Welcome to this episode of the NLN podcast, Nursing EDge Unscripted, the Surface Track, and thank you for joining us. The episode is entitled Diversity, Equity, and Inclusion: From Classroom Conversations to Clinical Care, where we will discuss how nurse educators can help bridge the academic gap around issues of diversity,
equity, and inclusion. More specifically, we will explore the knowledge, skills, and abilities our learners need to create meaningful and therapeutic relationships with their future colleagues, leaders, and patients. And to help us today, we have a very special guest, Dr. Jeffrey Ash, who is an associate dean for diversity and inclusion and an assistant professor in the partnerships professional education and practice department at the University of Maryland School of Nursing
in Baltimore, Maryland. Dr. Dr. Ash's experience includes a wide range of professional service and academic achievements, including serving as a diversity leadership mentor in the fellows mentoring program led by the National Association of Diversity Officers in Higher Education and he also co-chairs a diversity leadership consortium of diversity deans in the Big 10 academic alliance. Welcome Jeff. Thank you for joining us. You read about yourself, you're like,
"Wow, is that me? Did I do that?" Yes. And it's abbreviated. I cut out a lot of good stuff. No, it's fine. It's fine. I'm small town guy. These titles and I think a lot of it's just over overhyped to be perfectly honest. I'm from a small town, not much bigger than whatever room you're in. So, and it's a pretty informal place and, I know that I'm pretty informal and that's
probably that's my preference actually. Sure. The town I grew in grew up in has population the last I think 2010 census 642 people. There's one stoplight in town. There's one high school in the whole county. That's Kent County, Maryland. So, the name of the high school I was Kent County High School. I remember when I got to Towson University, the joke if you're from Kent County and you played sports is you automatically made the all county team because there's only
one high school in the county. But you know there there's crime is you know it's such a small place if if you stole someone's car everybody would know you did it. It's such a small town atmosphere. My parents, well, my mom still leaves the spare key in the extra cars on the floor mat very visible if you walk up to the yard to be right there. And most folks the keys under the under the doormat. So it's something special about growing up in a small town that kind of sticks with you many years
later. So, but yeah, it is it is very different. I would imagine that's a very maybe jarring is not the word or different transition going from Kent County to working in inner city Baltimore. Oh, it is. It is. I went to a workshop many years ago that spoke about that. I think it was I think it was entitled the positionality narrative which basically spoke to how where you're from really influences how you manage and work with people.
You know and that's why for me you don't necessarily need an appointment to I may not be there if you didn't have an appointment but you know I don't see these titles and you know sometimes I like it's just too much. You don't need an appointment to come see me if you got some stuff on your mind just see me in the hallway. You know, I prefer to walk places because in Kent County there was there was no mass transit.
So I often share the story when I was at Towson I'd been there about a month and I was catching the bus back home to Greyhound which was downtown Fyet Street at the time. I'd never been on a mass transit bus and I remember I called the bus station from Towson. I called Greyhound and asked how many miles is it from York Road where Towson was to the Greyhound station and I think they told me it was 11 miles. So I allowed myself 30 minutes and 30 minutes later I could still see the stop
that I had gotten on it at the university. It took it took like two hours to get to go to those 11 miles down York Road and then on Northern Park cross Northern Parkway and oh my I couldn't believe it would take that long. But I'd never been on a on a city or mass transit. I had no idea it would take that long to go 11 miles. So yeah, the traffic alone I imagine is very different. Oh yeah, there there is no rush hour. It's Yeah,
there's no such thing as rush hour, right? That's the That's the beauty of the Eastern Shore, though. Yeah. There's no rush hour. You're not rushing. The closer you get the closer you get to Ocean City, you might it gets a little hectic. Especially this time of year after what, Memorial Day. But most times it's pretty easygoing. So, just a different way of life. And it really does. I'm really proud of that. I if I had to do over
again, I do it the same way. So and yeah, I think it just helps relate helps me relate to folks. In fact, it's kind of annoying when I meet for me just personally when you meet people for the first time and you ask them their name and they say, "Oh, I'm Dr. So and so." I'm like, "That's not your name. That's not your name. Your name's
not Dr. So-and-so." You know that. anyway, you know that that really resonates with me, Jeff, because I've been working really hard on this recognition like when we introduce ourselves in in professional settings, I'll say, "Oh, I am an associate professor." Well, I that's not who I am. That's the role I function in. And so that type of thing resonates with me because it's a it's a paradigm shift of you're more than your role.
You're more than yeah that speaks to I've been even practicing that with emotions or all kinds of things right like I am angry you are not anger you are feeling angry it's an emotion it's an experience but you are not anger I have to remind myself that sure you know I've also followed the work of a researcher many years ago guy named David Rock and David Rock you know wrote an
article I want to say around 2009. It's entitled managing with the brain in mind and it speaks to just the neuroscience behind inclusion and he's identified like this acronym it's called scarf. What are the barriers to inclusion? And the S is for status. One of the barriers to inclusion is status. You know we use terms like junior faculty. Well who wants to be the junior? Who wants to be on the JV, right? Who who wants who wants to be
referred to like that? So status when I'm scar status, certainty or in this case uncertainty, autonomy, relatedness, and fairness. And when we don't have those things, rock essentially concludes to your brain, the feeling of exclusion is the same as being in pain or being hungry. So when we don't know things, you know, some people know, some people don't. So sometimes one of the first things I'll ask is it a secret? How is it this side of the aisle knows but that side
of the aisle doesn't? No. And people sometimes use information like that as a form of status, you know, and that that's a barrier to inclusion. So, it's and he basically concludes when you feel excluded to your brain, it heightens what he refers to as your threat response. But when you feel included, it heightens what's called your
reward response. And to me, a great example is if you've ever gone to like a workshop or conference or something, you open the door and there's a room full of people that that are seemingly looking at you and you don't know anybody, right? Your threat response is pretty high. But the minute you see a familiar face or somebody you recognize, you're like, "Oh, I'm going to sit by sit by you." Your reward response is really high because you see something familiar. So it's really about being
mindful. I feel like I sometimes will will boast and say my my memory is pretty photographic. But having said that, I really try to pay attention and be very observant, you know, reading body language. One of the things with the pandemic that I've missed doing is walking the building and engaging students because I see people sometimes sitting alone and they're really alone. You're not
studying you. There's just a look of alone. It's a different when you're looking you're studying and you're alone, but it's another look when you're just alone that looks isolated. So I've missed doing that. I like being back in the building, being engaged folks in the elevators and hearing conversations and infusing myself in those conversations. So it's good to be back in the building in that way. You know, that kind of observation you speak about, Jeff, you know, I
think that's it's interesting. I think some people have that skill very refined and some people need to work at it and I do think you can really re like you know work on your observation skills and I think that's actually something that nurse educators try to teach our students all the time right how do you like see beyond the patient's blood pressure right how do you see beyond the telemetry monitor that has the bells and whistles and really look at them and look at their eyes,
their body language, their non-verbals and how do you I think it's just a challenge though for some of us that are very good at that skill. It comes very naturally and then some people that it doesn't come naturally and we also understand the importance of developing it. So I just think in nursing education that's something that I think we could as a community of a profession just be better at of teaching this skill of observation. Sure. Is it's not natural to everybody.
And it's so tightly connected to emotional intelligence. Sure. Sure. You know, I'd also I would also offer just generationally, you know, there's a generation of folks who have grown up not engaging folks, right? We have these to talk for us, to spellcheck for us, to I was riding a friend of mine the other day and while in his car, he didn't even have to type the message. He just spoke the message. Tell Dave Smith I'm going to be late. in the car sent somebody a text message.
Right? So, there's a generation of folks who have have grown up not having to engage and look people in the eye and be mindful of the nonverbal. And so, it's really interesting how we do need that. I think that's I and in fact what really got me on this stick many years ago read a book Blink I believe by Gladwell that spoke to about spoke about how in an instant we have these micro
expressions. There's times where I can see there's times where I walk into a room or walk into a meeting or room and I see people look up to the right like you know just the whole n like oh wow they're I can tell they're not happy to see me right like here he is right like wow but what's
that about? Even in the book Blink, he mentions, Gladwell mentions how it starts with they're interviewing couples for something and how he could tell instantly how the couples walk into the room which couple is not getting along very well. You know what though, Jeff? I think what you said spoke to me because your first response when you described this person coming into the room and you know maybe looking up to the right
you said what's that about? You know, I think your curiosity has always been I think you role model that often. And I think it's that kind of curiosity that when we see somebody do something or say something that we're just that's kind of puts us on our heels, you know, digging into that a little bit and being like, that's interesting. That's not the look I was expecting. I don't know if I was expecting a hug or a high five or what, but I wasn't expecting
an eye roll. So I think just being curious about that and giving people the benefit of the doubt can be helpful. And I just heard that kind of resonate in what you were saying is upset about I use that as an opportunity because my first thought is not necessarily a negative one. My first thought is they don't they probably don't know me very well. So I try to see that as an opportunity to sometimes sit right beside that
person say, "Hey, how you doing? How's it going?" I don't think we've met, you know, to try to again when I think about, you know, the barriers to inclusion when I see that reaction sometime it let it's a reminder to me that we don't have much relatedness and you know a lot of times we have you know much we have much more in common than we do different but it's really our differences that get most of the attention.
I was thinking about something very similar to that when you were talking about the technology and how people are have grown up on that and the research around how when people feel disconnected or not leaning in to others how much easier it is to engage in some of these transgressions or these microaggressions that people wouldn't do may not do maybe I won't say wouldn't but might not be inclined to do if they leaned in and knew more about the person or understood them or connected
I think about the studies about the road rage and you know the online social media comments about things that are posted or typed or said or done because people feel disconnected. So when we lean it's easier to do that. when we lean in get curious like you talk about sit down, get connected with somebody, we learn a lot more about the humanity and the connection and the commonality that makes it I think helpful to find common ground and be able to be relatable. Sure.
I totally agree with that. I think you know when I think of relatedness when we don't have that there's a term sometimes folk folks in this work use is you'll graduate from MSU when you don't have information about folks and a lack of relatedness you'll make stuff up you know sometimes even in conversations you know when the and our bias speaks to us sometimes instantly the person that's always late the person who has to leave the meeting you know, well, you hear things
over, they're not a team player or they're always late and we make assumptions or they're lazy or, you know, and I'll sometimes I call people and I'm like, you just made that up, didn't you? And like, you know, like what do you mean? Like, because you don't know why they left. Maybe they got some medication to take. Maybe they got to check on their child and child care. Maybe they have a take care of older adult parent. You don't know why they're leaving early. You don't know why they're
arriving late. So don't make stuff up. Yeah. I And we know that the brain is wired cognitively in a way that in the absence of information, we fill in our own narrative. And that narrative gets by our lens, our biases, our upbringing, our experience, our culture, everything. And we shape a narrative in the absence of that information that can be inaccurate at best and harmful at worst, I think.
And you know, I always like to remind myself, you know, this is sort of an issue of the human condition, but our brains were hardwired to do that really for survival. You know, if we got little bits of pieces of information, we needed to fill in the blanks to make a bigger picture so
we could respond appropriately. And I so I always try to remind myself rather than getting hard on myself to say, you know, you shouldn't think this way or that's wrong, you know, just understanding that it's leaning into this idea that just being aware of it, right? And just trying to be open about this idea of how our brains are hardwired to function. And it's not such a bad thing, it's a survival thing that we kind of just it went awry, right? I mean, we're all overwhelmed
with stimuli, right? I'm often at the house here get annoyed. Anytime I click on something, there's an ad. I don't want to see an ad right now. U but we're all just overloaded with with stimuli. So when you see when we see and experience something different, our personal and cultural information that we already have tells us immediately what we think it is. And it's easier to take that shortcut rather than really kind of spend some
time and get to know the person, right? So, if you see somebody in a in a hoodie or if you I use my transcript sometimes as a prop. My transcript at one time I was academically dismissed and my GPA was really low. So, sometimes I'll show these pictures doesn't have my name on it of
the transcript and the GPA. So I show a series of pictures and I ask people write down your first thought and when they see academically dismissed and see the GPA and I collect these index cards later and I read what some of the commentary and the commentary is like lazy unmotivated but then later I said that's my transcript, right? So, and I was never any of those things. But when you see that, we our personal and cultural history tells us what that is when you see it. And we all do.
I do it as well, you know. I'm some people think I don't do this. I don't misspeak. I don't Hey, I don't always get it right, you know. So, we all do that. But we are wired like that. Soon as you see it, your personal culture tells you what it is.
So, we were having a little bit of a an informal conversation and these themes and topics came up about bias and self-awareness and I wanted to build on that and transition that into the academic setting and tap into your expertise and your perspective from a DEI perspective which would be you know there's been so much focus and emphasis on not only at college and programmatic levels but within in classrooms to really evaluate
fostering inclusivity and focusing on equity. And I think at the same time, we still have a lot of blind spots. We still have a lot of things that we're not aware of that fall under our subconscious. And so I'm curious to hear from your perspective perhaps maybe at multiple levels, maybe at a college or school level, programmatic level, even in our classrooms.
What are some of the things that you see as being things that are in our blind spots or we're unaware of that we really need to shift our focus on and think about in order to really foster inclusivity and equity in the spaces that we coexist and teach and work in? Well, that's a great question. A couple things just jump out jump out to me. One is I'm really fond of a phrase that
everything speaks. Everything speaks. So we need to be mindful of when I think of just blind spots the books materials that we use case studies that we use that that certain groups aren't depicted in a negative light all the time. We need to be aware of in our case studies and textbooks of the stereotypes that that have existed for generations. The other really important thing is mindful that the entire classroom environment. It's more than just being in class, right?
It's the pictures in the hallways. It's the names of the buildings. It's the names of the conference rooms. Everything speaks in a way that we have to be mindful that those images, those artifacts speak to the entire audience. and create this sense of whether or not you belong, you have this sense of belonging. So, it's all those things. You know, even when I think of just inclusive pedagogy, it's intentional.
We have to be intentional on understanding the different learning styles, different communication styles. We don't all learn the same way. We don't all communicate the same way and really try to institute smaller groups, smaller working groups, peer mentoring, peer coaching. So it's all those things. I think even organizationally I think when I just think of our blind spot, we have to
be mindful of who our students encounter. We have a number of instances where students encounter folks who are not our employees but to the students they feel like they're our employees. You know our clinical partners, preceptors and sometime we got to make sure that those folks are uphold our core values as well because they really represent a key component to the educational experience. So it's those things I think we got
to be mindful of. Another thing I think is a blind spot just organizationally is really trying to be more intentional on growing and developing our part-time and adjunct folks including them like like any other employee and oftentimes are your part-time folks. Adjuncts are sometimes
an afterthought. And I think we could a blind spot just I think for us organizationally when I think about how important it is to diversify the faculty is really looking at who we already have and who we're already familiar with and growing and developing them in a way to come on board full-time. So those are some things I think are some immediate blind spots that kind of jump
out at me. You know, one thing we know from the evidence is that it's really hard for us to get our own blind spots into focus and we usually need the help of somebody else to hopefully kindly bring our what's in our blind spot to our forefront. So, I think this conversation, right, is one way just talking about these blind
spots. I'm wondering though for the teacher in the seat at the desk who's writing this case study, who's writing these test questions, you know, what are some things that we can do for the faculty that are doing this work and how can that kind of level of of content clear, you know, how can we get that out of our blind spot and clear of of bias? I think one of the
things I think you could do is one. One we have to accept that we don't know everything right so it I think the first step is it really starts with us ourselves and recognizing that it's okay to be vulnerable I believe it's Brene Brown that speaks to that it's okay to be vulnerable and not not have all the answers and know everything. The other thing I think that's important to this work is at least from my perspectives is for folks not to feel alone. You don't have you don't have
to figure this out by yourself. So it's okay to not know and to say that you don't know. I think even as faculty I think we could partner with each other. You know I think what I think of the generation when I first started teaching there was a lot of classroom observations and you know, feedback doesn't always have to be threatening. You know, you can use feedback for growth, for development. So, it's really partnering.
I think it's okay to even though I think a course class is being captured on on, you know, class captures and videos, it's okay to look at yourself, not necessarily for the content, but to look at yourself and be critical of yourself and give yourself feedback and partner with other
faculty. You know even just solicit feedback. This all starts to me and you mentioned it earlier just self we talked about this earlier self-awareness is our greatest tool is our greatest tool and once we're more self-aware then we can really teach others to be more aware so that's what I would offer but it all starts with to me a certain level of humility and being vulnerable and acknowledging I don't know everything. And sometimes that's difficult for highly educated
folks to admit. You know, I don't know. I haven't figured that out. I need some help. Sometimes that's really hard for folks. So, anyone who has joined Michelle and I on this podcast before knows that we have a tendency not to be able to keep our conversations just to the 15 or 20 minutes that we ideally want to keep it at. There is so much good things to unpack and talk about and that is the case with our conversation with Dr. Jeff Ash. So, we're going to hit the pause button. We will
be back. We hope you will join us too. We'll pick up with our conversation with Dr. Ash on considering DEI initiatives within clinical and academic settings and how we bridge the gap. Thank you for joining us on this episode of NLN Nursing EDge Unscripted Surface. We hope you join us next time. Until then, remember, whether your water is calm or choppy, stay connected, get vulnerable, and dare to go beneath the surface.