A pedagogy of social justice for resilient/vulnerable populations: Structural competency and bio‐power

Abstract

Background Nursing schools frequently assert the importance of social justice curriculum, but little information is available about specifics for such a class. Purpose The purpose of this article is to describe a class that builds a foundation for the understanding of social justice and the pedagogical frameworks on which it rests. Methods The authors develop a class grounded in bio‐power and structural competency. Discussion Described are topics presented to students, the rationale for their selection along with class activities and implementation challenges. Highlighted is the use of praxis as students incorporate the components of structural competency and bio‐power. The focus is on the potential for public health and advanced practice registered nurses to recognize and evaluate structural factors in patient and population‐based care. Conclusion Faculty meet substantive challenges in teaching social justice, including lack of recognition of societal forces which affect student's ability to provide care. Focused effort incorporating newer structural and philosophical frameworks in a social justice class may improve the provision of health services. The frameworks of structural competency and bio‐power provide a critical paradigm salient in social justice pedagogy.

Resisting the muddy notion of the ‘Inclusionary Other’: A re/turn to the philosophical underpinnings of Othering's construction

“…Said and Wynter's critique of Othering will provide insight into how, for example, the American ideal came to be "associated with perspectives of European-American, middle-class, heterosexual males" (Canales, 2000, p.22). Canales's powerful illustrations of inclusivity in response to Othering could perhaps be better understood as a resistance to Othering rather than to construe, and potentially mis- (Kempenaar & Shanmugam, 2018;Valderama-Wallace & Apesoa-Varano, 2019;Woolsey & Narruhn, 2018), and the understanding of nursing students' experiences (Jackson et al, 2011). It has spread to nurses' experiences with patients in psychiatry (Jacob & Holmes, 2011), patients living with obesity (Shea & Gagnon, 2015), and with patients of "minority" ethnicities (DeWilde & Burton, 2017).…”

“…This distraction of Inclusionary Othering and the individualistic different‐from‐self definition of the Other put forward by Canales, has muddied the waters of Othering in spheres across the nursing landscape since 2010. It has infiltrated healthcare and nursing education (Kempenaar & Shanmugam, 2018; Valderama‐Wallace & Apesoa‐Varano, 2019; Woolsey & Narruhn, 2018), and the understanding of nursing students’ experiences (Jackson et al, 2011). It has spread to nurses’ experiences with patients in psychiatry (Jacob & Holmes, 2011), patients living with obesity (Shea & Gagnon, 2015), and with patients of “minority” ethnicities (DeWilde & Burton, 2017).…”

“…Its corollary, Exclusionary Othering, “utilizes the power within relationships for domination and subordination” (Canales, 2000, p.16). This argument Canales puts forward is built on the premise of the Other being one who is “different from self” (Canales, 2000, p.16) and has seen some concerning uptake within the nursing literature in recent years (Alpers, 2016; DeWilde & Burton, 2017; DeWilde et al, 2019; Haupt, 2015; Kempenaar & Shanmugam, 2018; Jacob & Holmes, 2011; Jackson et al, 2011; Roberts & Schiavenato, 2017; Shea & Gagnon, 2015; Valderama‐Wallace & Apesoa‐Varano, 2019; Woolsey & Narruhn, 2018). The notion of Inclusionary Othering puts the practice of Othering in focus, built on the construction of the Other as different‐from‐oneself.…”

“I Can't Breathe”: Biopower in the Time of COVID-19

“…Medical and nursing education has used structural competency as a pedagogical framework to equip professionals in training to recognize their status and privilege conferred on health care workers. 36 , 37 Structural competency guides us to acknowledge and use our agency—which is defined as the “social capacity to act” 38 —as health care workers. Structural competency guides health care workers to use our agency and examine our blind spots and the normalized hegemonic structures to acknowledge inequities that shape the lived experiences of the disenfranchised.…”

Teaching the Social and Structural Determinants of Health: Considerations for Faculty

“…People are bound by the choices they have. I wondered, to what extent do we prepare students with the knowledge, skills, and abilities to envision how the broader structural contexts are responsible for the conditions they are seeing in the individuals before them (Woolsey & Narruhn, 2018)? Do we teach students about the structural issues that influence health, that disparity is due to the allocation of resources, that differences in health outcomes are unjust and preventable, and to not assume that marginalized populations have made bad choices or lifestyle decisions (World Health Organization, 2019)?…”