Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) Using Simulation Experiences, Nik's Story: A Quasi-Experimental Study

Monakshi Sawhney; Jenny S Li; Michaela Patterson; Nathaniel P Gumapac; Crystal Sau; Ali Akbari

doi:10.1177/08445621241253124

Addressing Culturally Based Hidden Bias and RacisM (A-CHARM) Using Simulation Experiences, Nik's Story: A Quasi-Experimental Study

Can J Nurs Res. 2024 May 15:8445621241253124. doi: 10.1177/08445621241253124. Online ahead of print.

Authors

Monakshi Sawhney¹, Jenny S Li², Michaela Patterson³, Nathaniel P Gumapac⁴, Crystal Sau⁵, Ali Akbari⁶

Affiliations

¹ School of Nursing, Faculty of Health Sciences, Queens University, Kingston, ON, Canada.
² Intensive Care Unit, North York General Hospital, Toronto, ON, Canada.
³ Cardiovascular Intensive Care Unit, Unity Health, St. Micheal's Hospital, Toronto, ON, Canada.
⁴ Critical Care Resource Pool, Kingston Health Sciences Centre, Kingston, ON, Canada.
⁵ Mental Health, Kingston Health Sciences Centre, Kingston, ON, Canada.
⁶ School of Nursing, Queen's University, Kingston, ON, Canada.

PMID: 38751073
DOI: 10.1177/08445621241253124

Abstract

Background/purpose: Racism and hidden bias experienced by underrepresented nursing students contribute to a loss of confidence and anxiety. The A-CHARM nursing project developed virtual simulation experiences for nursing students to practice how to address racism. 'Nik's Story' virtual simulation was created as part of the A-CHARM project. The purpose of this study was to examine the effectiveness of an education intervention, that included Nik's story, on cultural humility and cultural diversity awareness.

Method: This quasi-experimental study included a convenience sample of final year nursing students. After informed consent, participants completed a pre-intervention questionnaire that included the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire to assess baseline knowledge. Students participated in an education intervention that included a lecture, Nik's story virtual simulation experience, a debrief and then completed a post-education/simulation questionnaire that included usability/learner engagement questions and the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire.

Results: Forty-seven students consented and completed the pre/post intervention questionnaire. Participants rated the effectiveness, engagement and usability of the simulation experience highly. There was a significant positive change in cultural humility "context for difference in perspective" subscale (pre-scores = 6.9, SD = 3.3; post-scores = 31.0, SD = 3.8, p < 0.001), and cultural diversity awareness (pre-scores = 95.4, SD = 8.9; post-scores = 103.4, SD = 9.8, p < 0.001).

Discussion: This intervention was effective in improving cultural humility and cultural diversity awareness in nursing students.

Conclusion: Simulation experiences regarding racism in the clinical setting provide a strategy for students to learn how to professionally navigate unwanted experiences.

Keywords: Nursing education; racism; simulation.