The Alberta Journal of Educational Research Vol. XLV. No. 4, Winter 1999,468-470

Diana L. Gustafson Ontario Institute for Studies in Education

and Institute for Women's Studies and Gender Studies, University of Toronto

Toward Inclusionary Practices in the Education of Nurses: A Critique of Transcultural Nursing Theory F o r o v e r a d e c a d e research that addresses i n c l u s i v e e d u c a t i o n has e x a m i n e d the s o c i a l o r g a n i z a t i o n of k n o w l e d g e ( A l c o f f & Potter , 1993; C a m p b e l l & M a n i c o m , 1995; H a r d i n g , 1992, S m i t h , 1987, 1990a, 1990b, 1996), access to e d u c a t i o n a l i n s t i t u t i o n s a n d p r o g r a m s (B lackmore & K e n w a y , 1993; R e y n o l d s & Y o u n g , 1995), c u r r i c u l a r r e f o r m ( G a s k e l l & M c L a r e n , 1991; G a s k e l l , M c L a r e n , & N o v o g r o d s k y , 1989), c h i l l y c l a s s r o o m c l imates ( C h i l l y C o l l e c t i v e , 1995; S a n d l e r , S i l v e r b e r g , & H a l l , 1996), a n d strategies for teaching a n d l e a r n i n g ( A c k e r , 1994; B r i s k i n , 1991; D e i , 1996a, 1996b; L a t h e r , 1991; M a n i c o m , 1992; M c C o r m i c k , 1994). F e m i n i s t s a n d cr i t i ca l theorists concerned w i t h a d v a n c i n g the a g e n d a of i n c l u s i v e e d u c a t i o n speak about h o w w o m e n a n d other m a r ­g i n a l i z e d g r o u p s affect a n d are affected b y e x c l u s i o n a r y practices i n e d u c a t i o n . U n d e r l y i n g this research is a n a s s u m p t i o n that h o w w e c o m e to k n o w (or not k n o w ) o u r s e l v e s is d i s c o v e r a b l e i n a n d m e d i a t e d b y i n s t i t u t i o n a l texts, images , p o l i c i e s , a n d s t r u c t u r a l processes. That is to say, d o m i n a n t e d u c a t i o n a l k n o w ­ledge sys tems o r g a n i z e h o w w e construct ourse lves a n d others as g e n d e r e d a n d m a l e o r female , r a c i a l i z e d a n d w h i t e or b lack , s tra ight o r gay , a b l e - b o d i e d or d i s a b l e d , v a l u e d or d isrespected , p o w e r f u l o r p o w e r l e s s . G e n e r a l l y , s t u ­dents a n d facu l ty w h o see themselves a n d their va lues , beliefs , a n d interests represented a n d protec ted i n ins t i tu t iona l k n o w l e d g e s feel i n c l u d e d a n d p o w e r f u l . C o n v e r s e l y , s tudents a n d facul ty w h o d o not see themselves repre­sented i n i n s t i t u t i o n a l i z e d k n o w l e d g e s genera l ly feel e x c l u d e d a n d o p p r e s s e d i n a n d b y the e d u c a t i o n a l s y s t e m .

T h e p r i m a r y p u r p o s e of this research is to extend the d i a l o g u e about i n ­c l u s i v e e d u c a t i o n i n t o n u r s i n g e d u c a t i o n b y e n g a g i n g i n the first anti-racist c r i t i q u e of t r a n s c u l t u r a l n u r s i n g theory ( T C N ) . D r a w i n g o n the w o r k s of D e i (1996a, 1996b), F i n e , W e i s , P o w e l l , a n d W o n g , (1997), F ine a n d W i s e (1993), F r a n k e n b e r g (1993,1997), M c C a r t h y a n d C r i c h l o w (1993), a n d others I e x a m i n e h o w T C N e m b o d i e s , i m p a r t s , a n d reinforces the d o m i n a n t socia l d iscourses (values , bel iefs , l a n g u a g e , a n d p o l i t i c a l interests) about race, e thnic i ty , cu l ture , a n d r a c i s m a n d o r g a n i z e s the e v e r y d a y l ives of w h i t e a n d m i n o r i t i z e d n u r s i n g s tudents a n d facu l ty . Spec i f i ca l ly , this research addresses three quest ions : (a) W h a t are the e x p l i c i t a n d i m p l i c i t de f in i t ions of race, e thnic i ty , c u l ture , a n d r a c i s m c o n s t r u c t e d i n t r a n s c u l t u r a l n u r s i n g theory? (b) H o w , if at a l l , d o n u r s -

Diana Gustafson is a dual-enrolled doctoral student whose research interests include health care reform and its impact on Canadian women. She can be reached at diana.gustafson@sympatico.ca or SESE - 12th floor, OISE/University of Toronto, 252 Bloor St W, Toronto O N M5S 1V6.

468

Toward Inclusionary Practices

i n g s tudents a n d facul ty take u p or chal lenge these w a y s of t h i n k i n g about race, e thn ic i ty , c u l t u r e , a n d rac i sm? (c) W h a t c o m m o n g r o u n d , if a n y , u n d e r l i e s the p r i n c i p l e s a n d practices of t r a n s c u l t u r a l n u r s i n g e d u c a t i o n a n d ant i - rac i sm e d u c a t i o n as p e d a g o g i c a l approaches to soc ia l di f ference a n d rac ia l o p p r e s ­s ion?

O n e i m p e t u s for this research arises f r o m m y interest i n c o m p l i c a t i n g n u r s e s ' l o c a t i o n as a female s u b o r d i n a t e i n hea l th care b y l o o k i n g at h o w other p o w e r re lat ions o r g a n i z e the e d u c a t i o n a l p r e p a r a t i o n of nurses a n d , i n t u r n , o r g a n i z e n u r s i n g pract ice . I n d o i n g this research I a m also t a k i n g u p the cha l l enge to e x a m i n e the u n e a r n e d benefits a n d p r i v i l e g e s that accrue to m e as •a w h i t e e d u c a t o r i n a r a c i a l i z e d e d u c a t i o n a l s y s t e m . If k n o w l e d g e is a c o n d u i t for p o w e r t h e n I m u s t c r i t i c a l l y e x a m i n e h o w I ques t ion , use, a n d g i v e a u t h o r ­i ty to k n o w l e d g e i n m y teach ing pract ice a n d i n m y w r i t i n g . These foc i c o m ­b i n e d w i t h the ear ly outcomes of s o m e p r e l i m i n a r y w o r k p r o d u c e d a second a n d p a r a l l e l p u r p o s e .

In the ear ly stages of this research I e x a m i n e d c u l t u r a l sens i t iv i ty as a n o r g a n i z i n g p r i n c i p l e i n the n u r s i n g c u r r i c u l u m at a n O n t a r i o c o m m u n i t y c o l ­lege ( G u s t a f s o n , 1998). C u l t u r a l sens i t iv i ty , a core theme of t ranscu l tura l n u r s ­i n g t h e o r y ( K o z i e r , E r b , B ia i s , & W i l k i n s o n , 1995) w a s a d o p t e d b y the n u r s i n g facu l ty i n the m i d 1980s as a response to i n c r e a s i n g c u l t u r a l d i v e r s i t y i n the c o m m u n i t y a n d s tudent p o p u l a t i o n s . I a r g u e d that c u l t u r a l sens i t iv i ty is a l i b e r a l response to race relat ions that organizes a n d reproduces whi teness a n d w h i t e r a c i a l i d e n t i t y as a d o m i n a n t , centered, absent presence i n n u r s i n g texts. S h i l l i n g (1993) f irst u s e d the phrase "absent presence" (p. 19) to refer to the status of the b o d y i n s o c i o l o g i c a l theory , b u t the t e r m is appl i cab le to construc­t ions of whi teness a n d w h i t e rac ia l i d e n t i t y i n n u r s i n g texts. Whi teness a n d w h i t e r a c i a l i d e n t i t y are absent i n the sense that they l ie outs ide the legi t imate concerns of n u r s i n g e d u c a t i o n a n d t h e o r i z i n g . A t the same t ime , whi teness a n d w h i t e r a c i a l i d e n t i t y are present i n the sense that they are at the centre of a n d " n o u r i s h " (p. 19) the i d e o l o g y a n d s y s t e m of r a c i s m .

T h e prac t i ca l issue that arose f r o m that p r e l i m i n a r y w o r k w a s p e d a g o g i c a l : H o w does one facil i tate the process of m a k i n g the i n v i s i b l e v i s i b l e to w h i t e s tudents a n d facu l ty w h o h a v e l earned not to see it? I c o n c l u d e d that this requires a " c o n t r a p u n t a l r e a d i n g of the text" or a consc ious effort to " r e a d against the g r a i n . " T o facil i tate this c r i t i ca l exercise, I a m generat ing a n d w i l l test a n i n s t r u m e n t that s u p p o r t s n u r s i n g facul ty a n d students i n r e c o g n i z i n g a n d e x a m i n i n g u n p r o b l e m a t i z e d a s s u m p t i o n s a n d beliefs about c u l t u r a l d i v e r ­s i ty a n d soc ia l di f ference . T h e structure a n d f o r m a t of the i n s t r u m e n t d r a w s o n the w o r k s of E i c h l e r (1991,1997) a n d E i c h l e r , G u s t a f s o n , a n d P o m p e t z k i (1999) w h o d e v e l o p e d a set of d iagnost i c quest ions for r e c o g n i z i n g s e x i s m i n research. T h i s i n s t r u m e n t for r e c o g n i z i n g overt a n d h i d d e n forms of r a c i s m is b e i n g f o r m u l a t e d so that it m a y be a p p l i c a b l e to other texts b e y o n d n u r s i n g .

Acknowledgments I am grateful to the Social Sciences and Humanities Research Council for their support of this research. M y thanks to Margrit Eichler and George Dei for their comments on this article and for our ongoing conversations.

References Acker, S. (1994). Gendered education: Sociological reflections on women, teaching and feminism.

Toronto, O N : OISE Press.

469

D . i . Gustafson

Aleoff, L., & Potter, E. (Eds.). (1993). Feminist epistemologies. New York: Routledge. Blackmore, }., & Kenway, J. (Eds.). (1993). Gender matters in education administration and policy: A

feminist introduction. Washington, DC: Falmer Press. Briskin, L. (1991). Feminist pedagogy: Teaching and learning liberation. Feminist perspectives. Ottawa:

Canadian Research Institute for the Advancement of Women (CRIAW). Campbell, M . , & Manicom, A. (Eds.). (1995). Knowledge, experience and ruling relations: Studies in

the social organization of knowledge. Toronto, O N : University of Toronto Press. Chilly Collective. (Eds.). (1995). Breaking anonymity: The chilly climate for women faculty. Waterloo,

O N : Wilfred Laurier University Press. Dei, G.J.S. (1996a). Anti-racism education: Theory and practice. Halifax, NS: Femwood. Dei, G.J.S. (1996b). Critical perspectives in antiracism: An introduction. Canadian Revieiv of

Sociology and Anthropology, 33,247-269. Eichler, M . (1991). Non-sexist research methods: A practical method. New York: Routledge. Eichler, M . (1997). Feminist methodology. Current Sociology, 45(2), 9-37. Fichier, M . , Gustafson, D.L., & Pompetzki, M . (1999). Moving toward equality: Recognizing and

eliminating gender bias in health. Ottawa: Health Canada. Fine, M . , & Wise, L. (Eds.). 1993). Beyond silenced voices: Class, race, and gender in United States

schools. Albany, NY: SUNY Press. Fine, M . , Weis, L., Powell, L.C., & Wong, L.M. (1997). Off white: Readings on race, power and society.

New York: Routledge. Frankenberg, R. (1993). The social construction ofivhiteness: White women, race matters. Minneapolis,

M N : University of Minnesota Press. Frankenberg, R. (Ed.). (1997). Displacing whiteness: Essays in social and cultural criticism. Durham,

N C : Duke University Press. Gaskell, J., & McLaren, A. (Eds.). (1991). Women and education: A Canadian perspective (2nd ed.).

Calgary, AB: Detselig. Gaskell, J., McLaren, A., & Novogrodsky, M . (Eds.). (1989). Claiming an education: Feminism and

Canadian schools. Toronto, O N : Garamond Press. Gustafson, D.L. (1998, June). Problematizing cultural sensitivity as a thematic in the nursing

curriculum at an Ontario college. In J.R. Epp (Ed.), Centering on the margins: The evaded curriculum (pp. 261-270). The Second Bi-Annual Canadian Association for the Study of Women and Education (CASWE) International Institute Proceedings, University of Ottawa.

Harding, S. (1992). Rethinking standpoint epistemology: What is "Strong Objectivity?" Centennial Review, 36,437-70.

Kozier, B., Erb, G , Biais, K., & Wilkinson, J. M . (Eds.). (1995). Fundamentals of nursing: Concepts, process, and practice (5th ed.). Don Mills, O N : Addison-Wesley.

Lather, P. (1991). Getting smart: Feminist research and pedagogy with/in the postmodern. New York: Routledge.

Manicom, A. (1992). Feminist pedagogy: Transformations, standpoints, and politics. Canadian Journal of Education, 17,365-389.

McCarthy, C., & Crichlow, W. (Eds.). (1993). Race, identity, and representation in education. New York: Routledge.

McCormick, T. (1994). Creating the nonsexist classroom: A multicultural approach. New York: Teachers College Press.

Reynolds, C , & Young, B. (Eds.). (1995). Women and leadership in Canadian education. Calgary, AB: Detselig.

Sandler, B.R., Silverberg, L.A., & Hall, R.M. (1996). The chilly classroom climate: A guide to improve the education of women. Washington, DC: National Association for Women in Education.

Shilling, C. (1993). The body and social theory. London: Sage. Smith, D.E. (1987). The everyday ivorld as problematic: A feminist sociology. Toronto, O N : University

of Toronto Press. Smith, D.E. (1990a). The conceptual practices of power: A feminist sociology of knoxoledge. Toronto, O N :

University of Toronto Press. Smith, D.E. (1990b). Te.vfs,/flcfs and femininity: Exploring the relations of ruling. London: Routledge. Smith, D.E. (1996). The relations of ruling: A feminist inquiry. Studies in Cultures, Organizations

and Societies, 2(1), 171-190.

470