Abstract
OT textbooks disseminate the official knowledge of the profession and communicate its values. A content analysis method was used to critically examine representations of race, gender, and disability to promote inclusive practices.
Primary Author and Speaker: Alisa Salbert
Additional Authors and Speakers: Taylor Choi, Efekona Nuwere, Madeline Tawil, Gabrielle Hershowitz, Karrianna L. Iseminger
Occupational therapy textbooks disseminate the official knowledge of the profession and communicate its values. Persistent biases within healthcare underscore the lack of racial, ethnic, gender, and disability representation within textbooks (Massie et al., 2021; Pusey-Reid et al., 2023). Underrepresentation can perpetuate implicit and explicit biases among students learning from these textbooks, impacting the quality of care delivered to future clients (Ogungbe et al., 2019). A quantitative and qualitative content analysis (Cena, McGruder, & Tomlin; 2002) was conducted to critically examine images and case studies imbued with racialized, gendered, and disability identities. Five textbooks were analyzed, four of which are among the most referenced by NBCOT OTR item writers (NBCOT, 2020). A preliminary analysis revealed three key themes: white females, essentialized and sterilized cultural representations, and authentic representations. The textbooks included in the analysis contained greater representations of white females as subjects, authors, and editors when compared to racialized, gendered, and minoritized groups. Markers of culture and identity represented in images and case studies were mixed. Often, these markers were absent, reductive, or reproduced heteronormative standards and society’s hierarchical structures. There were, however, notable exceptions where authentic perspectives and representations were included that promoted ideals of diversity and multiculturalism. Diverse representation in textbooks is a crucial component in the development of future occupational therapists who are clinically competent and culturally responsive. Reductive and scarce representations of race, ethnicity, gender, and disability perpetuate biases in healthcare and negatively affect students’ learning experience. We must continue to ensure educational content reflects the diverse populations served and enriches the quality of care future occupational therapy can provide.
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Massie, J. P., Cho, D. Y., Kneib, C. J., Sousa, J. D., Morrison, S. D., & Friedrich, J. B. (2021). A picture of modern medicine: Race and visual representation in medical literature. Journal of the National Medical Association, 113(1), 88–94. https://doi.org/10.1016/j.jnma.2020.07.013
Ogungbe, O., Mitra, A. K., & Roberts, J. K. (2019). A systematic review of implicit bias in health care: A call for intersectionality. IMC Journal of Medical Science, 13(1), 005. https://doi.org/10.3329/imcjms.v13i1.42050
Pusey-Reid, E., Quinn, L. W., Wong, J., & Wucherpfennig, A. (2023). Representation of dark skin tones in foundational nursing textbooks: An image analysis. Nurse Education Today, 130, 105927. https://doi.org/10.1016/j.nedt.2023.105927