Other Titles

Algorithmic Bias in Artificial Intelligence: Preparing Nurses for Critical and Culturally Safe Engagement [Title Slide]

Abstract

AI is increasingly used in healthcare and education, often framed as a tool for efficiency and objectivity. Yet, these systems are trained on data shaped by Western biomedical norms, reproducing structural and cultural biases. Deep learning does not create new knowledge; it reorganizes existing information. When that data-electronic health records, clinical trials, DSM-based tools- reflects Western perspectives, inequities are amplified under the guise of neutrality.

Consider mental health tools built on DSM frameworks, which pathologize non-Western expressions of distress. Despite the American Psychiatric Association’s 2021 acknowledgment of structural racism, AI-driven assessments still rely on instruments like PHQ-9 and GAD-7. Bias extends beyond mental health: race-based adjustments in kidney and pulmonary algorithms have delayed care for Black and Asian patients. Optum Health’s algorithm underestimated Black patients’ health risks by equating spending with need. These examples reveal how “precision” technologies can mask inequity.

For Indigenous peoples, algorithmic bias echoes colonial research practices. Frameworks like OCAP® (Ownership, Control, Access, Possession) offer ethical data governance grounded in sovereignty. Nursing education should adopt such models to prevent digital tools from perpetuating harm. Algorithmic bias is not a glitch, it reflects colonial logic embedded in data.

Teaching nurses to treat AI as neutral risks reinforcing inequities. Educators must foster critical AI literacy: questioning data origins, representation, and potential harms. Globally, nursing can shape AI integration to advance equity and cultural safety. Embedding these competencies aligns with the Truth and Reconciliation Commission’s Calls to Action and supports digital ethics in practice.

By developing critical engagement, nurses move from passive users to advocates for justice in digital health. Nursing curricula should integrate AI literacy, equity-focused frameworks, and critical data analysis to ensure technology serves all communities rather than reproducing systemic bias.

Notes

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References:

1. Couldry, N., & Mejias, U. (2019). The costs of connection: How data is colonizing human life and appropriating it for capitalism. Stanford University Press.

2. Fricker, M. (2007). Epistemic injustice: Power and the ethics of knowing. Oxford University Press.

3. Benjamin, R. (2019). Race after technology: Abolitionist tools for the new Jim Code. Polity Press.

4. Vyas, D. A., Eisenstein, L. G., & Jones, D. S. (2020). Hidden in plain sight—Reconsidering the use of race correction in clinical algorithms. New England Journal of Medicine, 383(9), 874–882.

5. First Nations Information Governance Centre. (2020). The First Nations principles of OCAP®. https://fnigc.ca/ocap-training/

6. Obermeyer, Z., et al. (2019). Dissecting racial bias in an algorithm used to manage the health of populations. Science, 366(6464), 447–453.

7. Adams, R. (2021). Can artificial intelligence be decolonized? Interdisciplinary Science Reviews, 46(1–2), 176–197.

8. O’Connor, S., & Booth, R. G. (2022). Algorithmic bias in health care: Opportunities for nurses to improve equality in the age of artificial intelligence. Nursing Outlook, 70(6), 780-782.

9. Adams, R. (2021). Can artificial intelligence be decolonized? Interdisciplinary Science Reviews, 46(1–2), 176–197.

10. Huh, S. (2023). Ethical consideration of the use of generative artificial intelligence, including ChatGPT in writing a nursing article. Child Health Nursing Research, 29(4), 249–251.

11. Arora, P. (2024). Creative data justice: A decolonial and Indigenous framework to assess creativity and artificial intelligence. Information, Communication & Society. Advance online publication.

12. Mohamed, S., Png, M.-T., & Isaac, W. (2020). Decolonial AI: Decolonial theory as sociotechnical foresight in artificial intelligence. Philosophy & Technology, 33(4), 659–684. https://doi.org/10.1007/s13347-020-00405-8

Description

AI is increasingly shaping healthcare and education, but it often reproduces bias rooted in colonial and racial hierarchies. This discussion explores how nursing education can foster critical AI literacy to prepare future nurses to challenge algorithmic inequities, promote cultural safety, and advance the Truth and Reconciliation Commission's Calls to Action.

Author Details

Claire Song, PhD(c), RPN, MSc; Tanvir Gill, M.Ed, BScN, RN; Pamela Cawley, PhD (Education), MEd, MPhil (Education), BSN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Competence, Implementation Science, Faculty Development, Artificial Intelligence, AI, Health Care Delivery, Machine Learning Algorithms, Medical Ethics

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-25

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Algorithmic Bias in AI: Preparing Nurses for Critical and Culturally Safe Engagement

Toronto, Ontario, Canada

AI is increasingly used in healthcare and education, often framed as a tool for efficiency and objectivity. Yet, these systems are trained on data shaped by Western biomedical norms, reproducing structural and cultural biases. Deep learning does not create new knowledge; it reorganizes existing information. When that data-electronic health records, clinical trials, DSM-based tools- reflects Western perspectives, inequities are amplified under the guise of neutrality.

Consider mental health tools built on DSM frameworks, which pathologize non-Western expressions of distress. Despite the American Psychiatric Association’s 2021 acknowledgment of structural racism, AI-driven assessments still rely on instruments like PHQ-9 and GAD-7. Bias extends beyond mental health: race-based adjustments in kidney and pulmonary algorithms have delayed care for Black and Asian patients. Optum Health’s algorithm underestimated Black patients’ health risks by equating spending with need. These examples reveal how “precision” technologies can mask inequity.

For Indigenous peoples, algorithmic bias echoes colonial research practices. Frameworks like OCAP® (Ownership, Control, Access, Possession) offer ethical data governance grounded in sovereignty. Nursing education should adopt such models to prevent digital tools from perpetuating harm. Algorithmic bias is not a glitch, it reflects colonial logic embedded in data.

Teaching nurses to treat AI as neutral risks reinforcing inequities. Educators must foster critical AI literacy: questioning data origins, representation, and potential harms. Globally, nursing can shape AI integration to advance equity and cultural safety. Embedding these competencies aligns with the Truth and Reconciliation Commission’s Calls to Action and supports digital ethics in practice.

By developing critical engagement, nurses move from passive users to advocates for justice in digital health. Nursing curricula should integrate AI literacy, equity-focused frameworks, and critical data analysis to ensure technology serves all communities rather than reproducing systemic bias.