Toward inclusive excellence:
Reducing stereotype threat and other
barriers in the graduate level
introductory basic science course
Nancy C. Tkacs, PhD, RN
Associate Professor of Nursing
Assistant Dean for Diversity and Cultural Affairs
University of Pennsylvania School of Nursing
Why is it important to be aware of
stereotype threat and other barriers?
• Consideration of barriers to high performance
of at-risk students (racial and ethnic
minorities, first-generation students, students
with highest financial aid needs) is imperative
when shaping introductory level courses
• In college, poor performance in the first year
can lead students to change majors away from
STEM fields and may even lead to attrition
Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce
www.nap.edu/catalog/10885.html
Institute of Medicine, 2004
The importance of increasing
healthcare workforce diversity
• National lack of improvement in key health
indicators, including healthcare access and care
of chronic disease, requires study by diverse
multidisciplinary and interprofessional teams
• Having more diverse healthcare providers is
thought to reduce health disparities
• Increasing access to careers in health care,
particularly in the healthcare professions
(physicians, nurses and nurse practitioners,
pharmacists, etc), can reduce income inequality
An unholy trinity of disparities
Health
Education
Economic
Inextricably linked
phenomena in atrisk populations:
• Health disparities
• Gaps in
educational
attainment
• Income inequality
Example: National Healthcare Disparities
Report 2010 – Diabetes care efficiency
Care =
HbA1c +
eye exam +
foot exam
Diabetes care efficiency (cont’d)
Introductory basic science courses in
the health professions curriculum
• Graduate school in the health professions often begins with
a series of basic science courses (biochemistry, physiology,
neuroscience, microbiology, etc.)
• In Penn School of Nursing, students in adult APRN programs
(nurse anesthesia, nurse midwifery, nurse practitioner)
begin with Advanced Physiology and Pathophysiology
• A “weed-out” course??!
• A single course with an extremely heterogeneous group of
students based on prior science coursework, age, race and
ethnicity, socioeconomic status, and number of years since
previous degree
• Students may feel threatened/intimidated based on their
prior science course experiences, their age, and other
characteristics, including race and ethnicity
Stereotype threat
• The concept of stereotype threat posits that
environmental cues remind an individual of
negative stereotypes associated with their group
status.
• These reminders then trigger anxiety, negative
reactions, and can lead to lower performance on
a variety of tests.
• Steele, C.M. & Aronson, J. (1995) Journal of
Personality and Social Psychology 69:797-811.
Consequences of stereotype threat
• Stereotype threat has been implicated in gaps
in test performance between racial and ethnic
minority students versus majority students.
• Similar gaps are seen in the performance of
women and minorities vs white males in STEM
fields.
www.ReducingStereotypeThreat.org:
Strategies – Reframing the task
• Modify task descriptions to be gender- and raceneutral
• Explicitly state that the task (such as a test) is sex-fair
or race-fair
• How can we introduce our tests in a way that
reduces anxiety? Faculty set the tone!
• What is the history – have course tests been
perceived as “tough but fair”?
Deemphasizing threatened social identities
• Standardized test scores improve when questions
about ethnicity and gender are moved to the END of
the test
• “Contextual cues reminding female undergraduates
of their status as college students (a group that is
expected to do well in math) eliminates genderbased stereotype threat”
• How can schools and individual faculty members
promote an inclusive culture such that ALL students
feel a part of the whole, rather than feeling that they
don’t belong?
Encouraging self-affirmation
The power of affirmation
“… that’s when I get to wondering, what would
happen if I told her she something good, ever
day?”
“I hold her tight, whisper, ‘You a smart girl. You a
kind girl, Mae Mobley. You hear me?’ And I keep
saying it till she repeat it back to me.”
Aibileen, in “The Help”
Self-affirmation classroom exercises
• Recall of key values and writing them down
with a brief description
• Encourage students to recall their own
characteristics, skills, values, or roles that they
view as important.
Emphasizing high standards with assurances
about capability for meeting them
• This bears repeating:
–
–
–
–
During the introduction to the course
During lectures and review sessions
When meeting with students for office hours
After a poor test performance
• What about before the course starts?
– What message is the office of student services giving?
– What about program directors or those leading
orientation?
Providing role models
• “… women performed more poorly than men
when a math test was administered by a man
but equivalently when the test was
administered by a woman with high
competence in math”
• “…Black individuals were less aware of
stereotype threat and less affected by it in
terms of test performance when the
administrator was also Black.”
Providing external attributions for
difficulty
• Giving explanations why anxiety is occurring
without validating the stereotype
• Transitions can be very difficult, but the challenge
decreases as with increased time to adjust (can
we authentically tell students that “it gets
better”?)
• Telling students about stereotype threat – the
anxiety they may feel has no bearing on their
ability to do well on the test
Emphasizing an incremental view of
intelligence
• How do we think of “intelligence” or “ability”?
• How much is responsive to effort and studying?
• Performance improved under conditions
presenting intelligence as a muscle that grows
stronger with practice (an incremental view),
rather than as a fixed attribute
• Encouragement to increase effort, rewarding
motivation, and de-emphasizing “talent” or
“genius” produced better results
How do we assess the classroom
climate for diversity?
• Checking in with students
– Anonymous evaluations
– Quality circles
– Check in during face-to-face meetings
• Peer evaluations of our classroom presence
and teaching style
Summary
• Why we think about this: Because helping ALL
students succeed in health care programs will
increase diversity in the health professions, thus
improving care, reducing disparities, and
producing role models for the next generation
• What to remember: Students who are at risk may
struggle in early basic science courses
• What to strive for: Faculty who recognize barriers
to success and actively work to overcome them
can be part of the solution, rather than
perpetuating the problem