Abstract

Introduction/Background: The CDC (2021) declared racism a serious threat to the Public's health. The Future of Nursing 2020-2030 called on nurses to strengthen nursing education curricula to prepare nurses to address health equity issues and social determinants of health in meaningful ways (National Academy of Medicine, 2021). To promote health equity and address the social determinants of health, nursing must confront racism and social identity meaningfully. However, many educators are wary of discussing cultural issues; others must learn how to address them or begin the conversation (Iheduru-Anderson & Wahi, 2022). Preparing nurses to address social determinants of health and health equity requires recruiting and supporting diverse students in an inclusive learning environment. Transforming academic and practice settings into inclusive, culturally responsive environments is an essential responsibility of educators and leaders.

Creating an inclusive, culturally responsive environment begins with understanding each other. Cultural understanding begins with storytelling. Storytelling is an empowering and transformative process, inspiring imagination and supporting creative thinking. Stories emanate from people's past experiences, rituals, and belief systems, from their encounters with other people and natural phenomena. Collective counterstories emerge through dialogue and discussion (Iheduru-Anderson & Waite, 2022). People create their cultural stories using 'The Culture Box'—a collection of random objects that define us or our social identities.

Method: Intervention Design used the 'Culture Box' activity with students and faculty to facilitate discussion about social identity, culture, race, ethnicity, racism, sexual orientation, and stereotypes. The participants created a 'Culture Box,' which they used to discuss their cultural identities in small groups. Facilitators must set ground rules before beginning the activity.

This session will provide participants with simple but powerful small-group activities applicable across settings to introduce discussions about diversity, inclusion, and racism.

Results: Participants reported that these activities promoted safety and belonging, facilitating open, honest, and respectful discussions about factors that create exclusion and drive disparities. The students felt invited, welcomed, acknowledged, respected, seen, heard, and engaged. Examples of participants' statements related to the activity include. "I am grateful for the opportunity to share who I am with the class. I can tell my own story, so they can see, for me, instead of a version of who they think I should be." The activity was empowering for student participants in different ways that shifted the classroom power dynamics in meaningful ways.

Discussion/Reflection: This session enables participants to engage in self-reflective activities about identity, facilitating open, honest, and respectful discussions about factors that create exclusion and drive disparities. With this activity, faculty/leaders can facilitate difficult conversations about social issues critical to decreasing individual biases and promote critical appraisal of systems and structures to promote equity (Womack et al., 2020). With these activities, participants embrace an attitude of cultural humility characterized by constant questioning, openness, self-awareness, absence of ego, self-reflection, and a willingness to interact with diverse individuals. The activity can be replicated across settings to facilitate discussion about various sociocultural topics in a non-threatening environment.

Notes

References:

CDC. (2021, July 8). Racism and Health. Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/racism-disparities/index.html

Iheduru-Anderson, K. C., & Wahi, M. M. (2022). Race and Racism Discourse in U.S. Nursing: Challenging the Silence. OJIN: The Online Journal of Issues in Nursing, 27(1), Manuscript 1. https://doi.org/10.3912/OJIN.Vol27No01Man01

Iheduru-Anderson, K., & Waite, R. (2022). Illuminating antiracist pedagogy in nursing education. Nursing Inquiry, 29(4), e12494. https://doi.org/10.1111/nin.12494

National Academies of Medicine, Engineering, and Medicine. (2021). The future of nursing 2020–2030: Charting a path to achieve health equity. The National Academies Press. https://www.nap.edu/read/12956/chapter/1

Womack, V. Y., Wood, C. V., House, S. C., Quinn, S. C., Thomas, S. B., McGee, R., & Byars-Winston, A. (2020). Culturally aware mentorship: Lasting impacts of a novel intervention on academic administrators and faculty. PLOS ONE, 15(8), e0236983. https://doi.org/10.1371/journal.pone.0236983

Description

Nurse educators and leaders must reimagine nursing work/learning environments to create inclusive spaces where all can thrive. The Culture Box is a simple, but highly effective activity that enables people to share their story and initiate conversations about identity and culture aimed to increase a sense of self and belonging.

Author Details

Kechi Iheduru-Anderson, DNP, RN, CNE, CWCN - 
The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Mt. Pleasant, MI, USA

Sigma Membership

Alpha Psi

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Nurse Educators, Nursing Education, Leaders, Group Identity, Cultural Identity, Self-Perception, Social Belonging, Diversity & Inclusion Policies

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

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

2026-03-10

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The ‘Culture Box’: A Promising Tool for Creating an Inclusive Space in Nursing

Washington, DC, USA

Introduction/Background: The CDC (2021) declared racism a serious threat to the Public's health. The Future of Nursing 2020-2030 called on nurses to strengthen nursing education curricula to prepare nurses to address health equity issues and social determinants of health in meaningful ways (National Academy of Medicine, 2021). To promote health equity and address the social determinants of health, nursing must confront racism and social identity meaningfully. However, many educators are wary of discussing cultural issues; others must learn how to address them or begin the conversation (Iheduru-Anderson & Wahi, 2022). Preparing nurses to address social determinants of health and health equity requires recruiting and supporting diverse students in an inclusive learning environment. Transforming academic and practice settings into inclusive, culturally responsive environments is an essential responsibility of educators and leaders.

Creating an inclusive, culturally responsive environment begins with understanding each other. Cultural understanding begins with storytelling. Storytelling is an empowering and transformative process, inspiring imagination and supporting creative thinking. Stories emanate from people's past experiences, rituals, and belief systems, from their encounters with other people and natural phenomena. Collective counterstories emerge through dialogue and discussion (Iheduru-Anderson & Waite, 2022). People create their cultural stories using 'The Culture Box'—a collection of random objects that define us or our social identities.

Method: Intervention Design used the 'Culture Box' activity with students and faculty to facilitate discussion about social identity, culture, race, ethnicity, racism, sexual orientation, and stereotypes. The participants created a 'Culture Box,' which they used to discuss their cultural identities in small groups. Facilitators must set ground rules before beginning the activity.

This session will provide participants with simple but powerful small-group activities applicable across settings to introduce discussions about diversity, inclusion, and racism.

Results: Participants reported that these activities promoted safety and belonging, facilitating open, honest, and respectful discussions about factors that create exclusion and drive disparities. The students felt invited, welcomed, acknowledged, respected, seen, heard, and engaged. Examples of participants' statements related to the activity include. "I am grateful for the opportunity to share who I am with the class. I can tell my own story, so they can see, for me, instead of a version of who they think I should be." The activity was empowering for student participants in different ways that shifted the classroom power dynamics in meaningful ways.

Discussion/Reflection: This session enables participants to engage in self-reflective activities about identity, facilitating open, honest, and respectful discussions about factors that create exclusion and drive disparities. With this activity, faculty/leaders can facilitate difficult conversations about social issues critical to decreasing individual biases and promote critical appraisal of systems and structures to promote equity (Womack et al., 2020). With these activities, participants embrace an attitude of cultural humility characterized by constant questioning, openness, self-awareness, absence of ego, self-reflection, and a willingness to interact with diverse individuals. The activity can be replicated across settings to facilitate discussion about various sociocultural topics in a non-threatening environment.