Health inequalities as a foundation for embodying knowledge within public health teaching: a qualitative study

Abstract

IntroductionRecent UK health policies identified nurses as key contributors to the social justice agenda of reducing health inequalities, on the assumption that all nurses understand and wish to contribute to public health. Following this policy shift, public health content within pre-registration nursing curricula increased. However, public health nurse educators (PHNEs) had various backgrounds, and some had limited formal public health training, or involvement in or understanding of policy required to contribute effectively to it. Their knowledge of this subject, their understanding and interpretation of how it could be taught, was not fully understood.MethodologyThis research aimed to understand how public health nurse educators’ professional knowledge could be conceptualised and to develop a substantive theory of their knowledge of teaching public health, using a qualitative data analysis approach. Qualitative in-depth semi-structured interviews (n=26) were conducted with eleven university-based PHNEs.ResultsIntegrating public health into all aspects of life was seen as central to the knowing and teaching of public health; this was conceptualised as ‘embodying knowledge’. Participants identified the meaning of embodying knowledge for teaching public health as: (a) possessing a wider vision of health; (b) reflecting and learning from experience; and (c) engaging in appropriate pedagogical practices.ConclusionThe concept of public health can mean different things to different people. The variations of meaning ascribed to public health reflect the various backgrounds from which the public health workforce is drawn. The analysis indicates that PHNEs are embodying knowledge for teaching through critical pedagogy, which involves them engaging in transformative, interpretive and integrative processes to refashion public health concepts; this requires PHNEs who possess a vision of what to teach, know how to teach, and are able to learn from experience. Their vision of public health is influenced by social justice principles in that health inequalities, socioeconomic determinants of health, epidemiology, and policy and politics are seen as essential areas of the public health curriculum. They believe in forms of teaching that achieve social transformation at individual, behavioural and societal levels, while also enabling learners to recognise their capacity to effect change.

Formação pedagógica das escolas técnicas do sistema único de saúde

“…The approach to service practice allows the process of reflection and learning of various experiences in the context of the service attributing meaning to the information received to interpret them, relating them to their life situations. 7 The theoretical framework that guides the thought of professional formation, which bases this study, shows that this is a process in permanent becoming, not only as an update that occurs from the accumulation of information, but that occurs through contextualized training with reality and that builds knowledge from critical reflection. 8 When considering the thematic relevance of Pedagogical Training, the object of this study is the pedagogical training of teachers performed in the Technical Schools of the Unified Health System.…”

Teaching Strategies to Approach Social Inequalities: An Overview of Nursing Studies

“…Approaching public health in education presupposes praxis, articulating practice with the theme of public health as a difficult area for dialogue and understanding among students. It is also notable that in most of the studies analyzed in this category there have been report on the unpreparedness of students to address social determinants since their training is only focused on the aspects related to the biomedical models [17,[20][21][22][23]. In addition, some studies indicated that students felt ill-prepared to deal with social and structural factors due to the complexity of the demanded care based on the individual needs of patients.…”

“…Nursing practice has been highlighted as an action allowing the visibility of health disparities by students, preparing them to adequately address these issues in situations encompassing various inequalities [17,[20][21][22][23]. Inservice learning contributes to the development of various abilities in students to learn from others through active reflection.…”

“…Regarding the theoretical conception of inequality, most of the reviewed studies have not proposed a specific concept for understanding this theme. In only one article, Mabhala (2013) stated that inequality is approached as a phenomenon built by unfair policies and practices in which such actions benefit certain groups, while neglecting others [21]. Therefore, data is scarce on the theoretical and normative frameworks adopted to understand inequalities in the context of public health.…”

Equidade nos cursos de graduação em Saúde: marco legal, desafios políticos e metodológicos

“…Mabhala 42 identificou no Reino Unido políticas de saúde a partir das quais os profissionais da enfermagem podem contribuir para a redução das inequidades no cotidiano das ações de saúde pública. O conhecimento necessário para incorporar a saúde pública no ensino necessita de uma visão ampla de saúde e refletir e aprender com a experiência e práticas pedagógicas apropriadas.…”