Uncovering Racial Bias in Nursing Fundamentals Textbooks

Article excerpt

ABSTRACT This article describes research that sought to identify and critique selected content areas from three nursing fundamentals textbooks for the presence or absence of racial bias embedded in the portrayal of African Americans. The analyzed content areas were the history of nursing, cultural content, and physical assessment/hygiene parameters. A researcher-developed guide was used for data collection and analysis of textual language, illustrations, linguistics, and references. A thematic analysis resulted in 11 themes reflecting the portrayal of African Americans in these sampled textbooks. An interpretive analysis with a lens of Sadker and Sadker's categories of bias, along with other literary and theoretical contexts, were used to explore for the presence or absence of racial bias. Recommendations for nursing education are provided.

TEXTBOOKS ARE CULTURAL ARTIFACTS THAT REFLECT THE NORMS, VALUES, AND BIASES OF THE DISCIPLINE AS WELL AS SOCIETY (1). Powerful instructional tools (2,3), they convey knowledge to students that is professionally sanctioned and "construct impressions and images that later become students' explanations, beliefs, and understanding of the world" (1, p. 11). > THIS ARTICLE REPORTS ON A STUDY TO IDENTIFY AND CRITIQUE SELECTED CONTENT AREAS FROM THREE NURSING FUNDAMENTALS TEXTBOOKS FOR THE PRESENCE OR ABSENCE OF RACIAL BIAS. Two research questions were asked: 1) What is the portrayal of African Americans in nursing fundamentals textbooks? 2) Is there a presence or absence of racial bias in nursing fundamentals textbooks? Five recommendations resulting from the analysis are offered. The intent is to move away from the language of criticism to a language of hope.

Significance to Nursing Educational systems, including nursing education institutions, may contribute to racial tensions or help eliminate the inequities of racism. It has been suggested that many black students drop out of nursing because of issues of identity, stereotyping, and the lack of inclusion in university settings (4). A monograph published by the American Academy of Nursing points out that educational reform is needed to reduce racial tensions: "The relationship between power exercised by the culturally dominant group and behavioral responses to differentness has major implications for education, professional practice and the development of cultural competence among practitioners" (5, p. 4).

Tanner has asked, "How euro-centric is our curriculum?" (6, p. 292). Eurocentric bias, or Eurocentrism, has been defined as "the consideration of events and people exclusively from the perspective of whites who came to the United States from Europe" (7, p. 5). Content presented from an exclusively European American perspective negates the experiences of differing racial groups and contributes to the reinforcement that "white" Americans are the norm. Because nursing has traditionally been a middle-class, female profession based on European American life experiences, the information and role models available to African American students in nursing may be limited.

Although nursing scholars have argued for cultural competence (5,6,13), and racial and gender bias have been identified in many categories of textbooks (1,8-12), nursing textbooks have never been researched for racial bias. A "deliberate, cognitive process in which health care providers become appreciative and sensitive to the values, beliefs, lifeways, practices and problem solving strategies of clients' cultures" (13, p. 204) is required. Specifically, one must examine one's own prejudice and bias.

A goal of this research was to promote culturally competent nursing education through an awareness of racial bias. There is a tendency to be blind to one's own biases. It is hoped that uncovering explicit examples of bias and ethnocentric assumptions may help educators see what previously was unseen (14), as one step toward educating nurses to be culturally competent practitioners. …