Teaching Social Inequities in Canadian Occupational Therapy: Tensions and Strategies for an 'Embedded Sociologist'.

Abstract

Health professions education increasingly addresses social inequities, cultivating student awareness of structured power relations. Yet such teaching is met with resistance, with students prioritizing "hard" sciences and demanding immediate relevance and clinical application for everything taught. Sociological teaching and pedagogies are too often dismissed as "fluffy" and "wasting time." In Canada, professional competencies in occupational therapy now require practitioners to engage in anti-oppressive practice, which means education programs need to teach those skills. This article employs an autoethnographic approach to critically reflect on 25 years of teaching about social inequities in occupational therapy. Four challenges arise: 1. Epistemological dissonance, with objectivity and individualism deeply unsettled by sociological thinking; 2. Insistence on immediate relevance and application, which can lead to a problematic reliance on first-voices guests; 3. Simultaneous privilege and absence-of-privilege in the classroom, alongside a "charitable model" rescuing stance; and 4. The importance of emotion in learning difficult topics. A pedagogy of discomfort invites learners to stay present to the unsettling emotions that may arise as they confront systemic social power relations. This means moving away from notions of "safe" classrooms toward emphasizing courage in the face of complex feelings. Helplessness and powerlessness may be countered through cultivating critical hope, as a necessary step toward social change.