Preface

This project began in the classroom.

I am an assistant professor in the Faculty of Applied Health Sciences at Brock University. Each year, I teach hundreds of undergraduate health and medical sciences students about the social dimensions of health. We start in a variety of different places, but we always find our way back to the foundational topics of health equity, critical social justice, and human rights. Much of our learning focusses on health disparities: we ask questions about why some people, communities, and nations face threats to their health more often and more seriously than others.  And we think about our own relationships to the social and political power structures and systems that shape many of our experiences in the world, and our social responsibilities within those systems. My goal is to help my students see themselves not as passive recipients or actors in an inequitable health system that is inevitable, but as active agents and future leaders who can work together to create something better: something that will work for all Canadians and not just a privileged few.

This is why it is so important that health sciences students learn about implicit bias in their training. Because implicit bias drives many health disparities. And when our unexamined and unconscious assumptions shape decisions, attitudes, and actions in the health system, they can be lethal.

There is robust Canadian scholarship that helps us understand what implicit bias is and how it operates (e.g., Parekh et al., 2021; Sukhera et al., 2018; Sukhera et al., 2019; Ungar et al., 2021). The frequent news reports of the egregious health experiences of Indigenous and racialized people like Brian Sinclair (Puxley, 2014), Joyce Echaquan (Laframboise, 2021), and Yosif Al-Hasnawi  (Clairmont, 2022), provide contemporary examples that emphasize the critical importance of including this analysis in the curriculum for students who are training to be leaders in the allied health sciences. But as I taught about implicit bias in my classroom, my students challenged me. Beyond learning to critically analyze problems, they said, they also wanted to learn how they could be part of solutions. Their tenacious and critical engagement with the research and news stories that I presented to them—so often from a place of radical hope— made me rethink my pedagogical practice. Beyond understanding problems, how could I teach this in a way that equipped my students to become leaders who could actively recognize and interrupt oppressive systems? And how could I give them tools to create solutions that are more equitable and just?

As I mulled over these questions, I met Joe Norris and the cast of Mirror Theatre. This not-for profit company uses a participatory and collaborative approach to promote discussions about social justice. This project grew out of our conversations—and later improvisations—together. The group introduced me to words that are not in my academic vocabulary such as “haunting”. A haunting is an educational encounter that leaves the learner thinking about possibilities and lingering questions: “What happened here that is troubling to us?” “Where is the power in this situation?” “What is my role in what happened?” “How could it be otherwise?” A haunting provides students with the opportunity to play and re-play real life situations that they may face in their careers. Our colleague Sheila O’Keefe-McCarthy from Brock’s Department of Nursing added further insights about the value of this approach in helping students to develop into reflexive practitioners. As our project evolved, we all began to recognize participatory theatre as a powerful medium to interrupt the biases that all of us hold and invite learners to re-imagine their own roles in the health system.

When we had the opportunity to further refine this work through the e-Ontario VLS Learning Strategy Grant we were motivated by the positive feedback from students. We heard many of them describe their surprise at discovering some of their own implicit biases and assumptions, and their appreciation of an experiential opportunity as a complement to their academic work. They no longer saw implicit bias as a health issue that happens “out there” but something that every single one of us needs to pay attention to in our own lives.

We realize that most educators who work in health disparities and social justice are not trained in leading participatory theatre. That’s why we developed this resource. We are all part of a transdisciplinary collaboration that involves leaders from Dramatic Arts, the Allied Health Sciences and Education, and we learn from each other constantly. We hope that the material in this resource will highlight the strategies we use (before, during, and after a workshop) so that you can employ them in ways that are helpful in your own teaching.

All the scenes were directed by PhD student Kevin Hobbs. The combination of his high-level directing skills, his creativity, and his innovative ideas in leading our diverse team was exceptional. Recent MEd graduate Mike M. Metz led the curriculum development and was lead author on Parts 2 and 3. Using his background in education and curriculum development, Mike made an enormous contribution to the curriculum in particular.  Nadia Ganesh, an MA student in psychology, conducted a thorough literature review that was foundational to our project. She also used her training in psychology research to design and implement an evaluation so that we could analyze the impact of our workshops. Sheila, Joe and I are faculty members at Brock University, and we all agree that between Nadia, Mike and Kevin, we couldn’t have asked for a more cohesive, talented, and overall remarkable team.

We would like to thank each of the project reviewers (Dr. Kerr Mesner, Dr. Monakshi Sawhney and Dr. Margot Francis) whose input and thoughtful critiques moved this work forward in important ways. We also acknowledge Sandy Howe and the entire Experiential Education team at Brock University. Their insightful contributions to all aspects of this project have been most welcome.

I am deeply grateful for the HLSC 2P21 students (over 600 in total) who participated in this project between fall 2020 and spring 2022. Their encouragement and feedback helped us move this project forward from a haphazard classroom activity to this shareable resource. We are especially appreciative of the 10 students who worked with us to develop and film videos for ‘jokering’ in January 2022: Mohamed Abd Elmagid, Kamryn Di Salvo, Jeanisa Haneiph, Raneem Kalbouna, Madeline Mantler, Katie McCarthy, Youssef Nassar, Rihab Nori,  Memie Ramey, and Sajnoor Sidhu. Your enthusiasm for and commitment to this project brought it to a whole new level.  Thank you. We have loved working with all of you.

This resource is by no means comprehensive. We hope that it offers one way into a complex and multi layered topic, one that will launch (or re-launch) learners on the lifelong journey of examining our own beliefs, attitudes and assumptions and so that we can better understand our collective responsibilities to one another.

With respect and in solidarity,

Valerie

Dr. Valerie Michaelson, Assistant Professor,
Department of Health Sciences, Faculty of Applied Health Sciences, Brock University