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case-based learning, nursing education methods, positionality, problem-based learning, race relations, systemic racism



  1. Altman, Molly R. PhD, CNM, MPH
  2. Kantrowitz-Gordon, Ira PhD, CNM
  3. Moise, Elba BA, MPH
  4. Malcolm, Katie PhD
  5. Vidakovic, Milan PhD
  6. Barrington, Wendy PhD
  7. O'Connor, M. Rebecca PhD, RN
  8. de Castro, A. B. PhD, MSN/MPH, RN, FAAN


Background: Case-based learning has historically focused on the individual patient; however, there is often little consideration within this teaching method of how social determinants of health, such as structural racism and its adverse health effects, bear upon patients' health status and consequent patient outcomes.


Problem: Implementing case studies necessitates taking into account the positionality of patients, as well as health care providers, to counter the racial oppression and discrimination embedded in existing health care and educational systems.


Approach: We describe a process for creating an inclusive, antiracist environment for case-based learning within nursing education, outlining steps for preparing students to more effectively examine case studies through social determinants of health framing and lens to mitigate harmful impacts from systemic racism and racial discrimination in clinical care.


Conclusions: Addressing positionality in case-based learning is one antiracist strategy to begin rectifying health disparities and moving health care toward equity.