IE) in Syllabi (University of Denver)
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Diversity Checklist: Guidelines for Course Planning (Penn State)
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Self Assessment Checklists
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Diversity & Inclusion Syllabus Statements (Brown University)
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Advice on Effective Curriculum Transformation (Diversity Digest)
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Incorporating Antiracism Coursework into a Cultural Competency Curriculum. Journal of Midwifery & Women’s Health, 61(6), 721-725.
See Course Topics >>>
(Gordon, McCarter & Myers, 2016)-
WEBINAR by authors
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Curriculum Tools for Discussing Race & Racism in Midwifery
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WEBINAR (CEUs available)
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At the University of Washington School of Nursing (SON), 8 faculty and staff members engaged in twelve half-day climate workshops that included a formal curriculum (for a description of course content, see Schroeder & DiAngelo, 2010, p. 249).
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Exploring Racism and Health: An Intensive Interactive Session for Medical Students. MedEdPORTAL: The Journal of Teaching and Learning Resources, 14. (DallaPiaza, Padilla-Register, Dwarakanath, Obamedo, Hill, & Soto-Greene, 2018).
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Diversity and Inclusion for Valuable Engagement Certificate (OSU College of Nursing's Office of Diversity, Equity and Inclusion)
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Open Door Provider Training Program: LGBT inclusion for family-building professionals (Family Equality Council)
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"An educational focus on social justice is necessary to prepare future nurses to address health concerns related to how societies are structured. This article reports on how social justice was used as a framework to teach concepts related to professional nursing. The course structure is described, a focus on how the course content was taught is outlined, and conclusions are drawn." (Boutain, 2005)
Existing Curriculum Available for Purchase:
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Transforming White Privilege: A 21st Century Leadership Capacity
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Funded by The W.K. Kellogg Foundation
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Comprised of 20 modules, with detailed lesson plans and all supporting materials (30min-2h ea)
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Free Existing Curriculum:
A former midwifery student recommends identifying "leaders, educators and health care professionals who are people of color in the midwifery profession since midwifery education is dominated by white educators." She suggests making "information about people of color such as workshops, mentors or culturally specific facts"
more accessible.
-Personal communication with recent student, 2017
"In retrospect, it is evident that all the project participants, but particularly people of color, should have been better supported to deal with painful issues as they arose. In future workshops, the racial makeup of the participants should ideally include a cohort of people of color to provide strength in numbers and group support. In this project, only 2 people self-identified as persons of color. White privilege operates in groups, and in groups dominated by white people talking about privilege and oppression, people of color can quickly become isolated and marginalized."
(Schroeder & DiAngelo, p.252)
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"Exposure to health disparities instruction is important for medical students. The authors’ experience provides insights for incorporating such material into the compulsory curriculum. Future evaluation of outcomes from similar curricula should include measures of clinical behaviors (e.g., through clinical examinations)." (Gonzalez, Fox & Marantz, 2015)
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"The recognition of bias cannot be taught in a single session. Our experience supports the value of teaching medical students to recognize their own implicit biases and develop skills to overcome them in each patient encounter, and in making this instruction part of the compulsory, longitudinal undergraduate medical curriculum." (Gonzalez, Kim & Marantz, 2014)
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"Guidance as to how to develop a curriculum based on social justice is evident in the Canadian and US literature (see, for e.g. AACN, 2008; Boutain, 2008; Cohen and Gregory, 2009; Fahrenwald, 2003) with key issues being that it is embedded within the curriculum from the outset, integrated throughout the entire programme, students’ competence is theoretically and clinically assessed and that students have opportunities to practise social justice action prior to qualification otherwise they may not be appropriately prepared to practise as social justice practitioners (Boutain, 2008)." (Merrell, Olumide & Khanom, 2014)
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"Racialized bodies are so often “othered” by white dominant bodies and Euro-centric institutions, yet how this is done within discourses of 'multiculturalism' and 'color blindness', and with the existence of race equity policies; consequently this “othering” becomes difficult to speak to. As a white educator, I begin to unpack my own complacencies in this practice. Moreover, I present some possible considerations as to ways in which we can move towards an anti-racism education, which will bring us closer to upholding race equity policies within the postsecondary education system and meeting the needs of all students." Moving Towards an Anti-racism Curriculum. In Politics of Anti-Racism Education: In Search of Strategies for Transformative Learning. (Deckers, 2014, pp. 61-69)
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See Transforming Classroom Environments, Effective Pedagogy, and Curricular Transformation pp.24-26 in (Milem, Chang & Antonio, 2005)
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Implicit Bias Against Sexual Minorities in Medicine: Cycles of Professional Influence and the Role of the Hidden Curriculum. Academic Medicine, 90(5), 549-552. (Fallin-Bennett, 2015)
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“Beyond Coming Out: New Insights about GLBQ College Students of Color. (Center for Higher Education Enterprise (CHEE), 2015)
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Racial Microaggressions in Everyday Life: Implications for Clinical Practice. American Psychologist, 62(4), 271. (Sue, et al., 2007)
*See also Microaggressions & Education
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Cultural Competence Revisited. Journal of Ethnic and Cultural Diversity in Social Work, 22(2), 97-111. (Garran & Werkmeister Rozas, 2013)
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Racial Discrimination and Adverse Birth Outcomes: An Integrative Review. Journal of Midwifery & Women’s Health. (Alhusen, Bower, Epstein & Sharps, 2016)
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The Impact of Racism and Midwifery's Lack of Racial Diversity: A Literature Review. Journal of Midwifery & Women’s Health, 61(6), 694-706. (Wren Serbin & Donnelly, 2016)
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Removing Barriers to Breastfeeding: A Structural Race Analysis of First Food. (Center for Social Inclusion, 2015)
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Structural Competency: Theorizing a New Medical Engagement with Stigma and Inequality. Social Science and Medicine, 103, 126-33 (Metzl & Hansen, 2014)
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Implicit Bias in Healthcare Professionals: A Systematic Review. BMC Medical Ethics,18(1),19.
(FitzGerald & Hurst, 2017)
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See also Implicit Bias Resources (Internal: Privilege & Bias Section)
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Understanding the marginalization of gay and gender non-conforming Black male students. Theory Into Practice, 43(2), 136-143. (McCready, 2004)
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Educational Strategies to Help Students Provide Respectful Sexual and Reproductive Health Care for Lesbian, Gay, Bisexual, and Transgender Persons. Journal of Midwifery & Women’s Health, 61(6), 737-743. Walker, Arbour & Waryold, 2016)
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Provision of Patient‐Centered Transgender Care. Journal of Midwifery & Women’s Health. (Selix & Rowniak, 2016)
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I had to Unlearn Medicine to Treat Invisibilized Patients (Ravi, 2019)
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Equity-Minded Faculty Development: An Intersectional Identity-Conscious Community of Practice Model for Faculty Learning (Costino, 2018).
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Emily Schuster, ed., “Intersectionality and Well-Being” (Schuster, ed., Diversity & Democracy special issue, 2018).
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A Vision for Equity (Association of American Colleges and Universities, 2018).
Midwifery in the United States was never lost, as white midwifery narratives portray. While their communities were undergoing incredible persecution and trauma, Black and Indigenous midwives have always continued to serve them.
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Keisha La'Nesha Goode, Birthing, Blackness, and the Body: Black Midwives and Experiential Continuities of Institutional Racism (2014)
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Gertrude Jacinta Fraser, African American Midwifery in the South (Harvard University Press, 1998)
Possible content for infusing an equity focus throughout every midwifery course exists, but as white midwifery educators, we must commit
time and effort to the process of transforming curricula and
learning how to learn what we don't know.
The process of this learning and growth is a lifelong commitment.
It will not always be easy, but it is critically important.
- Kristin Effland, LM, CPM, Site Developer
Click here to take a look at our Course Revision Checklist!