Social Justice: A Concept for Undergraduate Nursing Curricula?

April 2008
Deborah A. Vickers, RN, BSN, MA
Doctoral Student - University of Washington
dvickers@uw.edu
Abstract
As nursing enters the 21st Century, the profession continues to experience the effects of
heterosexism, gender inequality, and racism/ethnocentrism, in large part because these concerns
are not explored and processed by students prior to entering professional practice. This paper
evolved out of my concern that social justice issues are not examined in the majority of
undergraduate programs in nursing, or if they are, they belong to the realm of one or two courses
and are not integrated into the framework of the entire curriculum. Students examining these
issues in their college programs frequently do so through electives in sociology, anthropology,
womens studies, or English. A critical pedagogy not only gives students the tools needed to
perform a postmodern critique of these issues, but it also assists students in understanding social
practices that determine what and how they think about issues of social justice and oppression.
This paper begins with an exploration of the development of power/domination constructs in the
profession of nursing and how these constructs influence nursing education, nursing practice, and
the delivery of patient/client care. Equally important is an examination of the current state of
nursing education and the reasons why change must occur before an integration of social justice
issues can be realized. The paper will also illustrate the ways in which students benefit from the
integration of social justice discourses into the undergraduate nursing curricula. Changes in the
areas of values, ideology, focus, goals, and practice, can assist students in developing critical
thinking skills that consider the multiple realities and contexts which define their own and their
patients identities.
Key Words: nursing education, nursing curricula, social justice, discrimination
Social Justice: A Concept for Undergraduate Nursing Curricula?
Aside from a course or a class in transcultural nursing, nurses graduating from most
undergraduate nursing programs are not exposed to the concept of social justice, or related
discourses such as racism, postcolonialism, postmodernism, imperialism, or white privilege.
These issues may or may not be studied in graduate school, depending on program objectives

and individual faculty. However, since many of the nurses practicing today and in the future will
be baccalaureate-prepared, how can we expect that changes in nursing practice will occur on a
global level if we save the study of social justice issues for graduate education?
All disciplines, including nursing, benefit from education for freedom and a transformative
pedagogy.1,3 In an increasing number of university programs, social justice education begins in
the core curriculum. It is during the third year that many students concentrate on their majors
and, in an ideal educational structure, social justice will then be integrated into their areas of
specialty. Not only are many nursing students not receiving the benefits of a core curriculum that
concentrates on critical reflection for issues of democracy and social justice, many are also
recipients of a nursing education that is focused more on clinical expertise than one that also
prepares world citizens committed to social justice in the diverse areas of health care.
Equally important is an examination of the issues of power and domination within nursing that
lead to apathy and horizontal/vertical violence.4-8 Allen9 suggests that nursing schools create and
reinforce models of compliance, conformity, and obedience. The process moves from the top
(accreditation) down (to students) and leaves in its wake a path of anger, resentment, and
resistance that affects faculty as well as students. It perpetuates faculty efforts to dictate and
control how and what students learn and reinforces the students passivity and subordination.
This paper begins with an exploration of the development of power/domination constructs in the
profession of nursing and how these constructs influence nursing education, nursing practice, and
the delivery of patient/client care. It is important that nurses understand the sources of their own
oppression before they are able to look at the oppression suffered by other marginalized people,
many times at the hands of health professionals. Equally important is an examination of the
current state of nursing education and the reasons why change must occur before an integration
of social justice issues can be realized. The paper will also illustrate the ways in which students
benefit from the integration of social justice discourses into the undergraduate nursing curricula.
Changes in the areas of values, ideology, focus, goals, and practice, can assist students in
developing critical thinking skills that consider the multiple realities and contexts which define
their own and their patients identities.
Power and Domination in Nursing or Is That a Yoke around My Neck?
Prior to the evolution of hospitals into places of healing, as opposed to places of death, nursing
practice occurred in the home and the community. During this period, nurses had much more
autonomy than they did at the turn of the 19 th century when the direction and education of
nurses came under the control of physicians and hospitals. This change of power resulted in a
Victorian-like male domination of their behavior and practice that led to the stereotype of nurses
as the handmaidens of the physicians, serving mens needs and convenience."10
Training at the beginning of the 20 th century consisted of some classroom work and many hours
spent in apprenticeship arrangements on the wards. Much of the teaching was done by physicians
themselves and it was ideal as a means of keeping a female group in subjection to maledominated groups."10p75 It also left nursing equally vulnerable to the domination and control of
practice by hospital administrations.10

Roberts7 summarizes the characteristics of oppressed groups described by Freire1 and illustrates
how the attitudes and behaviors of nurses identify them as an oppressed group. Despite the myth
of autonomy that exists in the profession today, in reality, nurses lack autonomy, authority, and
control over their practice. Nurses have become so acculturated to the status quo that they do not
even see themselves as being oppressed. Cleland states that dominance is most complete when
it is not even recognized."7p30 Although unions provide some improvement in salary, benefits,
and working conditions, nursing practice is still highly controlled by physicians and hospital
administrations. The economic bottom-line seems to be the basis for many of the decisions made
at the institutional level. It is a sad commentary that nurses comprise the largest group of
employees and yet have relatively little, if any, voice in the decision-making process.
Marginality has been described as a state of successful assimilation7 an empty space in which
the marginalized person is without a cultural identity. Marginalized people reject their native
culture in an attempt to adopt the dominant culture, expecting that they will also receive the
power and control experienced by this group. When this does not happen, and it never does, the
marginalized person realizes that he or she does not fit in anywhere and is relegated to an
existence in the borderlands of their own group. This positionality is evident by the attempts
nurses have made to model nursing theory, practice, and research after the mechanistic model of
medicine, assuming that if they could only attain the characteristics of the powerful, or
professional status, they too would be powerful."7p26 Many times a little power is thrown their
way but it is only a paternalistic attempt to pacify and thereby maintain the dominant norm.
Nurses often think of themselves as second-class citizens. This evidences the lack of self-esteem
that is characteristic of many nurses, resulting from the fact that the qualities exhibited by
nursing, such as caring, warmth, nurturance, and sensitivity, are devalued by a dominant medical
culture that prizes intelligence, decisiveness, and lack of emotion.7,11 Injured self-esteem leads to
self-hatred and a dislike for other nurses, explaining the fragmentation nurses experience on a
national level (i.e. lack of involvement in professional organizations and political action groups)
and on a local level (i.e. divisiveness in hospital and community committees).
The divisiveness experienced in nursing causes nurses to lash out at each other because to do so
with their oppressors, the real source of their anger, could have devastating consequences. This
behavior is known as horizontal violence and has the unfortunate effect of providing proof to
the dominant group that subordinate people are unable to be rational and to organize/govern
themselves. The inability of nurses to unify on professional and political issues keeps them
vulnerable to the dominant culture, again maintaining the status quo.1,6,8,9,11
If It Isnt Broke, Why Fix It?
How do we determine if a particular nursing program is successful? There are many sources
available for critiquing a school/college of nursing: accrediting organizations, alumni, present
students, staff members in local hospitals, etc. The yardstick that is accepted as being the most
reliable measure for the present and future success of a nursing education seems to be the
percentage of students who passed the NCLEX-RN, a concept supported by Sayles, Shelton, &
Powell,12 in their paper on Predictors of Success in Nursing Education.

Do high NCLEX-RN percentages and equally high GPAs mean that institutions are offering their
students the best possible education? Do outstanding grades and scores automatically translate
into empathetic, caring nurses who also demonstrate exceptional critical thinking skills while
equally valorizing propositional and practical knowledge? Spence13 has suggested that the
persistent requirement for students to pass state examinations is actually a barrier to the progress
of nursing education:
Legislation requires that statutory bodies monitor standards of practice. Yet the ability to
memorize large amounts of very specific information gives no assurance that successful
candidates will respond appropriately in the highly contextual situations of nursing practice.
Much of what is important to nursing cannot be measured in this manner.13p190
Over the last two decades, there has been discussion regarding the need for a paradigm shift or
curriculum revolution in nursing education. These discourses refer to the widespread
replacement of behaviorist, Tylerian nursing curricula with those oriented to emancipatory,
caringeducative strategies."14p125 Kuhns15 notion of paradigmatic thinking has influenced
much of what has been written in recent nursing literature as scholars have applied his theory of
scientific revolutions to issues of curriculum reform. Thorne, Kirkham, & Henderson14 describe
paradigmatic shifts as extreme turns in direction in a manner that is philosophically
incompatible with the dominant paradigm, and imply that a complete break from former
educational process and content is required."14p126,15
This curriculum revolution is actually part of a larger movement within general education toward
a more liberal pedagogical model influenced by humanist existentialism, phenomenology, and
critical social theory.14 Nursing seems to be shifting from the behaviorist model more slowly
than other disciplines, presumably because of the nature of the information nurses must acquire
to pass licensing examinations.16 The behaviorist model of education has been compared to what
Freire1 describes as the banking system in which teachers deposit information into student
receptacles. The hallmark of this model is the lecture, described as one of the most patriarchal
forms of education"17p3in existence.
In her discussion of critical scholarship, Thompson18 describes the process of critical scholarship
as resting on reflection and insight, allowing one to see oneself in new ways. This reflection
and insight also reveals the ways in which the self has been formed (or deformed) through the
influence of coercive power relations.18p33 It is a goal of critical scholarship, and critical
education, to make these power relations transparent, providing nurses with the ability to see
through them, for these relations lose power when they become transparent.18p33
An emancipatory paradigm promotes process-driven curricula rather than those that are contentdriven. The focus, however, has been described as both student-centered14 and clientcentered19,20 Varcoe20 asserts that by making the client the focus of empowerment, one cannot
help but address the hegemonic influences of institutions in health care settings, a concept
which has not been discussed very often in nursing literature.13 The hierarchical relationship
between teacher and student can be broken down through the development of a dialogic
relationship where student and teacher together study the object of learning.21 This mutual

learning process itself challenges the authority of the teacher and encourages the technique of
drawing out both prescribed information and received knowledge.9,22
The movement to curricula reform is complex, unsettling, challenging, exciting, and in some
ways, intimidating. For professionals with a history of oppression, change can provoke fear and
feelings of inadequacy. It is for this reason that faculty, clinicians, clients, students, and
administrators need to work together for transformationsupporting, rather than opposing one
another. Only then can a climate for the discussion of social justice issues be created and only
then will the goals of fostering human worth and dignity and optimum health care be realized.
Five Coins in the Fountain
The five discourses discussed in this section provide a framework for the integration of social
justice concerns in undergraduate curricula. It is beyond the scope of this paper to provide more
than a cursory treatment of each discourse, especially since volumes have been written on each
one in the context of professional nursing and education.
1. Change in Values: Social Justice and Critical Theory in Higher Education
The need for the academy to deal with issues of social justice is evident on both an internal level
and an external level. On the internal level, the need to address social justice is illustrated in
documented cases of sexism in the hiring, decision-making, representation, salary, teaching and
promotion of faculty.23-28 Additional evidence is found in examples of sexual harassment of
students and faculty by other students and faculty members.25,26,29 Also relevant are examples of
racism inflicted upon faculty, as well as students.30-41 Social justice is also challenged by
harassment, safety, and job security issues resulting from homophobia directed toward students
and faculty.17,42,44 Another concern involves verbal and non-verbal behaviors affecting those with
different mental and physical abilities from that which is considered to be the norm.45-48 And
finally, questions of social justice are raised by stereotyping and/or encountering pressures to
meet socioeconomic expectations endemic in academic culture.17,36,49 These analyses also
suggest that the external realities of social justice questions mirror the microcosm of what is
faced within academic walls by those students and faculty not identified with the dominant
culture.
Young50 suggests that oppression is a central category of political discourse, however, many do
not equate oppression with social injustice. In her essay on the Five Faces of Oppression, Young
differentiates between the traditional use of the term oppression and a more contemporary
usagethe former meaning the exercise of tyranny by a ruling group and the latter designating
the disadvantage and injustice some people suffer because of the everyday practices of a
well-intentioned liberal society.50p36
Critical pedagogy seeks to alter the discourses responsible for repressive and oppressive
institutions by empowering the individual through the process of conscientization. Only when
students understand and accept the responsibility they carry for either maintaining social
institutions or causing them to change, can there be any hope for social transformation.
Drevdahl, Kneipp, Canales, & Dorcy51 provide a critical illustration:

What would happen if we treated people in poverty as if they were drowning? Addressing
poverty with such immediacy requires that nurses, along with other health professions, first
create a climate of unacceptability for socioeconomic differentials, including those in health. We
must take risks if we want to expose and change how the economy, the state, and civil society
with particular emphasis on the overpowering dominance of market philosophies and policies
generate health inequalities. Service is keywe must demonstrate our commitment to social
justice through our actions. This will require nurses to maintain an ecologic view of health, to
take seriously the public health core function of policy development, and to develop political
competency. Although we speak the words of social justice, it is how we act that demonstrates
our philosophy.51p26
Similar sentiments are expressed by Kirkham & Anderson:52
We have come to realize that our nursing scholarship needs to look beyond individual
experiences of health and illness to encompass the social foundations that determine health status
to a large extent.Influenced by the realization of a society structured by discrimination and
inequities, as well as legislated and public health policies that mandate equitable and accessible
health care, nursing scholarship has begun to examine the role of the profession in fostering
social justice.52p2
Taylor53 agrees, We must move beyond the comfort and safety net of multiculturalism and
cultural diversity and simultaneously address broader issues such as racism, sexism, and
classism, and how these operate, both within nursing and nurses, to deny access to optimal health
for populations/women of color.53p40 The case has been clearly presented that an understanding
and commitment to social justice is required for nurses to be able to act, on the parts of their
patients, to improve access to health care. Yet, it is equally clear that nurses are not receiving
education for social justice in their nursing programs.52,54
2. Change in Ideology: Post-Colonialism, Post-structuralism, and Postmodern Feminism
Post-colonialism
Post-colonialism focuses on the effects and aftermath of colonization, a process whereby a
powerful country (European or U.S.) conquers a less-powerful country and subjugates the people
and resources of the land. This process has also been called cultural imperialism and was
legitimized by the belief that Europeans were closer to God because of their appearance,
education, and civility. Every other race was considered to be less than and with Europeans
at the pinnacle of the hierarchy, it continued downward based on skin color and tone. It was
believed that at some point science would support the superiority of the white race, even as the
people of the 16 th and 17 th centuries believed religion had.55 Even today, studies show that
lighter-skinned persons of color experience less discrimination than darker-skinned people.56-58
Postcolonialism is a multifaceted concept and is best understood when it is seen from an
interdisciplinary point of view.52
The term postcolonialism originated with the writings of Frantz Fanon59-61 and Aim Csaire62
around the middle of the 20 th century. Edward Saids63 contemporary work, Orientalism,

initiated a new mode of academic inquiry and theory in the form of colonial discourse analysis.
As a philosophy and as a theory, postcolonialism provides nurses with the ability to interrogate
their own perspectives on racism, ethnocentricism, and white privilege, and to understand how
the health disparities present today are a result of a neocolonialism that exists in the dominant
culture of the 21 st century.
For example, Duran & Duran64 describe the effects that colonialism has had on Native
Americans forced to leave their families as young children to live in boarding schools until their
educations were completed. The residential school program was developed by the U.S. military
in the latter part of the 19 th century as a means of assimilating Indian children into the dominant
culture.65 Most schools were organized and run by religious communities. Conservative
estimates place the sexual and physical abuse in these schools at 80%, though the testimony of
the adults who survived them places it closer to 95%.66 There was little in the way of teaching or
health care in these schools and hundreds of children died from disease and injury. The off-land
boarding schools were closed by 1930 but the reservation school system lasted until the 1990s,
leaving a legacy of generations of abuse, poor education, loss of culture, dysfunctional families
with unprecedented rates of domestic violence, substance abuse, and suicide, far greater than the
national average, all leading to the most painful sacrificethe loss of soul.64-66 The horizontal
violence described in the nursing scenario at the beginning of this paper, is the same construct at
play in the lives of marginalized people who turn their anger inward on themselves and on their
families, generation after generation. These are the people who will become the patients of our
nursing students and it is important that they have a postcolonial framework in which to
understand this construct and its responsibility for the underlying physical and psychological
symptoms exhibited by their patients. Without such a framework, stereotypes can be fostered
that will look past the patients reality and make it difficult, if not impossible, for real healing to
occur.
Kirkham & Anderson52 found that undergraduate programs were failing to educate nurses for
social justice, as evidenced by the fact that these discourses had not yet found a home in our
discipline, Although postcolonial discourses are still infrequent within nursing, there is a
growing call for the integration of postcolonial perspectives into our science as an alternative to
the culturalist approaches that predominate nursing theory.52p2 Anderson67 explains why this is
important for nursing education and scholarship:
I believe that a postcolonial feminist perspective promises a more inclusive nursing scholarship.
It would give voice to racialized women who have been silenced, and provide the analytic lens to
examine how politics and history have variously positioned us, shaped our lives, knowledges,
opportunities, and choices. A postcolonial feminist perspective also has the analytic power to
illuminate how cultural facts are socially constructed and produced.67p145
Post-structuralism
The values of logical positivism are the values of the mechanistic medical model and are not
congruent with the varied ways of knowing that comprise the values situated in the framework of
nursing practice. This is not to say that there is not a place for logical positivism in nursing
research, only that the empirical model is one way of knowingand borrowed, at that. Doering68

explicates, The feminist poststructuralist framework provides a theoretical means of unmasking

the conflicts and contradictions between the experiences of nurses as women and as
professionals and the socially institutionalized definitions of womens and nurses nature and
their social and professional roles.68p32 Doering describes the importance of intuitive knowing
which does not rely on the quantitative elements of medicine but on the nonquantifiable
elements in the nurse-patient relationship that are not based on environmental cues.68p31 Equally
as important is the contextual, phenomena-centered knowledge which values and focuses on
personal experience [assuming] an intimate link between the knower and the thing to be
known.68p31 This subjective and personal knowing is in contrast to the empiricist need to
objectify, control, and manipulate. Nursing knowledge is concerned with the concept of caring, a
function which is experiential, and only measurable in its outcome.
Postmodernism
As opposed to post-structuralism, postmodern thought developed throughout a range of
disciplines during and since World War II. Postmodernism had its beginnings in art and
architecture but its influence has spread over the years to virtually all fields of culture and
study.69 Similar to post-structuralism, postmodern thought has been influenced by the French
theorists, most notably Foucault and Derrida. Its premise is that the Cartesian dualisms on which
Western society is constructed, are not appropriate for understanding the multiple realities
present in the world today.
Nursing must accept and work within the discourse of postmodernism just as other disciplines
are learning to do, otherwise it will not be possible to provide competent care to patients whose
realities and experiences differ from those of the dominant culture. If a postmodern perspective
is not part of the theoretical framework and design of nursing research, the research will be
limited in scope and not reflective of the global diversity within and beyond U.S. borders.
Watson70 appropriates a quote from Edward Said71p225 that emphasizes the importance of
postmodernism to nursing, Is it possible for [nursing science] to be different, that is to forget
itself and to become something elseor must it remain a partner in domination and
hegemony?70pp62-63 Change will occur only as nursing education instills within its students the
theory, skill, and reclamation of power necessary to foster a climate of creativity, innovation, and
transformation.
3. Change in Focus: Identity Politics
The second half of the twentieth century has seen the emergence of a number of large-scale
political movements that were the result of groups of people reacting to the injustices done to
their particular communities (e.g. racial/ethnic, gays/lesbian/bisexual/ transgender, women, etc.).
These injustices came through many different means and at the hands of the dominant social
class in the form of cultural imperialism. Identity politics starts with the analysis of the
oppression, moving to a rejection of the dominant cultures assessment of the groups inferiority,
and resting in the reclamation and redescription of ones own sense of value and worth.
Vandenberg72 explains, One has to position oneself, or acknowledge the position from which
one speaks, for one supposedly is always a gendered, racial, classed, ethnic subject, never an
abstract subject capable of universalizing thought.72p365 Thompson73 expands upon this concept

when she suggests that identity is not static, but fluid and changing ... not unitary, but fractured
and split by the different positions one occupies, by the different members of the group, by the
parts of oneself that are repressed, or by the members of the group who are silenced.73p26
The intersection of identity politics and various forms of multiculturalism is an important area of
investigation for nurse educators. A critique of identity politics suggests that celebrating
identities of difference may have stereotypical effects and may lead to distorted impressions of
power and identity. Pedersen74 for example, describes the phenomenon of false cultural
awareness in which students perceive themselves to have adequate skills when, in actuality,
they lack an understanding of multicultural experiences. This may occur when students rely on
cultural stereotypes with which they have become comfortable as substitutes for the actual
experiences, finding out after the fact that not all persons in any particular culture are the same.
Eliason75 in her study of undergraduate nursing students comfort with culturally diverse groups
discovered that lack of knowledge, skill, and exposure to different groups of people was the
primary factor that elicited discomfort among students around issues of race/ethnicity and patient
care. Results also maintained that the more exposure students received to different lifeways, the
more culturally sensitive they became.
4. Change in Goals: Praxis
The study of social justice discourses yields many opportunities for student reflectionon
themselves, their families, their community, the nation, and the world. The study of praxis
provides students with a context for transformative action. As with many of the social justice
discourses, praxis is difficult to define. Given the ways in which praxis has developed and
adapted through various disciplines over the years, it is easy to understand how the term could be
described as dynamic in both its evolution and its meaning.76
Nursing has an interesting history with the concept of praxis. Some scholars understand this
discourse from the perspective of bridging the theory-practice gap.77 Bevis78 explicates: In a
clinical field, such as nursing, the praxis of caring occurs; theory and practice live together, each
informing the other.78p56 Given the fractured relationship that theory and practice have had in
the history of nursing, this statement is particularly poignant. Other scholars view praxis from a
critical theory perspective in which the bridging of theory and practice motivates the professional
to reflect on the hegemonic power structures in play and to act in ways that will change those
structures, thereby empowering the profession of nursing and improving access and quality of
health care to clients.20,79-81
Action must be informed by critical reflection if it is to be considered emancipatory. The action
may involve risk-taking when an individual chooses to challenge the status quo. Ford & ProfettoMcGrath79 explain that there are two essential features of action in the critical thinking model
improvement and involvement: Improvement is a consequence of taking the appropriate action
in a specific context and involvement is a manifestation of a commitment to action79p343 based
on critical reflection. Both elements are significant in the context of a profession that is seeking
emancipation from powerful structures of oppression and from a group of professionals moving
towards resistance.

In her essay on Leadership for Social Justice and Equity, Brown82 expresses concern that schools
are not developing leaders who will commit to issues of social justice and transformation, stating
that there is a need for professors to retool their teaching and courses to address issues of power
and privilegeto weave social justice into the fabric of educational leadership curriculum,
pedagogy, programs, and policies.82p78 There is concern among scholars as to the feasibility of
attempting to teach the concept of praxis to undergraduate students.77,79,82-85 However, Brown82
counters these concerns by stating:
Because contemporary researchers (Argyris, 1990; Banks, 1994; Senge, Kleiner, Roberts, Ross,
& Smith, 1994; Wheatley, 1992) have found that effective leaders take responsibility for their
learning, share a vision for what can be, assess their own assumptions and beliefs, and
understand the structural and organic nature of schools, preparation programs need to carefully
craft authentic experiences aimed at developing such skills. Students need time to think, reflect,
assess, decide, and possibly change.78
It is beyond the scope of this thesis to discuss the many ways in which Browns model may be
appropriated. Praxis is a dynamic process that incorporates both inductive and deductive
reasoning, involving reflective dialogue, coupled with transformative and emancipatory action,
as a tool for dismantling the oppressive structures within our society. Many baccalaureate
graduates will never attend graduate school. If they do not develop a meaningful praxis in
college, where and when will this occur?
5. Change in Practice: Multiculturalism
During the last decade, much has been written on the subjects of transcultural nursing, racism in
nursing, heterosexism, the politics of difference, how we should and should not do nursing
research, etc. All are facets of the multicultural debates; all are contested discourses in and of
themselves. And why not? The definition of multiculturalism is as varied and contested as the
discourses surrounding it. Kincheloe & Steinberg discuss five type of multiculturalism currently
popular in the U.S., not all of which fit into a social justice context:86
1. Conservative Multiculturalism: monoculturalism; individuals blame minorities for their
own problems; never occurs to them that they are in any way responsible for the
hegemonic imbalance of power that makes it impossible for many minority populations
to rise above the dominant forces that keep them in their place.
2. Liberal Multiculturalisms: basic goal is the attainment of a world where there is only one
race, that being the human race; they work with a color-blind notion of perfect harmony
in which all people share more commonalities than differences (Kincheloe, 1997;
Wallace, 1993) [It just so happens that the commonalities that are shared happen to be
white, Western culture].
3. Pluralist Multiculturalism: appears when students learn about the customs, practices,
religions, values, and belief-systems of various cultures; emphasis is on multicultural
literacy, especially as it relates to a truly democratic citizenship; fails to interrogate the
issues of whiteness, structures of power, and the Eurocentric norm.
4. Left-Liberal Multiculturalism: also known as left-essentialist multiculturalism; predicated
on the belief that identity is comprised of a set of unchanging properties (essences), and

ignores the historical and cultural situatedness of difference as well as its relation to the
location and appropriation of power (Kincheloe & Steinberg, 1997).
5. Critical Multiculturalism: differentiates itself from other forms of multiculturalism by its
emphasis on critique, reflection (including self-reflection), and transformative action
(Kincheloe & Steinberg, 1997).
If nursing students understand the dominant texts that lie beneath the surface of the various
forms of multiculturalism, they acquire the ability to reflect on their own understanding of these
issues. Traditional students are forming adult understandings of their own identities as they move
through four years of college and they must determine what they believe and how they will
respond, not only for themselves but for the profession, their communities, and on behalf of the
patients for whom they will be caring.
It is an expected paradox of modern macrocosm/microcosm that the institutions which have
always been symbols of liberal and democratic educational opportunities find themselves, in
many ways, providing just the opposite. The discourses discussed in this paper are complex
issues that require students to think critically about many of the policies and programs embedded
in a western society that values capitalism over justice and socioeconomic equality.
It is necessary for students to receive an education that assists them in identifying ways in which
social injustice affects a global, multicultural population and how their own actions may
implicate them in the perpetration of many of these injustices, whether or not their actions are
intentional. A critical pedagogy not only gives students the tools needed to perform a
postmodern critique of these issues, but it also assists students in understanding social practices
that determine what and how they think about issues of social justice and oppression.
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