Interventions of Undergraduates and Universities in Healthcare Inequities Volume 3, Issue 2 2021 Allies for Education 2021, 3, 2 https://journals.library.csuci.edu/ojs/index.php/afe Interventions of Undergraduates and Universities in Healthcare Inequities Violet Lurz As a student who is soon entering the healthcare field, I recognize the importance of sharing what I have learned and what I am learning about the roles of students and university staff in issues of healthcare inequities and discussions at academic levels. To provide some related background on myself, I am a founding member and President of the Pre-Nursing Club at CSU Channel Islands. In our organization we promote the development of a supportive and inclusive community of Pre-Nursing and Health Science students as they pursue their academic and professional careers. We emphasize the importance of a non-competitive atmosphere, provide resources for prerequisite courses and application processes, and have recently begun discussing the necessity of diverse academic cohorts that are prepared to enter a culturally diverse world as health professionals. Last December, I had the incredible opportunity to attend the American Association of Colleges of Nursing’s Inaugural Diversity Symposium with Dr. Lasonya Davis. This conference was designed to encourage nursing staff and faculty from around the country to come together and discuss issues of diversity, equity, inclusion, and develop ideas and actions to bring back to their campuses and communities. I had my first lessons on the history of medical practices and research that have abused disadvantaged communities and populations, and how those events still affect the accessibility and trust of our healthcare system. I attended three breakout room presentations involving the effectiveness of radical listening in communities of learning, breakthrough learning modules to educate nursing students on sensitive and appropriate practices with LGBTQIA+ patients, and the benefits of the implementation of student-led academic centers for nursing students. I took away new perspectives on the creation of safe spaces in academic environments, holistic approaches to education and applications specifically in nursing programs and the necessity of being an advocate for progressive change in academic communities. Following this symposium, I brought these lessons and ideas back to my student organization and peers and will connect them to my ideas throughout this paper. Most recently, I was appointed to a student representative position on a campus Inclusive Excellence Action Team for Realizing a Campus Culture of Inclusive Excellence. Although much of my experience revolves around pre-nursing, I will be relating my ideas to pre-health undergraduate students and institutions. Using the lessons and interactions I have had from the previously mentioned opportunities, I will be discussing the role I believe universities have in partnership with pre-health undergraduate Interventions of Undergraduates and Universities in Healthcare Inequities Violet Lurz Allies for Education 2021, 3, 2 https://journals.library.csuci.edu/ojs/index.php/afe students, to advance education on these long-standing racist and discriminatory practices, and the involved yet undetected biases that we hold. The three levels of action and intervention I will be discussing are: 1) Universities and Programs, 2) Learning Communities and Courses, and 3) Student Organizations and Action Teams. Universities and Programs Before issues of racism, discrimination, and related bias are being addressed within majors and programs, ensure that it is being addressed at a university level. We can ask ourselves: How is the university supporting an inclusive and diverse community of students that can talk openly and critically about these pressing issues? Are these universities educating and involving their educators on their roles in these issues, and the manner in which they should approach culturally sensitive topics of conversation? Finally, what working policies, action plans, or initiatives are in place in universities to address their standings on inclusive excellence, cultural awareness, and equity at a university community level? These are all questions that universities or programs need to address first and foremost to set an environment for effective and engaging conversations within various programs and majors that need to happen now. Learning Communities and Courses Next I will discuss the specific interventions with pre-health students - the area that needs the most attention related to my topic. I must first begin by introducing the role that learning communities play at CSU Channel Islands, and my experience in one. CSU Channel Islands introduces and describes Learning Communities as follows: “First Year students have a variety of options to live the CI Mission through academic success and integration into the life of the University, both inside and outside of the classroom. Participating in these communities is shown to improve student learning, persistence to the second year, time to graduation and stronger relationships with peers and faculty” (CSU Channel Islands, 2021a). These communities also “promote academic success and students’ transition to University life aligned with a CI Mission Pillar” (CSU Channel Islands, 2021a). My freshman year at CI, I enrolled in the Healthcare Integrative Learning Community: a group of freshmen interested in pre-nursing, health science, and other related healthcare fields. Some of the perks in this community included priority registration in prerequisite classes, an introduction to university life, a curriculum that surrounded the CI mission pillars, and a beloved embedded peer mentor. My time in this community provided me with my first academic discussions on the meanings of culture, and the intersectionality of our lifestyles and experiences that make us all so diverse. It also familiarized me with the positive influences involved with being a member of a close community of peers and classmates with the same goals and desires. Following this brief explanation on learning communities, I hope you can see the beginning opportunities available to access and educate communities of healthcare students early on in less clinical, and more personal settings. The opportunities to have open and critical student-centered conversations. The opportunities to educate students about the history of medical experiments backed Interventions of Undergraduates and Universities in Healthcare Inequities Violet Lurz Allies for Education 2021, 3, 2 https://journals.library.csuci.edu/ojs/index.php/afe by racist practices, and how these atrocities still influence our healthcare interactions today. The opportunities for students to learn about their own unconscious biases, where they stem from, and best bias management strategies. We should also know the possible opportunities for intervention in pre-health courses and prerequisites. Generally, healthcare programs have rigorous application processes that include the applicant to have taken a variety of prerequisite courses. These programs could implement a multicultural course requirement for students to apply for admission. Science prerequisite course curriculum could be modified to include case studies, examinations of personal implicit biases, and the damage and mistrust this is causing in our healthcare systems. An article from the American Association of Medical Colleges by Janice A. Sabin, titled “How We Fail Black Patients in Pain” says, “To be effective, though, education about implicit bias must be grounded in science, appropriate to the audience, inclusive, and nonjudgmental. Education also must include effective strategies for reducing the impact of bias on patient care, such as using clinical guidelines and standardized checklists” (Sabin, 2020). This is a great example of how it could be beneficial to introduce these lessons into our science courses. Finally, avoid instructor-centered lectures and transition to open course discussions encouraging students to share related opinions and experiences. On a greater spectrum, these topics of cultural inequalities and discrimination in healthcare should have an equal level of importance to other topics of discussion within pre-health. I am not suggesting that the learning community or course interventions provide all the answers. I am only implying that I believe it is a great focus-point or blue-print for how campuses can incorporate these communities and curriculum changes to provide students with the materials and resources to prepare them for entering an intense world as healthcare professionals. I know these topics can be heavy, so along with these suggestions I have mentioned, I know that students also need to be encouraged and excited to enter programs and careers and become a part of making these changes. This brings me to my final idea for intervention. Student Organizations, Councils, and Action Teams I have talked about the roles of universities, faculty, and instructors of pre-health undergraduate programs and institutions in recognizing very current healthcare practices and beliefs that put BIPOC communities at risk. Now I want to talk about the roles and responsibilities of students. This was a question I had at the end of the earlier mentioned diversity symposium, and a question I believe a lot of students are stuck with right now. What is my role in these situations and my education? I asked, and got an answer that was somewhat obvious, but something I needed to hear. Communities of students need to come together and take initiative to educate each other, their communities, and uphold the words and actions of staff and the university. Student run councils or clubs provide students with opportunities outside of class to grasp an understanding of these issues and the roles that they have, to unite as a community and begin student-led initiatives. Some examples that I have seen or believe could be beneficial with this point are student organizations implementing officer roles whose job is to promote inclusion and equity in their club. Another example I have practiced is hosting socials or setting aside time in meetings to hold these discussions, which is one idea the pre-nursing club has been incorporating. I left the symposium inspired to bring back what I had learned to my peers and members https://www.aamc.org/news-insights/how-we-fail-black-patients-pain Interventions of Undergraduates and Universities in Healthcare Inequities Violet Lurz Allies for Education 2021, 3, 2 https://journals.library.csuci.edu/ojs/index.php/afe in the Pre-Nursing Club. This semester we have had discussions on the attributes of a culturally aware nurse, the necessity for diverse academic cohorts that are prepared to interact with and treat patients as individuals, and our roles as students in our education. Student-led councils and action teams are more campus-wide initiatives but have an equally important role on campus. The university recently introduced a Diversity and Inclusion Student Council in partnership with our Multicultural Dream Center. Their mission “is to empower students to build an inclusive campus environment that is safe and welcoming for all” (CSU Channel Islands, 2021b). Pre-health students and programs should use these campus-wide councils to their advantage by sending representatives to relay information to and from their program to effectively engage and contribute to these initiatives and conversations. Students are at the center of their universities social and educational reform. The roles of these organizations' initiatives should be to promote the university’s stance and actions, not make up for how they are lacking in these areas. Conclusion I have discussed the role universities have in partnership with pre-health undergraduate students to advance education on racist practices and implicit bias in healthcare by introducing my ideas for three levels of intervention. These examples, if executed correctly, could promote effective education, and benefit the future of healthcare. About the Author Violet Lurz is a Sophomore at Cal State Channel Islands, where she will begin her journey as a nursing student this Fall. She is a founding member and President of the Pre-Nursing Club on campus where her passions for student leadership, inclusive educational communities, and health advocacy were brought to light. Violet serves as a student representative on a campus Inclusive Excellence Action Team and the Healthy Campus Coalition. References CSU Channel Islands. (2021a). About our communities. https://www.csuci.edu/academics/learningcommunities/about-our-communities.htm CSU Channel Islands. (2021b). Diversity & Inclusion Student Council. Multicultural Dream Center. https://theisland.csuci.edu/ongoing-support-events/ko2ktjhqdl8m0p65xwh9k1dnfemohl Sabin, J.A. (2020, January 6). How we fail black patients in pain. American Association of Medical Colleges. https://www.aamc.org/news-insights/how-we-fail-black-patients-pain https://theisland.csuci.edu/ongoing-support-events/ko2ktjhqdl8m0p65xwh9k1dnfemohl https://www.csuci.edu/academics/learningcommunities/about-our-communities.htm https://theisland.csuci.edu/ongoing-support-events/ko2ktjhqdl8m0p65xwh9k1dnfemohl https://www.aamc.org/news-insights/how-we-fail-black-patients-pain Interventions of Undergraduates and Universities in Healthcare Inequities References