[Sharable materials] Embedding Health Equity Concepts into a Course: Using Relational Dialogue, Storytelling & Real World Issues

Step #1: First... establish a classroom culture of trust, openness and safety.

Try these 10-15 minute classroom culture building activities below. Introduce what relational dialogue is and the purpose for having these discussions: 

1. Direct the class with a "get to know each other activity". Put this slide on the screen so they can refer to them. Instructor should go first to role model. 

Stand up, introduce yourself, feel free to share 3 of the following:

• Your pronouns
• Your race
• Your ethnicity
• Your culture
• Who’s in your family (however you define family)

2. Together, create classroom norms for the Relational Dialogues that will take place. Here are some examples: 

• Not comfortable? Feel free to step out.
• Feel free to say: “pass”
• Recognize that the “share” may not be about them personally, could be a story you heard from a friend of a friend, or a clinical story or you can even make it up (tv show?)
• Ask questions, but don’t pry
• It’s ok to say, “I’d rather not say.”

Step #2: Connect your health equity dialogue with a course topic.

In my nursing med-surg course, I wanted to create dialogue about culture, bias, racism and more similar topics. I made a list of current topics in my my med-surg course and then decided what "health equity topic" would fit well for a 15-minute dialogue. Here's an example of each topic connected to a real-world issue and a health equity concept. 

Step #3: Use relatable storytelling and role model vulnerability.

One of the first dialogues I implemented is one about pain and pain bias. I start off by using a real story about myself experiencing pain. I share my account of a "pain experience" in a way that includes concepts related to personal experiences, values, upbringing, culture, etc.  Here is an example: 

INTRODUCTION:  Role model and be vulnerable: "The worst pain I've ever experienced was a few years ago. I woke up around 1AM and had 8/10 lower back and stomach pain. It was sudden and it was aching. It was constant for about 20 minutes. It hurt so bad I was questioning when to get in the car and go to the hospital.  My mom taught me to just "sleep off pain" and my dad was never a fan of going to the hospital." "What questions do you have?" I then answer their questions honestly. If I don't have an answer or I prefer not to answer, I role model ways to do so: "I don't recall" or "I don't have answer for that one" or "I'll take a pass on that question"

STUDENT ACTIVITY: After giving them an example (with the whole class/group). I then give them the dialogue activity:

1) Take 1 minute and THINK: "Think about a time you experienced pain. (Jot down notes if you'd like)" 

2) In groups of 3 (at your tables) PAIR and SHARE: "Explain the pain your experienced to your group without telling them what the pain was/is.  See if they can ask you questions to determine what it was." 

.......

A memorable student shared his pain experience of: heartbreak