Summary
In this paper, a laboratory experiment that is addressed in a health science chemistry course is described. The goal of this experiment was to link the functional group chemistry with a context that is relevant to students’ lives, the patients they will serve in their vocation, and larger society, using an appropriate cultural competence and justice-centered framework.
Dipstick urinalysis is frequently used to screen for various conditions and is used weekly in the last month of pregnancy. This lab models the prenatal clinical environment and allows for testing of chemical species that support a medical diagnosis: albumin testing for preeclampsia; leukocytes, nitrites, and pH for urinary tract infection; glucose, ketones, and pH to test for gestational diabetes, alcoholism, or other serious metabolic diseases. The related lessons were designed to support students in understanding the reactions involved in testing, biochemistry related to diagnosis, and test interpretation. While developing this experiment, the authors were confronted with disparities in prenatal care, namely, the absence of culturally competent care, inequitable access to care, and toxic stress due to racism that contribute to dramatically increased maternal death rates for women of color in the US.
To evaluate the impact of this approach two research questions have been devised. The first one was relevant with understanding of organic chemistry concepts and practices and the second with the intersection of this laboratory experiment with the cultural competence and social justice frameworks identified in the nursing profession.
The experimental procedures, the pedagogical approach used and the cultural competence and social justice framework applied, are presented.
A design-based research (DBR) methodology was used in order to address the research questions and to inform laboratory development. To evaluate chemistry learning, the authors studied outcome measures from students’ performed prelab, in-lab and postlab activities. To study outcomes with respect to cultural competence, codes for student work based on the applied framework were developed and student work for emergent codes was further examined The results are discussed in detail.
The findings indicated that student understandings of the chemistry and testing methods were adequate; on average, 77% of samples were properly diagnosed. With respect to social justice and cultural competence, the authors found that students predominantly discussed two elements of the cultural competence and social justice framework: reflection on privilege in society and agency to promote equity in healthcare.
Relevance for Complex Systems Knowledge
This paper proposes an approach to reimagine higher education at Health Science departments as it presents a simple experiment that connects organic functional groups to health equity. It deals with system thinking as social justice learning is particularly apt at supporting “system-as-cause” thinking, which encourages students to see particular outcomes as part of a larger system and not as isolated, random events.
