System Strengthening & Capacity Building
“Respondents wanted midwifery educators to encourage creative problem-solving and flexibility within the structure of midwifery programs”
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“Systems are perfectly designed to achieve the results they are achieving right now. At first glance, when we look at how dysfunctional existing systems can be, this premise seems absurd. For example, why would people design a system that perpetuates [racial inequity]...? The answer that emerges from a systems analysis is people are accomplishing something they want now, something other than what they say they want. They are receiving payoffs or benefits from the status quo, and they are avoiding the costs of change. Payoffs to an existing system include quick fixes that work in the short run to reduce problem symptoms and the immediate gratification that comes from implementing them.” (Stroh, 2015, p.138)
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“Burdens are shifted, unexpected results surface, and a host of other systems issues arise from good intentions. For any complex problem to be solved, the individual players all need to recognize how they unwittingly contribute to it. Once they understand their own responsibility for a problem, they can begin by changing the part of the system over which they have the greatest control: themselves...The greatest opportunities for lasting change arise when all the players reflect on and shift their own intentions, assumptions, and behavior.” (Stroh, 2015, p. 18)
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Excerpts from Harper and Hurtado (2007) on Implications for Institutional Transformation derived from 15 years of campus climate research.
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Systems thinking for social change: A practical guide to solving complex problems, avoiding unintended consequences, and achieving lasting results. (Stroh, 2015)
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Dr. Nancy Anderson's qualitative research for NACPM revealed the value of a rich range of alternate pathways to certification including distance learning which was the most pragmatic in many cases.
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The 2015-2016 HEED (Higher Education Excellence in Diversity) Award Benchmarking Report Sample. (Williams & Insight into Diversity, 2016)
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Examples of institutions that "engage students in the decision-making process on matters involving diversity and efforts to improve campus climate." (USDE, 2016, p.42-43)
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Examples of institutions with a multi-pronged commitment to diversity that have increased enrollment, graduation rates and faculty from underrepresented groups. Excerpt also lists examples of institutions that have established strong cultural and socio-emotional support systems (USDE, 2016, p.44-45).
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The Racial Justice Report Card evaluates medical schools on their progress towards creating an anti-racist climate
Sustained commitment to solving the complex and persistent system-wide problem of inequity in midwifery education and training programs including:
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Supporting:
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Flexibility for students
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Creative problem solving
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Student employment
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Single parents
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Student involvement in efforts to promote equity
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Developing sustainable employment models
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Expanding distance learning programs
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Including Direct Assessment opportunities through accredited programs
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Offering Academic Support
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May include
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Study groups & Tutoring
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Creating an:
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Organizational Change Team (Gordon, 2016)
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Equity advisory group (Gordon, 2016)
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Requiring Faculty, Staff and Preceptor Training and Development regarding equity and antiracism
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Ensuring the Recruitment and Retention of Underrepresented Students, Faculty, Staff & Preceptors including through:
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Expanded scholarship opportunities that cover more than just tuition
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Expansion of Financial Aid and Loan Repayment opportunities
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Promoting Equity-focused:
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School and Clinic Climates
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Policies, Statements, Reports & Reviews
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Equity impact analyses
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Dedicated equity plan
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Curriculum and Learning Environments
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Race-conscious
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Recognizing:
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The role of Power & Privilege in midwifery and health equity
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The need for Critical Consciousness
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Health care disparities
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The need for cross-racial teamwork
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The role of accreditation and certification in promoting equity
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Racial inequity
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The unique needs of underrepresented students and apprentices
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Structural Racism
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Intersectionality
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“Other recommendations that respondents made which did not appear in the literature included supporting student employment,... developing sustainable employment models and expanding distance learning programs.”
“Another participant echoed this idea and stated that African Americans did not want special treatment but wanted “sensitivity” to circumstances common among African American women, such as decreased economic resources and single motherhood. Respondents recounted ways their instructors or preceptors had shown flexibility to help them succeed, such as audio recording a class, allowing a student to come late due to childcare and travel issues, trading work hours for tuition, or allowing the student to write an essay instead of taking a standardized test.”