Patterns of race and gender representation in health assessment textbooks

With growing diversity in the nursing profession and in society, nursing educators face the challenge of selecting textbooks that promote cultural competence. A content analysis of photographs in nine health assessment textbooks was conducted in order to determine: 1) how accurately nurses and patients are presented in terms of race and gender; 2) how race and gender representations have changed over the last decade; and 3) how gender representations vary across different types of chapters within the texts. Although some recently published textbooks included a substantial proportion of photos of minority nurses, males and racial minorities were generally under-represented as nurses. Women and most ethnic minorities were consistently under-represented as patients. Female patients were also under-represented in cardiovascular and respiratory chapters and over-represented in chapters on reproduction. Nursing educators should screen visual images in textbooks for evidence of race and gender bias and inform publishers of the need for non-biased teaching materials.