Discuss an experience working with a diverse patient or student population or students with diverse learning needs NUR646

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NUR646 Nursing Education Seminar 1

Week 3 Discussion

DQ1 Discuss an experience working with a diverse patient or student population or students with diverse learning needs. Using evidence-based literature, develop a strategy to increase the success of these students in a classroom setting.

The recent decisions by the U.S. Supreme Court in two cases that challenged the use of affirmative action in undergraduate admissions and in law school admissions at the University of Michigan helped to provide some clarity to an ongoing debate regarding the educational value of diversity, and specifically, racial and ethnic diversity, on our nation’s college campuses. In the opinion that upheld the constitutionality of the admissions process used for selecting law school students at Michigan, Justice O’Connor wrote that a majority of the court agreed that diversity served a compelling interest for institutions of higher education as well as for our society. The University of Michigan successfully demonstrated to the Court that diversity was essential in helping it to achieve its education mission because more diverse colleges and universities provide opportunities for teaching and learning that are not available in institutions that are less diverse. The university was able to make this case, in large part, because of the array of empirical evidence that it and other organizations provided that established how diversity enhanced the learning outcomes for students at Michigan and at colleges and universities across the country.

The primary goal of this paper is to examine the ways in which existing evidence about diversity in higher education and its effects on students, institutions, and society can be used to inform and improve the quality of education received by students in health professions. Published reviews of the literature on undergraduate college students clearly demonstrate that various aspects of racial and ethnic diversity within higher education help promote benefits of assorted kinds (Milem, 2003; Hurtado et al., 2003; Milem and Hakuta, 2000; Gurin, 1999, Appendix A). These reviews indicate that diversity-related benefits are far ranging, spanning from benefits to individual students and the institutions in which they enroll, to private enterprise, the economy, and the broader society.

The benefits that accrue to individuals through enhancements to their educational experiences and educational outcomes (including process outcomes that help influence subsequent outcomes of these students; see Milem, 2003; Astin, 1991) are perhaps the most commonly recognized; diversity has been shown to enhance the ability of colleges and universities to achieve their missions—particularly as they relate to the missions of teaching, research, and service. Economic and private-sector benefits are reflected in the ways in which diversity enhances the economy and the functioning of organizations and businesses in the private sector. Societal benefits differ in that they transcend the boundaries of individual organizations and are related to the achievement of democratic ideals, the development of an educated and involved citizenry, and the ways in which underserved groups (e.g., low-income, elderly, those who lack insufficient health care) are able to receive the services they require. Recent original research efforts reinforce this viewpoint in higher education generally (Bowen and Bok, 1998), and specifically in medical education (Whitla et al., 2003).

It is important to note that research on the benefits of diversity indicates that these benefits do not automatically accrue to students who attend institutions that are, in terms of student or faculty composition, racially and ethnically diverse. Rather, if the benefits of diversity in higher education are to be realized, close attention must be paid to the institutional context in which that diversity is enacted. In other words, it is not enough to simply bring together a diverse group of students. Although this is an important first step in creating opportunities for students to learn from diversity, it cannot be the only step that is taken. Diverse learning environments provide unique challenges and opportunities that must be considered if we are to maximize the learning opportunities that they present.

If we are to change educational environments in ways that allow us to maximize the opportunities and minimize the challenges that are presented by diversity, we must first understand the conditions under which students are able to learn from diversity. In the pages that follow, we summarize the literature that does this. To begin, we review the literature drawn from studies of higher education generally, followed by a focused consideration of issues related specifically to health professions education (with an emphasis on medical education). To begin our discussion of higher education generally, we summarize and extend the key components of a framework for understanding campus diversity issues first developed by Hurtado and colleagues (1998, 1999). This provides a useful frame for understanding the different dimensions of campus diversity and their importance. Having provided some conceptual definitions of diversity, we turn to research linking diversity and learning, emphasizing in turn cognitive and emotional development issues, contextual issues and learning environments, and pedagogy.

The focused discussion of health professions issues follows a similar logic, beginning with a consideration of the importance of diversity in these fields and unique characteristics of these fields of study (including goals, standards, and curricular structure). The status of current curricular approaches that support diversity-related education is discussed as are problems and issues with current approaches. An extension of cognitive and emotional development concerns related to health professions education is presented, followed by a discussion of how educational settings and learning environments can influence learning related to diversity issues, as well as pedagogy that can promote transformative learning. These two strands of work—higher education generally, and health professions specifically—are brought together in a set of recommendations intended to guide the transformation of education in the health professions so that students in these fields realize the educational benefits of diversity, and so that all members of our society will be better served by the professionals who provide them with health care.

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