brent macwilliams phd, anp-bc bonnie schmidt phd, rn university of wisconsin-oshkosh wisconsin...
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Brent MacWilliams PhD, ANP-BC
Bonnie Schmidt PhD, RN
University of Wisconsin-Oshkosh
Wisconsin Diversity Assessment Tool (WI-DAT)
• Provide a Strategic Vision for increasing diversity and inclusion in nursing education, healthcare organizations and the workforce.
• Offer evidence-based Recommendations for sustainable change that results in a nursing workforce that better reflects the population being served.
Purpose of the WI-DAT
• Comprehensive review of Literature
• Identified current best diversity practices in education and the workforce.
• Recommendations and a set of metrics were then generated based on the that evidence.
• Initial report was send out to diversity leaders for feedback.
• Ready for wide spread stakeholder review
WI-DAT Development
Strategic plan for diversity that is integrated, outcomes–focused and creates a diversity bridge between education and the workforce.
Goal: Creating a sustainable and diverse nursing workforce.
WI-DAT
Cultural humility – lifelong commitment to self-evaluation and critique that addresses the power imbalances found in faculty, student and patient interactions and attained through lifelong learning
Diversity– “Who we are”
Inclusion – “What we do”
(Chang, Simon and Dong, 2014; Freire, 1970; Hunt 2001; Tevalon & Murray-Garcia, 1998).
Conceptual Model
Inclusive Excellence
• Links quality with diversity
• Involves change-oriented planning process
• Intentionally integrates inclusion into day-to-day operations
• Top down, bottom up approach
• It uses a metrics driven approach to create measurable change
• Championed by State University systems: Wisconsin, Oregon and California.
Education Model
Diversity Maturity Model• Business oriented – Viewing diversity as a valued commodity
Workforce Model
Let’s look at the Recommendations… Develop a standardized system with agreed-upon
benchmarks for tracking data on under-represented populations in nursing programs and health care systems
Track targeted underrepresented groups using a regional approach, local service areas
• Wisconsin Center of Nursing is leading the way
Recommendation 1
Primary and secondary education for many racial and minority groups is far below average Nursing schools should create educational pathways that
provide the support needed to facilitate student success
Diverse Students must be viewed as “Assets versus liabilities”
Shared accountability – Nursing education must be rigorous
• Patients are entitled to receive high quality care delivered by skilled professionals.
Recommendation 2
The history, experiences and stories of underrepresented populations must be infused into all educational curriculum.
Diverse individual perspectives should be viewed by faculty and staff as essential to inform change and viewed from a filtered lens of cultural humility.
• Offer content and learning strategies that are inclusive. Avoid stereotypic assumptions about learners.
(AAMN, 2013; AACN, NLN, 2009)
Recommendation 3
Diversity initiatives should be centered on integrated and sustainable partnerships based on a shared education/workforce vison.
• Initiatives must be “Woven into the organizational fabric” versus “superimposed”
• The Diversity Maturity and Inclusive Excellence Models can be used to guide educational and workplace change.
Recommendation 4
Nursing–specific credentialing agencies like…
• Magnet Recognition Program
• Commission on Collegiate Nursing education (CCNE)
• Commission for Nursing Education Accreditation (CNEA)
Should take a lead role in formulating and enforcing explicit policy standards to ensure equitable access and treatment of underrepresented groups.
•Goal: to move nursing educators from “gatekeepers” to “change agents”
Recommendation 5
Organizational/institutional climate must be assessed on a regular and cyclical basis and identified inequities must be addressed as part of an integrated quality improvement process.
•Assess the Organizational vital signs
•Diagnose needed change
• Plan for systemic climate change
• Implement identified interventions
• Evaluate on a regular cyclical basis (Continuous quality improvement)
Recommendation 6
The organization/institution should self-regulate by implementing and enforcing a code of conduct to enhance bi-directional communication, teamwork, and collaboration.
• bullying, lateral violence and oppression must be managed
• shift from “code of ethics” to “code of expected behaviors”
Recommendation 7
The experiences of diverse groups are often unique and regionally specific; therefore, interventions should be tailored to identified needs in the local area.
• “one size fits all” approaches do not work
Recommendation 8
Develop a research agenda that is focused on creating a diverse nursing workforce pipeline that begins in elementary school and results in the recruitment and retention of a diverse nursing workforce.
•Goal: to attract qualified candidates and break down barriers
Recommendation 9
Best practices related to diversity need to be documented and disseminated…
A sustainable diversity exemplar and research repository is recommended.
• From Toolkits to Centers of Excellence
• Like the Toolkit developed by the WCN
(AACN, NLN California Initiatives WCN, 2014)
Recommendation 10
Convene stakeholders w/ potential interest in piloting WI-DAT for review, feedback & continuous process improvement.
Pilot WI-DAT in minimum of 3 settings: Health or health-related system or clinic Educational setting
Non-health system or business setting.
Compile results of WI-DAT pilots into report for dissemination
Next Steps…
Stakeholders who champion Diversity …
American Assembly for Men in Nursing. (2013). Excellence in nursing education: Environments supportive of men. Retrieved from
http://aamn.org/docs/AAMN%20Recognition%20of%20School%20Excellence%20Packet__09-13-2013.pdf
American Association of Colleges of Nursing. (2014a). Commission of Collegiate Nursing Education. Retrieved from
http://www.aacn.nche.edu/ccne-accreditation
American Association of Colleges of Nursing. (2014b). Cultural competency in nursing education. Retrieved from
http://www.aacn.nche.edu/education-resources/cultural-competency
American Nurses Credentialing Center. (2014). Magnet Recognition Program. Retrieved from
http://www.nursecredentialing.org/magnet.aspx
Association of American Colleges and Universities (2014a) Making Excellence Inclusive Retrieved from http://
www.aacu.org/compass/inclusive_excellence.cfm
Anand, R., & Winters, M. (2008). A retrospective view of corporate diversity training from 1964 to the present. Academy of
Management Learning & Education, 7(3), 356-372.
Chang, E., Simon, M., & Dong, X. (2012). Integrating cultural humility into health care professional education and training. Advances in Health
Science Education, 17(2), 269-278. doi: 10.1007/s10459-010-9264-1
Coffey, G. (2011). Capitalizing on diversity: maximizing performance. Retrieved from
www.diversity.va.gov/training/files/diversity-business-case.ppt
References
References cont.,
Dower, C., McRee, T., Briggance, B. & O’Neil, E. (2001). Diversifying the Nursing Workforce: A California Imperative. California
Workforce Imitative. Retrieved from http://
www.cpec.ca.gov/CompleteReports/ExternalDocuments/Diversifying_the_Nursing_Workforce_2001.pdf
Drumgo, K. & Ramos, E. (2014). Improving diversity and inclusivity in the profession. Retrieved from http://
www.slideshare.net/YCPA/4-diversity-and-inclusivity-in-the-profession-kim-drumgo-ed-ramos
Freire, P. (1970) Pedagogy of the oppressed. New York: Seabury Press.
Hunt, L.M. (2001). Beyond cultural competence: Applying humility to clinical settings. The Park Ridge Center Bulletin, 24, 3-4.
Retrieved from https://www.med.unc.edu/pedclerk/files/hunthumility.pdf
Institute of Medicine. (2004). In the nation’s compelling interest: Ensuring diversity in the health care workforce. Washington, DC: National
Academy Press.
Institute of Medicine, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2010). The future of nursing:
Leading change, advancing health. Washington, DC: National Academies Press.
Lee, M. (2007). Diversity Maturity Model: Charting our progress towards inclusiveness. Retrieved from
http://www.bus.iastate.edu/emullen/mgmt472/LMDiversityMaturityModelPPoint.pdf
Lockheed Martin. (n.d.). Diversity includes you. We are stronger as a whole. Retrieved from
http://lockheedmartinjobs.com/pdfs/DiversityIncludesYou.pdf
References cont.,
Institute of Medicine. (2004). In the nation’s compelling interest: Ensuring diversity in the health care workforce. Washington, DC:
National Academy Press.
Institute of Medicine, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2010). The future of
nursing: Leading change, advancing health. Washington, DC: National Academies Press.
Lee, M. (2007). Diversity Maturity Model: Charting our progress towards inclusiveness. Retrieved from
http://www.bus.iastate.edu/emullen/mgmt472/LMDiversityMaturityModelPPoint.pdf
Lockheed Martin. (n.d.). Diversity includes you. We are stronger as a whole. Retrieved from
http://lockheedmartinjobs.com/pdfs/DiversityIncludesYou.pdf
National Center for Education Statistics, Digest of Education Statistics. (2008). Table
300. Retrieved from http://nces.ed.gov/programs/digest/.
National League for Nursing. (2009). Diversity Toolkit. Retrieved from
http://www.nln.org/facultyprograms/Diversity_Toolkit/diversity_toolkit.pdf
National League for Nursing. (2009). A Commitment to Diversity in Nursing and
Nursing Education. Retrieved from
http://www.nln.org/aboutnln/reflection_dialogue/refl_dial_3.htm
References cont.,
National Center for Education Statistics, Digest of Education Statistics. (2008). Table
300. Retrieved from http://nces.ed.gov/programs/digest/.
National League for Nursing. (2009). Diversity Toolkit. Retrieved from
http://www.nln.org/facultyprograms/Diversity_Toolkit/diversity_toolkit.pdf
National League for Nursing. (2009). A Commitment to Diversity in Nursing and
Nursing Education. Retrieved from
http://www.nln.org/aboutnln/reflection_dialogue/refl_dial_3.htm
Sullivan, L. (2004). A Report of the Sullivan Commission on Diversity in the Healthcare Workforce. Missing persons: Minorities in
the health professions. Retrieved from http://www.aacn.nche.edu/media-relations/SullivanReport.pdf
Sullivan, L.W., & Mittman, I. S. (2010). The state of diversity in the health professions: A century after Flexner. Academic Medicine,
85(2), 246-253.
The Sullivan Alliance. (2014). Retrieved from http://www.thesullivanalliance.org/
Tevalon, M. & Murray-Garcia. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician
training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9 (2), 117-125.
References cont.,
United States Census Bureau. (2012). Most children under the age of 1 are minorities, Census Bureau reports. Retrieved from
https://www.census.gov/newsroom/releases/archives/population/cb12-90.html
United States Census Bureau. (2010). Quick Facts, Census Bureau reports. Retrieved from http://www.census.gov/2010census/data/
University of Wisconsin System (2014). Inclusive Excellence: Definitions
Retrieved from http://www.wisconsin.edu/vpacad/Inclusive_Excellence/definitions.htm
Wisconsin Center for Nursing. (2013a). Enhancing diversity in the nursing workforce.
Retrieved from http://www.wisconsincenterfornursing.org/documents/2013%20WCN%20DiversityReport_final.pdf
Wisconsin Center for Nursing. (2013b). The Wisconsin nursing workforce: Status and recommendations. Retrieved from
http://www.wisconsincenterfornursing.org/documents/2013WIStateWorkforce_new.pdf
Wisconsin Center for Nursing. (In Press) Wisconsin Diversity Assessment Tool.
For further information contact:
Brent MacWilliams PhD, ANP-BC
Bonnie Schmidt PhD, RN
Questions