Teaching Canadian Health History through Photographs and Primary Sources

Published on September 14, 2021

Lydia Wytenbroek

The Course in Context

As a nurse and a health historian (with three degrees in history), my research and teaching bring me to many interdisciplinary spaces and classrooms! Five years ago I designed a large, online, cross-listed health science and history course on the social history of Canadian health care. Most of the students in the course intended to pursue a career in the health professions, and were enrolled in public health, therapeutic recreation, addictions counseling, nursing, and health science programs. For many students, this was their first and only undergraduate history course. They entered the course with limited knowledge about historical methodology, and often little interest in history (Student evaluations included comments like: “I thought I would enjoy this course the least, but it turned out to be my favourite!”) I saw the course as an opportunity to pique students’ interest in history, show them the value of history as a tool for critical reflection, and teach them that all scientific and medical knowledge, tools, and practices are shaped by social, historical, economic, and political contexts. In this blog post, I describe how I incorporated photographs and primary sources into my course to creatively engage mostly non-history students in historical dialogue.

Setting the Stage

To begin, I provided students with a framework for interrogating images. Students were taught to think about how power shapes knowledge production, and to reflect on who created and produced particular images and for what purpose. My course consisted of twelve modules. Students did the assigned pre-reading, which included secondary sources and a variety of online primary sources, before engaging in discussion with their peers. They were also required to take four out of twelve module quizzes (they could choose which four they wanted to take). In the quizzes, students were asked to analyze the assigned primary source. For our unit on care providers and caregiving until the end of the nineteenth century, students read Brigitte Violette’s chapter on Catholic nursing sisters in Quebec and Kristin Burnett’s chapter on Indigenous women’s healing work in Indigenous communities and settler societies.[1] I wanted students to think about the ways that the category “nurse” had shifted over time, and who was excluded from these definitions. Violette’s chapter includes many images, so for the quiz I asked students to select any one photograph from the chapter and answer the following questions: Why did Violette choose to include that image in the chapter? How does it relate to Violette’s overall argument in the chapter? One student, for example, chose an image of a mortar and pestle, and explained that it represented nursing sisters’ pharmacological expertise and their prominent role in developing and administering hospitals. Through the quizzes and discussions, I had students think critically about the context of the photos. Not surprisingly, students’ analyses became more sophisticated over the course of the semester.

Learning to Analyze, Learning to Argue: The Photograph Analysis

On our web-based learning management system I paired each module with a photograph from Library and Archives Canada (see figure 1). For the major assignment in the course, I asked students to choose one of the twelve photographs and write an analytical paper about whether or not that particular photograph represented the assigned readings and themes for that unit. Students could make an argument either way, but they were required to use specific evidence from the assigned readings to support their analysis.

Image 1 - 14 September

Photographs are a great tool to disrupt and challenge established narratives. Much of the content that I covered in my course was new to students. Nursing students, for example, were unaware that there was a colour bar in place that largely prevented students of colour from entering nursing prior to the 1940s. In our unit on the history of nursing, students read Kathryn McPherson’s chapter on the cultivation of nursing as a “respectable” profession for white, unmarried women.[2] Students also read Karen Flynn’s article on the experiences of Black nursing students in the mid-twentieth century and the racism they encountered as they sought to enter nursing.[3] They also explored primary sources on the Nova Scotia Nursing History Digitization Project website, including a voice recording of Donna Smith, the first Black Nurse Practitioner in Nova Scotia, who discusses her repeated efforts to enter nursing school.

Many nursing students chose to write their photograph analysis on the photograph that displays a class of nurses at Winnipeg General Hospital School of Nursing. The photograph shows a group of white nursing students seated at a table, while a Black nursing student stands behind them, apart, at the back of the room. Some students argue that the photograph represents the ways that racism shaped the nursing profession. Other students argue that the photograph shows the strength and resilience of Black nurses who integrated into a white dominated profession. The assignment offered students flexibility and helped them learn how to craft an argument and defend it with evidence.

 Image 2a - 14 September

Library and Archives Canada/Canada Department of Manpower and Immigration/1972-047 NPC  Six Student Nurses Studying in the Library at Winnipeg General Hospital School of Nursing [1930-1960] https://www.bac-lac.gc.ca/eng/CollectionSearch/Pages/record.aspx?app=FonAndCol&IdNumber=4365895 


Over the past several years, I have come to observe some of the ways that historical research differs from research in science. Health science students are taught that they should only consult research that has been published in the past five years. They are less familiar with the use of monographs as a secondary source and often search for journal articles in health-related databases. I had the fun job of introducing them to JSTOR! Some students entered the class with the view that science is (and should be) objective. My course was designed to have them think about the way that power and context shape science and healthcare. I noticed that students struggled to understand race as a social construction. I had students watch Dorothy Robert’s TED talk: The Problem with Race-Based Medicine (It’s amazing!). Finally, I have found that health science students often struggle to articulate an argument supported by evidence. The course was designed so that students practiced this skill in discussion every week. One of the student’s favourite discussion questions was: Should Tommy Douglas be considered the “father of Medicare” or not?

The Value of History

History offers a valuable opportunity for health science students to critically analyze and question the assumptions and narratives that underlie scientific evidence and clinical practice. Guiding students to think about the past from a critical lens and enabling them to critique and better understand their own practice as socially and historically constructed is extremely rewarding. The actual process of historical study also teaches students key assessment and communication skills relevant to clinical practice because it requires synthesis, analysis, concise argumentation, and clear communication.

[1] Brigitte Violette, “Healing the Body and Saving the Soul: Nursing Sisters and the First Catholic Hospitals in Quebec (1639-1880),” in On All Frontiers: Four Centuries of Canadian Nursing , ed. Christina Bates, Nicole Rousseau, Dianne Dodd (Ottawa: University of Ottawa Press, 2005), 57-71; Kristin Burnett, “The Healing Work of Aboriginal Women in Indigenous and Newcomer Communities,” in Place and Practice in Canadian Nursing, ed. Jayne Elliott, Meryn Stuart and Cynthia Toman (Vancouver: UBC Press, 2009), 40-52.
[2] Kathryn McPherson, “‘The Case of the Kissing Nurse’: Femininity, Sexuality, and Canadian Nursing, 1900-1970,” in Gendered Pasts: Historical Essays in Femininity and Masculinity, ed. Kathryn McPherson, Cecilia Morgan, Nancy Forestell (Toronto: University of Toronto Press, 2003), 179-198.
[3] Karen Flynn, “Beyond the Glass Wall: Black Canadian Nurses, 1940-1970.” Nursing History Review 17 (1996): 129-152.

Author 14 September


Lydia Wytenbroek is an Assistant Professor of Nursing at the University of British Columbia, where she is a faculty co-lead of the Consortium for Nursing History Inquiry. She completed her PhD in History from York University in 2018, and is working on a monograph on American nursing imperialism and inter(nationalism) in Iran. Twitter: @LydiaWytenbroek. 


























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