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Abstract

This article offers a critical examination of the pervasive issue of anti-Black racism within the Canadian physiotherapy (PT) academy. Despite initiatives aimed at addressing inequities in health professions education, systemic barriers to equity, diversity, and inclusion persist for the Black PT learner and practitioner. The profession is characterized by whiteness. Employing a critical race methodology, the historical roots and contemporary manifestations of anti-Black racism on campus are analyzed through a critical race theory and critical race feminist lens in response to the call by Canadian PT scholars to advance critical anti-racism research in this field. Our findings reveal a pattern of discrimination and exclusionary practices within the profession. Specifically, it uncovers a hostile racial climate influenced by ‘racial realism,’ a concept with origins linked to slavery, white supremacy, and negro-ness.

Moreover, we discuss the potential ramifications of systemic racism that negatively impacts Black students, in particular those who identify as women. These include reactive invisibility, intersectional disempowerment, representational intersectionality, and hypervisibility of Black women. Paradoxically, the ramifications of this article will be to make the presence of anti-Blackness within the PT educational environment hyper-visible. It provides an opportunity for the academy to critically analyze anti-Blackness in the PT environment as an initial step to guide future anti-racist actions and research endeavors.

Introduction

“Don’t think there are no crocodiles, just because the water’s calm” (African Proverb).

This article opens with an African proverb that underscores the significance of the environment in determining an individual’s ability to merely survive or thrive. We, the Black[1], cis-gendered, female physiotherapists (PTs) and authors of this work, aim to confront anti-Blackness, whiteness, and white[2] supremacy within the field of PT that may serve to perpetuate inequities in racialized populations, directly opposing thriving. Within this discourse, our investigation contributes to a more inclusive and equitable understanding of the human experience by amplifying the voices of Black individuals within the PT academy.

Experiencing Anti-Blackness

Anti-Blackness refers to a type of racism that is deeply ingrained in the laws and policies of Canadian institutions including education, healthcare, prisons, and the workforce.^2-6 It specifically targets Black individuals and is rooted in white supremacy, colonization, and the slave trade.^4,7 As Black women and former PT students at Canadian universities, we have encountered anti-Blackness and its detrimental consequences in this academic setting. These experiences are the motivation to pursue research that focuses on critical epistemologies aimed at documenting, analyzing, and transforming anti-Blackness in PT practice. In this article, anti-Blackness refers to all forms of racial aggression experienced by Black individuals.

This project is grounded in four premises:

1. Race is a social construct manufactured by white colonizers and legitimized by policies to define hierarchy and accumulate capital. It is devoid of biological reality. ^8-10
2. Institutional factors, coupled with the process of racialization, allow those at the top of the hierarchy to enjoy better economic, political, and social benefits.¹¹
3. People’s experiences are significantly influenced by their interactions with institutions that are informed by their race and other intersecting identities.¹²
4. The Canadian PT academy is predominantly characterized by anti-Blackness, with Black students often facing exclusion, discrimination, and low academic grades.¹ Black physiotherapists are also devalued in the workplace.¹³

CRT Applied to PT Education in Canada

The primary objective of our research is to investigate and expand anti-Blackness research within the rehabilitation sciences, with a focus on the field of PT education in Canada. Employing critical race theory (CRT) as a theoretical perspective and framework, we seek to illuminate the documented evidence of anti-Blackness within the Canadian PT academy. Research focusing solely on Black participants in the Canadian PT academy remains limited, with only Wegrzyn et al¹ having published on this topic. However, their study did not extensively analyze the data using CRT, as indicated in their study’s limitations. Hence, our project aims to conduct an in-depth analysis of their published data, incorporating CRT perspectives.

CRF Perspectives

Moreover, we intend to employ critical race feminism (CRF) perspectives to explore the phenomenon of gendered racism¹⁴ among Black women students within the PT educational setting. Through this approach, we aim to present CRT and CRF as rigorous theoretical concepts and frameworks suitable for the analysis of anti-Blackness in Canadian PT schools, thus addressing the call by Canadian PT scholars to advance CRT and anti-racism research in this field.^1,13,15 Additionally, our research aims to expand the limited scholarly knowledge in the Canadian academy regarding the intersecting identities of PT students. Furthermore, the over-representation of white PTs in the field, combined with evidence of systemic racism, may unwittingly perpetuate health inequities by limiting the potential benefits of PT treatments in racialized populations.^13,38,40-42 Consequently, this study may hold significant implications for population health.

To examine and dismantle contemporary racism, it is imperative to account for historical patterns, as they provide insights into the roots of this oppression and are essential for devising effective strategies for its eradication.^16-19 Therefore, in the following section, we explore the history of anti-Blackness in Canada and contextualize it within the Canadian PT Academy. An all-encompassing history is beyond the scope of this discourse.

Background and Context

History of Anti-Blackness in Canada

For 200 years, beginning in the 1600s, Canadian colonizers, like their American counterparts, violently removed Black individuals from their native lands and forced them into chattel slavery on stolen land.^20-21 These actions were legally sanctioned by the government during this period.^22-23 The resulting construct of “Negro-ness,” ie, “the construction of non-humanness by the West,”^24(p245) effectively legitimized chattel slavery and rationalized the idea that Black lives held value only as white property.^{22, 25-26} Additionally, this logic of Negro-ness serves as a stronghold of white supremacy resulting in detrimental consequences that continue to impact Black lives to this day.^6-7

Despite popular beliefs that anti-Blackness is not as pervasive as in the United States, it is deeply embedded in everyday life in Canada.^12,27 One of the reasons for its persistence is a false notion that all Black Canadians are new immigrants and their issues are related to being out of place.^26,28 We know that Black Canadians have been present in Canada since the 1600s.²³ Moreover, in 2016, approximately 44% of Black Canadians were born in Canada.²⁹

Anti-Blackness and Canadian PT

PT is recognized as an allied health profession within the realm of rehabilitation sciences, with eligibility requirements varying among the 15 Canadian universities offering postgraduate programs in this field.³⁰ The origins of this profession can be traced back to China in 3000 BC, although the profession as we know it was later developed in Sweden.³¹ In Canada, PT gained traction following World War I, when returning soldiers required rehabilitation services.³² However, the country was plagued by institutionalized racism during this period, with Black soldiers serving in segregated military units.³³ It is plausible the anti-Blackness that existed at the inception of the profession has contributed to the whiteness of the profession, although there is a lack of anti-racism research to prove this definitively.

Recent research has shown that anti-Blackness is prevalent in healthcare and health professions education in Canada, including nursing, medicine, and occupational therapy.^{1,4,13,15,34-36} However, there is limited research on this issue in Canadian PT academia, as most studies have focused on the United States (US) and the United Kingdom (UK). ^13,15,37-38

The available Canadian studies have consistently found that PT education and the profession are characterized by whiteness, which is distressing to Black individuals and reinforced by institutional factors.^1,13,15 Anti-Blackness in Canadian PT education restricts the entry and upward mobility of Black individuals,¹ which may result in an under-representation of Black physiotherapists in the Canadian workforce. A significant under-representation of Black people in the field of PT has also been observed in the UK and US.^38-39

Theoretical Frameworks

Critical Race Theory

Critical race theory (CRT) emerged from critical legal scholarship (CLS) as a response to the racist judiciary decisions in the American legal system that negatively impacted racialized groups.^8,43 Developed to examine racial matters, it actively works toward social justice and the elimination of racial oppression.^44,19 The first use of a CRT framework in education (K-12) was by Gloria Ladson-Billings and William Tate in 1995. It was introduced in higher education by Solorzano⁴⁵ in 1998 to examine the role of racial and gender aggression in Mexican-American scholars. Although the CRT framework is still developing within Canadian PT studies,^1,13,15 its utilization in our research is essential because it aligns with our objectives, especially given the historical context of anti-Blackness within Canada and the PT academy. The subsequent section elucidates the core principles of CRT that substantiate its relevance to our study.

The Fundamental Principles of Critical Race Theory

Centralization of Race, Racism, and Intersectionality. In the field of education, CRT operates based on the assumption that racism is present and pervasive in educational institutions, and aims to eliminate it.¹⁹ It prioritizes racism, taking into account varying intersecting identities, thereby rejecting essentialism.^8,19,43 In anti-Blackness works in Canada, a CRT approach is particularly significant, as racism is often analyzed within the context of multiculturalism, which has been criticized for perpetuating oppressive and colonial practices, erasing the unique needs of different cultures, and releasing institutions from their specific anti-racist obligations.^3,12,46 Specifically, it is crucial to emphasize that the Canadian PT academy has significant challenges related to anti-Blackness.^1,13,15

Transformation and Social Justice. CRT portrays educational institutions as having a dual nature, serving both as a means of perpetuating racial oppression and as a tool for promoting social justice through transformation.¹⁹ It analyzes how dominant ideologies are embedded in educational policies, practice, research, and theory to further the racial oppression, exclusion, and marginalization of racialized people.⁴⁵ The Canadian PT academy exhibits evidence of Eurocentric ideologies and epistemologies, resulting in adverse effects on racialized PT students.^71,72 Despite the nascent state of critical and anti-racism research in Canadian PT,¹ we posit that the academy possesses the potential to engage in such research, employing methodologies that prevent the distortion of narratives related to oppression.

Liberalism Critique. CRT challenges claims of neutrality and color blindness inherent in educational liberalism given that it exacerbates harm to racialized students by promoting meritocracy as an answer to education inequity.^8,10,19,43 The culture of whiteness in Canadian PT renders anti-Black racism invisible to the majority, potentially bearing consequences for promoting neutrality in the academy.¹

Amplification of the Experience of the Oppressed. This is of utmost relevance to this project as it centralizes and legitimizes the experiences and perspectives of Black people providing a distinct conceptualization and examination of anti-Blackness that challenges prevailing ideologies of racism.^8,19,43,47

Historical Context and Inter-disciplinary Context. CRT acknowledges the historical context of racialization and the institutionalization of these belief systems, which continue to cause harm to racialized communities.¹⁰ It incorporates critical epistemologies from Critical Legal Studies (CLS) and other disciplines, such as Ethnic Studies, Women’s Studies, Sociology, and History, to enhance perspectives that deeply explore the historical and institutional contexts of racism and racialization.^17,19 In this study, we have elucidated the historical context of anti-Blackness in Canada and its implications for the contemporary state of the PT profession. Moreover, the data in this study is analyzed using epistemologies from various disciplines, including Law^16,63 and other disciplines.^19,58,62

Critical Race Feminism

Critical Race Feminism (CRF) stemmed from CRT and CLS in the late 20th century and is intended to analyze the intersection of race and gender within a feminist perspective.^9,27 Although the roots of this ideology can be traced back centuries to the practices of women, such as Harriet Tubman and Sojourner Truth,⁴⁹ its emergence was prompted by the marginalization of female critical-race scholars who were racialized by both men within their communities and white feminists. In addition to the foundational principles of CRT, CRF is fundamentally anti-essentialist.⁹

Anti-essentialism is a concept that challenges the notion of a shared identity among groups such as women or Black people. As articulated by Wing,⁹ the idea of “multiplicative identity”^9(p7) posits that Black women are not simply white women with added racial identity or Black men with added gender identity. This concept, popularized by Kimberlé Crenshaw, a leading figure in the CRF movement, forms the foundation of the intersectionality theory. This notion of intersecting identities has been embraced by the Canadian third wave of feminists, who have questioned the role of earlier generations of white feminists in the marginalization of racialized women.²⁷

Black women experience a distinct and intersectional form of oppression, referred to as misogynoir.⁵⁰ CRF methodology draws on critical race theory and feminist theories, such as Black feminist thought, to analyze misogynoir.^51,52 Like Black feminism, CRF recognizes that Black women occupy a complex intersectionality matrix, defined as a “specific location where multiple systems of oppression simultaneously intersect and subjugate to conceal deliberate, marginalizing ideological maneuvers that define otherness.”^51(p454) As an intersectionality matrix, the Canadian faculties of PT may impose boundaries on how Black women experience their education and how they are perceived by that institution. The CRF framework is appropriate and valuable for this research, as it presents, illuminates, analyzes, and challenges hegemonic ideologies that oppress Black women in higher educational institutions.^14,49,52

Methodology and Methods

In this project, we utilize Critical Race Methodology (CRM),¹⁹ which aligns well with our research aims and objectives. Grounded in CRT, CRM examines the interconnected nature of racialized oppression, considering factors like race, gender, and accent, among others. This methodology is deemed apt for investigating the experiences of racialized individuals within higher education settings.¹⁹ Notably, CRM diverges from prevailing methodologies and epistemologies by recognizing the credibility of various data sources, including lived experiences, existing literature, and the authors’ personal and professional insights.

Data Collection and Search Strategy

A rapid literature search was conducted to identify how anti-Blackness is reported and perpetuated in PT education in Canada. This is an efficient and trusted method of synthesizing evidence for research.⁵³

In February 2023, the search was conducted across several databases, including PUBMED, PEDRO, SCOPUS, PsychInfo, and ERIC, as well as gray literature. The search was conducted using the following terms: “Anti-Blackness,” “Physiotherapy,” AND “Canada,”. The search also included synonyms common to these terms and applied wildcard and Boolean operators where applicable. In total, the search yielded 3,041 articles.

Study Selection

Upon completion of the search and removal of duplicates, the titles and abstracts of the retrieved articles were screened. Four full texts were reviewed in cases where the abstracts lacked sufficient information. One reviewer completed the search and data extraction, an acceptable approach for conducting a rapid literature search.⁵³ Our inclusion criteria mandated the utilization of narratives exclusively from Black students/ Black physiotherapists as data, alongside the provision of sufficient demographic information attached to the published excerpts of these narratives. Additionally, the selected studies were required to focus on anti-racism in the PT academy. Ideal studies identified Black female PT students. Studies that did not specify the race of its participants were excluded. None of the screened articles met the initial eligibility criteria. However, Wegrzyn et al’s¹ anti-Blackness study was selected because it was the only one available that focused on exclusively utilizing Black students in the Canadian PT academy, although the gender information of participants was not provided.

Originally, we intended to rely on published data exclusively from studies that focused on Black participants in Canada. However, due to the limited literature available in this specific area, we opted to broaden our approach. We turned to research in UK PT education for its pertinent insights into anti-Blackness, which demonstrated parallels with the Canadian context.^13,15,37,38 This decision was also influenced by the closely linked historical roots of PT practice in both Canada and the UK.⁷⁴ Consequently, while not formally part of the rapid review, Hammond et al’s³⁷ scholarly work from the UK was also incorporated into our study, an approach acceptable within CRM.¹⁹ This study³⁷ offers relevant insights into anti-Blackness and shares parallels with the Canadian context. Additionally, it met our inclusion criteria as it identifies both the race and gender of participants with excerpts of their narratives. Their study³⁷ also included Black female PT students in its participant pool.

In the study by Wegryzn and colleagues,¹ narratives were collected from seven Black physiotherapists, a Black PT student, and two university staff. They analyzed these narratives using the definitions of institutionalized and personally-mediated racism explained in a theoretical framework by the public health physician Camara Jones.⁵⁴ Additionally, the study utilized the work of cultural theorist Sara Ahmed’s 2006 work to explore how PT schools are oriented toward whiteness.⁷⁶

Hammond et al³⁷ collected narratives from 17 PT students, including Black, Asian, and other non-specified racialized groups, using focus group interviews. Although they did not strictly employ CRT, they utilized a thematic analysis framework alongside a CRT lens to analyze their data. Their findings were similar to those of Wegryzn et al,¹ indicating that racism is pervasive in the PT academy. The themes identified in their study included racialized people feeling like outsiders, a lack of response from the faculty, and persistence as a strategy by racialized people to persevere despite a lack of power. In total, we collated nine data entries, seven from Wegrzyn et al¹ and two from Hammond et al.³

Data Analysis

We conducted an analysis of previously published narratives from only Black PT students and Black physiotherapists from the Canadian study (Wegryzn et al¹), and Black female PT students from the UK study (Hammond et al³⁷). A continuous examination and re-examination of the data was conducted until discernible patterns emerged,⁷⁵ an approach done by others in higher education that utilize a critical race methodology to analyze racism.^19,45 Specifically, a four-step process was used to analyze data.

First, a dataset was created by collecting the nine entries of data from the narratives of participants and the preceding statements for context as provided by the authors in the selected articles. Aligned with the research objectives, the Canadian study¹ exclusively included narratives relevant to physiotherapy education, while the UK study³⁷ encompassed narratives specifying the participants’ race as Black.

Next, specific forms of anti-Blackness in each data entry were identified and conceptualized drawing on the principles of CRT and CRF, while using related philosophies extracted from applicable scholarly works.

Subsequently, similar concepts were grouped into related categories.^57-58

Lastly, the first author’s experiences (OO) of anti-Blackness in this context were incorporated as they relate to specific concepts and ideas during the analytical process, a practice common in CRM.^19,47,59

Results

Racial Realism

In his seminal work on critical race theory, Bell¹⁶—a CRT founding scholar—introduced the concept of racial realism, which posits that Black people retain a permanent subordinate status in Western society and institutions. He traces the origins of this concept to the legacy of slavery, white supremacy, and negro-ness. Within the Canadian PT school context, racial realism may be reflected in the perception of Black people as inferior. The history of Black slavery in Canada and its implications in Canadian universities,^3,20-21,60 as well as the origins of Canadian PT, along with evidence from this study and others,^13,15 lend credibility to this concept. We posit that the conspicuous absence of Black representation in Canadian PT schools may serve as a testament to racial realism. This perception of inferiority may prevent Black individuals from pursuing PT as a career option. For example, the following is a quote from a Black PT student speaking about whiteness in Canadian PT schools:

I just think that PT [physiotherapy] is not something that Black people have been…it’s not something that has penetrated aspects of different Black cultures…I mean…a stereotypical image of a physical therapist… I think it’s very Caucasian. At least that’s the image that I’ve kind of—that comes into my mind.^1(p5)

In support of this contention, a Black physiotherapist spoke of a Black applicant who noted the lack of pluralism¹⁹ and rejected his offer to enter a PT program:

 “…[He] interviewed, got in, talked to a student, uh, another… Black student who was there, and… that [ie, the whiteness of PT as a profession] heavily influenced his decision in fact to… turn down the spot when it was offered for him”^1(p7)

In his work with racial realism, Bell¹⁶ proposed that the attainment of status, privilege, or entry into a predominantly white space by Black individuals does not exempt them from experiencing racial discrimination. Based on this analogy, we contend that Canadian PT academic institutions may discriminate against Black students, even when they gain admission. The personal experience of (OO) as a recent former student is instructive in this regard. During her first year in the PT program, she sought guidance from an instructor to address course-related concerns. However, the instructor dismissed her inquiries and proceeded to question her current academic competence and the adequacy of her educational background for PT, despite her exceptional performance in all mandatory prerequisite courses at a Canadian university. Even though she got in, she was viewed as inferior. Furthermore, the findings of a participant from Wegrzyn and colleagues¹ corroborate this sentiment, as she recounts an experience with a white colleague with whom she had only communicated via phone previously:

[She said] “You know, I had no idea you were Black.” I’m like, “Well, you probably wouldn’t, though, because you hadn’t met me…” And she said, “No, no, no, but you speak so clearly and you…”^1(p7)  

The authors of the original article analyzed these narratives as PT being a “white space”^1(p6) constructed around whiteness, which systematically excludes Black individuals. In our analysis, we contend that this whiteness is a pervasive feature that extends beyond the absence of Black bodies in the academy. It is an indication of racial realism that is entrenched in the Canadian faculties of PT.

Racial Aggression and Hostile Racial Climates

In their CRT study examining anti-Blackness and racial climates on college campuses in the United States, Solorzano et al⁷⁷ documented an unsupportive racial campus climate. Building upon this, Yosso and colleagues⁵⁸ conducted a study involving Latina/Latino students, further expanding the concept by introducing the term “hostile racial climate.”^58(p664) This term encompasses the existence of racist incidents and aggression within university settings, which detrimentally impacts racialized students, resulting in adverse learning and social outcomes. From the findings of this project, we propose that a hostile racial climate in the PT academy is a product of racist injuries rooted in a foundational racial realism that significantly impedes Black PT students’ ability to flourish. To illustrate this phenomenon, we present the narratives of these participants. A Black physiotherapist articulated an occurrence during the PT program:

“Everything I wrote [as part of my physiotherapy training program] for, like, the next 2 years, I never got higher than a 76%… Until the last assignment… it’s anonymous, so you’re not allowed to use your own name at any point through this document…So… I get 98.5%”^1(p7)

Hughes et al¹⁵ delineated the potential for the Canadian PT Academy to remain unaware of their antagonistic racial milieu. The presence of a hostile racial climate is often obscured by those who do not experience its effects, as educational institutions are commonly depicted as benign spaces devoid of racism.⁶¹ This Black student noted:

“[T]here’s a culture in place that is in a sense almost invisible to the people who are comfortable within and the people who are the majority within that culture.”^1(p6)          

As survivors of hostile racial climates, the authors have experienced multiple instances of racial aggression. In particular, OO was carded by university security officers during her academic program. Her race and distinctive physical appearance as a Black woman with long and thick dreadlocks, made her stand out. On one occasion, she was stopped and asked for identification (ID) in the presence of her friend and classmate, a white woman. After presenting her ID, the officer proceeded to offer her friend an escort to her vehicle, citing the supposed danger she faced as a white woman walking alone at night. This incident highlights how (OO) was treated with hostility and viewed as not worthy of protection by the security officers. In this case, her Blackness predisposed her to a hostile racial climate.

Wegryzn et al¹ presented their participant narratives as further evidence of the dominance of whiteness within the field of PT. We extend their inference by presenting Black PT students as survivors of a hostile racial climate, which is an outcome of the pervasive whiteness present in PT and is underscored by racial realism.

Moving forward, we will employ CRF to analyze OO’s experiences plus the narratives of Black female PT students, as documented in the article by Hammond et al.^37.

Reactive Invisibility and Representational Intersectionality

Hotchkins and Dancy^62(p35) define “reactive invisibility” as a racial avoidance approach employed by Black students to navigate hostile racial climates, involving intentional removal of oneself from physical locations where racial aggressions may occur or employing other strategies to evade confrontations during racial interactions. This defensive strategy manifests as deliberately attempting to be invisible when faced with racial assaults.

The concept of “representational intersectionality” was introduced by Crenshaw⁶³ as a means of elucidating the cultural portrayal of racialized women by the dominant society. One such portrayal is the “Sapphire” stereotype, which depicts Black women as being “stubborn, bitchy, bossy, and hateful”^43(p89) and has its roots in the historical era of slavery. The portrayal of Black women as the sapphire⁴³ predisposes Black female college students to employ reactive invisibility strategies when confronted with racial aggressions in hostile racial climates.

For example, imposed silence as a form of reactive invisibility is supported by remarks made by a Black female PT student who discussed her approach to handling racist comments:

“I just take it as it’s just the way it is; so it’s kind of like you acknowledge it but you just move on, you don’t really give it too much energy,…Yeah, at the time just what else can you do? I mean especially on placement you’re just trying to get through placement, to be honest, you’re not really trying to change the world there.”^37(p7)

Like this student, (OO) tries not to stir the pot and fly under the radar when confronted with racial injustice. She ignored repeated blatantly-racist comments from her perpetrator (a clinical instructor) and avoided the instructor as much as possible. When she could not, she stayed silent and did not participate in conversations with the clinical instructor or other members of the team. She muted herself and “picked her battles, by being strong.”^64(p633)

Hammond et al³⁷ interpreted similar strategies simply as a coping mechanism employed in racially-charged situations but did not explicitly consider the concept of misogynoir.⁵⁰ By employing a CRF lens, we established a connection between gendered racism¹⁴ and responses to racial atrocities.

Being the only Black individual in (OO)’s master’s class, her physical appearance, which included being a woman with long black dreads and a Nigerian accent, made her hyper-visible. Despite her attempts to go unnoticed, she struggled to evade attention and the ensuing misogynoir.⁵⁰ In fact, the more hyper-visible she felt, the more she tried to make herself invisible. For instance, a professor in her department who perceived her hair to be an anomaly once asked, “Are you just having a bad hair day or what is this?” in reference to her dreads. Rather than verbally respond to this racial abuse, she reacted by making herself invisible and refrained from wearing dreads for the remainder of her time in the master’s program; instead, she straightened her hair to conform to Eurocentric beauty standards, akin to a white woman’s hairstyle. Furthermore, she tried and failed woefully to speak with a Canadian accent. After all, an accent hierarchy exists in PT settings, with African accents often marginalized and placed at the bottom of this hierarchy.¹³

Structural Intersectionality and Intersectional Disempowerment

Crenshaw⁶³ coined the term “structural intersectionality” to describe the unique experiences of Black women, which are shaped by their physical location, cultural position, marginalization, and oppression. This concept highlights the need for knowledge and guidance to be specifically tailored to meet the needs of Black women. The intersectional identities and experiences of Black women underscore the importance of seeking guidance from those who can offer relevant and relatable perspectives;⁶⁶ however, there appear to be limited opportunities to do so. This Black PT student, who is a woman, noted:

So I didn’t really see it [physiotherapy] as a race issue and even discussing it with family, friends, people that I’d come across, I think the only time that I sort of picked up that there weren’t a lot of … black women that were doing it when I was researching was when I was looking for mentors and people to actually talk to.^37(p6)

Hammond et al³⁷ surmised this statement as an attempt at belonging and a lack of Black representation in PT schools. We took this further by showing that the cultural position of Black PT students who identify as women in the intersectional matrix is disempowering, such that thriving in the PT academy may require initiatives tailored specifically to this category of individuals. We postulate that this intersectional disempowerment of these Black women is a product of a hostile racial climate.

Discussion and Implications

This project presents CRT and CRF as rigorous theoretical frameworks to examine anti-Blackness in Canadian PT education. Our results present the problem of racial realism,¹⁶ hostile racial climate,⁵⁸ and intersectional disempowerment⁶³ in PT education.

Canadian PT researchers^1,13,15 investigating racism in academic settings have heavily relied on Jones’s⁵⁴ framework for their analysis. These studies mark a significant initial stride in documenting racism within Canadian PT contexts. To adequately assess and address racism in higher education institutions, CRT and CRF frameworks necessitate a thorough exploration of whiteness and racial aggression.^9,58 Similarly, Ladson-Billings⁶⁷ emphasized the importance of providing contextual background for comprehensive analysis of narratives. Building upon these perspectives, we employed a CRT and CRF theoretical framework to comprehensively examine anti-Blackness in the PT academy.

Contextualizing Anti-Blackness

This project presents a valuable opportunity for Black PT students and the academy to contextualize the presence of anti-Blackness within the educational environment, specifically addressing it in relation to Black women’s experiences. It delivers a critical and thorough analysis, with the potential to guide future anti-racist initiatives and research endeavors.

By using these theories, this research demonstrates that the intersectionality of race and gender impacts the coping mechanisms of Black women PT students and physiotherapists in hostile racial climates. The findings indicate that these individuals may avoid responding to racial insults spurred on by racist stereotypes.

Furthermore, these findings corroborate those by Corbin et al⁶⁴ wherein they observed that the phenomenon of representational intersectionality, particularly the portrayal of Black women as the sapphire,⁴³ predisposes Black female college students to employ reactive invisibility strategies when confronted with racial aggressions in hostile racial climates. Newton¹⁴ also presented similar findings in her work, which used a CRF framework to explore the experiences of gendered racism among Black female college students in a hostile campus climate. Additionally, Franklin⁶⁵ acknowledged that although Black female college students confront racial aggression to some extent, they are comparatively less likely to do so than their male counterparts.

Furthermore, we identified a paradox of hypervisibility and invisibility among Black female PT students. These experiences echo Newton’s¹⁴ work, which found that Black female college students undergo the paradox of being invisible and hyper-visible in a university setting, thereby making them targets of racial hostilities.

Further Research Required. Avoiding addressing anti-Blackness in educational settings can lead to social isolation, low academic achievement, increased racial battle fatigue, and missed opportunities for professional advancement.^18,77,62,68 Therefore, further research is needed to document and analyze racial aggressions and racial battle fatigue experienced by Black women in Canadian PT schools using critical theories. Knowing that Black women in this setting require information specificity for the eradication of racial oppression,⁶³ findings from such research may enable the PT academy to provide specific strategies to combat racism in this population. For instance, mentorship provided by Black women to Black women is an often-missed anti-racist strategy.⁶³

By transforming the narrative surrounding white supremacy within Canadian PT schools, this study has shed light on the possible influence of racial realism¹⁶ in fostering a hostile environment within the academy. Racial realism dismisses the attainability of racial equality, urging Black individuals to embrace their circumstances, resist despair, and advocate for pragmatic approaches to combat oppression.¹⁶ While acknowledging the enduring presence of this concept, there remains a hopeful outlook for achieving racial equity in Canada’s PT schools.

More Rigorous Analysis Needed. A crucial initial step toward this objective is a rigorous analysis of anti-Blackness. Therefore, expansion of research on this subject is strongly urged. For instance, it is imperative to conduct studies that examine and categorize racial aggressions contributing to the hostile racial climate⁵⁸ of anti-Blackness in Canadian PT schools, exploring their impact on the lives of Black individuals, while highlighting tales of resilience. By gaining deeper insights into these matters and understanding the contextual backdrop, it becomes possible to identify specific institutional factors that perpetuate racial realism and discern strategies for its eradication.

The issue of anti-Blackness in PT schools is multifactorial and this study does not aim to provide a solution. We argue that a band-aid approach will not be effective in combating anti-Blackness in this context, given the pervasive nature of racial realism.¹⁶ The laws and policies in Western institutions reinforce white supremacy and institutional racism;^16,69 thus, we recommend that faculty leaders should “look to the bottom”^8(p22) when enacting policies by rejecting those that do not improve the circumstances of Black students and other marginalized groups.

Furthermore, incorporating insights from Maloney et al’s⁷³ examination of the effect of structural racism in the PT profession, we urge faculty leaders to demonstrate the necessary courage in posing challenging inquiries within their respective domains regarding the eradication of anti-Blackness. These questions may pertain to potential adjustments in curriculum, organizational policies, or modifications to admissions practices and faculty employment.⁷³

Methodological Considerations

This research analyzed previously-published data and relied on the authors’ interpretation of the statements that preceded the narratives. Consequently, the study may not have accurately captured the complete details of the participants’ experiences. Additionally, the researchers analyzed a small number of participants, and we utilized excerpts from the published narratives, thus further limiting our dataset. Moreover, this project shares limitations common to those employing secondary data sources, including the inability to perform member checking or conduct additional interviews to confirm the findings.⁷⁰

During our study selection process, we broadened our search strategy after finalizing the screening process, focusing specifically on the UK due to its relevance to anti-Blackness, which shares parallels with the Canadian context. We chose Hammond’s³⁷ work as it met our inclusion criteria. While this departure from our initial study design may be perceived as lacking systematic rigour, it was necessary due to the limited availability of relevant research within the Canadian academy. Furthermore, Hammond’s study offers valuable insights into the issue of anti-Blackness, with similarities to the Canadian context.

Although CRT has gained significant attention in research, it has not been immune to criticism. One such critique was put forth by Andrews,²⁴ who argued that scholars utilize CRT to diagnose the problem of racism and create excellent sub-theories with limited pragmatic application. However, given the current racial reality in Canadian PT schools and the limited availability of evidence, it is essential to conduct CRT scholarly work as a critical first step toward activism and transformation.

Conclusion

This study employed a CRT and CRF lens to examine anti-Blackness in Canadian PT academia by drawing connections between the historical patterns of racism and anti-Blackness in Canada, the PT profession, and the lived experiences of Black PT students and Black physiotherapists, including the personal experiences of a recent former PT student who is the lead author (OO). By demonstrating the effectiveness of CRT and CRF as rigorous analytical theories, this project explicates the documented evidence of anti-Blackness in the Canadian PT academy and explores the intersecting identities of Black women within the field. Furthermore, it underscores the urgent need for further research in this area and encourages other scholars in rehabilitation sciences to consider using these theoretical concepts in their work.

[1] Black is capitalized to recognize racial, ethnic and cultural communities.

[2] The “w” in white is in lower case to correct the conditions of disadvantage that suggest white is superior.

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