July 9, 2021

Reflecting on DEI and antiracism efforts this past 2020-2021 academic year

To all in our UW School of Nursing community, 

As we reflect on the past year and prepare for the next, we share the following updates about our school’s work in diversity, equity, inclusion, and antiracism.  First, we highly recognize and deeply appreciate the time, energy, and efforts of those who have volunteered to serve on Antiracism Workgroups and the Diversity Committee. Second, we acknowledge that our work is not yet complete as many steps remain to more meaningfully operate in antiracist ways. While we take stock in what we have achieved, we take note of what still needs to be accomplished. We realize through our endeavors that more needs to be confronted and more needs to be learned. We will continue to strive while we commit to listening and being mindful to center the needs and assets of those with marginalized identities throughout our school community and the communities we serve. Thank you to all who engage in and support our collective ongoing efforts.

DIVERSIFYING THE NEXT GENERATIONS OF THE NURSING WORKFORCE 

• DEI Dashboard.  To address the lack of diversity and underrepresentation in the nursing workforce, we looked inward into the demographic representation of our own student body.  Whether graduates from our academic programs represent the changing profile of the ‘ ”s country’s general and patient population requires us to understand who is applying to, gets admitted into, matriculates, and completes academic programs.  We created a public-facing interactive DEI Dashboard that provides breakdowns by race/ethnicity, gender identity, age, residency region, by year, and over time.  Dashboard data reveals how our student body reflects the population demographics of Washington State and compares to nursing student demographic data nationally (here and here) 

• Recruitment.  To diversify our applicant pool, we establish relationships with partners within the UW and other organizations. Due to COVID-19, the School of Nursing transitioned all information sessions to an online format which allowed for a wider audience of graduate and undergraduate prospective students to attend and learn about our different programs. The plan is to maintain online sessions as an added means to get our information to prospective students and re-introduce some in-person events. We also plan to continue our partnerships with UW campus departments to work with our minority undergraduate students, such as Office of Minority Affairs & Diversity (OMA&D). We are working with other health sciences schools to promote health profession careers to underrepresented students in high school through the Health Sciences Recruitment Collaborative (HSRC) by providing monthly online information sessions for high schools. We work with the Multicultural Outreach & Recruitment office and attend events throughout UW. We will continue to work with nursing organizations, such as the Western Washington chapter of the National Association of Hispanic Nurses and the Mary Mahoney Professional Nurses Organization. Nurse Camp will run as an online event for the second year in 2021 during the pandemic providing underrepresented students a chance to be mentored by our current nursing students. An online platform has allowed us to reach students who may not live in the area but also being able to establish a connection to the UW School of Nursing. 
• Admissions.  We conduct a holistic approach to our admissions process in all programs. Training is available for reviewers in application scoring and information on implicit bias is provided. Application workshops were offered to student in the OMA&D, and this provided individual appointments with students of color who may have questions about the application process. During COVID-19, we were not able to provide an in-person workshop but offered online information sessions. Online information sessions offered a wider range of access to many prospective students interested in the nursing program. Our efforts continue to review our admissions policies and application after every admissions cycle with each program with a DEI lens. Our plan going forward is to offer a user-friendly application to nursing applicants and provide more workshops at OMA&D, as well as possibly offering future workshops at the Othello-UW Commons to reach other areas of nursing applicants. We continue to stay up-to-date with GO-MAP and the Equity & Justice in Graduate Programs office with graduate admissions best practices. 
• BIPOC Student Gatherings.  Quarterly gatherings (conducted virtually during the 2020-2021 academic year) were held to provide students of color an opportunity to connect in a shared space.  Open to all students of color no matter what academic degree program, this is particularly important for incoming students.  We recognize that many students of color may experience a sense of isolation because of their racial/ethnic identity.  Feeling a sense of belonging necessitates building a sense of community, which these gatherings foster to enhance ‘students’ capacity to thrive and be successful.  These gatherings provide a safe space for students of color to exchange experiences and challenges they may be facing and to inform them of school and campus resources that might be helpful.  They also offer the opportunity to promote self-care and identify new or additional supports students need.  Future planning will continue in the summer for the 2021-2022 academic year to establish more set meetings throughout the year, especially in-person meetings (when permitted) to reinforce that sense of community. We also provide resources for students of color within the UW for counseling or other affinity groups for support. 
• Student Groups.  Several student-led groups focused on diverse identities provide a non-academic space for students with shared a shared identity to build community by working on service-oriented projects and engaging in social activities.  They are also an invaluable source of ideas and insights about how we as a school can improve operationally and create a more inclusive environment.  Some groups actively organize and coordinate events to promote and support a diverse student body. These student organizations participate in different events, fundraisers, and recruitment. Some organizations, such as SON Dawgs (School of Nursing Diversity Awareness Group) mentor underrepresented students during our Nurse Camp event. The Future Nurses Club provides workshops with undergraduate students interested in learning more about the nursing career. 

FACULTY AND STAFF DIVERSIFICATION AND TRAINING 

• Diversity Best Practices for Recruitment and Hiring.  Standard practice now school-wide is the use of best practices and strategies when conducting faculty and staff searches.  Training is done for all search committees using UW Office of Faculty Advancement resources to promote the hiring, retention, and success of a diverse and inclusive faculty; and resources from the UW Staff Diversity Hiring Toolkit. 
• Professional Development.  Various opportunities are offered to elevate faculty and staff awareness on various DEI topics, such as UndocuAlly training by UW Leadership Without Borders, SaferZone training by the UW Q Center, and others.  A highlight this past year was pausing operations for an all-school antiracism learning day that featured Dr. Ben Danielson, Loretta Ross, and racial identity caucus sessions led by national racial equity scholars, advocates, and activists convened through SpeakOut.org.   Every September, a 4-day DEI Teaching Institute is held, providing faculty a professional development opportunity to learn how to create inclusive learning environments and knowledge on how to review course content through an antiracist lens.  As an extension, an open forum, peer-to-peer support meeting is held quarterly where faculty bring questions and get consultation and advice from other faculty to improve an aspect of their teaching or problem-solve a challenging situation related to a DEI issue.  Looking ahead, we are preparing for the implementation of the passed Washington State Senate Bill 5227, which requires, beginning 2022-2023, that public institutions of higher education provide a professional development program for faculty and staff to eliminate structural racism and promote DEI, as well as a campus climate assessment.  We do not yet know if this will be a centralized effort or left to the academic and administrative units to implement.  Additionally, into the near future, we will monitor how Washington State Senate Bill SB 5229  unfolds, as this requires by January 1, 2024 that health care professions subject to continuing education requirements must adopt rules requiring licensees to complete health equity continuing education training once every four years. 

TRANSFORMING ORGANIZATIONAL CULTURE AND EXPECTATIONS 

• Pledging to Be Antiracist.  A workgroup of faculty and staff developed an antiracism pledge statement.  Review and input was solicited from faculty via Faculty Council, staff via Staff Council, students via Student Leadership Board, and external stakeholder organizations representing the interests of nurses of color.  Review was then conducted by the UW Division of the Attorney General’s Office, and feedback provided to the ‘ ‘school’s Executive Assistant Dean and Director of Human Resources & Organizational Development, which will be reported back to the workgroup.  More developments to come regarding next steps. 
• Expecting Antiracism from Students.  A revision to the student essential behaviors policy has been drafted and circulated among faculty across the UW Seattle, Bothell, and Tacoma campuses for review and comment.  Approval vote is needed from faculty across the three campuses because nursing academic degree programs are accredited under the Tri-Campus School of Nursing structure.  Feedback has been submitted by UW Tacoma faculty, and input from UW Bothell is pending.  Having an antiracism student essential behavior is a vital expectation standard in order to convey to students that discrimination based on racial identity is not acceptable, and action must be taken to address the matter.  Completing the feedback process from across the three campuses will resume in Autumn 2021; due to faculty not being on contract over summer months.  Once an agreed upon version of the antiracism student essential behavior is reached, it will be voted upon for official approval. 

• Expecting Antiracism and Diversity, Equity and Inclusion Efforts from Faculty and Staff.  Implemented this year, merit and performance reviews of faculty and staff asked for self-report of ways they contributed to advancing antiracism and diversity, equity and inclusion in the school, as part of their annual performance review.  Establishing a process to recognize ‘ ‘one’s contribution to these areas in the past year and setting personal goals for professional development the following year is an important step to set an expectation for school personnel and hold them accountable for them individual level progress. 
• Setting Exemplars for Faculty Promotion.  The faculty Appointments, Promotion, & Tenure (APT) committee recognized the need to explicitly include illustrative exemplars of faculty engagement and accomplishment in antiracism and diversity, equity, and inclusion.  This is essential to have on record to assess whether they were fulfilling expectations according to the level of professorial rank.  Meeting these levels of exemplars has implications on whether a faculty member is worthy of promotion in rank.  These exemplars, including further solicitation of review and input, will continue into Autumn 2021 quarter. 
• Calling In, Not Calling Out.  We continue to encourage and foster an organizational cultural norm that cultivates and nurtures a respectful, inclusive organizational environment.  HEALS (Halt-Engage-Allow-Learn-Synthesize) is our ‘ ‘school’s chosen structured approach to identify, deconstruct, and address bias, stereotyping, or exclusionary behavior that occurs in learning and working spaces.  The ‘ ‘method’s intent is to address the impact of what was said or done, and not the person who said or did what was problematic.  It is important to center the HEALS conversation on those adversely impacted rather than on the intent.  HEALS training workshops are routinely offered quarterly to faculty and staff.  Incoming students are informed about HEALS during their orientation at the start of the academic year, but do not undergo a full training workshop. 
• Assistance with Navigating Antiracism and Diversity, Equity and Inclusion Issues.  Across the UW Seattle, Bothell, and Tacoma campuses, a group of faculty have generously and graciously stepped forward in service to faculty colleagues, staff, and students.  They are available for consultation for those who have questions or need assistance with regard to navigating school policies and procedures to address a diversity, equity, and inclusion issue or problem.  Their names and contact info are available here. 
• Respecting Personal Pronouns.  With the growing recognition of the variety of gender identities people have, it is important not to make assumptions based on their appearance or name.  Such assumptions are not always correct and conveys a harmful message that people must look a certain way to demonstrate the gender they are or are not.  In order to further improve an inclusive organizational environment, faculty and staff were educated as to why this is vital for student and co-worker well-being as well as to effectively, yet simply, communicate their own pronouns verbally (e.g., as part of introducing ‘ ‘one’s self) and visually (e.g., on e-mail signatures, university directory listing, online video calls, and nametags).  Instructions were given on adding pronouns to ‘ ‘one’s last name via the UW Identity webpage. 

• Supporting Small, Local, and Diverse Businesses.  Standard practice promotes and utilizes small, local, and diverse businesses identified by the UW Business Diversity & Equity program when sourcing and purchasing goods and services.  Listings of these businesses from catering to consulting services, and office supplies to promotional products, can be found here.  Directing business to these establishments is a mechanism to direct fiscal resources to business owners from underrepresented, marginalized groups, thus contributing to their asset and wealth development. 
• DEI Resource Webpages.  To elevate awareness and accessibility of DEI resources and information, a suite of webpages was developed dedicated to covering topics such as statements about our ‘ ‘school’s commitment to DEI, DEI statistics, bias reporting assistance, and DEI orientation resources. 
• Faces, Names, and Language.  Our Marketing & Communications team has actively integrated best practices and strategies to ensure that diversity is intentionally represented throughout images, feature stories, news, person profiles, and language used to portray the school.  All members of among our students, staff, and faculty need to be able to see their own identities represented in the ‘ ‘school’s identity.  Continual review and revision of online and publication content will occur using UW’s Communicating with an Equity Lens guide.  Also, the UW Continuing Nursing Education (CNE) unit developed its Principles of Inclusive Language guidance for course instructors and guest speakers.  Committed to creating an open, inclusive, and equitable learning community for every partner and participant of CNE programs, this guide offers a breadth of principles and tips for communicating in ways that foster inclusivity and prevent harmful microaggressions as well as other offensive statements and characterizations. 

IMPROVING CURRICULUM AND LEARNING ENVIRONMENTS 

• Preparing Nurses to Be Antiracist.  The need to examine our curriculum and courses to ensure the inclusion and reflection of antiracism and diversity, equity and inclusion concepts, principles, and skills was clearly recognized.  With a revision of the Doctor of Nursing Practice (DNP) curriculum scheduled for the 2021-2022 academic year, this past year offered the opportunity to assess current content and gaps. Our DNP Coordinating Committee (DNPCC) convened two task forces: one to identify antiracism and diversity, equity and inclusion content present at the course level, and course instructor knowledge, competency, and strategies to teach it; and another to address LGBQTTSIA+ content and issues.  These task forces provided reports and recommendations to DNPCC which will guide the DNP program revision ‘ ‘committee’s work.  As part of this effort, there are plans to seek educational/curriculum consultation to assist with the DNP program revision through an antiracism and diversity, equity, and inclusion lens.  Extending this antiracism and diversity, equity and inclusion educational/curriculum consultation to other academic programs is also being worked out, even without any significant program revisions presently being considered.  Undertaking the incorporation of antiracism and diversity, equity and inclusion content as part of curricular revisions is particularly timely given the April 6, 2021 release of the American Association of Colleges and Schools of ‘ ‘Nursing’s new The Essentials: Core Competencies for Professional Nursing Education and its emphasis on health equity, health disparities, social determinants of health, antiracism, and population health.  These themes are also reflected in the National Academies of Sciences, Engineering, and ‘ ‘Medicine’s report The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, further emphasizing the need to include them in our curriculum. 

• Expecting our Curriculum to Be Antiracist and True to Diversity, Equity, and Inclusion.  An end of program learning expectation has been drafted and circulated among faculty across the UW Seattle, Bothell, and Tacoma campuses for review and comment.  Approval vote is needed from faculty across the three campuses because nursing academic degree programs are accredited under the Tri-Campus School of Nursing structure.  Feedback has been submitted by UW Tacoma faculty, and feedback from UW Bothell is pending.  Having an antiracism and diversity, equity and inclusion specific end of program learning expectation will establish a standard to which the curriculum and its offerings will be held.  Completing the feedback process from across the three campuses will resume in Autumn 2021; due to faculty not being on contract over summer months.  Once an agreed-upon version of the end of program learning expectation is reached, it will be voted upon for official approval. 
• Helping Faculty Be Antiracist Educators.  As a complement and reinforcement to our 4-Day DEI Teaching Institute, the University of California, San Francisco antiracism primer and toolkit was promoted and distributed to all faculty and curriculum/teaching groups.  This primer and toolkit provides a structured approach to equip new and existing faculty with the tools to engage learners in topics of health disparities, social justice, bias, and racism in the classroom and clinical environment.  To assist faculty with applying concepts and principles from this resource to their own teaching, as well as address antiracism and diversity, equity, and inclusion related teaching challenges, an open forum, peer-to-peer support meeting is conducted quarterly where faculty bring questions and get consultation and advice from other faculty to improve an aspect of their teaching or problem-solve a challenging situation related to an antiracism and diversity, equity and inclusion issue. 
• Beyond Classroom Learning into Practicum Learning.  Critical to nursing education and training is learning in real-world settings.  Professional clinical practice partners, whether health care systems and organizations or individual practitioners, offer a valuable learning space that brings to life what students learn in our classroom environments.  This is where students come face-to-face with increasingly diverse patient and client populations and for whom health inequities and inequalities playout for groups with marginalized identities along lines like race/ethnicity, gender, social class, and nativity; to name a few.  We also acknowledge that collectively, this learning space lacks diverse representation among the professional practice preceptors who play a vital role in teaching and modeling sound, exemplary nursing care.  Much work is needed to bring our preceptor educators into the fold of understanding and to demonstrate how care must be delivered through antiracist actions and according to diversity, equity and inclusion principles.  We sent out preceptor outreach letters explaining our ‘ ‘school’s stance on antiracism and diversity, equity and inclusion along with access to resources to begin or expand their learnings in this area.  We also examined our affiliation agreements with the UW Attorney ‘ ‘General’s office to ensure that sites did not exclude student practicum learning based on demographic identities.  In particular, affiliation agreements were updated to explicitly expand the application of non-discrimination rules and policies to gender identity and citizenship categories.  And, we continued work on refining the process to evaluate practicum learning sites and preceptors so that students could provide anonymous feedback on their antiracism and diversity, equity and inclusion experiences related to organizational climate and preceptor behavior.  Key to our efforts to continue quality improvement of the practicum learning space is engagement with our school/s Clinical Community Advisory Board, comprised of nurse executives, administrators, and leaders; which provides helpful guidance and avenues to better the student experience. 

ORIENTING RESEARCH WITH ‘COMMUNITIES’ GOALS AND PERSPECTIVES 

• Engaging Community to Direct Research.  As part of the Office of Nursing ‘ ‘Research’s internal pilot research grants program, the school introduced a new quarterly funding award dedicated to community-engaged projects.  This award intends to fund projects that authentically engage communities within research projects to incorporate equitable research practices.  Proposals applying for this funding mechanism are to be focused on research projects partnered with or co-led by populations or groups who are underserved, underrepresented, or historically excluded, or communities that have limited access to facilitate research agendas. 

• Imbuing Considerations for Diversity, Equity and Inclusion in Research.  All applications (not just those dedicated to a community-engaged project funding mechanism) to the ‘ ‘school’s internal pilot research grants program must address DEI by clearly articulating how the project addresses an important health-related problem in the context of diversity, equity and inclusion; impacts an issue relevant to an underserved, underrepresented population, health equity, or health inequality; challenges and seeks to shift current research or practice towards the betterment of diversity, equity and inclusion by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions; and include strategies that demonstrate respect and value for cultural considerations of the population(s) of interest.  This effort directs our ‘ ‘school’s researchers to center the needs and goals determined and prioritized by the community or population that is the focus of the research. 
• Building Skills to Be Equity-Minded Researchers.  To develop our ‘ ‘school’s faculty to improve their stewardship of the research process with study populations, the Office of Nursing Research sponsored a workshop focused on incorporating and executing best practices in conducting research in equitable ways.  A guide developed by Dr. Rebecca ‘O’Connor delineates strategies for integrating the value of equity into the research process and is intended to help generate ideas on how to engage underrepresented research populations in each step of the that process. 
• Diversifying the Investigator Demographic Profile.  Several faculty throughout our school worked with (primarily junior level) research investigators to submit funding proposals for diversity supplements to their research projects presently funded by the National Institutes of Health (NIH).  This federal government administrative supplement is designed to provide support for research experiences for individuals from diverse backgrounds throughout the continuum from high school to the faculty level.  Several of our faculty also participated in a UW Health Sciences Schools workshop to learn about the policies and procedures of applying for this diversity supplement as well as how to craft strong, competitive proposals.  An additional opportunity for our ‘ ‘school’s PhD students to learn about NIH diversity supplements was integrated into a workshop about NIH research career development awards organized by the Office of Nursing Research that featured Dr. David Banks, Extramural Research Training Officer at the National Institute of Nursing Research. 
• Responding to a National Call for Diversifying Researchers and Research.  Led by the Office of Nursing Research, our school submitted comments in response to the ‘ ‘NIH’s request for information (RFI) Inviting Comments and Suggestions to Advance and Strengthen Racial Equity, Diversity, and Inclusion in the Biomedical Research Workforce and Advance Health Disparities and Health Equity Research.  Our ‘ ‘school’s statement expressed deep commitment to ensuring the benefits of science are shared by all; while acknowledging that historical trauma and systematic discrimination in the U.S. have prevented marginalized communities, specifically communities of color, from fully enjoying the benefits of scientific research progress.  The statement further recognized that, while reasons for this are multifactorial, there remains an unacceptable lack of racial and ethnic diversity in the biomedical workforce that prevents progress in reducing health disparities throughout the U.S.  Our comments offered pragmatic solutions to increase diversity in the scientific workforce, and specific programmatic and bureaucratic changes to ensure that the research funded by NIH will more effectively serve to reduce health disparities. 

ENDORSING AND ENCOURAGING GIVING FOR HEALTH EQUITY 

• Opportunities to Support Antiracism and Diversity, Equity and Inclusion.  Our Advancement Team led efforts to re-orient its priority initiatives so that antiracism and diversity, equity and inclusion was centered and highlighted as a major way that supporters of our school could make a lasting impact in support of health equity.  Also, an examination of policies and processes was undertaken to better align philanthropy operations with prioritizing and reflecting on antiracism as a guiding principle.  This led to the creation of a detailed plan and prospectus used to message with individuals and entities with philanthropic interest in the school that supporting ANTIRACISM AND DIVERSITY, EQUITY AND INCLUSION initiatives is a priority option. 
• Spotlighting with Equity for Student Needs.  Centering the needs of students, the Fathi Family Emergency Fund for Nursing Students was selected as the ‘ ‘school’s featured fund for Husky Giving Day (April 8, 2021).  The fund provides financial support to nursing students facing emergency or unpredictable situations jeopardizing their ability to remain enrolled.  A matching goal from a group of faculty and staff was met, thus boosting the funds size.  A list of UW School of Nursing giving funds can be found here. 
• A Platform and Hub for Antiracism in Nursing.  Systemic racism has for generations undermined the health of individuals and communities across America, and clearly is a public health crisis.  Recognizing that nurses play a central role in and hold major responsibility for the health of individuals and communities hit hard by historic racial inequity, the UW School of Nursing established the Center for Antiracism in Nursing in February 2021, with a long-term vision to serve as a nationally recognized hub that transforms nursing training, practice, and research, as well as influences health and public policy in ways that are guided by antiracism as a fundamental principle.  Creation of the center reflects goals of the ‘ ‘school’s broader diversity, equity, and inclusion strategic action plan, launched in 2016, that lays out a framework to advance and imbue diversity, equity, and inclusion within learning, research, and practice settings.  The commencement of the ‘ ‘center’s work will be catalyzed by an Endowed Fund for Antiracism and Health Equity in Nursing established by alumna Patty Hayes and her husband, Bob, in celebration of her retirement as Director of Public Health – Seattle & King County.