Administrators at the University of Cincinnati College of Nursing (UCCON) are leading a learning collaborative of 13 nursing schools that are confronting structural racism in academic nursing. With support from the Josiah Macy Jr. Foundation, the UCCON team invited other nursing schools to join them in taking a systematic anti-racism approach to dismantling barriers to equity and inclusion at their institutions. Now, a year into the three-year project, UCCON and 12 other schools are laying the groundwork for significant changes ahead.
Building the Learning Collaborative
The Macy-funded UCCON project — Eliminating Structural Racism in Nursing Academia: A Systems Change Approach to Anti-Racist Nursing Education — builds on a national 2023 culture and climate survey by the American Association of Colleges of Nursing (AACN). The AACN’s Leading Across Multidimensional Perspectives (LAMP) Survey was designed to “assess the experiences of diverse students, faculty, and staff at nursing schools and identify practices that facilitate student success and a sense of belonging.” Among its findings: Nearly three in four survey respondents agreed that a diverse student body enhances the educational experience of all students.
As a first step for UCCON’s Macy project, which is being led by associate dean Ann Gakumo, RN, PhD and dean emeritus Greer Glazer, RN, CNP, PhD, FAAN, an RFP was sent to all 50 schools that completed the pilot AACN LAMP Survey. “Schools that were interested in joining the collaborative needed to explain to us why their institution was uniquely positioned to do this work, address structural racism, and whether they could maximize high engagement from administration, faculty, and students. Success is a collective effort, and we need everyone on board,” said Dr. Gakumo.
The UCCON team and the project’s national advisory board reviewed applications and accepted the top 13. The schools, both public and private, are in different geographic regions of the country, with some located in states that now have legislated against efforts focused on diversity, equity, and inclusion (DEI), making anti-racism work that much harder. Yet, a year into the program, all 13 schools that joined UCCON in this work remain engaged and focused on the big task at hand.
“We didn’t know if we would be able to avoid dropoff with the anti-DEI legislation affecting some of our schools, but we knew it would be important to grow and adapt with them,” said Dr. Glazer. It was important for the UCCON team and their advisory board to include a breadth of support and resources for those who have the resolve to make a difference.
Learning and Growing Together
UCCON’s anti-racism approach is grounded in a transformative systems change framework as well as intergroup contact theory, which have been used in other spaces to reduce prejudice and disparities. Each of the 13 schools (including UCCON) are pursuing improvements in five key areas: curriculum and pedagogy; inclusion and belonging of students of color; inclusion and belonging of faculty and staff of color; academic culture/environment; and clinical environment.
As an example of the way the project will work, a team from one of the 13 schools identifies systemic barriers to inclusion and belonging for students of color, such as a lack of diverse representation of faculty due to potentially biased hiring practices of faculty or search committees. The schools then examine what parts of the system can be changed, and how those parts might interact with one another. Once the team can see how to leverage change in a specific area, the UCCON representatives will work with them to develop goals that are specific, measurable, achievable, relevant, and time-bound (SMART).
This type of work is already underway at UCCON, which serves as a model for the other 12 schools. For example, it recently completed an initial policy equity review spearheaded by the interim dean. “We sent our college’s student-facing policies to thousands of students, staff, and faculty for review of potential structural barriers to equity. Our Committee for Equity and Inclusive Excellence (including students, staff, and faculty) and senior leadership team then met to talk through feedback and recommended changes before bringing these recommendations to the larger college community,” explained Dr. Gakumo.
The committee and leadership team came together for a half-day retreat that allowed members to express opinions and concerns over policy language and talk through how it could be more inclusive. The process allowed them to be vulnerable with one another and advocate for students, part of the fundamental change journey. Other than larger bylaw changes, many of the recommended changes — such as removal of discriminatory language — have already been made.
While the UCCON identified and implemented needed policy changes, this may not be a realistic goal at this time for every school in the cohort. Some lack resources, staffing, or funding, while others have had transitional changes in leadership, which potentially make change efforts more complex.
Though the schools aren’t experiencing the same challenges or following the same timetable, the cohort provides support and the ability to share ideas with others to problem-solve. The first-year evaluation forms have allowed programs to reflect and change course as necessary to ensure they can implement the change they’re seeking. The UCCON national project team, in particular, has been guiding programs around identifying constituents and bringing them into the process and using that engagement to leverage change.
For the UCCON team, it is as much about the process as the end result. Program manager Jordan Gayle emphasized the importance of using evidence-based approaches to implement change: “Our project is about knowing the people and the environment and meeting them where they are. We prioritize collecting data and using that data to make decisions.”
What’s Next
The UCCON team has bold plans in the pipeline for the next year, including a website that will provide program resources and feature a DEI legislation tracker — created by the Chronicle of Higher Education — to help those in states restricting DEI efforts understand the legal limitations of their work and allow others to track similarities across states. In addition, now that schools have had a chance to re-evaluate their own objectives, the implementation of projects can begin.
In the second year of the program, the UCCON team is focused on project implementation for the individual schools of nursing. They are emphasizing the importance of communication within schools and universities and getting groups together within the cohort to determine who wants to work together, write together, or present together on their program implementation. In the third and final year of the program, the UCCON team will primarily focus on evaluating individual projects. Additionally, the UCCON team will continue hosting monthly meetings with the cohort, inviting presentations from national leaders in the field to help schools learn and network. In June 2025, the cohort will meet at the AACN Access, Connection, Engagement (ACE) annual symposium.
Looking ahead, the UCCON team remains hopeful and determined that their work can help solidify impact across the country. Sean Brown Jr., BSN, RN, a doctor of nursing practice student and graduate assistant, was the only Black man in his first year of nursing school and is now the only nurse of color in a leadership position at the hospital where he works. “We need to do a better job as a profession to ensure nursing education is accessible for underrepresented students and making sure the culture matches the vision of the initiatives championed by the AACN,” said Brown. We look forward to continuing to support them in their critical work to promote diversity, equity, and belonging in nursing.
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