Most of the people who have worked on this resource live, work and play in the traditional territory of the Haudenosaunee and Anishinaabe peoples. This territory is covered by the Upper Canada Treaties and is within the land protected by the Dish with One Spoon Wampum agreement. Our work together is guided by the spirit of this agreement. To the best of our knowledge and abilities, we stand in solidarity with and alongside First Nations, Métis and Inuit Peoples.
This project began in the classroom.
I am an assistant professor in the Faculty of Applied Health Sciences at Brock University. Each year, I teach hundreds of undergraduate health and medical sciences students about the social dimensions of health. We start in a variety of different places, but we always find our way back to the foundational topics of health equity, critical social justice, and human rights. Much of our learning focusses on health disparities: we ask questions about why some people, communities, and nations face threats to their health more often and more seriously than others. And we think about our own relationships to the social and political power structures and systems that shape many of our experiences in the world, and our social responsibilities within those systems. My goal is to help my students see themselves not as passive recipients or actors in an inequitable health system that is inevitable, but as active agents and future leaders who can work together to create something better: something that will work for all Canadians and not just a privileged few.
This is why it is so important that health sciences students learn about implicit bias in their training. Because implicit bias drives many health disparities. And when our unexamined and unconscious assumptions shape decisions, attitudes, and actions in the health system, they can be lethal.
There is robust Canadian scholarship that helps us understand what implicit bias is and how it operates (e.g., Parekh et al., 2021; Sukhera et al., 2018; Sukhera et al., 2019; Ungar et al., 2021). The frequent news reports of the egregious health experiences of Indigenous and racialized people like Brian Sinclair (Puxley, 2014), Joyce Echaquan (Laframboise, 2021), and Yosif Al-Haswani (Clairmont, 2022), provide contemporary examples that emphasize the critical importance of including this analysis in the curriculum for students who are training to be leaders in the allied health sciences. But as I taught about implicit bias in my classroom, my students challenged me. Beyond learning to critically analyze problems, they said, they also wanted to learn how they could be part of solutions. Their tenacious and critical engagement with the research and news stories that I presented to them—so often from a place of radical hope— made me rethink my pedagogical practice. Beyond understanding problems, how could I teach this in a way that equipped my students to become leaders who could actively recognize and interrupt oppressive systems? And how could I give them tools to create solutions that are more equitable and just?
As I mulled over these questions, I met Joe Norris and the cast of Mirror Theatre. This not-for profit company uses a participatory and collaborative approach to promote discussions about social justice. This project grew out of our conversations—and later improvisations—together. The group introduced me to words that are not in my academic vocabulary such as “haunting”. A haunting is an educational encounter that leaves the learner thinking about possibilities and lingering questions: “What happened here that is troubling to us?” “Where is the power in this situation?” “What is my role in what happened?” “How could it be otherwise?” A haunting provides students with the opportunity to play and re-play real life situations that they may face in their careers. Our colleague Sheila O’Keefe-McCarthy from Brock’s Department of Nursing added further insights about the value of this approach in helping students to develop into reflexive practitioners. As our project evolved, we all began to recognize participatory theatre as a powerful medium to interrupt the biases that all of us hold and invite learners to re-imagine their own roles in the health system.
When we had the opportunity to further refine this work through the e-Ontario VLS Learning Strategy Grant we were motivated by the positive feedback from students. We heard many of them describe their surprise at discovering some of their own implicit biases and assumptions, and their appreciation of an experiential opportunity as a complement to their academic work. They no longer saw implicit bias as a health issue that happens “out there” but something that every single one of us needs to pay attention to in our own lives.
We realize that most educators who work in health disparities and social justice are not trained in leading participatory theatre. That’s why we developed this resource. We are all part of a transdisciplinary collaboration that involves leaders from Dramatic Arts, the Allied Health Sciences and Education, and we learn from each other constantly. We hope that the material in this resource will highlight the strategies we use (before, during, and after a workshop) so that you can employ them in ways that are helpful in your own teaching.
All the scenes were directed by PhD student Kevin Hobbs. The combination of his high-level directing skills, his creativity, and his innovative ideas in leading our diverse team was exceptional. Recent MEd graduate Mike M. Metz led the curriculum development and was lead author on Parts 2 and 3. Using his background in education and curriculum development, Mike made an enormous contribution to the curriculum in particular. Nadia Ganesh, an MA student in psychology, conducted a thorough literature review that was foundational to our project. She also used her training in psychology research to design and implement an evaluation so that we could analyze the impact of our workshops. Sheila, Joe and I are faculty members at Brock University, and we all agree that between Nadia, Mike and Kevin, we couldn’t have asked for a more cohesive, talented, and overall remarkable team.
We would like to thank each of the project reviewers (Dr. Kerr Mesner, Dr. Monakshi Sawhney and Dr. Margot Francis) whose input and thoughtful critiques moved this work forward in important ways. We also acknowledge Sandy Howe and the entire Experiential Education team at Brock University. Their insightful contributions to all aspects of this project have been most welcome.
I am deeply grateful for the HLSC 2P21 students (over 600 in total) who participated in this project between fall 2020 and spring 2022. Their encouragement and feedback helped us move this project forward from a haphazard classroom activity to this shareable resource. We are especially appreciative of the 10 students who worked with us to develop and film videos for ‘jokering’ in January 2022: Mohamed Abd Elmagid, Kamryn Di Salvo, Jeanisa Haneiph, Raneem Kalbouna, Madeline Mantler, Katie McCarthy, Youssef Nassar, Rihab Nori, Memie Ramey, and Sajnoor Sidhu. Your enthusiasm for and commitment to this project brought it to a whole new level. Thank you. We have loved working with all of you.
This resource is by no means comprehensive. We hope that it offers one way into a complex and multi layered topic, one that will launch (or re-launch) learners on the lifelong journey of examining our own beliefs, attitudes and assumptions and so that we can better understand our collective responsibilities to one another.
With respect and in solidarity,
Valerie
Dr. Valerie Michaelson, Assistant Professor,
Department of Health Sciences, Faculty of Applied Health Sciences, Brock University
Accessibility:
We have designed this online resource with accessibility in mind, and want to ensure that anyone using this resource has a positive experience. If you experienced trouble with any part of this resource, please get in touch with us by emailing vmichaelson@brocku.ca
Funding:
This project is made possible with funding by the Government of Ontario and the e-Ontario Learning Strategy. To learn more about the e-Ontario Learning Strategy, visit eCampus Ontario’s webpage.
Customization:
This textbook is licensed under a Creative Commons Attribution 4.0 International (CC-BY) license, which means that you are free to:
SHARE – copy and redistribute the material in any medium or format.
ADAPT – remix, transform, and build upon the material for any purpose, including commercial use. The licensor cannot revoke these freedoms if you follow the license terms.
How to Navigate this Resource
2
General Layout
The format of this website may be new for readers and we felt it would be helpful to give a general idea as to the structure of the resource. On this page we describe the various ways you can navigate this PressBook.
First, here is a list of the different sections of this resource. They include: Front Matter, six major sections, 27 chapters, and Back Matter
Front Matter: This is divided into two parts – ‘Preface’ and ‘How to Navigate this Resource’
Section 1: Introduction & Goals (Chapter 1 is included in this section.)
Section 2: Applied Theatre: Facilitation and Techniques (Chapters 2 through 11 are included in this section.)
Section 3: The Scenes (Chapters 12 through 20 are included within this section.)
Section 4: What we Learned in a Large Undergraduate Health Sciences Class (Chapters 21-26 are included in this section.)
Section 5: Becoming Reflexive Practitioners (Chapter 27 is included in this section.)
Section 6: Appendix: Scripts for Scenes (Text scripts for participatory theatre scenes are included in this section.)
Back Matter: This is divided into two parts – ‘References’ and ‘Contributors’
Navigating from the main page
Image 1 is of our main page. By clicking on the ‘read book’ button (circled in red), you will be taken to our ‘Preface’
Image 1: Main Page
‘Flipping’ through Pages
If you are reading this in the order the chapters are presented you can quickly move to the next section by clicking ‘next’ in the bottom right corner (Image 2). Alternatively, if you want to go back a page you can click ‘previous’ in the bottom left corner (Image 3).
Image 2: Next
Image 3: Previous
Using the Contents Menu
If you want to jump through different sections and chapters you can use the contents menu at the top right to navigate the whole book. First, click on the contents menu to open up a drop down list (Images 4 and 5). If you would like to get to the start of a section, just click on one of the different sections or on the Front or Back Matter (Image 6). If you would like to go to a specific chapter click on the plus icon (Image 7) of the section the chapter is within, then click on the chapter (Image 8).
Image 4: Contents Menu Button
Image 5: Contents Menu List
Image 6: Accessing Sections
Image 7: Plus Icon
Image 8: Accessing Chapters in the Contents Menu
Introduction and Goals
I
Implicit biases involve the mental shortcuts that we take without being aware of what we are doing and the attitudes and assumptions that can shape our assessments, actions and decisions in subconscious ways (Greenwald & Krieger, 2006). In the applied health sciences such as nursing, medicine and public health, unexamined biases and assumptions cause already at-risk populations to be at increased threat of inequitable access to health care services and to health promoting resources such as the determinants of health (Banks, Kohn-wood & Spencer, 2006; Fitzgerald & Hurst, 2017). Research (i.e. Pritlove et al., 2019) and reported experiences (Feith, 2020; Gray, 2020) demonstrate the acute impact of implicit biases when they are left unaddressed and the moral imperative to address this in our training of health care professionals in the strongest way possible.
The good news is that our brain can learn to slow down and examine our neural associations and assumptions so that we mitigate the harm that implicit biases can cause in our professional lives and beyond. But we have to be intentional about this work. As scholars and practitioners in the Dramatic Arts and the Applied Health Sciences, we have experienced the value of using applied participatory theatre approaches as a way for learners to explore our implicit biases and develop self-reflexivity.
We intentionally think about learning as a co-reciprocal journey; everyone who participates—from facilitators to students—is involved in a journey of self awareness. Together as co-learners we each bring our unique lived experiences to this shared work and co-reciprocally create new knowledge. We hope that this in turn leads to more self reflexive actions from all of us.
Our main learning objective is that co-learners who engage with this resource will develop a deepened sense of self-reflexivity about the implicit biases that they themselves hold and what the impacts of addressing (or not addressing) these implicit biases may be. In participatory theatre, we often talk about this kind of invitation for self exploration as “a haunting”. Haunting refers to the sense that the thoughts, reflections, and conversations that remain after the educational encounter are etched into the heart and mind of the learner, leaving a lasting impression that evokes further questions and more self-reflexive actions and behaviours. Our purpose is to help people slow down, reflect and recognize that sometimes our responses to situations and people are based on assumptions and that we are guided by implicit biases rather than facts. If we can get in the habit of slowing ourselves down and considering how our biases might be shaping our decisions and conclusions, we can then explore possible alternative interpretations of a situation. This in turn helps us to consider more ethical, just and respectful responses. We hope that this resource contributes to promoting social accountability among our learners.
Our primaryintended audience is undergraduate learners in the applied health sciences. For many of the learners we had in mind when we started on this project, the concept of implicit or unconscious bias was entirely new. We wanted to create an entry level resource for them and for others who feel they are near the beginning of this journey or who have not started it yet, so that they could become more effective health professionals. It’s not just health professionals who need to be attentive to implicit bias though. Everyone has biases and makes assumptions that are unconscious: teachers, police officers, paramedics, parents, political leaders, and even leaders such as judges and arbitrators whose job it is to be unbiased. We hope that people in many different disciplines will make connections and apply the scenes to their own context in ways that are useful.
We present this resource with humility. We developed it from our own social positions and lived experiences as people who self-identify as women and men; racialized and White; gay and straight and we recognize that there are many experiences of discrimination that we do not have lived experiences of as individuals or within our group. The privileges that many of us experience in our lives limit the ways that we can engage in this area of scholarship and action. Through this project, each of us has become increasingly aware of our own biases—the mental shortcuts that we make every day—that prevent us from seeing each other and situations as we are.
This resource can be used free of charge and without permission. You are welcome to adapt it to your own teaching and disciplinary contexts. We hope that it will spark conversations and encourage all of us to slow down, take a step back, and realize our own roles in perpetuating systems of oppression through the unexamined unconscious biases that we hold. This is a lifelong journey and this small resource is meant to be one piece.
Why Drama? Tapping into the Power of Play and Storytelling
1
A participatory theatre approach workshop may seem unusual for a health sciences classroom, but we have seen its potential to create transformative learning experiences. It has the power to transgress the traditional boundaries between stage and audience in order to generate a deep level of engagement from everyone involved in the learning experience.
In the video below, team member Dr. Joe Norris speaks to the power of this type of work. Joe is an arts-based researcher who has over 30 years of experience in participatory theatre. While this video was created for this project, Joe has given similar talks at the beginning of workshops around the world. It may be useful to show this video at the beginning of your workshop or class in order to help learnersunderstand why we are using drama to invite them into this type of transformational work.
Written Transcript of Why Drama? Tapping into the Power and Play of Storytelling.
So why a drama workshop?
Frankly, it is one of the better ways to explore and understand the human condition. It relies on the basic and natural forms of learning, namely, play and storytelling.
We think in many ways, some explain things, like an expository essay, some express things, like stories, dramas and other art forms. Both have enormous value but unfortunately our education system has privileged telling over showing. This workshop utilizes the enormous power of drama.
But this is not that new. In fact, we play daily as we try, or dare I say, experiment with new things such as preparing a meal, redecorating, deciding what to wear and how to interact at an upcoming tense meeting. When we were young, play was our natural way of learning. Think of lion cubs or any newborn animal. By tussling, they learn motor control and social interactions.
As humans, we have extended this to role play. Children continually make up dramas. “I’ll be sick and you be the doctor. Or, you be the teacher and the rest of us will be students.” Through such dramas we learn how to interact socially; the magic of imaginative ‘what if’ in many situations. We come by play honestly and naturally.
AND… we haven’t stopped doing it. Richard Courtney claims that we are all playwrights, yes, playwrights. All of us write many plays a day. However, unlike young children who eagerly participate in public role plays, as adults we tend to make them solitary and private as we relive and pre-live life’s situations in our minds. For example, we may relive an embarrassing moment thinking about how we wished we had done things differently. If I said it this way that could have happened and if I did that way, maybe this. In doing so, we wrote a play.
And we could pre-live a job interview creating our answers to hypothetical questions. Pre-living could be as simple as replotting our way to work based upon traffic and weather. We playwright far more than we think we do. It is a common daily activity, so why don’t we use it more often?
This workshop enables us to return to the power of public play to help us understand various aspects of implicit biases so that we can take our new insight from the pre-living of possibilities to applying them to our future experiences. We use a few stories to serve as starting points to begin the conversation…
Applied Theatre: Facilitation and Techniques
II
Applied Theatre is an umbrella term that is meant to describe a broad set of theatre practices that are simultaneously research methods and pedagogical approaches. They are often participatory and community-based, they foster an awareness of social issues and they exist outside the scope of traditional and mainstream performance theatre (Prentki & Preston, 2009). For this resource, we have used a convention called Playbuilding (Norris, 2009) to devise a series of scenes that pose haunting questions. These scenes can then be facilitated and discussed with learners.
This next section is for facilitators for whom the conventions of participatory theatre may be new. We outline a variety of ‘facilitation techniques’ that you may find useful. Our goal is not to prescribe what to do; rather, our aim is to provide a framework and techniques for exploring implicit biases as you use the scenes in your own pedagogical context.
Emily Style (1988) notes that curriculum functions as both a window and mirror. As a mirror, learners should be able to see themselves reflected within the content. As a window, learners should also be able to see the perspectives and experiences that are not of their own. This participatory method of co-reciprocal learning functions in a similar manner. Within this work, learners should be able to reflect upon experiences that relate to themselves while also being introduced to new experiences and perspectives. Beyond the value of definitions and case studies about implicit bias, our experience is that this method is well-situated to invite learners to go further. It invites learners to become more aware of the implicit biases that they themselves hold and to consider their own decisions and actions in new ways in the future. We recommend that you start slowly. Over time, we hope that you will become comfortable facilitating this cooperative learning approach.
Facilitation and the Joker
Facilitating through Applied Theatre techniques can add insights that cannot be gleaned through conversations alone. The scenes in this resource initiate conversation by providing concrete examples of situations. Relying on problem-based learning strategies (Hmelo-Silver, 2004), they ask co-learners to consider “what is going on here?” and “what might be done differently?”
While viewing the scenes (either as a whole class or in small groups), the facilitator of the workshop works with the class to navigate meaningful and sometimes challenging conversations. Beyond eliciting discussion about a scene, the goal is to utilize drama techniques in order to enable learners to re-envision the scenes. In re-envisioning the scenes, learners also re-envision new possibilities for future behaviours. In participatory theatre we refer to the person who facilitates this dialogic process as the ‘Joker’.
The Joker (or facilitator) acts as an intermediary, bridging the interactions between the scenes and the participants (Boal, 1992). The Joker listens deeply and guides the learners by proposing ways to explore the scenes further through a series of jokering techniques. (We introduce you to many of these jokering techniques in chapters 2-11). It is important that the Joker adopt an amoral stance (Norris, 2009), taking care not to provide prescriptive answers that can quickly shut down conversations. Instead, the Joker should dwell on an imaginative ‘what if,’ and enable learnersto take an active role in their own discovery and learning.
Activating Scenes
The scenes that we created for this project were designed to be “activated” by the Joker. As Rohd (1998) describes,
“an activating scene grabs everyone in the room. It’s a scene that you create with your group. People need to care about it, recognize it, and be pulled into the drama of it. Most important, people must want to effect change in what they see. They need to see a clear opportunity to get involved and to explore options. An activating scene does not show what to do. It does not have a message. It asks what can be done” (Rohd 1998, p. 97).
When watching the scenes learners may find themselves faced with all kinds of emotional responses: discomfort, annoyance, anger, guilt, excitement, empathy, confusion and more. None of these emotions are right or wrong. Indeed, these emotions are indicators that the scenes are activating. The Joker (or facilitator) must pay careful attention to the kind of space that is created in the room while the workshop is being presented. It is the Joker’s responsibility to shape a space that is open to exploration, that is attentive to safety, risk and courage and that respects the unique needs and journeys of all involved in the learning encounter.
Table 1 provides a brief description of many jokering techniques. These techniques are adapted from the first edition of Playbuilding as Qualitative Research an expanded version will also be available in the forthcoming second edition (Norris, J., Hobbs, K., & Mirror Theatre, 2023). We provide specific details on each technique in chapters 2-11.
These jokering techniques are used to invite participation, but participation should never be forced. If these scenes are being used in an academic context where grading is involved, we strongly discourage attaching grades to participation in the scenes.
Table 1. Jokering Techniques
Technique
Description
Remote Control
As a scene is playing, the Joker can use an imaginary remote control to pause, rewind, or fast forward the scene in order to look closely at different moments or perspectives.
Tag Team
As a scene is playing, a participant or the Joker can pause/freeze the scene. A volunteer switches places with one of the current actors and re-plays the scene with new insights or exploring a different idea.
Hot Seating
This technique involves someone assuming the role of one of the characters in the scene. The audience can then ask questions to this “character.”
Voices for and Against
Here, a tug-of-war situation is created. Two participants play the scene with one ‘for’ and the other ‘against’ a problem (issue, or possible action) while a third participant is in the middle, deciding what action or stance to take. This involves the audience providing suggestions to both positions of ‘for’ and ‘against.’
Out Scenes
Co-learners are invited to construct scenes that might happen before or after the scene being workshopped. The might also construct scenes with different characters that could connect to the original scene.
Image Theatre
This technique involves physical or verbal sculpting of a partner’s body into an image relating to an issue or moment in the scene.
Inner Dialogue
Scenes are paused (using the remote control) in order to witness the inner thoughts of characters. What are they really thinking in this moment? How might it differ from what they are saying?
Voting with your Feet or Mentimeter/Chat Bursts
This involves generating group perspectives in order to illicit discussion. In person, learners would move to one side of the room or the other in order to indicate preferences. Online, participants would vote in the chat and/or use an online word cloud to achieve a similar effect.
Index Cards
This technique for expressing ideas involves writing comments or prompts anonymously. This approach is lower risk than expressing ideas out loud. The index cards are collected and then can be shuffled and used to generate new scenes, directions, or discussions.
Further reading on Applied Theatre and Jokering
Boal, A. (1992). Games for actors and non-actors. Routledge.
Kandil, Y., & Freeman, B. (2022). Applied Theatre. Canadian Theatre Review, (Winter, Special Issue).
Neelands, J., & Goode, T. (2015). Structuring drama work. Cambridge University Press.
Prentki, T., & Preston, S. (2009). The applied theatre reader. Routledge.
Considerations for Representation in Implicit Bias Work
2
In the video below, team member and Impact Research Lead Nadia Ganesh, speaks on representation in applied theatre work on implicit bias.
As we began to film scenes for this Implicit Bias project, we often would switch roles between actors, as we normally do. In Mirror Theatre, we usually believe that characters can be played by almost any member. But while we were exploring Implicit Bias, we began to realize that this project required specific care, because many characters’ experiences are particularly relevant to their actor’s marginalized identities. For one thing, this is about representation, which can be very important in spreading and amplifying the voices of marginalized communities, who often feel unheard or ignored. I’ll give you an example: in the scene called “Role Call”, Rosie’s character experiences a microaggression by being the only student to be asked “where she is from” on the first day of class, rather than more benign questions that the rest of her White classmates received. Being asked where one is from is a common experience of people of colour and this question often can be perceived as expressing beliefs that we do not belong here. We might feel that way even if it wasn’t the intention of the person asking the question. As a person of colour, I relate to this story because I have also experienced similar questions of my origin, and these types of questions make me feel othered, even though I was born in Canada. This microaggression is specific to being a Person of Colour, because people of colour as a group experience being asked where we are from far more often than White people. So in this scene, if we were to recast Rosie with a different person of colour, we would still be drawing upon the lived experiences of people of Colour. But, if we were to recast this character with a White person, I believe that this would undermine the fact that this is a microaggression particularly faced by People of Colour. Not only would it be changing the intention behind the scene, but it would be ignoring their lived-experiences and the additional marginalization and discrimination that we experience as People of Colour. As a Person of Colour, if I were a student learning through the facilitation of this scene, I would feel hurt if a professor were to recast this character as a White person. I would feel like this would discount or even erase my similar lived experiences to Rosie’s character. However, recasting Rosie’s character as another Person of Colour, would still honor the lived experiences that inspired this scene.
The scene I just described is one of the early scenes that we developed. We soon realized that representation could become an even stickier topic. For example, in the scene entitled “Missed Interpretations”, my character is mistaken as a babysitter to her own children. This is yet another experience that is common for Woman of Colour. The scene was actually inspired by the lived experiences of Dr. Boni Wozole, who is herself a woman of colour. In rehearsals, we discussed the possibility of substituting the actor playing my character with a White woman, and whether this could result in discussion on how we interpret behaviour depending on the race of the character. We became more and more aware of how complex the issue or representation is and we started considering it very deeply. I personally feel that if we were to recast my character to be portrayed by someone White, the recasting could be seen as diminishing the lived experiences of Women of Colour. This could also lead to ignoring how much more common this type of experience is for women of Colour compared with White women, and it could be hurtful and diminishing to Women of Colour students who have similar experiences to my character.
There is more: recasting this character as a non-Woman of Colour might encourage participants to think that their own levels of marginalization are equivalent to other people’s experience of marginalization. For example, a well-intentioned White woman portraying my role may later believe that the sexism that they experience is equivalent to the racism that Women of Colour experience, which is untrue and both hurtful and harmful to Women of Colour. Making sure that my character is represented as a Woman of Colour encourages participants to learn of the unique discrimination faced by Women of Colour compared to other marginalized groups.
Marginalized students are often particularly encouraged or ‘voluntold’ to be vocal when topics of race/gender/discrimination etc. come up and I personally can attest to the fact this can place a great deal of pressure and mental and emotional energy on marginalized students to describe and clarify their experiences of marginalization to their peers. If marginalized students don’t want to roleplay marginalized roles, this is important to respect.
My overall takeaway is that we should respect that some of these scenes were inspired by the lived experiences of marginalized groups by ensuring that these roles are portrayed by people belonging to the groups. Although we hope that our program will assist participants in gaining the ability to perspective take and learn insights on what it may be like to experience marginalization or bias, we acknowledge that taking part in short improvisational situations will never be enough to truly understand the lived experiences of people who belong to marginalized groups that we are not apart of. In fact, as much as we can try and perspective take, empathize, it’s impossible to truly understand their experiences if we do not belong to these groups. This workshop isn’t about learning what it’s like to be a part of a marginalized group—it’s about learning about our own biases and working to reduce them so that we can all be better people.
Representation is a challenging issue and there isn’t always a right or wrong answer about what we should do. In fact, our team has often-times struggled with issues surrounding representation, trying our best to be as respectful as possible while realizing we, ourselves, aren’t always sure how to approach it. I believe that drawing upon the lived-experiences in the room will both aid in allowing students to gain perspective on the experiences of marginalization while still being respectful of the lived-experiences of prejudice and discrimination experienced by specific marginalized groups.
As facilitators of this program, you have the opportunity to really listen to your students, particularly the marginalized students who will have similar lived experiences to the characters in these scenes, on how to tackle any issues of representation. We are all on the lifelong journey of reducing our bias together and representation is one way we can attempt to ensure that our students feel comfortable and safe when exploring topics of bias. Thank you!
Remote Control
3
The Remote Control is a general technique that can be applied to any scene that is being acted out live. As one might use a remote control for a TV, our Remote Control has many different functions:
You can pause a scene. For example, when a scene is re-enacted or replayed, the Joker can ask the audience to raise their hands when they perceive a misuse or abuse of power. When a hand is raised, the Joker yells ‘pause.’ The actors in the scene instantly freeze or the video is stopped. The person who raised their hand speaks on why they chose to pause in that moment. The scene (if performed live) can be re-directed as an Out Scene as a result of this. If learners were initially watching the video, they can try reenacting the scene live and pausing in this way.
You can also rewind a scene to go back to an earlier moment, maybe one that we have not yet explored. The Joker (or audience member) suggests a return to this point and asks the character what they were thinking at this moment. The character can also be asked to consider what they wanted to happen in this situation or how they imagine things could have gone differently.
You can fast forward the scene to later in the day, week, etc., to see how the characters have or have not changed since the original moment of the scene.
Considerations while Jokering
Begin by having the facilitator/Joker hold the Remote Control. As the co-learners become more confident, they may also hold the Remote Control and use it to explore new insights in the scene.
Mimicking fast-forward and rewind sounds can be fun for bringing a light sense of humour to the room if the Joker senses that it is appropriate.
Examples for using the Remote Control
As the Remote Control is a general technique, you may find yourself using it at any point where learners are enacting a scene. You may want to pause what is happening for open discussion, or rewind to highlight a certain moment.
Tag Team
4
Tag Team is another general technique that can be used while scenes are playing. The Joker instructs that at anytime an audience member can ask the actor(s) to stop (freeze) so that they can switch places with one of the audience members/participants. When the scene is re-played or continued, the new actor might bring a completely new interpretation to the character and offer new insights to all learners.
No one person needs to continue in role until the re-enactment has completed. Others can take their place and often this leads to new discovery. For example, if you are using Voices For and Against, anyone can ‘tag team’ and take the place of another. This keeps the process collaborative and dialogic.
Considerations while Jokering
If you see a freezable moment that co-learners may have missed, consider freezing the scene and either switching into the scene yourself or inviting another learner to switch places with a character.
Rewind the scene a few seconds back to allow the new learner who has joined the scene to arrive naturally to the moment they wanted to explore through pausing the scene.
Always invite participation, but never force.
Examples for using Tag Team
As this is a general technique, this can be used at any point where participants are enacting a scene or playing a role.
Hot Seating
5
Hot seating is a useful way for a group to explore and gain more insights about a particular character’s motivation in a scene. Hot seating involves a volunteer taking a seat and assuming the role of a character. The audience is then free to ask the character open questions while the Joker acts as a mediator. Depending on how the volunteer develops the character, the audience gains much more insight into what might be going on in the character.
Considerations while Jokering
Being in the hot seat can be a high-pressure task for some learners. Consider taking on the role yourself for certain characters. Do not force or cajole people to take the hot seat.
After hot seating the character, replay the scene with the new insights that have been gained. Explore how the scene plays differently.
Exercise caution when it comes to role-playing. While we want to encourage active participation, we must also be aware that when we take on a role, we are doing so with dignity and respect for the diversity of each particular character. Please exercise care to avoid misrepresentations and stereotypes. It is important to discuss this openly with the co-learners in your group. If the character to be hot-seated is marginalized based upon their race, gender, ability status, etc., then non-marginalized persons should not play these roles. (Please see the video in Chapter 2 for more thoughts on representation from team member Nadia.)
Examples of Hot Seating
What’s in a Title? (See Chapter 14)
Labels (See Chapter 16)
Role Call (See Chapter 17)
Voices For and Against
6
Often characters in scenes come to a cross-road. Do I say something or stay silent? Do I get involved in the situation or not? These decisions can play out as a mental tug-of-war. In this technique we bring this mental tug-of-war to life. One learner assumes the roles ‘for’ and another assumes the role ‘against.’ They each attempt to influence the decisions of a third character who stands in the middle. This technique usually involves three volunteers:
Person A assumes the role of the character in the scene who is experiencing some sort of dilemma and needs to make a decision.
Person B plays the inner dialogue of Person A, arguing for a certain decision.
Person C plays the inner dialogue of Person A, arguing against a certain decision.
These inner voices can offer ideas, cautions and new perspectives. After a couple of ideas have been explored ask for other audience members to give ideas both for and against. Once a number of arguments on both sides have been given the Joker instructs Person A to make a choice, based solely on the ideas that were given in this situation.
Considerations while Jokering
Know your group. If this would be fun and comfortable for your group, have Person B and C hold both wrists of Person A, gently pulling to their side, as if they are creating the tug-of-war.
Sometimes the final decision of Person A is not the expected outcome. For example, in a past workshop on Academic Integrity, a student chose to cheat on a test! As Joker, it is important to respect the decision of the volunteer. And often, these are the decisions that happen in real life. If this happens, see this as a teachable moment.
Sometimes leaving the decision of Person A hanging is the strongest option.
After the tug-of-war, have Person A replay the moment in the scene where they need to make a decision. What does the scene look like?
This activity may lead to a rich discussion about the forced binary nature of many decisions we make. Is it possible to reach a conclusion that is not either/or, for/against? What would a non binary decision look like in this situation?
Sometimes “Voices for an against” is confused with the cliché of the ‘devil and angel.’ This should be discouraged; using metaphors of the devil and angel implicitly communicates to an audience that one position should be preferred over the other. With ‘for and against,’ all options should be considered.
Examples of Voices For and Against
What’s in a Title? (See Chapter 14)
Donation (See Chapter 15)
Out Scenes
7
As the Joker guides learners through problems that require solving, sometimes creating a new scene allows for further investigation of the original scene. An out scene could be something that happens before or after the initial scene that is being workshopped. In addition, one can also create side-scenes with characters who may not have originally been in the scene. An example of this could be used in But I’m a Good Person. Have two learners play the characters of Kevin and Jordan. It is suggested that Kevin and Jordan have a conversation in which Jordan expresses her concerns about Sheila’s performance but we don’t see this conversation. What might it have looked or sounded like? What conversation might Sheila have later that night when she goes home and reflects on her day with a family member or friend?
Considerations while Jokering
Through the nature of role play, Out Scenes can be a higher risk form of participation for learners. We recommend that you use techniques such as Voices For and Against or Inner Dialogue before moving on to creating full scenes.
Examples of Out Scenes
What’s in a Title? (See Chapter 14)
Role Call (See Chapter 17)
Missed Interpretation (See Chapter 18)
But I’m a Good Person (See Chapter 19)
Better? (See Chapter 20)
Image Theatre
8
This technique involves physical or verbal sculpting of a partners body into an image relating to an issue or moment in the scene. As there is no dialogue in Image Theatre, audience members might interpret images differently. This technique can also involve ‘re-sculpting’ images in order to generate new meaning. Images created may be realistic or metaphorical, lending to a variety of interpretations. (See Who Would You Like to Work With? in chapter 12 for an example of Image Theatre.) An extension to this activity would be to take one sculpture or image and have the audience re-sculpt it to gain new meaning. (See Better? for an example of this technique.)
Considerations while Jokering
If learners are standing as statues, give them time to rest as needed.
If a learner is re-sculpting and physical contact is being proposed, always ensure consent before beginning. If the person being sculpted declines contact, this must be respected with no questions asked. The sculptor will then give verbal instructions for the re-sculpting of the statue. Verbal instructions for sculpting is an alternative for online facilitation.
Examples of Image Theatre
But I’m a Good Person (See Chapter 19)
Better? (See Chapter 20)
Inner Dialogue
9
Through inner dialogue, we can pause key moments of the scene to gain more personal insights into characters’ thoughts that the character may not say aloud. The Joker can use inner dialogue during re-enactments or out scenes in order to add additional layers to a situation. For example, if there was a re-enactment of Missed Interpretation (Chapter 18), what were these characters thinking during the silence that is part of the scene? How do their thoughts differ from what they might say out loud? What might this tell us about how people react when they recognize their own biases?
Considerations while Jokering
Ask those presenting inner dialogue to speak in the first person, not third. This establishes a stronger sense of belief.
If comfortable and consent is given, have those speaking the inner dialogue gently place their hand on the shoulder of the character they are giving the inner dialogue for.
Examples of Inner Dialogue
What’s in a Title? (See Chapter 14)
Labels (See Chapter 16)
Missed Interpretation (See Chapter 18)
Voting with your Feet
10
When working with large groups it can be a difficult task for the Joker to quickly see how people are responding to certain things that are happening. Using the technique “Voting with your feet,” we invite learners to get on their feet and respond to questions by standing in specific areas. For example, in Who Would You Like to Work With (Chapter 12), we might ask learners to stand behind the statue that they would most like to work with in a group project. This can give us quick surface level insights of the choices that co-learners are making and enable us to move into a deeper discussion as to why certain choices were made.
This can also be utilized as a Likert Scale. The middle of the room represents ‘neutral’. The far ends represent ‘strongly agree’ or ‘strongly disagree’. Participants answer a question by positioning themselves across the room. For example, in How Can I Help You? (Chapter 13), choose one of the voices and ask participants how sincere they believed the voice to be. On one side would be ‘very sincere’ and the other side would be ‘not sincere at all’. Participants then “vote with their feet” to indicate their preferences along an imaginary Likert Scale in the room.
Online Variation: Mentimeter and Chat Bursts
When we moved to performing in online formats during the COVID-19 pandemic, we wanted to recreate this technique to fit an online format. First, we use the chat to create a ‘chat burst.’ This involves all participants voting in the chat all at once. For example, in Who Would You like to Work With? (Chapter 12), we ask participants to choose the statue they would most like to work with by entering a number from 1-6 in the chat (see Image 1 in Chapter 12). This gives a general idea of participant’s initial preferences and offers a launching point for discussion. You may ask why certain people chose certain statues or highlight that only one or two people chose another.
After discussion, we use Mentimeter. This is an online presentation tool that allows learners to respond to prompts in real-time and so to further delve into perceptions and assumptions about one of the statues in Who Would You like to Work With? As the Joker, choose one of the statues and prompt participants by asking them to describe the statue in up to six separate words. Mentimeter will then create a word cloud that will enlarge the words that have been written by multiple participants. This can spark discussion on the variation of words that have been chosen. During the debrief, juxtaposing different perspectives can generate insightful discussions.
Considerations while Jokering
Who Would You Like to Work With? is a image-based scene with no audible dialogue. As a contrast, we have also created a second version of this scene: How can I help you? This second scene uses voice only and has no visible content. Depending on your context, one of these scenes may be more useful than another. (For example, if you are training learners to be Telehealth leaders, the audio only version may be extremely useful in exploring potential biases that might come into play during voice only Telehealth calls.)
You may also want to use both Who would you like to work with? and How can I help? you as a way to introduce a discussion on the assumptions we make when we have only visual or only audio information in isolation.
Examples of Voting with your Feet
Who Would You like to Work With? (See Chapter 12)
How Can I Help you? (See Chapter 13)
What’s in a Title? (See Chapter 14)
Index Cards
11
Writing—or simply jotting down ideas— can be a powerful tool for reflection. We often use index cards (or cue cards or small pieces of paper) to enable learners to participate in a manner that many experience as lower risk. For example, we might ask participants to jot down ideas on separate cards about something related to one of the scenes: things like a time they made a mistake or a time they once felt judged. They would then have the opportunity to share if they wanted to. We also might invite participants to write while assuming a role. For example, the Joker could ask learners to assume the role of a co-worker of someone in one of the scenes and write them a letter.
Considerations while Jokering
Index cards can serve as a good tool to ease participants into the workshop. We suggest building upon this lower risk activity and trying some of the more active jokering techniques as well.
If the Joker is asking learners to write about something personal, ensure it is clear that sharing publicly is optional but never mandatory.
Examples of Index Cards
Donation (See Chapter 15)
Missed Interpretation (See Chapter 18)
The Scenes
III
Thank you to the Actor/Research/Teachers (A/R/Tors)We use A/R/Tors as an overall descriptor for Mirror Theatre members. of Mirror Theatre in the devising and performing of the scenes for this module:
Kevin Hobbs (director), Dani Shae Barkley (stage manager), Taissa Fuke, Bernadette Kahnert, Rosa Moreno-Zutautas, Abby Rollo, Rosie Torres Hernandez, Jordan Tzouhas, Wang Yan (Angie), Xia Xiaoyang (Nick), Joe Norris, Michael Metz, Nadia Ganesh, Sheila O’Keefe-McCarthy, Valerie Michaelson, Lindsey Abrams, Lindsay Detta, & Candice De Freitas Braz
Mirror Theatre continues to provide workshops to assist those focusing on implicit bias and other social issues. If you would like to bring Mirror Theatre in for a workshop, or for more information on Mirror Theatre’s work, please visit mirrortheatre.ca
We have developed nine scenes that we invite educators to use as they incorporate teaching on Implicit Bias into their learning spaces. In the following section we include the scenes themselves and also ideas for facilitating/jokering the scenes. We have been intentional in ordering the scenes so that they are scaffolded in terms of how we view their depth of content and risk level for participation. Instructors have the option of using the scenes in a different order if that works better for their learning setting and goals. We have also suggested jokering techniques for each scene based on our own experiences of facilitating them. However, the possibility of how to Joker each scene is virtually unlimited. We think that facilitators will find it useful to consider any number of the jokering techniques that we introduced in the previous chapter. We encourage jokering rather than simply discussion whenever possible as jokering techniques move us beyond preset ideas to consideration of what else might be possible. Discussion can then be utilized more effectively during a debrief of the role.
Table 1 provides an overview of the scenes available, their respective jokering techniques as well as the topic risk level and dramatic skill level. (Both are described in more detail in Table 2.)
Table 1: Scene Layout
Scene
Suggested Jokering Techniques
Topic Risk Level
Dramatic Skill Difficulty
1. Who Would You Like to Work With?
Voting with Your Feet/Mentimeter and Word Burst
Low
Low
2. How Can I Help You?
Voting with Your Feet/Mentimeter and Word Burst
Low
Low
3. What’s in a Title?
Hot Seating
Voices For and Against
Inner Dialogue
Out Scenes
Voting with your Feet
Low
Low to High
4. Donation
Voices For and Against
Index Cards
Medium
Low
5. Labels
Inner Dialogue
Hot Seating
Low
Low to High
6. Role Call
Hot Seating
Out Scene
High
High
7. Missed Interpretation
Inner Dialogue
Index Cards
Out Scene
High
Low to High
8. But I’m a Good Person
Image Theatre
Out Scene
High
Low to High
9. Better?
Image Theatre
Out Scene
Low to High
Low
Learning Outcomes of the Scenes
As we cannot foresee what discussions and discoveries will emerge in this process of co-reciprocal learning, we do not prescribe specific outcomes for each scene. However, the scenes are all intended to be used in a way that is in keeping with our overarching learning objective for this project: that learnerswho engage with this resource will develop a deepened sense of self-reflexivity about the implicit biases that they themselves hold and what the impacts of addressing (or not addressing) these implicit biases may be.
This process is important to the principles of participatory theatre: that learning outcomes are not framed as prescriptive goals but as an invitation to discovery. They are framed as questions that can be open up, explored, and reflected on in an infinite number of ways. Indeed, Osberg and Biesta (2008) note the limitations of prescribed goals in educational settings in that they constrain the kinds of discoveries that can emerge in the classroom. By using this approach, we hope that participants will be better equipped to address, identify and interrupt injustices both externally around them and internally inside themselves.
In section four (“What we learned in a large health sciences class”), we provide important contextual information and insights about how to use the scenes effectively and ethically. This includes principles for preparing our learners to engage with the scenes and debriefing with them afterwards. We hope you will consider this section carefully as a complement to how to use the scenes themselves.
Organization
Table 2 describes the organizational flow for each scene and how to use each part.
Table 2: Organization of Scenes
Section
Description
Description
These are short descriptions of each scene to give a sense of what the scene is about and what themes will be addressed during facilitation.
Topic Risk Level
We define risk level as the level of risk involved in participating based on our suggested jokering and facilitation techniques. We want to recognize that the risk levels stated are general and can still vary depending on the discussions had and the subject matter of the scene. We suggest that before moving on to medium or high risk scenes that you have done some work with your group to build trust and have practiced in having challenging conversations.
Dramatic Skill Difficulty
Some people are comfortable role playing while others are happy providing input as observers. The activities suggested within the jokering techniques require various degrees of involvement, ranging from discussion to role play. We have ranked them accordingly. All of these have been successfully used with participants who have no acting experience. We encourage participants to explore these scenes by actively engaging as this will enable them to gain insights that cannot be gained through discussion alone.
Watch the Scene
YouTube links to videos of the scenes. (All of these videos include subtitles.)
Jokering and Facilitation
These are the suggested jokering techniques that we have found to work well as we have used these scenes.
Initiating Questions
These are additional discussion questions that can be posed to the group in addition to the jokering. Groups can spend a long time with one individual scene so it is important to budget enough time for discussion.
Virtual Variation
For some of the scenes, we suggest virtual modifications.
Spotlight on Jokering
Thanks to some volunteer health sciences students from Brock, we have filmed an online workshop to demonstrate what jokering a selection of these scenes could look/sound/feel like. Where appropriate, we have attached a YouTube link to these workshop clips.
Logistics
As you get ready to use the scenes, here are some logistical considerations. The following list is not a set of instructions, but rather a description of some of the things we have experienced and found useful.
Time: We expect each scene will take anywhere from 20 to 60 minutes depending on the size of your group and the facilitation strategies that you employ. Please leave enough time and space for rich discussions and for sharing that may involve complexity. Rushing through the scenes can be frustrating for everyone who is involved. In the many times we have done this program, we have never run out of things to discuss and we have often wished we had left more time for a discussion to unfold organically.
Scene Order: We have designed the scenes so that you can use all of them progressively or use them one at a time. You will find different scenes useful for exploring different topics. Each scene is labelled with an associated risk factor (see above table). We recommend that you start with lower-risk scenes before moving to medium or higher-risk scenes.
Set-up: We have found it helpful to work in small groups of six to eight people during facilitation. Scenes such as Who Would You Like to Work With? and How Can I Help You? were designed with whole-group facilitation in mind.
Virtual platforms: We have conducted this workshop in both virtual and face-to-face settings. In online settings, we recommend inviting learners to turn their cameras on, but respecting that some may not be comfortable or able to do this. In order to be inclusive of various participation needs, styles and comfort level, we recommend using the chat function as an alternative form of communication. We have included a ‘virtual variation’ for guidance in facilitating some of the scenes.
Who Would You Like to Work With?
12
Description:
In Who Would You Like to Work With?, six different statues are presented to the audience. This introductory activity begins to ask important questions about what initial assumptions we might make about people without even realizing it.
In this scene, we ask learners: “If you were to do a group project, based solely on what you can see of these statues, who would you most want in your group?” We then ask them to ‘vote’ by either going to an area of the room that represents one of the statues or by raising hands. This is the first step in understanding what underlying assumptions one might make that impact their decision making. Once they have voted, you can ask co-learners to reflect on what was going on internally as they made their decisions.
After a first discussion, choose one of the statues. It can be interesting to choose a statue one that received very few or no votes. Invite learners to come up with words that they might associate with that statue. Through this process we can deepen the discussion around underlying assumptions. We have found that learners are very surprised to hear that others in their group or class have interpreted the statue very differently than they did.
Initiating Questions
What was your decision-making process in picking the statue you chose? (A possible prompt is to ask learners to consider if it was a physical characteristic, a facial expression, something about the pose they stuck, or something else altogether.)
Based upon your decision, who would you be least likely to work with and why?
What words might you choose to describe this statue? Please explain your choices.
If two opposing words were given to describe the same statue, explore how different people can interpret a situation or person very differently even when they have the same information. What does this tell us? Accept all interpretations as valid.
Virtual Variation
When using this scene in an online format, we follow a similar process but show learners a still image of the six statues with a number over each statue (See Image 1). We then ask learners to choose who they would most want to work with by creating a ‘chat burst.’ This involves asking learners to type the number of the person they would like to work with and hitting enter at the same time. We continue jokering this scene by using Mentimeter.com. We choose one statue to discuss in depth and ask learners to follow a link where they are invited to input up to six words that they think describes the statue. We use this to create a word cloud of the learners’ choices. We then discuss the variation in the words in the word cloud.
Image 1: 6 Statues
Spotlight on Jokering
Watch a virtual workshop of the scene in the video below.
The scene Who Would You Like to Work With? contains video with no audio. We also felt it important to create a complementary auditory version of the scene that could be used to joker similar themes. We encourage that you choose one of these scenes to best fit your own context and the needs of your learners.
In How Can I Help You?, we hear four voices saying the same sentence. What assumptions do we make based upon vocal qualities such as tone?
Similar to Who Would You like to Work With?, we can joker this scene by asking learners “if you were to be involved in a group project, based solely on what you can hear from these voices, who would you most want in your group?” Participants can vote by going to certain areas of the room or raising their hands. From here, learners can have discussions about why they chose certain voices over others and delve into why some tones might not be interpreted as ‘appealing’ over others. We can also joker this scene by thinking about a health situation and ask “Who would you want to help you?” Explain your decision.
Initiating Questions
What was your decision-making process in picking out a particular voice over the others?
Who would you be least likely to work with (or choose help from) and why?
What overall assumptions do we make based on how we hear people?
How can we relate this to a health sciences context? How might this play a role in equipping leaders in health settings such as Telehealth?
Virtual Variation
The Joker can share the audio of the voices, and ask participants one at a time to vocally provide their first choice. Since Mentimeter cannot be used, ask them to provide orally up to three one-word descriptors for each voice. Have the participants prepare their words in advance of listening to the words of others.
What's in a Title?
14
Description:
What’s in a Title? presents eight different variations of a similar encounter that explores preferences characters have in the titles that are ascribed to them. Through this scene, learners can discuss assumptions that are made based upon perceived gender, including homophobic and transphobic microaggressions. Additionally, the scenes prompt us to think about how implicit biases around gender exist systemically. Even something as seemingly innocuous as a questionnaire can be embedded with biases about what responses are possible—and what responses are not.
Topic Risk Level: Low to High
Dramatic Skill Difficulty: Low to High
Note: These are eight small vignettes that have been combined into one video. You may choose to use the entire video, or you may want to use one or a combination of the vignettes. Our facilitation and jokering section is divided into 2 sections: general jokering ideas for all scenes and specific jokering ideas for specific scenes.
Facilitation and Jokering: General
Hot Seating
In Hot Seating, learners can take on the role of any one of the characters such as the person asking questions or the person answering. Here, we can ask questions like “Why did you assume that they went by Mr. or Mrs.?”
Voices For and Against
In a number of the small scenes, characters questioned whether or not to correct the questioner regarding their title. We can gain deeper insights about these decisions to speak up or not by using “voices for and against” to joker this scene. One side can represent “for,” one side can represent “against,” and a learner in the middle can be left to make a decision. Some people have this kind of experience frequently; this scene invites exploration of the many reasons that people may feel not able to speak up.
Inner Dialogue
What might the in-the-moment thoughts be of characters who have been misidentified? Here we can replay the scenes and pause at specific moments to glean more information about how different people might react in certain situations.
Facilitation and Jokering: Specific
Scene 1: Man Asking Preference: “Wife Prefers”
Out Scene – Rescue the Situation (higher skill)
In this sub-scene, we see an encounter where the questioner assumes that Taissa has a husband, yet she responds that she has a wife. Any one of us can make mistakes or presumptions about another person. But what do we do with those mistakes? When someone has made an untrue assumption about us, how can we ‘rescue’ these situations, respecting all individuals involved? Invite two learners to replay the scene and have the questioner improvise a new line after he learns that Taissa has a wife.
Scene 2: Woman Asking Preference: “Wife Prefers”
When used in tandem with Scene 1, Scene 2 can open the room to intriguing discussion on bias.
Is there a difference between a woman asking these questions and a man asking these questions? While both scenes hold the same dialogue, what assumptions might we make based upon the perceived gender of the person asking?
Scene 3: Woman Asking Preference: “Husband Prefers”
Discussion: Do you think that people tend to generalize what a female and male point of view might be? Explain your answer.
Out Scene (higher skill): Create a scene where the ‘husband’ and ‘wife’ discuss this choice prior to their wedding.
Out Scene (higher skill): Create a scene where the ‘husband’ and ‘wife’ have a discussion after this encounter.
Scene 4: “Actually it’s Doctor”
Voices For and Against (lower skill): Create a voices for or against tug-of-war based on whether or not the character should correct the questioner. What risks are associating with correcting a title? Are there different risks depending on the gender identity of the person doing the asking and the gender identity of the person who has been mis-identified? Does the character potentially open herself up to further biases if she corrects the questioner? Do you think that this character should correct the questioner or not?
Scene 5: “Doctorate in Nursing”
Voting with your Feet/Chat Burst (lower skill): The character explains that he has a doctorate degree in nursing but is told not to share that information as it would confuse the patients. What do you think? Would this information confuse the patients or not. Are there common gendered assumptions that people make about ‘doctor’ vs ‘nurse’?
Out Scene (higher skill): Create a new scene between the Doctorate in Nursing having a conversation with management insisting that the title Doctor be used.
Scene 6: “Mr.” is Assumed
Discussion: Not all cultures distinguish marital status. In Canada, why do we distinguish women as married/unmarried with words like Mrs. and Miss, but not men? Are these assumptions based on implicit biases? Explain your answer.
Out Scene (Higher Risk): Have a debate between two betrothed whether or not to wear rings. Debrief society’s beliefs on martial status declarations.
Scene 7: Pilot
Do you think that occupations are gendered? Are some more gendered than others? Give some examples to back up your ideas.
Voting with your Feet (lower skill): Based upon the Pilot’s tone, did she seem offended by the assumption that she was a flight attendant? Should the questioner attempt to rescue the situation by saying something more or move on to the next question? What would pros and cons of each approach be?
Scene 8: Mx
Out Scene – Elevator Pitch (lower skill): Questionnaires are often systemically biased, and prioritize binaries of male and female while leaving out a broad scope of gender identities or simply putting all non binary identities under the umbrella term “other.” Invite learners to create a new and inclusive demographics questionnaire. What would it include? What might be omitted or replaced? Download a PDF example of a demographics questionnaire that we developed for this project as a starting point for discussion.
Discussion Questions:
Is it possible for a questionnaire to be implicitly biased?
Often, questionnaires will have an ‘other’ section. Is ‘other’ an appropriate word? Are there risks or disadvantages that come with using the word ‘other’ to describe a person? Why or why not?
Initiating Questions
How do titles establish status and social positioning?
What are the social justice implications in such positionings?
What title do you personally prefer? Does your preference of title change with your context?
Do you think the titles used in these scenes are out dated? Why or why not? How do they line up with your experiences in health care and other like settings?
How important do you think it is to collect titles on official forms? Is it possible that titles can sometimes do more harm than good? Explain your perspective.
Microaggressions and “What’s in a Title?”
Using titles that assume a binary identity can be a form of homophobic and/or transphobic microaggression. These kinds of microaggressions can prevent LGBQ and trans people from seeking needed healthcare.
The following readings and news sources may be useful to initiative class discussion before or after using these scenes.
Bear Bergman, S., & Barker, M. J. (2017). Non-binary activism. In Genderqueer and non-binary genders (pp. 31-51). Palgrave Macmillan, London.
Liszewski, W., Peebles, J. K., Yeung, H., & Arron, S. (2018). Persons of nonbinary gender—awareness, visibility, and health disparities. The New England journal of medicine, 379(25), 2391.
Moser, C., & Devereux, M. (2019). Gender neutral pronouns: A modest proposal. The international Journal of Transgenderism, 20(2-3), 331.
Spotlight on Jokering:
Watch a virtual workshop of the scene in the video below.
In Donation, Joe’s character describes a personal encounter with someone who had asked him for money. Joe gave them a $10 bill. One friend said that it was a good choice and that Joe had helped the person. Another friend was against the decision, noting that there is a liquor store next door and Joe could have been enabling an addict.
Topic Risk Level: Medium
Dramatic Skill Difficulty: Low
The two characters in the scene had different opinions about whether giving a $10 bill was a good idea or not. Come up with some of your own reasons for or against giving money and explore questions around whether or not giving money is a good idea. This scene also provides opportunity to discuss the difference between charity and justice.
Index Cards
On index cards, learners can reflect on their own personal encounters with people asking for money. If some are comfortable, they can be invited to share what they have written to open up further discussion.
Note: While we label this scene as generally medium risk in terms of topic, this jokering technique can lead to higher risk depending on how the discussion unfolds.
Initiating Questions
Consider the different implicit biases that might be held by all three characters. Are there overlaps between characters in the biases that you identified?
When we make a donation, who benefits? Does it benefit the person in need? Does it benefit us? What might different motivations for donating be?
Is there a threshold for the “right amount” to donate? How much is too much?
What is the difference between charity and justice?
Is a focus on charitable acts distracting from working for deep justice and equity for all? Are the two mutually exclusive? Explore.
In the scene “Labels,” four healthcare practitioners interact with an unseen patient and write in the patient’s file. One main focus of this scene is the biases held by each of the practitioners and how those biases are transmitted between practitioners. This scene also presents an avenue to discuss issues within the field of healthcare, including how to manage time when one is faced with competing demands.
Topic Risk Level: Low
Dramatic Skill Difficulty: Low to High
During the interactions with the unseen patient, what do you think the patient might be thinking? Invite a learner to role play as the patient. What might the patient say in response to what he is experiencing? How might the patient’s contribution escalate or deescalate a situation? Now switch and invite a learner to role play as the “inner voice” of the health care provider. What might the inner voice be saying as the scene unfolds?
Hot Seating (Higher Skill)
Invite any learner to play one of the health care workers. Have the audience ask them questions. Sample questions might include: Why did you write what you did on the chart? What was the morning like for you before you saw this patient? What did you find most challenging about the morning? Did you try anything to deescalate the encounter? If not, could you have tried anything? What might it have been?
Initiating Questions
What implicit biases underpin the term ‘difficult’? Who was being difficult in this scene?
Whose narrative is being told in the written report?
What does it mean to give voice to the experiences of patients?
Beyond the issues presented in this scene, are there other more systemic issues that are highlighted in this scene? What would they be and how could they be addressed?
Spotlight on Jokering:
Watch a virtual workshop of the scene in the video below.
In Role Call, a teacher ‘unintentionally’ directs a microaggression towards a student he assumed was from another culture/country based upon physical characteristics in a get-to-know-you activity. This scene invites participants to explore issues of power and how we might talk back to power when these encounters happen. It also invites an exploration of microaggressions and of the relationship between ‘intent’ and ‘impact’.
Topic Risk Level: High
Dramatic Skill Difficulty: High
Have someone play as the teacher to be hot seated. (This may be a difficult role and if there is hesitancy from learners, consider playing the character yourself).
What questions can we ask the teacher about how the get-to-know-you activity went? How does having more information help us understand the situation better?
Why did Mike ask Rosie where she was from? Did he intentionally ask about her country of origin because of how he perceived Rosie’s cultural identity or was it a random choice? Do you think he regrets using that question?
Have someone play as Rosie’s character
What were your first impressions of the instructor? Did your impression change through the morning? Why did you turn your camera off? How will you respond? Is dropping the course something you would consider?
Note: As mentioned in Chapter 2, caution against having a non-marginalized person play this role. (see next suggestion).
Have someone play as another student who witnessed the encounter
What were your first impressions of the instructor? Did they change through the morning’s activity? How will you respond? Is dropping the course something you would consider?
Out Scene
There are a number of opportunities to create a new scene from this scene. One idea would be to invite someone to play the instructor at their office hours. Then, have another audience member play Rosie who goes to the instructor to discuss what had happened.
What might this conversation look like?
Based upon the conversation, did the instructor recognize that what he said was inappropriate and potentially harmful for Rosie? Do you think he will change his behaviours in the future?
What risks exist for Rosie’s character to challenge an instructor as compared to a non-marginalized witness?
Do you think it would be appropriate for another student in the class to go and talk with the instructor on Rosie’s behalf? Explain.
Initiating Questions
Was the instructor a ‘good teacher’? What does it mean to be a ‘good teacher’?
Where is the power in this scene?
What risks are associated when it comes to talking back to power? What are potential benefits? Do the risks and benefits change based on social location and positionality? (If this is a new term for your learners, please see the activities in the next section around preparing learners for this work.)
How could the power in this scene be disrupted? Shared? Redistributed?
Spotlight on Jokering:
Watch a virtual workshop of the scene in the video below.
In Missed Interpretation, we witness an encounter between two parents. A White parent makes an assumption about a parent who is a Person of Colour. This scene invites discussion about microaggressions, and how the intention of what one says or does might be very different from the impact.
Topic Risk Level: High
Dramatic Skill Difficulty: Low to High
Replay the scene to the point where there is a long period of silence between the two characters. Provide what the inner dialogue of each character might be.
Index Cards (Lower Skill)
Have learners write and reflect on a time that someone made an assumption about them. What was that like for them? How did they respond to the situation? If comfortable, share with the larger group and practice active listening.
Out Scene (Higher Skill)
Imagine what might have happened later that night when these two characters went home. How might each character tell this story to their partner, family member, roommate, etc.?
Imagine what might happen if the two parents returned to the same park the next day. Now that both characters have had a chance to reflect overnight, role play what might happen in the next encounter.
Initiating Questions
How do we handle mistakes, especially when they cause harm to others?
Are there different levels of apology? If so, what might they be? When is an apology meaningful?
Have you ever felt so scared of making a mistake that you didn’t act? What was that like? What about admitting to a mistake?
Have you ever been forgiven for making a mistake? What was that like?
How can we take responsibility for our mistakes in our actions?
Spotlight on Jokering:
Watch a virtual workshop of “Missed Interpretation” in the video below
The idea for this scene came from a story that was told by Dr. Boni Wozolek, Assistant Professor of Education at Penn State University. We would like to thank Dr. Wozolek for permission to adapt her story for this project. For more information about her work in social justice, see: Wozolek, B. (2020). Assemblages of violence in education: Everyday trajectories of oppression. Routledge.
But I'm a Good Person
19
Description:
In But I’m a Good Person, an older health care worker assumes that a woman’s pain is more emotion than anything else and questions the decisions of a younger colleague. Later that night, she meets with her supervisor to debrief. She has realized that she was incorrect about her assumptions and questions her own role and ‘blindspots’ towards patients’ experiences. The scene invites questions about what it means to be good and do good, as well as exploration of issues of power related to age and hierarchy. It also provides opportunity to reflect on what we do with our mistakes.
Topic Risk Level: High
Dramatic Skill Difficulty: Low to High
What does ‘good’ look/sound/feel like? Invite learners to pose as ‘good’? Or have two participants partner up, with one sculpting the other as ‘good’.
Does what is good vary between individuals?
What does it mean to be a ‘good person’?
Who determines what is good?
Is Sheila’s character a good person?
Out Scene (Higher Skill)
An unseen conversation between the characters of Jordan and Kevin happens in between the two scenes that we have provided. What do you imagine happened during this conversation? Place learners into pairs and have them role play this missing scene. Invite some to share in front of the whole group.
Sheila and Kevin have an important debrief. Imagine that after that Sheila’s character and Jordan’s character have another conversation. What might they say?
Initiating Questions
What responsibility do you think Sheila has for her mistake? Beyond Sheila, are there other mistakes that were made in these scenes?
Who holds the power in this scene? How does power shape our biases? (Remember to consider the experiences of both holding power and not holding power.)
How do you provide feedback to colleagues who seem to be acting on their implicit biases?
How willing are you to discuss your own mistakes with your supervisor?
Do you have people you can critically reflect with? What do you look for in a friend like that?
Do you think there are broad systemic issues at play in this scene? If so, what are they? How do they shape the situation?
Considerations and Research
This scene may lead to a broad discussion about how systemic racism shapes pain management in the health care system. The following research studies may be useful for discussion after viewing this scene.
Benoit, A. C., Cotnam, J., O’Brien-Teengs, D., Greene, S., Beaver, K., Zoccole, A., & Loutfy, M. (2019). Racism experiences of urban indigenous women in Ontario, Canada: “We all have that story that will break your heart”. International Indigenous Policy Journal, 10(2).
Badreldin, N., Grobman, W. A., & Yee, L. M. (2019). Racial disparities in postpartum pain management. Obstetrics and gynecology, 134(6), 1147.
Yearby, R. (2021). Race based medicine, colorblind disease: how racism in medicine harms us all. The American Journal of Bioethics, 21(2), 19-27.
Spotlight on Jokering:
Watch a virtual workshop of the scene in the video below.
Better? brings together themes that we have explored in all of the scenes thus far. Because of this, we think that it makes an excellent final scene and can be used as a way of helping learners synthesize their learning from this workshop.
In this scene we use the Image Theatre technique as a person tries to re-sculpt statues for the sake of making them ‘better.’ But what does it really mean to be better? This scene invites exploration of possible motivations behind making things better and raises the question “Better: for whom?”
Topic Risk Level: Low to High
Dramatic Skill Difficulty: Low
In our experience, depending on both the group and the jokering techniques that are used, participating in this scene could be low to high topic risk.
Create a new sculpture and have learners re-sculpt to make it ‘better’, articulating and questioning the rationale behind every choice.
Discuss the choices people made for changing certain positions or expressions to make the statue better.
For the person being the statue, did you feel any better based upon how you were re-sculpted?
Initiating Questions
What are the implicit assumptions that underpin what is ‘better’?
Why might something be perceived as better than something else?
How does power play into who gets to decide what is better and what is not?
Who gets to decide what is better for an individual? Who gets to decide about what is ‘better’ for a society as a whole?
Are there limits to individual choice? Do individuals always have the right to decide what is better for themselves?
What happens when what is perceived as ‘better’ for one person is potentially harmful for another? How do our collective responsibilities contribute to deciding what is better? What happens when individual rights and freedoms appear to collide with collective responsibilities?
Viktor Frankl was an Austrian neurologist, philosopher and Holocaust survivor. In his bestselling book “Man’s Search for Meaning”, Frankl chronicles his beliefs that freedom must be tempered by responsibility. He writes “That is why I recommend that the Statue of Liberty on the East Coast be supplemented by a Statue of Responsibility on the West Coast” (Frankl, 1963, p. 209-210). What do you think such a statue might look like?
What are different ways that the phrase “for whom?” could be interpreted? How does this interpretation change the way we interpret this scene?
Facilitators who choose to use this scene should be prepared for discussion and opinions about how collective responsibilities relate to individual rights. This can be a very emotionally charged and contentious discussion. We provide some readings that may useful to combine with this scene.
Mahlin, M. (2010). Individual patient advocacy, collective responsibility and activism within professional nursing associations. Nursing Ethics, 17(2), 247-254.
Looker, K. J., & Hallett, T. B. (2006). Individual freedom versus collective responsibility: too many rights make a wrong?. Emerging Themes in Epidemiology, 3(1), 1-3.
Loewenson, R., Accoe, K., Bajpai, N., Buse, K., Abi Deivanayagam, T., London, L., … & van Rensburg, A. J. (2020). Reclaiming comprehensive public health. BMJ global health, 5(9), e003886.
Spotlight on Jokering:
Watch the conclusion of a virtual workshop and the jokering of this scene in the video below.
What we Learned in a Large Undergraduate Health Sciences Class
IV
Confronting our own implicit biases compels us not only to engage with abstract data but to understand that we are all embedded in systems that oppress some and privilege others. Discomfort is an “essential ingredient” in this work (Gonzalez et al., 2021), and it is also central to the process that we have described as “haunting.” Our students have told us that their most important learning has happened not in the lectures or readings about implicit bias but in the “willing and curious discomfort” of engaging with the scenes.
With discomfort comes risk. As we have workshopped the scenes with groups of learners, we have asked questions about how we can create a space for this work that is culturally, psychologically and spiritually safer: but that is not so safe that learners are not challenged to grow. A further layer to this challenge is the reality that safety and risk will be experienced differently by different learners, especially as they engage from their own social identities of marginalization and unearned privilege.
In this next section, the Principal Investigator of our project, Valerie Michaelson, outlines what she currently does to prepare her students for Mirror Theatre’s workshop. This is an evolving practice. While this is written in the first person, our entire team contributed, including Joe, Sheila, Mike, Kevin, and Nadia as well as the Mirror Theatre Cast and the Experiential Learning staff at Brock. We hope that this section will help you think about how to use the scenes in a way that creates space for transformative experiences and conversations and at the same time that mitigates the risk of causing harm.
Please take very seriously that the scenes can raise contentious, complex and emotionally charged responses. If your group does not know each other well or does not have a high level of maturity and trust, we suggest you start with the lower-risk scenes. Use these to build trust and relationships and to practice having challenging conversations before moving on to any medium risk or higher-risk scenes.
Leader preparation
21
“We teach who we are” (Palmer, 2017). At one-and-the-same-time Palmer’s words demand a challenging level of self-reflexivity and extend a liberating release from pretences. Experts in anti-racist pedagogy (Kishimoto, 2018) have heightened my awareness that I cannot invite my students into challenging discussions about oppressive systems as they relate to race, gender and social class as the scenes require unless I am intentional about authentically locating myself. This requires preparation.
As a White, cis-gendered, well-educated, able-bodied, middle-class woman who has been shaped primarily by a Western European education system, my experiences usually map readily onto any “default option” that I encounter. Solely because of this social location, my personal experiences of negative implicit biases have tended to be limited. A high level of self awareness and authenticity is essential for teachers who want to invite their students to discover their own implicit biases in the classroom (Sukhera et al. 2018, Gonzalez et al. 2019) and I strive for this in my work.
My own social identity (the advantages, disadvantages, and privileges that shape who I am) informs not only what I will bring to this work as a teacher/facilitator but also how others will perceive me. Given this, I try to pay close attention to how the power that I hold as a White professor will impact student engagement in this material and remind myself that well-intentioned people can reinforce stereotypes and assumptions and often do it unconsciously. I could easily do this as well, especially if I am not paying attention and alert to this danger. We talk a lot in this resource about what we have described as “haunting.” Being open to haunting my own assumptions and biases has been an important part of my own evolving journey as an educator.
Given the potential sensitive nature of this content, I also try to provide formal and informal opportunities for my students to check in. I have found that they are more likely to “check in” if I linger in a quiet space near the front of the classroom than if I invite them to make an appointment for office hours. “Lingering” has become an important part of my pedagogical strategy.
The resources are listed in this section have informed and shaped my own ideas and practice in important ways. I highly recommend them to other educators who want to do this work with their students.
A Guidebook to the Health Equity Curricular Toolkit: Focus on Facilitation Tips
This Guidebook to the Health Equity Curricular Toolkit offers strong ideas for facilitators as they prepare to engage in challenging discussions with students. The section on facilitation is excellent and has informed our own approach (see pg. 15 onward). They offer self reflection ideas for before the learning session, guidelines for discussion and “things to remember if things get tense.” We cite what they identify as their “most important” facilitation guideline here:
“The most important thing to remember is that your behavior is just as instructive as any content you provide. You are modeling the patience, compassion, curiosity and courage that you would like your participants to practice.
Use your own mistakes as a transparent learning session. Apologize and recognize why what you said or did was painful or ignorant. Openly discuss the mistake you made and what biases reveal in your own self. Model that it’s ok to make mistakes; what’s most important is what we do afterwards.
Be present. Don’t just plan what you’re going to say next. You are allowed to think after someone speaks, and it models thoughtful behavior for others to emulate.” (Starfield Summit, 2017, pg 17.)
Scholarship on Teaching Implicit Bias
Educators who are using this resource may want to look at some of the current scholarship in this area.
Gonzalez, C. M., Lypson, M. L., & Sukhera, J. (2021). Twelve tips for teaching implicit bias recognition and management. Medical Teacher, 1-11.
Gonzalez, C. M., Walker, S. A., Rodriguez, N., Noah, Y. S., & Marantz, P. R. (2021). Implicit Bias Recognition and Management in Interpersonal Encounters and the Learning Environment: A Skills-Based Curriculum for Medical Students. MedEdPORTAL, 17, 11168.
Rodriguez, N., Kintzer, E., List, J., Lypson, M., Grochowalski, J. H., Marantz, P. R., & Gonzalez, C. M. (2021). Implicit Bias Recognition and Management: Tailored Instruction for Faculty. Journal of the National Medical Association.
Gonzalez, C. M., Kim, M. Y., & Marantz, P. R. (2014). Implicit bias and its relation to health disparities: a teaching program and survey of medical students. Teaching and learning in medicine, 26(1), 64-71.
Joseph, O. R., Flint, S. W., Raymond-Williams, R., Awadzi, R., & Johnson, J. (2021). Understanding Healthcare Students’ Experiences of Racial Bias: A Narrative Review of the Role of Implicit Bias and Potential Interventions in Educational Settings. International journal of environmental research and public health, 18(23), 12771.
Individual student preparation
22
All workshop learners should come into the learning environment with the understanding that there will be some risk involved. Each person brings with them different lived experiences that shape their perspectives and assumptions and therefore will have different understandings of a given situation. Together we hold the responsibility to ensure that the space is as healthy as possible for everyone.
In the boxes below, I point to two of the resources that I use to support my students to do their own self-reflexive preparation before engaging with the scenes.
Reading
Sensoy, O., & DiAngelo, R. (2017). “How to Engage Constructively in Courses” (Chapter 1) in: O. Sensoy & R. DiAngelo, Is everyone really equal?: An introduction to key concepts in social justice education. Teachers College Press.
Authors O. Sensory and R. DiAngelo offer five guidelines that will help to maximize the ways that students can engage constructively with social justice content in pedagogical settings. They are:
“1. Strive for intellectual humility; 2. Recognize the difference between opinions and informed knowledge; 3. Let go of personal anecdotal evidence and look at broader societal patterns; 4. Notice your own defensive reactions and attempt to use these reactions as entry points for gaining deeper self-knowledge; 5. Recognize your own social positionality (such as your race, class, gender, sexuality, ability-status) informs your perspectives and reactions to your instructor and the individuals whose work you study in the course” (Sensoy & DiAngelo, 2017, p. 4).
The chapter ends with five discussion questions (p. 22) that I ask students to reflect on in the first weeks of the course.
Web resource: Using a social identity wheel
When we are not aware of our own social identities, it prevents us from understanding our own complicit roles in perpetuating health inequities. Conversely, when we do understand our social identities and positions, it provides us with a starting place for authentic conversations and active listening to others. In light of this, we ask student to use LSA Inclusive Teaching’s (n.d.) Social Identity Wheel activity to create a first draft of a positionality statement that describes their best understanding of their own social positions. (Adapted for use by the Program on Intergroup Relations and the Spectrum Center, University of Michigan).
Group preparation
23
Humans are complex and unpredictable. Safety is a high priority when using this resource and creating safer spaces requires intention. We don’t know what will happen in each facilitation and we also have limited insights into the lived experiences and struggles that our students bring with them to class. What safety looks like for one student may look very different for another student, especially when a diverse range of people are represented in your group. For example, what may be perceived as liberating and transformative by some may be perceived as intimidating or even threatening by others.
In the boxes below, I describe some of the strategies and resources that have helped us to hold safer, brave and principled spaces for all learners.
Starting with a Group Learning Agreement
One of the most fundamental things we do is to ask students to create a group learning agreement together at the beginning of the course. This is a “living document.” Through our entire term together, we revisit and update it as required. By the time we get to the implicit bias module (which happens about week 6 in a 12 week term), the students have had a chance to practice this group learning agreement in lessons that are perhaps lower stakes.
The following example is what we developed in one of our classes. The important thing is not to duplicate our learning commitment, but to develop one with your own students so that they have ownership over it.
Sample Group Commitment (HLSC 2P21, Fall 2022, Brock University)
Listen actively to everyone in the room (virtual or live)
Be open to different perspectives and viewpoints
Always be respectful. Differentiate between disagreeing with people and disagreeing with ideas
Recognize that while something might be unfamiliar to you, it may be the lived experience of someone else in the room: be sensitive
Work hard to recognize your own biases; be open that you may have biases you don’t yet realize you have or that make you uncomfortable
Do not dispute lived experiences of marginalization or struggle that people in the class might choose to share. Listen non-judgmentally to what people choose to share
If people share personal stories in the class, do not share them without explicit consent
If you don’t understand something, take responsibility for learning about it. Don’t leave it to people who have the experience to educate you
Just because you aren’t aware of a struggle or have not experienced it yourself, it doesn’t mean that it doesn’t exist.
If you find it difficult to participate for whatever reason, challenge yourself: recognize that the whole class is enriched by your participation
If you find it easy to participate, challenge yourself: make sure you are listening actively and not taking up more than your share of “airtime”
Take real responsibility if you realize (or if you are told) that you’ve said something harmful. Apologize. Learn from it. Move on. Do better.
This is a safe space to make mistakes; but we have to also take responsibility for the impact of our mistakes and be open to growth.
Be respectful. Be curious. Be humble.
An inequitable distribution of health promoting resources and opportunities is not inevitable. Neither is an unjust world. Stay hopeful.
Principled spaces: Barc workshop on “Building the Anti-racist classroom”
In the Barc workshop resource “Building the Anti-racist Classroom” (Ramos, 2021), developers draw on the ideas of artist and activist Hanalie Ramos who suggests that “principled spaces” are more useful than simply “safe spaces.” Because we don’t know in advance how a given event, workshop or conversation will go, it is naïve to claim that we can guarantee safety. Citing Ramos, they claim that principled spaces “are better suited to creating the environments we wish to develop: we can commit to adhering to a set of principles that guide and shape the space and increase the possibility of safety for all involved.” Read their six guiding principles.
AWARE-LA’s (n.d.) “White Anti-Racist Culture Building Toolkit” supports the development of “consciousness-raising dialogue spaces.” Their ten “Communication guidelines for a brave space” have informed our approach to workshopping this material in racially diverse classrooms. The developers draw attention to the different realities around what brave space can be for White people compared with for People of Colour, and are attentive to historic power differentials that are rooted in racist and colonial policies, attitudes and practices.
This resource is written by White people, and is primarily about how White people can talk about race. It is best used in combination with other resources that are written by People of Colour, and people who are Black and First Nations, Inuit and/or Métis.
Using this resource in a virtual context
Because of COVID 19 public health guidelines, we unexpectedly have had to offer this workshop in fully virtual spaces. It was important for us to reconsider how to shape safe, brave and principled spaces in virtual contexts. We realized that there would be internet and technological inequities between students and while we couldn’t solve these problems, we considered how we could make this workshop most accessible to our learners. We were also attentive to safety around participation and clearly communicated the option to have video on or off and to use the chat box for group participation if that was most comfortable for learners.
Academic preparation
24
Our entire team believes that when learners come to these sessions with some introductory understanding of what implicit bias is and why it is of such critical importance for leaders in the health system to be attentive to their own implicit biases, they are better equipped to engage. Because of this, we ask learners to take responsibility for engaging with preparatory material before interacting with the scenes.
Preparation includes engagement with a short lecture, assigned readings and videos, all of which introduce learners to contemporary (primarily Canadian) scholarship. I also show learners present day news stories that illustrate how persistent and pernicious implicit bias is across Canada, and document its predictable consequences to people and groups who are most under threat from oppressive systems. I intentionally include stories from our local context (the Niagara region) because I want learners to understand that implicit bias is not something far away that has little to do with us but rather, that it is causing profound harm in our own neighbourhoods, hospitals, services and communities. Some of the resources that are used in HLSC 2P21 are in the boxes below.
Teaching Resources
This short course from the Kirwan Institute for the Study of Race & Ethnicity (2018) “Implicit Bias Module series” includes four introductory modules about what implicit bias is and how it operates. Classroom educators who are preparing their students to engage with the scenes may find it useful as preparation material for their students.
“Peanut butter, jelly and racism” is an accessible and engaging video that introduces Implicit Bias as a concept. Developed by New York Times reporter Saleem Reshamwala, it was posted in the New York Times in December, 2016.
Contemporary scholarship
Every time I teach about implicit bias and use the scenes I update course readings with Canadian health scholarship in this area. It could easily be updated with research from many different disciplines.
Parekh, G., Brown, R. S., & Zheng, S. (2021). Learning Skills, System Equity, and Implicit Bias Within Ontario, Canada. Educational Policy,35(3), 395-421.
Sit, C. (2021). ES15. 06 Global Perspectives on Implicit Bias in Oncology Care: Canada. Journal of Thoracic Oncology, 16(10), S837-S838.
Luomala, K. (2021). Implicit Bias in Canada’s Healthcare System: Implications, Solutions and a Case Study. Lynchburg Journal of Medical Science, 3(3), 69.
Andersen, J. P., Di Nota, P. M., Boychuk, E. C., Schimmack, U., & Collins, P. I. (2021). Racial bias and lethal force errors among Canadian police officers.
Current news stories
I also keep news stories current and so that students understand clearly that this is a pressing current health issue.
Finally, we show students this video that features Brock’s Experiential Education Director Sandy Howe. Sandy offers a challenge to students to learn how to “unsee”.
One of the questions I’d like to pose to you as we get under way with this workshop is: How do we see?
All of us come to our day-to-day, regardless of the people around us at work, school, home, with friends, or out in public in general, with our OWN lens. Me, mine and you yours. This has been shaped by a lot of different things including our own personal histories and lived experiences, and this sometimes means that we hold assumptions or biases. These are our own individual “ways of seeing” that we may not even be aware of and which have an influence on how we show up in our lives and how we interact and treat others. I’m particularly thinking about your work in this course and the connections between what you’re learning and the work we’ll be doing in this workshop. So, how do YOU really see?
Sometimes, before we can change how we see, we have to learn how to unsee or broaden our view.
During this workshop we invite you and encourage you to participate in the activities and dialogue that will have you reflecting on the assumptions and biases you may hold when you look at a particular person, thing, or situation.
For many of you, this will be a whole new learning experience. For some of you, it might even feel uncomfortable, intimidating or even a bit scary. This is a safe and non-threatening environment and a space to practice and try things out without judgement. You’re encouraged to participate actively, but also in a way that keeps with your level of comfort. Please use this as a learning lab as you explore the scenarios you’re presented with.
On that note, we hope you’re ready to unsee, in order to find new ways of seeing moving forward. We hope that you learn new things about yourself in relation to your class content and the people you may find yourself interacting with. Get ready to unsee.
After the session: debrief, assessment and reflection
25
What happens after we engage with the scenes is as important as how we use the scenes themselves. I have used the following four strategies to create space for learners to process and reflect on their experiences with the scenes:
Have an immediate debrief
Provide safer space for meaningful feedback
Include a short assessment about the learning on implicit bias
Re-introduce opportunity for reflection after some time has passed.
1. Immediate In Class Debrief
I offer learners the opportunity to debrief their experience in class immediately after we use the scenes. I do not have an agenda and my goal is simply to “hold space” (Plett, 2015) for learners to process and give voice (either out loud or internally) to what they have learned and to listen to their classmates. The kinds of debrief questions I ask might include questions from the list below. However, the debrief will always be responsive to the class climate and dynamics around safety and trust. The debrief environment should be taken as seriously as we take creating a safer, brave and principled space for the activity itself.
As we prepare for our debrief, I remind all learners of our group commitment. This is a safer place and we listen to each other without judgement. As learners share their insights and experiences, I try to remember to thank each student for their comments without judgement (even positive judgement). In this way, each person’s comments are equally held within the group.
Was anything unexpected or surprising about today’s class? What was that like for you?
In what way did this experience of examining your own implicit biases through participatory theatre challenge or reinforce your values, beliefs, or attitudes?
What do you understand better about yourself as a result of the experience?
Did you give this activity your best effort? If so, what supported you? If not, what hindered you?
Did anyone offer an insight that you wouldn’t have come to on your own?
Are there parts of this activity that you want to disagree with or critique?
Is there anyone you would like to thank after today’s experience?
Is there anything else anyone would like to share?
2. Safer opportunity for meaningful feedback
With the risks that come with this activity also comes responsibility. I need to set up authentic and safe opportunities for learners to offer feedback about this activity (with an anonymous option). In our current approach, we collect anonymous responses from learners about their experiences and use their responses to refine our practice.
If the impact of our program has been harmful to a student, or if I or the other facilitators have made a mistake that has caused harm, students need to know where to go express their experience and concerns. We work with leaders from Human Rights and Equity at our institution to create channels for student support and feedback.
We also make relevant campus resources available at the beginning of the class. These include information about Aboriginal Student Services, Mental Health Services and Human Rights and Equity. Each of these services offer valuable, accessible and prompt student support.
3. Short assessment
Assessment is tricky. On one hand, it is difficult and perhaps counter productive to put a grade on student reflection about this kind of work. Yet at the same time, education literature is clear that assessment supports (Scott, 2020) and even drives student learning (Bezuidenhout & Alt, 2011). There is also a danger that if this work is not in some way assessed, students will not take it as seriously. To balance these tensions, I assign a reflexive task for students to complete immediately after we use the scenes. If they do it, they earn full marks; if they don’t do it, they do not earn any marks. In this way, the grade is connected with their engagement and participation and not with any external assessment or judgement. Students have reported that this approach has freed them from “trying to give the instructor what she wants to get a good grade” to being able to focus on deep learning and reflection. When I initially took this approach, I feared that the students might not take it seriously. In reality, the opposite happened. Students tend to take this reflection very seriously and write far more—and far more deeply—than would be required.
The initial “assessment” is simply to reflect on the same questions that I have used in the full class debrief. (See Immediate in-class debrief.) Learners are asked to pick one or two of the questions of their choice and reflect on them on their own, in an assignment that will be handed in.
4. Re-introduce opportunity for reflection after some time has passed
I revisit the topic of implicit bias later in the term, through readings, lecture content, class discussion and another opportunity for group and personal reflection. One thing I have done is ask students to visit “Project Implicit” (n.d.) and take the Implicit Association Test (IAT). This test was developed by psychologists at Harvard, the University of Virginia and the University of Washington with the goal of measuring implicit biases. With a reminder to visit the Canadian site, students are requested to visit the IAT site and take at two of the tests (their choice).
Students are then asked to reflect on the following questions in one page, with the caveat that if they want to take the assignment in a different direction that they think would better support their learning or need for a debrief, that is their prerogative. The questions include: Did anything surprise you about your experience with the IAT? How did this activity, combined with the exercise with Mirror Theatre in class earlier this term, help you to think about your own implicit biases? Did these two experiences give you new insights into the readings or our lesson about implicit bias in health? Please explain. How do you think being intentional about understanding your own implicit biases will support you as you become a professional in the health or medical sciences? If you wanted to continue with this learning, what might some of your next steps be?
5. Developing a rubric for reflexive assignments
Brock’s Experiential Learning Team provides resources on the value of reflecting on learning and on how to develop reflexive assignments and rubrics that we find very helpful as starting places for assessing this work. Drawing from Denton (2011), they have helped our team to understand that “Reflection is a central feature of experiential education and serves the function of solidifying connection between what a student experienced and the meaning/learning that they derived from that experience” (Brock University, Centre for Pedagogical Innovation, n.d.).
Evidence from the field - how effective are the workshops?
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Research is mixed about the effectiveness of implicit bias education. Even if implicit biases can be changed on an intellectual level, do the changes actually lead to changes in behaviour? The evidence is simply not clear (FitzGerald et al, 2019). This research gives us pause for thought as we reflect on the potential long term impact of our project. In October 2021, our team member Nadia received ethical clearance to conduct a participant survey after the two workshops that we conducted.
Our total sample was 111 students in the undergraduate HLSC 2P21 class at Brock University. We conducted an anonymous survey on the platform Qualtrics. Students in the class had the option to opt in or opt out of participating and there were no consequences for non participation. Most workshop attendees reported this type of experiential program to have a stronger impact on them in comparison to lectures (78%), PowerPoints (76%), instructional movies (67%) and seminars (63%). A large percentage of attendees reported that the workshop provided a range of issues that enabled good discussion (93%) and indicated that the workshop provided them with “lots to think about” (89%). Many participants appreciated the interactivity of the session (86%) and the majority of participants stated that that they were given the opportunity to provide their opinions on the topic (89%). A full 95% of attendees expressed that they did not feel pressured to participate more than they wanted to (95%). Finally, 90% of the workshop attendees indicated that they would recommend this implicit bias program. Overall, the data suggests that a large percentage of attendees found this implicit bias workshop to be impactful and engaging. We were very encouraged by these initial findings.
Open ended questions on the survey allowed for more nuanced and personally reflexive responses from attendees about their experiences in the workshop. First, participants were asked to provide opinions on the style of the workshop. We had already learned through our quantitative findings that learners tended to enjoy the workshop, but now we had some illustrative data about why. One attendee stated:
“The style of presentation is very effective as it provided us with realistic situations and allows for hands-on learning where students can speak about their thoughts and think critically about certain issues”.
We also heard comments about how much the interactivity of the workshop was appreciated. As this attendee said,
“I feel being able to interact with my peers along with the comparisons made by the demonstration done by the presenters was extremely useful in helping me understand and put into perspective what we were learning”.
In fact, when asked to describe the unique features of the workshop, many students reported that they particularly appreciated the level of engagement and interactivity. Participants also reflected on how the style of the workshop was effective in helping them to learn. One participant wrote that the workshop was “very effective and helped with understanding concepts”.
These preliminary data indicate that the workshop enabled good discussion on implicit bias and supported learning. Even though these initial findings are encouraging, they have many limitations. First, our study only measures the experiences of participants immediately after our workshop. While these experiences appeared to be positive, our small study tells us nothing about long term impacts of using participatory theatre to interrupt implicit biases at a deep enough level to change behaviour. We hope to continue with this work and conduct a longitudinal study of students who engage with their implicit biases through participatory theatre. While we believe that these workshops have important short term impacts, we are cautious about making any claims that they create long term change in behaviours until we have studied this further.
Experiential Learning Impact: some observations
In this next video, Brock’s Experiential Education Director Sandy Howe shares her observations about the effectiveness of this participatory theatre approach to “haunting” our biases.
This participatory theatre style of workshop is experiential learning at its best. With learners engaging with live simulation and real-life scenario-based content, not only does this satisfy the direct experience component of experiential learning, but it also includes significant opportunities for reflective practice throughout. The opportunity for learners, and even us facilitators, to have “aha” moments, to unpack impactful realizations about themselves and their relation to others, it also helps to develop skills such as problem solving, critical thinking and communication and also helps learners to clarify their values and understand more deeply how to contribute to or in community.
Just to reflect on what I see happening in this experience, I see most learners coming in uncomfortable. They’re sometimes silent, maybe anxious and are watching their peers closely to see how deeply people are willing to engage. What happens as we gently question, ask them to try the response they’re thinking about with their gut instincts, or to provide a more appropriate solution to a problem, is students also building confidence, trusting themselves and creating strong learning communities among themselves that other group work or team tasks rarely achieve.
Students comment that the experience is impactful, eye-opening, something they’ll never forget and often say that they’ve never had the chance to do anything quite like this. We also see and hear them continuing to talk about this weeks and even months, after the workshop. They’re still thinking about what they learned about themselves, they’ve continued to question their learning in similar ways in different venues and that they’ve cared to continue to be more self-aware as students and as they head into their dream professions.
My final reflection is “trust the model, and model the trust”. Learners are more easily engaged when they know the facilitators are enthusiastic and willing to be fully human in the process themselves, whatever directions that may take them in, and that pays off in so many ways in my opinion.
Best wishes, you can do this and know that this will stick with you and your learners, for a long time to come.
Becoming Reflexive Practitioners
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For those of us involved in creating this resource, the words “haunting” and “reflexive practice” are two sides of the same coin. Reflection is a state of mind, an evolving component of professional practice and growth and a way of continuing ongoing learning (Bolton, 2010). Reflective practice is the conscious effort to pause and think through events in practice and develop insights into why something happened or didn’t happen, to understand our own blind spots in relation to others. There is critical value and indeed—necessity—in the use of reflexivity for everyone who works in the applied health sciences. Reflexivity is engaging in strategies, like those presented in this workshop, that assist us to reflect and to question our own attitudes, prejudices and hidden implicit biases.
Reflection permits a purposeful act of thinking through an experience or health related encounter at a deeper level and is essential if one is to understand the layered meanings of the situation and to grow wiser from it. “Reflective learning is the process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and results in a changed conceptual perspective” (Boyd & Fales, 1983, p.113). Reflectivepractice in and of itself should haunt us. It should haunt us, because we are in significant positions of power over the people that we serve as health professionals. And haunt us-because it requires us to go deep inside ourselves in ways that sometimes challenge the worldview we hold that is familiar and comforting to us. It makes us ask hard questions: “Could I be racist?” “How could I have caused harm when I didn’t mean to?” And “Aren’t I a good person?” These are “haunting questions” and they are a catalyst to reflective practice.
Reflective practice is a deliberate way of critically unpacking a situation or experience to learn from, creating new awareness and knowledge or skill development, to improve or further develop professional competency and provide compassionate, ethical and humane practice (CNO, 2015; DunnGalvin, Cooper, Shorten, & Blum, 2019; Taplay, O’Keefe-McCarthy, & Tyrer et al., 2021). Typically, it may be carried out individually, in a peer-to-peer dyad or within a group reflection. Reflective practice allows health care professionals the opportunity to reflect on their practice and to evaluate strengths and weaknesses, identify areas for improvement: to constantly re-evaluate the care they provided to another (Taplay et al., 2021). Within medicine and nursing over the decades, reflective practice has been understood to augment student self-directed learning and motivation, promote integration of theoretical concepts to practice (Davies, 1995), enhance experiential learning (Atkins & Murphy, 1993), improve self awareness and facilitate greater quality care, individualized treatment and more accurate diagnoses (Bonde, 1998; Brookfield, 2000; Clouder, 2000; Coombs, 2001). Alternatively, without ongoing reflective practice that challenges our thinking, reasoning, assumptions and judgements can translate into missed or inappropriate diagnosis and treatment decisions and disparate and or privilege levels of care. Health care professionals need to be intentional to use reflective practice and participate in reflexive exercises and activities.
Seeking out effective learning strategies such as providing this applied theatre dialogic educational encounter in class is a direct example of engaging in reflexive practice. Reflexivity helps us find ways to question our own preconceived notions, ideas, values and thought processes. It enables us to examine our own biases, assumptions and habitual actions and reactions to situations and helps us to understand the complexity of our role(s) in relation to others (Bolton, 2010). Reflexivity allows us to examine, for example, how we— seemingly unknowingly—help create professional hierarchies or social or professional structures and systems that promote privilege, exert power or normalize exclusion or marginalization of some individuals or social groups over others. These actions are often different from what we espouse or what we believe our values stand for (Cunliffe, 2009). By engaging in reflexive activities and practices, we can then unlearn in order to learn and to relearn a more ethical and intentional way of providing care.
Helping Our Students to become Reflexive Practitioners, with Dr. Sheila O’Keefe-McCarthy, RN BScN MN PhD CNCC(C)
Hello, my name is Dr. Sheila O’Keefe-McCarthy, I am an Associate Professor at Brock University in the Department of Nursing. I have been privileged to be able to work in clinical practice in the various areas of GI medicine, neurology, hematology, cardiology, in the intensive care and the emergency wards. I have always been very privileged to work with individuals on their health, illness, wellness and death trajectories. I am delighted to speak with you a little bit to identify how important it is for us as health care professionals-how to use our ability to think reflexively to uncover, perhaps our implicit biases.
For those of us involved in creating this resource for you, the words “haunting” and “reflexive practice” go together, they are kind of two sides of the same coin. Reflection as you well know, is a state of mind, an evolving component of professional practice that allows us to grow in an ongoing continual way. Reflection permits that purposeful act of thinking through an experience that might have impacted the care that we gave, thinking about the care we gave and the health-related encounter at a deeper level. It allows us to understand that meaning, the rich layered nuances that perhaps we were blind to. Reflective learning is the process of internally examining and exploring an issue of concern, triggered by our clinical experience (Boyd & Fales, 1983). This practice reality is in and of itself-should haunt us. I say Haunt us, because we are in a significant position of power over some one. And haunt us because it requires us to go deep, deep inside ourselves in ways that sometimes challenges our worldview or what we hold as familiar or comfortable to us. It challenges us, it makes us ask those hard questions: Could I be racist? And to say things like “But I didn’t mean any harm” or “But I’m a good person.” These are the kinds of questions as health care providers and people that engage in the health sciences, these are “haunting questions” and they are the actual impetus, a catalyst in doing reflexive care.
For me over the years, a foundational core attribute that guides the health care encounters that I engage in, is the word “care.” When I think of care, I think health care cannot really happen without care. What does it mean to care for someone, or to provide care to someone… more importantly, are we able to provide unbiased care? As health care professionals our actions, inactions and thoughts (both conscious and unconscious) impact the care that we give and the care that we withhold. We know that from research and clinical practice that research has documented and demonstrates unrecognized and uncontested or unchallenged implicit biased encounters that have been in health care result in health inequities and disparities. Entrenched Implicit Bias encounters, they create poorer health related quality of life for individuals, worse diabetic, chronic care and disease and pain care management related care. Less colorectal, breast cancer and in my area of research cardiovascular screening. The ways in which we think as health care professionals really does impact the care that is received by others. This is important to think about.
We are guests, as I have said, in the individual’s life. Our invitation comes with that person seeking health care for a health-related symptom, issue or problem. In order to provide care for another, one needs to understand the meaning within that human experience and how (or not) our implicit biases may have shaped and or impacted that encounter. We achieve this knowing by incorporating reflective practice and reflexive activities within our professional work.
So hopefully by seeking out effective learning strategies such incorporating an applied theatre dialogic educational experience allows you to operationalize or use reflective practice in a very focused way. This use of reflexivity, is a strategy to help us question our own preconceived notions, ideas, values, thought processes, biases and assumptions that we have not examined thoroughly. It will help us to understand then, the complexity of of our role within the relationship to others and how we impact care.
Some last thoughts, to be reflexive means that we actively, it is courageous work to engage in confronting what disturbs us. Reflexivity allows us to examine, for example, how we – seemingly, unknowingly, help create professional hierarchies or social or professional structures and systems that promote privilege, exert power or normalize exclusion or marginalization of certain kinds of individuals (different from what we espouse or think we believe that our values stand for). Something to think about. In being reflective and engaging in reflexive activities we can unlearn to relearn a better way of being ethical health care professionals. Thank you very much.
Final thoughts
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Transformative learning and un-learning requires courage: courage to lead our self and others into unfamiliar and uncomfortable places where meaningful growth can occur. Participatory theatre invites learners to develop and cultivate reflective skills so that they become responsive to the horrors of what happens when implicit bias goes unrecognized and unchecked. As leaders in health, education and other systems, we must be willing to explore our core values and beliefs and how these have shaped and formed our understandings of our self, others and the world around us. We must be honest about how lethal implicit bias can be here in Canada. The reflexive exercises that we have provided in this resource invite us to take one step toward challenging our own engrained mental constructs and working toward something more equitable for everyone.
As we come to the end of this resource, here are some of the questions that continue to haunt us:
What assumptions do I make, on a day to day basis, that I am still not aware of?
How does implicit bias impact me personally?
How might I cultivate a life-long reflexive practice?
How does implicit bias affect those around me professionally, such as my co-workers, my patients and their families?
How do I use, misuse, and abuse my personal power and privilege? How can learn to share power in ways that are more equitable?
What am I going to stop, start and continue doing as a result of my heightened awareness about implicit biases?
We continue to live in these questions long after we have finished with the scenes.
Our students who have participated in these activities have expressed their appreciation for this curriculum in ways that extended well beyond its content. They have told us that while it was uncomfortable, they also felt strangely exhilarated, humbled and empowered through their experiences with the scenes. We hope this experience will be similar for others who use this resource.
There is no end point to this work. There are, however, starting points and “starting again” points. While it’s not likely you will get rid of all your implicit biases, becoming increasingly aware of them will mean that they have less and less control over your decisions, conclusions and actions. We hope that this resource leaves you and your co-learners “haunted” as you confront implicit biases. Taking concrete responsibility for our own growth is one of the ways that we honour our collective responsibility to create a more just and equitable world.
Appendix: Scripts for scenes
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Below are scripts for the scenes we have used in this resource. We have elected not to write scripts for Who Would Your like to Work With? and How Can I Help You? We felt that if we were to describe how the bodies were positioned or the tones of voice that are being used, we would be going against the points of the scenes, which are to discuss how these factors can be interpreted differently.
License
All scripts are Copyright Mirror Theatre 2022.
What’s in a Title?
These vignettes all take place at a health care facility.
Vignette 1
In an examination room.
Nurse A: Taissa, is it Miss, Mrs., or Ms.?
Patient A: Um, technically Mrs., but I actually prefer Ms..
Nurse A: But I think your husband would prefer Mrs….
Patient A: Um, actually, my wife doesn’t care for Mrs. either, so just put Ms.
Nurse A: Oh, okay.
Vignette 2
In an examination room.
Nurse B: Hey, good day. Is it Mrs., Miss, or Ms.?
Patient B: Technically Mrs., but I prefer Ms.
Nurse B: Thanks, but I guess your husband might prefer Mrs.
Patient B: Actually, my wife doesn’t care for Mrs. either, so please just put Ms.
Vignette 3
In an examination room.
Nurse C: Miss, Mrs., or Ms.?
Patient C: Um, technically Mrs., but I actually prefer Ms.
Nurse C: Thank you. Um, does your husband prefer Mrs.?
Patient C: Um, actually, he prefers Ms.
Vignette 4
In an examination room.
Nurse D: Before I take your blood pressure, I notice one boxed hasn’t been ticked off. It is Miss, Mrs., or Ms.?
Patient D: [inner voice] Do I say anything? Uh… [to the nurse] Actually, it’s Dr.
Vignette 5
In an health care office.
Nursing Supervisor A: Welcome to the team. Um, do you prefer Mr. Norris or Joe?
Nurse E: Actually, I have a doctorate in nursing.
Nursing Supervisor A: Oh wow, but maybe not used here because it might confuse the patients.
Vignette 6
In an health care office.
Nursing Supervisor B: Oh hello you two, I’m so glad you could make it to our first meeting. Um, Angie, do you go by Miss., Mrs., or Ms.
Nurse F: Um, Miss will do.
Nursing Supervisor B: Thank you. And, Joe you obviously go by Mr.
Vignette 7
In an examination room.
Nurse G: Employer please?
Patient G: West Coast Airlines.
Nurse G: Oh, it must be so much being a flight attendant, huh?
Patient G: Pilot.
Vignette 8
In an office.
Interviewer: So, do you go by Miss, Mrs., or Ms.?
Patient H: [inner voice] uh, not again! [to the interview] Mix. Spelled Mx.
Interviewer: Sorry, that’s not on the form.
Donation
To be published in: Norris, J., Hobbs, K., & Mirror Theatre (In Press). Playbuilding as qualitative research.
[Nadia, Joe, and Candace are drinking coffee around a table.]
Joe: So you’re going to Cosco on the weekend, aren’t you?
Nadia: Yeah.
Joe: So, if I gave you 50 dollars would you pick up a bunch of treats, uh, for next rehearsal?
Nadia: Yeah, of course.
Joe: Okay thanks. Just bring the receipt and then we’ll claim for it.
Nadia: Okay!
Joe: Okay, good.
Nadia: Do you know that this reminds me of?
Joe: What?
Nadia: Have you guys scene the new $10 bill?
Joe: No.
Candace: No, I didn’t know there was one.
Nadia: Really? It’s the first Canadian bill to feature a woman of colour.
Joe: Wow. That’s great.
Candace: That’s amazing… so cool!
Joe: Speaking of $10 bills, when I was coming out of the Dollar Tree picking up our coffee mugs for rehearsal, there was a woman coming across the parking lot in a walker. And, I figured out what was gonna happen… and she said, “Hey sir”. And I decided to be a little friendly, I said, “Yes?”. And she said, “Look, I have three teenage boys, they’re hungry, we don’t have any money. Would you mind giving me some cash?” Normally, I say I don’t have any change and I don’t have any bills. And, often I don’t, I just go by credit card, but this time I looked in my wallet and I found a $10 bill and I gave it to her.
Nadia: You gave her a $10 bill?
Joe: Yes!
Candace: That was really nice of you.
Joe: Yep, I think so.
Nadia: But, isn’t there an LCBO right beside that Walmart?
Joe: Yes, and I knew that.
Nadia: Well, she could of easily went and bought alcohol. If she’s an addict, you’re enabling her, Joe.
Candace: But you’re just stereotyping and assuming that she’s going to go to the LCBO and get alcohol.
Nadia: Well, you’re right. It is a stereotype, but it is still possible that she may do that.
Candace: And it’s possible that she may not.
Nadia: Yes, but by giving her the money you’re possibly enabling a drug addict. Joe could have just bought her food from Walmart.
Candace: What if her kids don’t like the food that Joe got her?
Nadia: Well then, he could have asked her what they eat and what they prefer.
Joe: Well, I decided… I didn’t have time to go into Walmart. I was rushing off to a meeting, so I decided to take a leap of faith and give her the money. I think sometimes you have to demonstrate that you trust people some of the time. If not, it’s not a fun world to live in. That was my choice.
Candace: I agree.
Nadia: I don’t.
Labels
Originally published in: Hobbs, K. (2019). To Know Their Stories: Using Playbuilding to Develop a Training/Orientation Video on Person-Centred Care [Unpublished Thesis, Brock University]. St. Catharines.
Health Worker 1: [writes in chart] Patient is difficult.
Health Worker 2: [reads in chart] Difficult. [speaks to camera/patient] So are you going to be difficult today? [writes in chart] Patient refuses to have breakfast.
Health Worker 3: [reads in chart] Okay. Hmm. [speaks to camera/patient] So we’re going to work on eating breakfast. [writes in chart] Patient lashes out.
Health Worker 4: [reads chart then speaks to camera/patient] Hi Mr. Hobbs. How are you doing today? Oh you didn’t like that? Well I can bring you a different meal next time. Okay, I’m going to check in on you later, alright? [writes in chart] Patient is having a difficult time adjusting to the new environment, due to dietary restrictions, change of the meals… Responds well to positive feedback.
Role Call
In an online seminar class.
Instructor: Alright, good afternoon, everyone. My name is Mr. M, I’m going to be the instructor for you all this term. I know we are a bit of smaller class today, but I’d like to go over just a quick attendance call to make sure everyone is here. And then when I ask for your name, I’m just going to ask you a question with that to just so we can start to get to know each other just a little bit better before we start. Uh, so first on my list I have a Bernadette.
Student A: Here.
Instructor: Hi Bernadette. Welcome! Bernadette, if you could have any superpower, what would it be and why?
Student A: I think I would pick shapeshifting ‘cause that’s kind of like all the superpowers in one. You know, if I want to fly, I’ll just turn into a bird.
Instructor: Hey, that’s a pretty one. Can’t argue with that logic. Okay, welcome Bernadette. Um, next up: John. Um, John, are you here? I can see your camera is off and you’re muted.
Student B: Whoops, I had my phone on mute. I’m not going to show my face today. Actually, my name is John Joseph, but I go by Joe.
Instructor: Okay great Joe, thank you. Yeah, no worries at all. Uh, Joe, my question for you: if you could go anywhere in the world to vacation where would you want to go?
Student B: It wouldn’t matter as long as it was warm and had a nice, sandy beach.
Instructor: I like your thinking. That’s a good response. Thank you very much, Joe. Next up, Rosa.
Student C: Hello, I’m here.
Instructor: Hi Rosa. Question for Rosa, um… Rosa, where are you from?
Student C: I’m from St. Catharines.
Instructor: St. Catharines, right yeah, but like… where are you from?
Student C: Um, well I grew up in Toronto, so I guess there.
Instructor: Yeah, I think what I’m getting at is I’m just curious where you were born.
Student C: Um okay… I’m from South America.
Instructor: South America! Okay, cool! Well, welcome Rosa. Next up: Dani Shae.
Student C: Hi, yeah.
Instructor. Hello, uh, Dani Shae, welcome. My question for you: What’s the most recent book you’ve read?
Student C: Oh, um, I just finished reading the Lord of the Rings.
Instructor: Lord of the Rings, very nice. Did you like it?
Student C: Yeah, I thought it was pretty good.
Missed Interpretation
At a playground. Mother A is a white woman. Mother B is a Woman of Colour.
Mother A: [calling to her children] Have fun! Be careful on the swings!
Mother B: You’re so good with them. They seem to really enjoy you.
Mother A: Thank you [chuckles].
Mother B: Can I ask… Are you exclusively with this family or are you taking other applications?
Mother A: They are my kids.
Mother B: Oh. [awkward pause] They look just like you, so makes sense… [another awkward pause]. Sorry…
But I’m a Good Person
At a hospital.
Nurse A: Hi Sheila, how’s it going?
Nurse B: Hey Jordan, god, crazy shift, eh? How are you?
Nurse A: I’m good, thank you. I’m just calling to make a plan for Shirley in Bed 8.
Nurse B: Right.
Nurse A: Okay, so she’s got the compound fracture, right. I just left her. She’s in a lot of pain, so I wanted to call you immediately. I am going to order her a morphine IV: 5-10 ml every 30 minutes for her pain, okay?
Nurse B: Oh, okay. Shirley, right? Okay, yeah, I’ll see. She might not need that much morphine though, Jordan. She seems to be more emotional than anything. I mean she can barely collect her thoughts. Are you sure you want that much?
Nurse A: Yep, so she’s reporting an 8 out of 10 on the pain scale. I know it’s been a absolutely crazy night; have you had a chance to take a look at the x-ray yet?
Nurse B: No, no, no…
Nurse A: Okay, that’s okay, it just came in, but when you do get a chance please take a look at it. I think you’ll agree with me, it’s a really complicated compound fracture. I think that she’s right in saying 8 out of 10. Our main priority is to get that pain under control before you can do anything. Before you can even start thinking about prepping her for surgery, we need to get that pain management.
Nurse B: Mhm. Okay, I’ll go reassess her. Maybe, but I can’t imagine she’s having that much pain, but anyway…
Nurse A: Okay, yeah, go take another look. I think you’ll change your mind.
Later that night.
Nursing Supervisor: Hi Sheila, how are you doing?
Nurse B: Hey Kev, how are you?
Nursing Supervisor: I’m okay. I hear you had quite the night on the floor tonight.
Nurse B: [almost in tears] Brutal.
Nursing Supervisor: Mhm. Yeah, brutal. I was hearing… I was talking to Jordan, just to be upfront with you and that’s how I know it was a rough night. Tell me what was brutal about it.
Nurse B: Uh. I just- I feel… I feel sick. I really was ineffective. I just- I can’t believe it. We had this lady, you see, in Room 8, and she had a really bad fracture. And, you know, she came in and she was really, really emotional and, uh, you know Jordan evaluated her pain. And, you know I didn’t really agree with her. I thought she was just really upset and more emotional. And, the fact of, you know, how she was…
Nursing Supervisor: “How she was”? I’m a little confused. You mentioned emotional as well and, frankly, if I had a broken leg, I’d be pretty emotional too, so tell me more about that.
Nurse B: Well, you know… Well, she was really, really emotional and… you know, certain cultures, they can be more emotional, and it doesn’t mean that, you know… that we have to give them the maximum amount of pain medication. I mean, you know, it’s a high dose. It’s addictive and we have to be careful, you know, but… and yes, of course, she’d be upset. I mean… yeah, of course she would be. But that’s not what’s upsets me, you see, it’s… [holding back tears]. It’s like I have a- I have blind spot or something and, I mean, I just went against everything that I was taught, in terms of, like, patients’ pain. You want to believe what the patient says because that’s their perception. It’s not what I think. And, I was wrong! I assumed she didn’t have, you know, that much pain because, you know, who she was. And I assumed that she was just more emotional. Oh my god, Kevin… When we went to prep her for surgery – I mean I’ve seen people in pain but – she was in unbearable pain. I’ve never… And I gave her the minimal amount of an adult dose. It was barely spitting in a jar. I mean, it was not enough. You know, that’s on me. That’s what’s really upsetting me. I think I was… I didn’t help her. I could have harmed her and… You know, I’m a good person.
Better?
To be published in: Norris, J., Hobbs, K., & Mirror Theatre (In Press). Playbuilding as qualitative research.
[Four people hold tableau sculptures. Someone approaches the sculptures, assessing them.].
Fixer: Hmm… mhm [shakes head: “no”. She adjusts the first sculpture]. Better.
[Adjusts the second sculpture. Better. [The sculpture slowly molds back into its original position].
[Adjusts the third sculpture]. Better. [The sculpture slowly molds back into its original position].
[Adjusts the fourth sculpture]. Better. [The sculpture slowly molds back into its original position].
[Glances at her sculptures.] Better?
[The sculptures approach her and glance at her inquisitively] For whom?
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Contributors
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NadiaGanesh
Impact Researcher Lead. Nadia is a graduate student at Brock University who studies the psychology of prejudice and discrimination. She is currently conducting research on healthcare and hiring discrimination towards Women of Colour as she works towards a Masters degree in psychology. An Actor/Researcher/Teacherwith Mirror Theatre since 2017, Nadia co-directed a prevention program on the consequences of vaping in Niagararegionhigh schools.
Kevin Hobbs
Directorand Project Manager. Kevinis anactor, writer, researcher and educator. He employs narrative theory, performance and other artistic methodologies in his research and educational work. Presently Kevin is pursuing his PhD in Curriculum Studies, where he is exploring how performance pedagogies enhance healthcare education.
Sandy Howe
Experiential Education Lead. Sandy is the Associate Director of Experiential Education at Brock University and has a background in constructing and facilitating experiential pedagogy. Sandy and her team provided support throughout this project, including technical, administrative, creative and practical support. They also provided important feedback and insights throughout the entire project.
MikeM. Metz
Curriculum Developer, and lead author of the Facilitating Applied Theatre chapter. Mike is an educator, artist, and researcher. Mike utilizes Playbuildingand other arts-based methodologies to explore problems within education. Mike holds a Master of Education degree from the Ontario Institute of Studies in Education and will be pursuing his PhD in Education in the Fall of 2022.
Valerie Michaelson
Project Principal Investigator. Valerieis an Assistant Professor in the Department of Health Sciences at Brock University. Her research focuses on health equity and the social dimensions of the health, and she takes a critical social justice approach to her research and teaching.We first developed our workshop on Implicit Bias to support student learning in a 2ndyear course that she teaches regularly called “Health in Canadian Society.”
Joe Norris
Subject Matter Expert Dramatic Arts (SME-DA). Joe is an award-winning author on the use of participatory drama for research and pedagogical purposes. In this project he served as a curriculum consultant; assisted in the direction of scenarios and participatory workshops; trained module directors and actors; and assessed pilot versions for revision prior to distribution.
Sheila O’Keefe-McCarthy
Co-investigator. Sheila is an Associate Professor in the Department of Nursing at Brock University. Sheila is a cardio/vascular and pain researcher and critical care clinician, and she has a long-standing collaboration with Mirror Theatre. She is committed to conducting high quality patient-focused research that provides meaningful knowledge mobilization through use of integrated arts-based approaches to learning.
