e015. Learning Structures with Dr. Angela Alston

Full Interview with Dr. Angela Alston

Interview Transcript

[00:00:46] Amy: Welcome back to including you. I’m your host, Amy C. Waninger. I am also the founder and CEO of lead at any level. My guest today is Dr. Angela Alsten. Angela is the chief diversity officer at the Ohio state university college of nursing. Based in Columbus, Ohio, the college employs about 350 faculty and staff combined.

[00:01:06] Amy: Angela, welcome to the show.

Dr. Alston: Thank you Amy, for having me.

Amy: I am so excited to have you here, and I wanna just start with the basic why is diversity equity and inclusion important at the Ohio state university college of nursing? and specifically, why is it so important that they created a whole position to address the challenges of DEI at the campus?

[00:01:29] Dr. Alston: Diversity equity and inclusion is important to us in the college of nursing for a number of different reasons. Our society is becoming increasingly diverse. As we think about the need to prepare more clinicians for the type of healthcare environment that they are going to experience, it’s really important that they don’t just rely on perhaps on the job training.

[00:01:53] Dr. Alston: It’s really important to us as a college that we provide our students with the opportunity to be exposed to different types of individuals, their cultures, their preferences, backgrounds, et cetera, so that when they become our next generation of clinicians and practitioners, they’ve had learning that helps to better prepare them for the world in which they’re going to be practicing in.

[00:02:17] Dr. Alston: As our chief diversity officer, my role, doesn’t just focus on the support of our students, but I also help to support the needs of both our faculty and our staff within our college. It’s a big role, we’re growing college of nursing in a large metropolitan city here, as you mentioned in Columbus, Ohio. So, we have lots of diversity in our city as well.

[00:02:39] Dr. Alston: This role really helps us to look at how do we stay at the forefront of helping our students be better prepared? How do we help to ensure that we are really making a lasting mark on our communities by preparing clinicians for what they’re going to experience and having someone that is directly responsible and that we can have

[00:03:02] Dr. Alston: goals and outcomes tied to, and their metrics related to that. It’s really important if you don’t have true strategy around what it is that you’re trying to do, we have to question whether or not you’re really gonna get what you hope to get.

[00:03:18] Amy: Talk a little bit about that, about some of the goals and metrics that you’re tracking.

[00:03:23] Amy: What does success look like for you and for the college and how will you know, when you’ve gotten there?

[00:03:29] Dr. Alston: Sure, I don’t know that we will ever get there, and that’s something that is, might be weird to say, but it’s truly how I feel. I think I look at this as a journey. I don’t necessarily see it as a destination where we’re gonna achieve X and we’ll feel like we have made it,

[00:03:45] Dr. Alston: we have mastered the area of DEI. I think it’s ongoing training, but there are a few things that we use to help evaluate where we are. We don’t have a specific score card necessarily that we use within our college of nursing, but we certainly set goals at the beginning of each year with items that we hope to accomplish.

[00:04:05] Dr. Alston: As I think about that a little bit further, it’s really looking at how, what’s the environment looking like and feeling like for our faculty staff and students. You can feel the energy, people can tell when the environment feels more welcoming versus when it does not. So, there’s a perception factor that I think goes along with this, but also, I look at, what types of conversations have I had to be involved with faculty, staff and students over the course of an academic year?

[00:04:37] Dr. Alston: What types of new programmings have we developed? What were the outcomes of that? How much participation was there? What type of feedback that we received from those? We do a lot of training programs and looking at ways in which we can continue to be innovative in this space. Our college also annually applies for insight to diversity magazines, higher education excellence in diversity award or the heat award,

[00:05:04] Dr. Alston: which we have won for the past six consecutive years. So, that is certainly something that we use as a benchmark and we’ve recently completed our application for the 2022 year. So, we’re awaiting those results, which will come out in September of this year.

[00:05:20] Amy: I think that’s fantastic, and I’m curious as you think about the progress that you’ve made, can you cite one initiative or one, one type of activity that you feel has really

[00:05:31] Amy: been the key driver in your process? You have to come at this from a lot of different angles, cause there are a lot of different kinds of diversity, there are a lot of different ways to measure it and think about it, there are a lot of different stakeholders, but is there one area that you just feel like, man, we’re really nailing it.

[00:05:45] Dr. Alston: I, that’s a great question, and I’m rolling through the rolodex of my mind right now, trying to think about one specific thing that I feel like is an exemplar, and I can’t necessarily say Amy, that there is one particular thing because some of the initiatives that are focused on students are gonna look different than what we would have in place for faculty and staff

[00:06:08] Dr. Alston: and because our diversity strategy encompasses all of that. There’s not really one particular thing. I would say for our students, I think a strategy that has been incredibly helpful for them is helping to create structures by which to help support their learning, and so we’ve developed a couple different programs and I’ll just give you just a few examples of those here that I think are really making a difference for our students.

[00:06:33] Dr. Alston: We have developed what we call a success series programming, and so we have that available for new students when they come on board, and really what’s designed to do is help prepare these students for what we call some of the soft skills of nursing. So, thinking about how do they think about the concept of professionalism?

[00:06:53] Dr. Alston: What does it really mean to be a nurse? Yes, they’re in nursing school. They know what they’re gonna be going through in terms of clinicals, but there’s some unspoken rules, I think, as it relates to being in nursing school, that this program is designed to help assist our students with facilitating and also getting to know and talk with faculty, getting to talk with current students

[00:07:14] Dr. Alston: before they’re actually immersed into the program, and so we have that type of program that I think is something that will continue to grow. It’s relatively new, it’s now gone through two cycles or two academic years. So, it’s newer, but it’s certainly something that I think has a lot of potential, and as we recognize

[00:07:31] Dr. Alston: what types of challenges have we had over the year? Those are the types of things that we can look at how do we incorporate into a program such as this, to try to address those things, to make sure that our students are as best prepared as possible. Another program that we have, we offer a summer institute for future nurses program, which is designed for high school students, really trying to get them exposure to nursing,

[00:07:55] Dr. Alston: and so as we think about the fact that it’s hard for kid, I think to be what they don’t see, kids need exposure. They need to know that nurses don’t all look a certain way, and so it’s important for them to see the uniqueness of that and have that kind of exposure. So that’s something that we’ve been doing a while

[00:08:14] Dr. Alston: that program was in place, even before my tenure at the college, I’ve been there for just three years now. So that was something that was in place and going well, even before my arrival, certainly count that as something that we’re doing well. Another thing that I like and something that I instituted when COVID came on board was I created these sessions that I called chats with the chief diversity officer,

[00:08:39] Dr. Alston: and so, I sit down monthly with faculty and staff, really creating an open environment for us to communicate about whatever is on the hearts and minds of individuals. It’s nothing it’s been offered via zoom because of COVID, it’s nothing that’s recorded, but it really just gives individuals a chance to connecting with me as their chief diversity officer bringing any issues forward,

[00:09:02] Dr. Alston: if there’s something that’s going on in the news or in the media, we have a forum by which we can have conversations and be open and be vulnerable, and I’ve been really honestly pleased and impressed with how open some of our faculty staff have been in regards to talking about things. But I think the bigger thing that’s important for faculty and staff is that space has been created.

[00:09:27] Dr. Alston: Sometimes people just need to be able to talk about what’s going on, feel heard and feel validated. And so those types of sessions are something that, for me, it’s not something that’s been going on for five years, but it’s certainly something that I think others could model in terms of how are you creating open space for people to communicate on a regular basis and have that direct one-to-one contact with their leader around this topic?

[00:09:55] Amy: So, it sounds like you’ve implemented different learning structures for different groups.

Dr. Alston: Yes.

Amy: From high school students to incoming students, to faculty and staff, and what have been some of the benefits of that, that you’ve seen, are you seeing, for example, an uptick in applications to the school from the high school program? are you seeing better graduation rates because of the incoming students program?

[00:10:16] Amy: Are you seeing better retention rates among faculty and staff? How are you gauging the success?

[00:10:21] Dr. Alston: Sure, because these programs are relatively new, those metrics are really not known just yet. We’re not at a point that I can really report out on those numbers, but those are absolutely the types of things that we would be looking at.

[00:10:33] Dr. Alston: It is my hope that more people will feel more included, more involved and really enjoy the details of their job because of the environment that’s been created, now it’s not just about DEI strategy that I think is important to individuals in terms of retention. Our college really does help to support health and wellness with our faculty, staff and students, which I think is incredibly important,

[00:10:57] Dr. Alston: and we’re fortunate to have the college’s chief wellness officer as our team, the college of nursing. So, we really do have that environment where we want people to take care of themselves. Not just around DEI, but just broadly. So, I say all of that to say, I don’t yet have those types of metrics yet to be able to report out on, but those are certainly the types of things that we would look for.

[00:11:22] Dr. Alston: We do have a climate wellness survey that’s going to come out in the fall of this year, been instituted by our, by the Ohio state university. So, we’ll see what kind of feedback we get from that in terms of how people are feeling about what’s going on within our college. I don’t know the details of what those questions are going to look like, but I imagine it’s gonna ask them about the environment in which they are working and how things are going,

[00:11:48] Dr. Alston: and so I’m looking forward to seeing what kind of feedback we get from that and how it measures up to some of the things that we’ve put in place to try to help support faculty, staff, and students.

[00:11:59] Amy: Yeah, I think this notion of wellness has become merged into, or sort of an overlay of a lot of the DNI work that I’m seeing done.

[00:12:07] Amy: A lot of the human resources work broadly that I’m seeing done, around employee engagement and employee satisfaction. It’s, it seems to me to be not just an employee engagement effort, but also a mitigation against things like Workplace violence and increased health expenses because people are literally breaking down right now.

[00:12:29] Amy: We’ve been under so much stress as a society for, a couple of years collectively, right? I know that black and brown employees have been under a lot more stress for a lot longer as a chronic condition of the way our nation and our workplaces are structured.

[00:12:46] Amy: But I’m wondering if you are seeing, as you think about the wellness piece, do you see wellness as an equity play within your organization or do you have concerns that the application of wellness is? I’m not sure exactly how to put this, but is it being distributed in the same way that other resources are being distributed?

[00:13:10] Amy: So, do you feel like there’s a closing of the gap there?

[00:13:14] Dr. Alston: Sure, I think the application of wellness principles certainly look different for different individuals. So, if someone’s role, doesn’t have perhaps the same level of degree of flexibility as another role, then what that might look like in terms of how they navigate their day,

[00:13:34] Dr. Alston: you could see some differences there. So, I don’t think that the concept of what everyone is able to do for wellness is going to look the same because, just individuals, and then again, thinking about the scope of their work, and then also thinking about our students, they have classes, they have clinical rotations that they have to do,

[00:13:53] Dr. Alston: they have tests that they have to prepare for there’s different layers that just come along with being a student. So, their wellness strategies are going to be different. So, I don’t know if I’d necessarily call them inequities around it necessarily, or a word similar to that, I think it’s just a recognition

[00:14:10] Dr. Alston: that there is no universal principle around wellness for everyone. What we try to do is equip our college members, faculty, staff and students. With a variety of tools, and so what you get to do is figure out within that toolbox, what’s gonna work for you. So, if I take myself, for example, what works for me in terms of wellness?

[00:14:31] Dr. Alston: I’m gonna get up a little bit and step away from the computer, maybe I’ll do some walking meetings if it’s something via zoom that I don’t have to have my camera on, and I’m getting some steps in and getting my heart rate pumping well, that sort of thing. But for someone else, if their meetings require them to always have to have the camera on, that’s not necessarily an option for them without it looking distracting to others.

[00:14:55] Dr. Alston: So, I think it’s just a recognition of giving people different tools and helping them feel supported to utilize whatever works for them to achieve a sense of wellness that feels right for them.

[00:15:08] Amy: I think it’s important too, when you’re talking about in the college setting, you’re going to have nurses graduating and going into very hectic, very stressful workplaces,

[00:15:17] Amy: nurses are experiencing, across the board, very high rates of burnout. Lots of nurses have left the practice in the last months and up to, a couple years, and so it sounds like the tools that they’re getting in school are going to help them with longevity in their careers as well.

[00:15:35] Dr. Alston: Yes, absolutely. It’s preparing them to be the future clinicians that they’re going to be with my class for example, this semester I start things off with a mindfulness moment, and so I read something inspirational to my students, I ask them to just put everything down for a moment and just focus on the sound of my voice,

[00:15:55] Dr. Alston: and I read something that I think will be uplifting to them, hopefully, it was uplifting to me, so I share it with them, but just to give them a sense of calm before we get started with the day and wanting them to just recognize, sometimes you just need to take a minute, just take a minute, calm down for a second and then approach whatever is at hand,

[00:16:15] Dr. Alston: and I think that helps us with clarity around whatever it is that’s going on. I’m one of those people I believe just haste makes waste, and so I think when we rush and do things, that’s when we make lots of mistakes, even when we think about implicit biases, for example, we know that when people make kneejerk reactions, when people are thinking too quickly, They are more likely to allow those types of biases to creep in.

[00:16:41] Dr. Alston: So, there’s a lot of value to taking a moment and then proceeding, and that’s something that I’m trying to instill in my students as well.

[00:16:50] Amy: This mindfulness will really save lives in practice because, when, as you said, when we’re stressed, when there’s a lot going on, we tend to get very focused on whatever is in front of us,

[00:17:02] Amy: we’re goal oriented. Right? I want to finish this task. I want to get this off my plate, move on to the next task, and if the information or data that nurses need is not right in front of them in that moment, they may forget to look a little bit left or right.

[00:17:15] Amy: Check their peripheral vision, literally or figuratively to see what else might be going on, taking a whole picture of a patient or a circumstance or a family environment or something like that, they can really mean the difference between whether or not a patient receives appropriate care.

[00:17:35] Dr. Alston: Sure. You’re absolutely right.

[00:17:35] Amy: I’m thinking then that there’s a lot of education going into your students, are they then, are they going into hospital environments that are prepared to continue that education or are they really coming in as thought leaders at that point to help the hospitals catch up to these industry trends, to these population differences, to these societal pressures that are emerging and ongoing.

[00:18:03] Dr. Alston: Sure, so it’s hard for me to answer that completely broadly, just because I can’t speak to the layer of depth that the different organizations that they’re performing their rotations in, or perhaps where they’re gonna work, what it’s going to look like. But what I can say is that I believe it will probably be a combination of what you mentioned there.

[00:18:24] Dr. Alston: I think that we will have some clinicians who will go into areas and there will be great opportunity for them to introduce what may be novel concepts or ideas to the organization. Maybe not necessarily to the world, but they will have the opportunity to bring that to the table based upon what they’ve seen in places that they’ve been within their learning environment or what they’ve been exposed to as a student.

[00:18:47] Dr. Alston: I think there will be some organizations who are very much, a little bit further along the DEI journey and have already had some structures in place and maybe have some well-defined trainings that people are required to do on an annual basis, and they will help to keep the momentum of that going. So, I think that it’s probably going to be a combination of it’s my hope that more students will continue to be employees who will be engaged,

[00:19:15] Dr. Alston: who will feel the confidence to speak up about what is not right and not sit back and sit silently. I think we’re in the situations that we are in because there have just been chronically individuals who have set back and not said anything, because maybe it wasn’t directly affecting them, and I feel like in today’s society, we have a lot more individuals who are willing to say that this is not right,

[00:19:44] Dr. Alston: I don’t agree with this, I think we should do something differently, and so I think encouraging students to do that is going to prepare more healthcare clinicians and ultimately leaders who will not tolerate some of the things that have been in place for so long in this country that have helped to contribute to some of the inequities that we see in healthcare, not just in the delivery of care, but even in some of the background, things that we don’t see that create the structures and policies that allow some of these types of things to continue to thrive.

[00:20:18] Amy: Yeah, this notion of background and context is so important because it’s not just the delivery of care, as you said, it’s access to healthcare, but then not just access to healthcare, what’s the access to wellness. What are the environments that people are living in?

[00:20:31] Amy: And these things all contribute to whether or not people need healthcare access and delivery in the first place, right?

[00:20:40] Dr. Alston: Absolutely, I just recently did a lecture and we talked about the social determinants of health and helping students to understand that the patient is not just what there is so much more that’s going on to contribute to who they are and how they present to you for care.

[00:20:56] Dr. Alston: So, you’re absolutely right. You take, for example, when people come in for healthcare, we’re talking with patients about wellness and getting out and exercise. We take for granted that everyone can safely get out into their neighborhood and walk around for 20, 30 minutes a day. Maybe it’s not safe for them to be able to do, but if we’re not asking, if we’re not being considerate of that, we could be recommending something that could potentially instill some sense of panic or harm to the patient.

[00:21:25] Dr. Alston: So, you’re absolutely right, and we are helping our students to understand those dynamics. I don’t believe I’m a nurse practitioner, I still see patients myself, I don’t believe that people just wake up and say, I don’t care about my health today, I don’t care what happens. I don’t believe that, but we know that situations that people are born into, we know that where they live life expectancy can vary depending upon the zip code in which someone lives.

[00:21:54] Dr. Alston: So, there are a lot of factors that are at place for what types of people are going to be ultimately what their health potentially may look like. Yes, there are genetic factors or things that people are born with that they can’t do anything about, but there are other variables that play as well,

[00:22:10] Dr. Alston: and some of those are us as a healthcare team, what type of experience are we helping to create for people? When we talked earlier about some of the things that we’re thinking about in our college of nursing, we recognize the need to have a more diverse group of nurses, advanced practice nurses, and other clinician leaders

[00:22:31] Dr. Alston: in the field, it’s incredibly important. Studies show that patient outcomes tend to be better when they can relate to their healthcare provider. So, it makes sense for the need, for us to educate a more diverse group of clinicians, to better meet the needs of the individuals that we’re seeing, and we know that our society, no matter where you live is becoming increasingly diverse or different than what it wants used to be.

[00:23:02] Amy: So Dr. Alston, what’s next for you? As chief diversity officer for the college of nursing, what are some of the future initiatives you’re hoping to undertake?

[00:23:09] Dr. Alston: Sure. I’m really interested, as I mentioned to see what the university climate wellness survey results are going to look like, and if that might inform a different strategy for us, I certainly wanna continue on with some of the programming that we’re doing that

[00:23:25] Dr. Alston: even though it may be new, it’s showing great potential. It has the opportunity for us to thrive. I do wanna continue to create these open forums and open space for communication, and that allows me to hear from individuals about what is important to them. I look at my role as the chief diversity officer as not the one that’s solely responsible for DEI within our college.

[00:23:48] Dr. Alston: This is everyone’s responsibility, and what I hope through, the education forums that I do, I always tell people I’m not perfect, I don’t have all the answers, it doesn’t always come out right when I say things and I need people to understand the humanness of that so that they don’t feel afraid to try or do something differently because they’re worried that it’s not gonna come out

[00:24:12] Dr. Alston: right, so I always let people know. I don’t always say things the right way, I make mistakes, I correct them and I move forward, and that’s really what we’re wanting everyone to be able to do. In terms of what’s next, we have an innovation and entrepreneurial fellowship program that’s going on within our college of nursing,

[00:24:29] Dr. Alston: and I’m one of those inaugural fellows. So, I can’t share publicly just yet what my project is going to look like, but I would certainly say be on the lookout for some innovative changes that we’re looking at as it relates to DEI. There is one thing too, Amy, that I wanted to mention just that others are listening from colleges of nursing.

[00:24:49] Dr. Alston: We’re doing some educational training around bias in the admission review process, for example. So, as we talk about the need to bring in more students from underrepresented groups, really thinking about the individuals who are participating in that selection process and what that looks like. So that’s certainly something that, we will look at continuing to do to help better prepare those for the admission process in the training of that, to understand really the huge responsibility that lies in those who helped to make recommendations on who’s going to be admitted for nursing school.

[00:25:25] Amy: I think educating gatekeepers is such a critical component of any program, because if there are people who, if there are people who are guarding the rope, and they don’t change their behavior. It doesn’t matter what you’re doing inside at all.

[00:25:40] Dr. Alston: No, you’re absolutely right. If you think about it from an office setting with the people who take your insurance card and check you in truly are gatekeepers, and they can set the stage for how that patient is ultimately going to feel about their visit.

[00:25:55] Dr. Alston: It’s incredibly important. That’s a great example, Amy. Thank you for sharing that.

[00:26:00] Amy: Yeah, thank you so much, Angela, for being on the show. Thank you for sharing what you’re doing at the Ohio state university school of nursing. I’ve interviewed a couple of people already about, college and university programs.

[00:26:10] Amy: I’ve interviewed some folks in healthcare, but I think for these theories, you’re the first one to combine the two, which is fantastic, and I really appreciate what you’re doing and I hope that you’ll keep us apprised of all of the innovation coming our way.

[00:26:24] Dr. Alston: Yes. Thank you so much, Amy, for having me today.

[00:26:26] Dr. Alston: Appreciate it.