Uncomfortable Conversations Research Articles

Towards a critical co-construction of equity communities of practice in education

Students in Canada have unequal access to safe environments and learning in schools, which impacts their participation in education and their achievement of educational goals. Equity, diversity, and inclusion (EDI) courses for future educators are one way to help them see that the benefits of schooling are not equally available to all students. The authors describe how post-secondary students, who were members of equity-seeking communities and their allies, worked together with instructor guidance to co-create EDI courses. The students were already familiar with the fully online learning community model (FOLC) where student voice and agency feature prominently. As the students co-designed new EDI courses, the critical co-construction of equity model was developed. The model is anchored in human rights and relies on a shared spirit of equity humility. The model recognizes the need for student safety as well as the necessity of potentially uncomfortable conversations. While, in the past, equity teaching tended to focus on distinct aspects of oppression in society as individual topics, the co-construction of equity model relies, instead, on building bridges of equity concepts that cross oppressions. These cross-equity understandings can help future educators see the importance of dismantling oppression and rebuilding safer and more inclusive learning spaces in education.

Post-mortems: An overview

A post-mortem is an examination of the body of someone who has recently died, with the aim of determining the cause of death. It is a process with which most members of the public are not familiar. Doctors often have not witnessed a post-mortem in their training and are unaware of the practicalities involved. It can, therefore, generate difficult and uncomfortable conversations if the clinician is unprepared. This article aims to demystify the process to allow an informed conversation between the clinician and patient and a more positive outcome for all.

In a Digital World With Generative AI Detection Will Not be Enough

Recent and dramatic improvements in AI driven large language models (LLMs), image generators, audio and video have fed an exponential growth in Generative AI applications and accessibility. The disruptive ripples of this rapid evolution have already begun to fundamentally impact how we create and consume content on a global scale. While the use of Generative AI has and will continue to enable massive increases in the speed and efficiency of content creation, it has come at the cost of uncomfortable conversations about transparency and the erosion of digital trust. To have any chance at actually diminishing the societal impact of digital disinformation in an age of generative AI, approaches strategically designed to assist human decision making must move past simple detection and provide more robust solutions.

Ticking the boxes: fathers’ performativity, change and intimate partner violence

ABSTRACT Increasingly, perpetrator programmes that specialize in working with fathers who have been violent towards their partners aim both to improve parenting skills and to challenge and change men’s abusive behaviour. The context of the cultural discourses around fatherhood against which programmes are delivered have however received little recognition. We contribute to this conversation by exploring how eight fathers in Iceland approach fatherhood in their process of changing violent behaviour. Inspired by feminist post structural theories, the analysis shows that fatherhood could be performative at times. Fathers tried to perform fatherhood in line with dominant discourses of gender equal and involved fatherhood to assert their identities as good and respectable men and avoid shame. However, this performance did not necessarily engage with or show understanding of their children’s perspectives. When these fathers did engage in uncomfortable conversations with their children it had potential to move them towards change through critical reflections on their violent behaviour and ongoing power differences. This paper provides insights into possibilities of and obstacles to change for violent fathers that may prove useful for perpetrator programmes that intersect work on men‘s intimate partner violence with addressing their fathering skills and capacity.

Words matter: How clinical encounters can be unknowingly stigmatizing to some patient communities.

356 Background: Lack of patient engagement around the content and approach to care conversations related to social determinants of health (SDOH) can negatively impact healthcare experiences and exacerbate disparities in outcomes. Lived environment, financial/logistical challenges, general access barriers and patient mistrust must be addressed on a systemic and individual level. Assumptions based on socioeconomic status, age, race, gender, and medical conditions can undermine communication and/or invalidate a patient's feelings and lived experiences. Accelerating the requirement of SDOH screenings without addressing the patient-centeredness of these conversations will likely contribute to health inequities and yield substandard patient experiences and outcomes. Methods: To better understand patient perspectives about language commonly used in SDOH screenings, we gathered views on terminology used towards patients through surveys, focus groups, and virtual workshops. Participants were recruited from a diverse pool of insured patients served by Patient Advocate Foundation representing various medical diagnoses, were lower income (<$48,000), racially/ethnically reflective of the US, and experienced healthcare access and/or affordability challenges. Results: Patients had both positive and negative perspectives on SDOH screening in clinical settings, specifically focused on communication, bias, and privacy. Survey/focus group results revealed the discomfort of financial and non-medical information (SDOH) being included in their electronic medical record (EMR). “It’s important to find words that are less stigmatizing because it affects how we see ourselves and others.” Only 21% reported being extremely comfortable with SDOH information being recorded in their EMR and subsequently being available to multiple members of their healthcare team. Judgement, embarrassment, shame, and lack of action (i.e., linkage to resources) were often cited as reasons for not wanting to have uncomfortable conversations. Patients also felt that disclosing this information could (or would) influence the treatment options offered, creating bias solely regarding their perceived ability to manage their medical and non-medical financial obligations. Conclusions: We uncovered how, without patient engagement, language and processes the healthcare system uses can feel biased and stigmatizing to those it is designed to help. Stigmatizing conversations can perpetuate discriminatory attitudes, influence clinicians' decision-making when treating a patient, and affect patient trust and disclosure within care settings. This cycle impacts quality of care and contributes to health disparities. By listening to patient perspectives, researchers and health care professionals can become more culturally aware and reduce stigmatizing language, while making care more patient-centric and inclusive.

Towards healing – creating space for uncomfortable conversations: An interview about race between Ellen Yun and Janet Penny

Towards healing – creating space for uncomfortable conversations: An interview about race between Ellen Yun and Janet Penny

Equity in perioperative care essay

There are lots of ways to lead on issues of race and equity in medicine, provided we're willing to engage in sometimes uncomfortable conversations and be honest about the role racism and discrimination have played in creating the deep societal disparities we see today.

Chapter 2 Diversity is Not Enough: Advocating and Organizing for Inclusion in Archaeology

ABSTRACTRacism, microaggressions, sexism, gendered, financial, ableism, and many more facets of discrimination are legacies still prevalent within the field of archaeology, perpetuating an environment of exclusion. Graduate students are particularly cognizant of the ways in which exclusion impacts their academic experiences and their choices to continue pursuing archaeology professionally and academically. Despite the rise of critical and collaborative approaches to the historical archaeologies of Indigeneity, the African Diaspora, and more, graduate programs often do not critically examine the historical and structural elements preventing an inclusive environment when courting students of visibly diverse backgrounds. There is a pragmatic disconnect between institutional discussions surrounding diversity and the tangible outcomes of these discussions at a grassroots level. Through the creation of the Community, Anti‐Racist, Respect, Engagement (CARE) Inclusivity Committee, conversations among the student body in an interdisciplinary, community‐centered, and collaborative historical archaeology graduate program have begun to address problems with exclusion and identify ways in which inclusion can be furthered. This chapter outlines the process and methodology used in the creation of the CARE Inclusivity Committee and subsequent workshop and offers thoughtful reflection about the effectiveness of grassroots organization at the graduate student level in advocating for change. CARE aims to create safe spaces where uncomfortable conversations are encouraged, to help both students and faculty acknowledge the different levels of exclusion. The goal is not only to foster an inclusive environment, but to create a sustainable process for future cohorts and empower other graduate students to enact tangible change.

“You Asked, I Answered, Now What?”: A White Principal’s Struggle to Confront Race(ism) and Address Black Teacher Retention

After viewing a video about Black teachers’ experiences, Vince Matthews, a White male middle school principal, invited Black teachers to a listening session to learn about their school experiences. He was certain that it would be a short, pleasant meeting because he believed he did not have a racist bone in his body. Instead, four teachers shared stories that revealed patterns of racism within the school. Furthermore, they said they considered leaving the school. Principal Matthews was challenged by how to shift from color evasiveness to centering race in decision-making, move beyond listening to implementing racial equity through policy and practice, and facilitate uncomfortable conversations with White faculty.

Disrupting the discourse: Applying critical race theory as a conceptual framework for reflecting on learning and teaching in higher education

The Higher Education Sector in Britain, United Kingdom (UK) is currently being taken to task regarding issues of structural inequality and unfair outcomes for student learners from non-white backgrounds, also referred to as the degree awarding gap. How do we disrupt the narrative concerning race, and more specifically as part of our learning, teaching and assessment practices? Using Critical Race Theory, a project, ‘Disrupt the Discourse,’ an initiative launched in 2021 is a small scale case study piloting the application of the aforementioned theory as part of learning and teaching in a Higher Education Institution based in London. The project explored issues of curriculum design, and assessment practices in response to the issue of the degree awarding gap. The initiative explicitly explores uncomfortable conversations about race as part of learning and teaching practice and by working with a team of anti-racist scholars, a curriculum framework and digital toolkit to explore the lived experiences of student and staff was created. Feedback from the pilot was encouraging, academics from different curriculum disciplines and cultural backgrounds saw the initiative as instrumental in re considering assessment practices, curriculum content and pedagogy as part of learning and teaching practice.

Discussing Difficult News: Reframing Patient and Family Preferences Surrounding the Content and Style of Communication.

Uncomfortable conversations transcend medicine across all sites of care and at all stages of a serious illness. From discussion of prognosis or prognostic uncertainty, to evaluation of competing treatment options, to disclosure of medical errors, to consideration of potentially toxic treatments, clinicians must approach such conversations with sensitivity to a patient's cognitive, emotional, spiritual, and cultural needs. Conversations small and large may be seen as "difficult" by a patient or their family, and there may be discordant views of the perceived "difficulty" of a conversation from the perspective of the medical team as compared to the patient or family.

Exploring Challenging Picturebooks in Education. International Perspectives on Language and Literature Learning ed. by Åse Marie Ommundsen, Gunnar Haaland, Bettina Kümmerling-Meibauer

Reviewed by: Exploring Challenging Picturebooks in Education. International Perspectives on Language and Literature Learning ed. by Åse Marie Ommundsen, Gunnar Haaland, Bettina Kümmerling-Meibauer Lauren Rizzuto EXPLORING CHALLENGING PICTUREBOOKS IN EDUCATION. International Perspectives on Language and Literature Learning. Edited by Åse Marie Ommundsen, Gunnar Haaland, and Bettina Kümmerling-Meibauer. Routledge, 2022, 343 pages. ISBN: 978-0-367-85625-0 What do we—scholars, teachers, readers— really mean when we say that a picturebook is “challenging”? And what roles might the challenging picturebook play in twenty-first-century existence, a time of accelerating globalization and evolving dependency on visual forms of communication? These questions animate this valuable edited volume of critical essays on the uses of unconventional, at times controversial, picturebooks in early, primary, secondary, and tertiary education. Part I, “Theoretical Perspectives on Challenging Picturebooks in Education,” begins by helpfully deconstructing the descriptor challenging. From a cognitive development perspective, what makes picturebook challenging is not necessarily any controversial content (for what one person decides is controversial, another will consider a fact of life) but rather the reader’s intellectual recognition of a marked structure in the picturebook. That is, the child readers will recognize that there is something markedly [End Page 74] different going on in the text—a challenge— from what they have encountered before (Kümmerling-Meibauer and Meibauer; all citations refer to the corresponding chapter in the book). Further, because literacy is a social and culturally situated practice, the picturebook is best understood as a “whole package” that can bridge the perceived research/practice divide (Farrar et al.). Drawing upon major theorists such as Maria Nikolajeva, Carole Scott, and Perry Nodelman, among others, the authors argue that discussions about form and illustrative conventions can complement and expand students’ understandings of empathy, the Self, and the Other, but they also warn that teachers should be prepared for uncomfortable conversations when they select picturebooks for classroom use. The five articles in Part II, “Challenging Picturebooks in Early Childhood and Primary Education,” are practice-oriented. Subjects include the uses of the wordless picture-book in low-exposure foreign-language contexts (Mourão); improved aesthetic literacy in preprimary students (Campagnaro); the contrapuntal picturebook’s capacity to stoke eight-year-olds’ curiosity and critical thinking skills (Ommundsen); and complementing coursebooks with picturebooks in English-language learning through active, creative learning experience (Bland). The final contribution of this section finds that bringing trans-affirmative picturebooks like Joana Estrela’s Os vestidos do Tiago (2015) into conservative classrooms of six-to nine-year-olds can result in refreshing conversations about gender identity and acceptance (Madalena and Ramos). Part III details practitioners’ experiences in secondary and tertiary education in Scandinavia. One contribution concerns itself with secondary school libraries in Norway, which ironically, despite the national curriculum’s emphasis on multimodal forms of communication, do not necessarily prioritize visual literacy in their collections, let alone picture-books (Tveit). The other three articles of Part III confirm the picturebook’s potential to assist intellectual and emotional development. Peter Sís’s memoir, The Wall: Growing Up behind the Iron Curtain (2007), moves a group of initially reluctant, then mostly enthusiastic ESL students in Norway to acquire knowledge of Czechoslovakian history (Heggernes). Biblical stories, retold through comedic picturebook illustration, challenge students to leave “right” interpretations at the door and instead practice free associations and collaborative learning (Haaland et al.). Picturebooks offer unique creative writing oppor tuni-ties for upper-secondary and tertiary students in Sweden, who first unscramble pictures from published texts to (re) create coherent narratives and then give the narrative linguistic form (Sundmark and Jers). Each contribution of this section emphatically disproves the misconception that picturebooks are exclusively for young readers. The final section of the volume, Part IV, dedicates itself to “Global Perspectives.” The works discussed range from texts about Finnish child evacuees during World War II (Österlund) to picturebooks from tribal cultures like the Warli in India and the Australian Aboriginal peoples (Beckett). All invite readers to imagine different ways of being in the world. Looking toward the future, readers may also find new challenges in sophisticated apps, like the one that accompanies the picturebook Pīsim Finds Her Miskanow (2013), which calls...

Protecting Children: A Social Model, Brid Featherstone, Anna Gupta, Kate Morris, and Sue White

This book is eloquently written, bold and refreshing. As an expert by experience, it has been a privilege to have been asked to review this text; had I not been asked to read it, I would never have known about the different techniques of learning we all undertake. Reading is not my strength, but all the chapters and their practice suggestions aligned with my values, my experiences and my hope for a more serene society. The book offered some relief to me as an expert by experience as I was able to understand the patterns I encountered as a victim of systematic failures involving my family. The book raised some really important key issues and factors that must be considered whilst thinking about the reform or transformation of child protection, whilst tidily presenting them all in one place. The authors were brave enough to hold the uncomfortable conversations that are so needed, yet which so many professionals avoid as they stick with the systems they know. They offer a range of critiques as to why systematic change is not already happening within child protection whilst suggesting the potential avenues to move forward. It is so important not to continue a perpetuating ‘toxic’ cycle of blame, although the authors recognise that the previous failings must be acknowledged if a new narrative is to be created.

Moving Towards Meaningful Change, One Uncomfortable Conversation at a Time

The concept of health equity in the management of the pandemic has captured the attention of many within the field of health services and policy research and has shaped the identity of a generation of young scholars. This commentary summarizes the work done by the Student Working Group of the Canadian Association of Health Services and Policy Research to meaningfully engage with the concept as part of a seminar series, as well as the limits of that work. As part of efforts to address those limits, the Student Working Group has joined forces with the Healthy Populations Journal to develop a special issue on health equity. We invite all trainees, patient partners, and knowledge users who are committed to moving the conversation on health equity forward to contribute to this special issue.

Deliberately Dying Is an Appropriate Example to Challenge Current Definitions of the Concept of Occupation

Deliberately Dying Is an Appropriate Example to Challenge Current Definitions of the Concept of Occupation

Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students.

Discrimination and bias in clinical training often take the form of microaggressions, which, albeit unintentional, are detrimental to the learning environment and well-being of students. Although there are a few reports of medical schools training students to respond to microaggressions, none have included a complementery student-led faculty training module. The aim of this study was to develop and evaluate a case-based approach to improving student resilience and increasing faculty awareness of microaggressions in the clinical setting. We created four realistic cases of microaggressions and uncomfortable conversations, based on students' experiences on the wards, to implement training for incoming third-year students and their core faculty. Standardized patients were trained to effectively portray discriminatory faculty, residents, and patients. Institutional review board-approved surveys were administered and statistically analyzed to evaluate for efficacy. Students had greater mean confidence scores for responding to microaggressions immediately and at 6 months after the sessions (P < 0.05). Faculty showed improved mean confidence and understanding of the definition of a microaggression (P < 0.05). This approach had results similar to other studies, with the additional benefit of training faculty with the same scenarios. We believe that this method helped bridge the gap between students' notions of discrimination and faculty understanding of microaggressions.

Scientific mobilization of keystone actors for biosphere stewardship

The biosphere crisis requires changes to existing business practices. We ask how corporations can become sustainability leaders, when constrained by multiple barriers to collaboration for biosphere stewardship. We describe how scientists motivated, inspired and engaged with ten of the world’s largest seafood companies, in a collaborative process aimed to enable science-based and systemic transformations (2015–2021). CEOs faced multiple industry crises in 2015 that incentivized novel approaches. New scientific insights, an invitation to collaborate, and a bold vision of transformative change towards ocean stewardship, created new opportunities and direction. Co-creation of solutions resulted in new knowledge and trust, a joint agenda for action, new capacities, international recognition, formalization of an organization, increased policy influence, time-bound goals, and convergence of corporate change. Independently funded scientists helped remove barriers to cooperation, provided means for reflection, and guided corporate strategies and actions toward ocean stewardship. By 2021, multiple individuals exercised leadership and the initiative had transitioned from preliminary and uncomfortable conversations, to a dynamic, operational organization, with capacity to perform global leadership in the seafood industry. Mobilizing transformational agency through learning, collaboration, and innovation represents a cultural evolution with potential to redirect and accelerate corporate action, to the benefit of business, people and the planet.

Cultural Humility: A Critical Step in Achieving Health Equity.

Cultural Humility: A Critical Step in Achieving Health Equity.

The Highs and Lows of Interviewing Legal Elites

This article addresses some of the challenges faced by researchers who are seeking to identify, gain access to, conduct interviews with, and analyze data from elites. Drawing on the first author’s experience of conducting elite interviews as a source of social research regarding laws and legal processes, this article offers both theoretical and practical insights. Theoretically, we examine interviews with senior legal experts as a particular form of elite interviewing. Interviewing legal elites poses its own set of challenges that at times relate to and sometimes depart from other experiences of interviewing elite groups. Practically, we provide suggestions for how researchers new to elite interviewing and those more experienced can reflect on and navigate different stages of their field research to help capture novel insights. Paradoxically, we show that while an uncomfortable conversation can appear to the researcher that it has not gone well, often it can be a sign of a high quality elite interview.

The Sacred Exchange: Creating a Jewish Money Ethic

The Sacred Exchange: Creating a Jewish Money Ethic