The Education Journal of the
Woodruff Health Sciences Center

The Education Journal of the
Woodruff Health Sciences Center

Strategies to Promote Inclusive Learning Environments in Health Professions Education: Instructor Reflections From an Evaluation of a Diversity, Equity, and Engagement Course Reflection Tool

E. R. Walker, R. E. McGee, J. McGriff, & D. L. Lang

10.59450/RVZY7213

In this “How-to”, we describe strategies that instructors can use to enhance inclusive teaching practices in a variety of settings, based on the evaluation of a DEI Course Reflection Tool.

Introduction

Across the health professional schools of Emory University’s Woodruff Health Sciences Center, centering diversity, equity, and inclusion (DEI) is a core value of the educational mission to train diverse cohorts of health professionals (School of Medicine, 2021; School of Nursing, nd; Rollins School of Public Health, 2024c). Engaging students in diverse and inclusive learning environments promotes improved educational outcomes, student health, and the health of those they will serve in their careers (Day & Beard, 2019; Dewsberry et al., 2022; Hammond, 2014). Creating and facilitating such environments requires instructors to intentionally develop a “culture in which all learners feel welcomed, valued, and safe” (Hogan & Sathy, 2022, p. 10). However, instructors do not always feel prepared to integrate inclusive pedagogy into their teaching (Aqil et al., 2021; Altes et al., 2024).

Therefore, we offer several practical strategies—that can be applied to a variety of educational programs and settings across the health professions—for instructors to consider as they prepare a course or training. These strategies are drawn from the development, pilot implementation, and evaluation of a DEI Course Reflection Tool at the Rollins School of Public Health (RSPH, 2024b). The Tool, which broadly defines DEI to recognize students’ intersecting identities (see Table 1), prompts instructors to reflect on how dimensions of DEI are included in their course content, materials, and implementation.

The evaluation included eight interviews with 12 key informants, analysis of 155 completed Tools (46% of courses from Fall 2022, Spring 2023, Fall 2023), and a brief online instructor survey in Fall 2022 (n=39; 57.4% response rate). A key finding of the evaluation was that instructors desire specific examples of how they can implement inclusive teaching practices and further infuse dimensions of DEI in their courses. Thus, this How-to paper aims to share examples from instructors’ reflections on steps they have taken to ensure diverse, equitable, and inclusive learning spaces for their students (see Tables 2 & 3).

COURSE PREPARATION: SETTING THE FOUNDATIONS FOR INCLUSIVE LEARNING ENVIRONMENT

Inclusive teaching starts with designing accessible and equity-minded learning opportunities (Cuenca-Carlino, 2023). Based on the data reviewed, during course preparation, instructors ensured that they included “sections that describe accommodations and attendance policies, reflecting student considerations with health and social justice work” in their syllabi. For assignments, instructors reported that they “allow assignments to be done in multiple formats” and “review the calendar with religious holidays” to ensure they are “not requesting important due dates on or close to these.”

 

 In choosing course content and materials, instructors should intentionally consider which dimensions of DEI are currently represented and which could be added (see Table 1). Specific examples from instructors include infusing “…the scholarship of authors from historically underrepresented groups in academia, such as women and people of color…,” integrating “…topics that try to bring out issues of structural racism more,” and paying attention to “diversity in guest speaker choices, readings, examples, [and topics for] classroom discussions.” Strategies mentioned by instructors to enhance accessibility include ensuring that captions are added to all recordings and using the accessibility checker feature in the course learning management system (e.g., Canvas).

COURSE IMPLEMENTATION: DEVELOPING AN INCLUSIVE CLASSROOM COMMUNITY

At the start of the semester, developing an inclusive classroom community can be facilitated through an initial discussion with the students about class expectations and ground rules for conversations or situations. One instructor reflected,

 

“The hope is that by acknowledging that microaggressions and/or tough subjects that may come up, any harm that might come to students may be prevented/ minimized and that we have a plan as a class to best handle the situation to repair any damage caused and maintain a safe space for learning.”

Another instructor facilitated “shared classroom power including shared refinement of syllabi.”

Getting to know students and engaging them in their learning is a key aspect of inclusive teaching (Hogan & Sathy, 2022). When getting to know students, one instructor noted that they “ask about pronunciation of names and write it phonetically.” Another instructor practices “listening more so than asking. Always listening to what students communicate.” Regarding activities in class sessions, instructors reported that they “purposively ask students to think about diversity and equity in their classroom discussions and on assignments” and create “space for students to discuss DEI issues.” To provide support to students throughout a course, an instructor wrote,

“I aim to advance equity by periodically reviewing each student’s performance in my courses and proactively reaching out to those who seem to be falling behind…I gladly work with each student’s specific circumstances and give students reasonable accommodations whenever possible.”

ENGAGING IN ONGOING PRACTICE OF REFLECTION ON TEACHING

Instructors recognized the importance of ongoing reflection along with professional development and learning. For example, one instructor noted that they intended to learn more about “which language or terms and behaviors are stigmatizing or biased.” We encourage instructors to reflect on their teaching and make changes to further infuse aspects of DEI each time they teach. These changes can be sweeping, such as a course redesign, or smaller tweaks that, overtime, lead to substantial changes in facilitating inclusive learning environments. Inclusive teaching skills can be developed through ongoing learning by reading, attending workshops, discussing ideas with colleagues, and using the DEI Course Reflection Tool (see Table 4).

Table 4. Resources to support instructors’ professional and personal development in inclusive teaching

Category

Resources

Resources on inclusive teaching

·  Emory’s Teaching Toolkit (CFDE)

·  Rollins Teaching and Learning Core (RSPH)

·  RSPH DEI Course Reflection Tool

·  Department of Accessibility Services (Emory)

Resources for developing an inclusive syllabus

·  Syllabus Resources (CFDE)

·  Religious Holidays (Emory University Office of Spiritual and Religious Life)

Resources for supporting an inclusive learning environment

·  Antiracist Discussion Pedagogy (Chew et al., 2020)

·  Disarming racial microaggressions (Sue et al., 2019)

Resources for development on DEI

·  Emory + You Diversity and Inclusion Training

While it is crucial for instructors to continually reflect on and further develop their teaching, we also recognize the necessity of institutional culture shift and support to facilitate sustainment of inclusive pedagogy throughout health professions education. In recognition of institution’s role in supporting inclusive teaching, the Association of Schools and Programs of Public Health (2024) released a report with five recommendations to increase inclusive excellence through an anti-racism lens. The recommendations include articulating norms and values, assuring accountability, increasing commitment and consistency of efforts, and sharing initiatives to accelerate institutionalization of inclusive excellence. Therefore, we encourage programs to offer spaces where instructors can share ideas and schools to offer training and resources that encourage instructors to develop their skills further.

Acknowledgments

We extend much gratitude to Erica Hsu and Grace Im for their contributions to the evaluation. This work was funded by a DEI mini-grant from the Professional and Organizational Development (POD) Network. The authors declare that we received no payment or services from any third party to support this work.

Association of Schools and Programs of Public Health. (2024). Building Inclusive Excellence Through an Anti-Racism Lens: Transformative Action in Academic Public Health. ASPPH Framing the Future 2030: Education for Public Health. https://aspph.org/framing-the-future-2030s-building-inclusive-excellence-through-an-anti-racism-lens-report/

Aqil, A. R., Malik, M., Jacques, K. A., Lee, K., Parker, L. J., Kennedy, C. E., … & German, D. (2021). Engaging in anti-oppressive public health teaching: challenges and recommendations. Pedagogy in Health Promotion, 7(4), 344-353.

Altes, T. K., Willemse, M., Goei, S. L., & Ehren, M. (2024). Higher education teachers’ understandings of and challenges for inclusion and inclusive learning environments: A systematic literature review. Educational Research Review, 43, 1-16.

Center for Faculty Development and Excellence. (nd). Emory’s Teaching Toolkit. https://cfde.emory.edu/toolkit/index.html

Center for Faculty Development and Excellence. (nd). Syllabus Resources. https://emory.instructure.com/courses/87913/pages/syllabus-resources?module_item_id=1444068

Chew, S., Houston, A. & Cooper, A. (2020). The antiracist discussion pedagogy. Packback. https://www.packback.co/resources/anti-racist-discussion-pedagogy-guide/

Cuenca-Carlino, Y., Giovagnoli, D. J., Friberg, J. C., Meyers, D. J., Catanzaro, S. J., & Karraker, D. (2023). Creating the framework for inclusive teaching excellence. International Journal for Academic Development, 28(3), 334-347.

Day, L., & Beard, K. V. (2019). Meaningful inclusion of diverse voices: The case for culturally responsive teaching in nursing education. Journal of Professional Nursing, 35(4), 277-281.

Dewsbury, B. M., Swanson, H. J., Moseman-Valtierra, S., & Caulkins, J. (2022). Inclusive and active pedagogies reduce academic outcome gaps and improve long-term performance. Plos One, 17(6), e0268620.

Emory University Office of Spiritual and Religious Life. (nd). Religious holidays – List of major religious holidays. https://religiouslife.emory.edu/about_us/holidays.html
Emory University Human Resources (nd). Emory + You – Your Learning: Diversity and Inclusion Training. https://hr.emory.edu/eu/learning/diversity-and-inclusion/index.html

Hammond, Z. (2014). Culturally responsive teaching and the brain: Promoting authentic engagement and rigor among culturally and linguistically diverse students. Corwin Press.

Hogan, K. A., & Sathy, V. (2022). Inclusive Teaching: Strategies for promoting equity in the college classroom. West Virginia University Press.
Nell Hodgson School of Nursing (nd). SON Diversity, Equity, and Inclusion. https://www.nursing.emory.edu/diversity-equity-and-inclusion#about

Office of Faculty Academic Advancement, Leadership, and Inclusion. (2021). 2021 Executive Summary for Diversity, Equity, and Inclusion Strategic Plan. Emory University School of Medicine. https://deiexecutivesummary2021.com/dei2021/

Rollins School of Public Health. (2024a). Rollins TLC. https://sph.emory.edu/rollins-tlc/index.html

Rollins School of Public Health (2024b). RSPH DEI Course Reflection Tool. https://sph.emory.edu/rollins-tlc/documents/RollinsDEICourseReflectionTool.pdf

Rollins School of Public Health. (2024c). Strategic Plan FY2024 – FY2029: Delivering on the promise of public health for all. https://strategicplan.sph.emory.edu/

Sue, D. W., Alsaidi, S., Awad, M. N., Glaeser, E., Calle, C. Z., & Mendez, N. (2019). Disarming racial microaggressions: Microintervention strategies for targets, White allies, and bystanders. American Psychologist, 74(1), 128.

Elizabeth Reisinger Walker, PhD, MPH, MAT

Teaching Associate Professor, Department of Behavioral, Social, and Health Education Sciences, Emory University’s Rollins School of Public Health, ereisin@emory.edu

ORCiD ID: 0000-0001-7221-3089

Robin E. McGee, PhD, MPH

Teaching Assistant Professor, Department of Behavioral, Social, and Health Education Sciences, Emory University’s Rollins School of Public Health

ORCiD ID: 0000-0002-1129-4054

Joanne McGriff, MD, JD, MPH

Assistant Dean for Diversity, Equity, and Inclusion and Assistant Research Professor, Hubert Department of Global Health, Emory University’s Rollins School of Public Health

ORCiD ID: 0000-0001-6783-100X

Delia L. Lang, PhD, MPH

Executive Associate Dean of Academic Affairs and Teaching Professor, Department of Behavioral, Social, and Health Education Sciences, Emory University’s Rollins School of Public Health

ORCiD ID: 0000-0002-5898-7245

Published: 2/24/25