Power and Privilege
“Feedback from one student in an anonymous course evaluation captured this:
‘How do you really teach about cultural competency without a thorough discussion of racism? Most of all, how do you teach a group that is largely white to provide culturally competent care without discussing white privilege? This course was a gloss-over of cultural issues that will allow participants to feel like they are “culturally competent” without really understanding the issues that women of color, immigrants, etc. deal with in their daily lives.” - Gordon, McCarter, Myers, p. 722
“Even though they all had successfully become and practiced as midwives, the scars left after the educational process ran deep,
leaving a thick defense and a commitment to future midwives.”
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"World Trust’s holistic frame shows the continual interaction between the internal (personal) and external (interpersonal, structural/institutional) manifestations of bias. The system of inequity functions the same way regardless of the “ism.”
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"The advantage of using a frame is that it applies not only to racism, but sexism, heterosexism, ageism, ableism — any attitude, action or institutional structure which subordinates (oppresses) a person or group — including bias against women who are overweight or men who are short."
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The system must be interrupted at both the internal and external levels for lasting change to occur. The importance of continual self-work to understand and heal one’s own internalized privilege/oppression is integral to the ability...to analyze and dismantle systemic inequity. We offer this frame to support personal insight and renewal as well as to build capacity to analyze inequity in policy, law and institutions such as education, health care, corporations and the judicial system."
(WorldTrust, 2017)
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“The importance of continual self-work to understand and heal one’s own internalized privilege/oppression is integral to the ability of changemakers to analyze and dismantle systemic inequity.” (WorldTrust)
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VIDEO: Exploring Unconscious Bias in Academic Medicine (30 min)
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Exploring Unconscious Bias in Disparities Research and Medical Education (van Ryn & Saha, 2011)
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Stereotype Threat and Health Disparities: What Medical Educators and Future Physicians Need to Know (Burgess, Warren, Phelan, Dovidio & van Ryn, 2010)
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The New Science of Unconscious Bias: Workforce & Patient Care Implications. (Powerpoint Slides by Critical Measures)
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The Science of Equality, Volume 1: Addressing Implicit Bias, Racial Anxiety, and Stereotype Threat in Education and Health Care. Perception Institute.
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“Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare.”
Implicit Bias in Healthcare Professionals: A Systematic Review. BMC Medical Ethics, 18(1), 19. (FitzGerald & Hurst, 2017)
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Non-Conscious Bias in Medical Decision Making: What Can Be Done to Reduce it? (Stone & Moskowitz, 2011)
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The Associations of Clinicians’ Implicit Attitudes About Race With Medical Visit Communication and Patient Ratings of Interpersonal Care (Cooper et al, 2011)
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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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Addressing implicit bias, racial anxiety, and stereotype threat in education and healthcare
(Godsil, Tropp, Goff, & Powell, 2014)
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Proceedings of the Diversity and Inclusion Innovation Forum: Unconscious Bias in Academic Medicine Report (AAMC+Kirwan)
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More Unconscious Bias Resources (UCSF)
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VIDEO: How Structural Racism Works by Professor Tricia Rose
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The Impact of Racism and Midwifery's Lack of Racial Diversity: A Literature Review. JMWH, 61(6),694-706(Wren Serbin & Donnelly, 2016)
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"Instead of antiracist education, trainings and course content focusing on 'cultural competence' are the norm in nursing, an approach that usually leaves intact institutionalized structures of white privilege and racism.” (Schroeder & DiAngelo, 2010, p.245)
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“In most institutions, a climate of white privilege is unmarked and seen as simply “normal”; lack of strategic efforts to address sociopolitical climate from an antiracist perspective hinders efforts to support racial diversity in recruitment, retention, scholarship, pedagogy, and personal and professional learning. Addressing these issues has been particularly difficult in nursing because our persistent identification of being a “caring” profession inadvertently creates and maintains identity of color blindness (we treat everyone the same; caring nurses do not oppress). As a result of this culture of color blindness, nurses may displace problems of lack of advantage onto the individuals/ groups that are different from our white, middle class, female norm.” (Schroeder & DiAngelo, 2010, p.247)
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“If our emancipatory goal is to interrupt the production of racial inequity so that ultimately no one’s race affords them more or less access, we must first speak about the impact of race on white faculty, staff, and students, their relationships to one another, and on people of color. “Un- naming” whiteness serves to secure its privileged location, whereas naming whiteness interrupts the normalized status that is itself an effect of dominance.” (Schroeder & DiAngelo, 2010, p.254)
“To address racism and whiteness within a program is not to mark the program as particularly racist or as a special case of racism but to
acknowledge that the institutional default
is racist;
to not address racism is to actively collude
with racism.”
“Schroeder, & DiAngelo (2010) connect the difficulty of retaining nursing students of color at their school to the “failure of so many efforts to ‘improve diversity’ within institutions.” They go on to link this failure with the fact 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.245)
“Because of these unique midwives, we learned how the backdrop of racial/ethnic and gender diversity influenced their personal entry and socialization as a midwife, as well as their practice. Because none of the three investigators matched the participants' diversity, it became our own lesson in cultural humility to hear from our colleagues about barriers far greater than we had ever experienced in our own professional struggles in midwifery.” - Kennedy et al, 2006, p. 89
