Implementing An Antiracist Training Module for Clinical and Non-Clinical Nursing Faculty

Background: In the U.S., White females comprise the majority of the nursing profession; nationwide at 81% and in Utah at 91%. A culturally diverse nursing workforce is critically needed to meet the healthcare needs of the United States' increasingly diverse population. Nursing students of color often face discrimination and racism by faculty, preceptors, peers, hospital staff, and patients. Given Registered Nurses (RNs) are frequently targets of patient mistreatment, RNs of color are even more likely to encounter patient harm than white RNs. Nursing faculty, especially those who identify as White, often feel frightened, uncomfortable, or unequipped to address topics of racism and racist acts. Therefore, nursing educators can benefit from cultural competency education to increase their confidence with anti-racist communication and actions in clinical practice. Methods: This quality improvement project was implemented at the University of Utah College of Nursing (UUCON). The Antiracist Training Module for Nursing Faculty aimed to provide clinical and non-clinical faculty the tools to better support students of color in the clinical setting when they experience a racist patient act. A 32-minute video was developed that portrays racist acts from a white male patient to a nurse and student of color. The video shows examples of inappropriate and appropriate responses from hospital leadership and clinical nursing faculty, and provides a referenced sheet titled, "A Framework for Responding Racist Patients." The video and framework sheet were embedded in a REDCap survey with nine questions pre-and post-intervention assessing clinical and non-clinical faculty's ranking of comfort, skill and knowledge of addressing racism and racist acts. Additionally, feasibility, usability, satisfaction and intent to use the framework was surveyed at the end of the module. Results: Post-intervention, the study results showed that the educational module and framework statistically increased knowledge, comfort and skill for clinical and non-clinical faculty. The comfort questions for all clinical nursing faculty had the following results: talking to students about racism (p=.003), following a student's lead and supporting them through a racist act (p=.008) and discussing a racist act directed at a student with hospital management (p=.034). These results were compared to those of non-clinical faculty with the following p-values (p=.009, p=.002, p=.005) in the same order. The skill-level questions for clinical faculty had the following results: talking to students about racism (p=.002), supporting a student of color in the clinical setting following a racist act (p=.006), and following up with management, ensuring an incident report and behavioral contract was filed (p=.010). These results were compared to those of non-clinical faculty with the following p-values respectively (p<.001, p<.001, p=.002). The knowledge questions for clinical nursing faculty had the following results: the specific processes that should be followed if they were to witness racism during clinicals (p=.003), how to address a racist act if they felt safe enough (p=.002), and if they witness a racist act and did not feel safe enough to address it (p=.046). These results were compared to those of non-clinical faculty with the following p-values respectively (p<.001, p=.003, p=.008). Conclusion: There was a significant increase in knowledge, comfort and skill after clinical and non-clinical faculty completed the Antiracist Training Module for Nursing Faculty. The change in pre and post-test scores is meaningful because it suggests a clinical change in which students of color may feel more supported through a racist act from their nursing faculty. Implementing a refined version of this visual representation of racist patients and nursing students should be considered for future efforts to increase comfort, skill and knowledge in topics of anti-racism among clinical and non-clinical faculty.