From Structural Blindness to Structural Perception: Theorizing LUMEN, a Multisensory Pedagogy for the Structural Determinants of Health in Nursing Education.
5 affiliations
- 1Department of Biobehavioral Nursing & Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA.
- 2National League for Nursing, Washington, DC, USA.
- 3Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
- 4Oregon Health & Science University School of Nursing, Portland, Oregon, USA.
- 5Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA.
Abstract
Structural competency has advanced health-professions education by orienting clinicians to the social, political, and economic structures that produce health inequities, yet its nursing applications treat experiential and sensory teaching methods as instructional delivery rather than explaining why such methods work, and assume rather than cultivate the perceptual acts, recognition, and responses that they depend on. This conceptual paper develops LUMEN, a multisensory pedagogy for teaching the structural determinants of health in nursing, and introduces structural perception as the foundational competency it cultivates. Through an argument-based synthesis integrating structural competency, critical pedagogy, transformative learning, embodied and grounded cognition, social theory, and the arts with the nursing literature, we argue that structural determinants are pedagogically difficult because they are imperceptible, abstract, upstream, and naturalized, making the foundational educational task perceptual rather than informational. Because perception is sensory and embodied, multisensory pedagogy is its fitting mechanism. LUMEN operationalizes this through five domains, Look, Uncover, Mirror, Engage, and Navigate, sequenced across a three-phase arc moving learners from structural blindness through critical consciousness to structural action. LUMEN names a competency the field has assumed and theorizes a mechanism it has used but not justified, offering nurse educators a theoretically grounded, testable foundation for teaching structural perception. We also subject the framework to critique, including the risk that adding another model to a crowded field could individualize what is ultimately an institutional problem.
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BibTeX
@article{ballout2026from,
title = {{From Structural Blindness to Structural Perception: Theorizing LUMEN, a Multisensory Pedagogy for the Structural Determinants of Health in Nursing Education.}},
author = {Suha Ballout and Sandra Davis and Megan Jester and Claire McKinley Yoder and Sara K Kaylor},
journal = {Nursing inquiry},
year = {2026},
month = nov,
doi = {10.1111/nin.70181},
url = {https://europepmc.org/article/MED/42967321},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - From Structural Blindness to Structural Perception: Theorizing LUMEN, a Multisensory Pedagogy for the Structural Determinants of Health in Nursing Education.
AU - Suha Ballout
AU - Sandra Davis
AU - Megan Jester
AU - Claire McKinley Yoder
AU - Sara K Kaylor
PY - 2026
DA - 2026/11/01
JO - Nursing inquiry
DO - 10.1111/nin.70181
UR - https://europepmc.org/article/MED/42967321
AB - Structural competency has advanced health-professions education by orienting clinicians to the social, political, and economic structures that produce health inequities, yet its nursing applications treat experiential and sensory teaching methods as instructional delivery rather than explaining why such methods work, and assume rather than cultivate the perceptual acts, recognition, and responses that they depend on. This conceptual paper develops LUMEN, a multisensory pedagogy for teaching the structural determinants of health in nursing, and introduces structural perception as the foundational competency it cultivates. Through an argument-based synthesis integrating structural competency, critical pedagogy, transformative learning, embodied and grounded cognition, social theory, and the arts with the nursing literature, we argue that structural determinants are pedagogically difficult because they are imperceptible, abstract, upstream, and naturalized, making the foundational educational task perceptual rather than informational. Because perception is sensory and embodied, multisensory pedagogy is its fitting mechanism. LUMEN operationalizes this through five domains, Look, Uncover, Mirror, Engage, and Navigate, sequenced across a three-phase arc moving learners from structural blindness through critical consciousness to structural action. LUMEN names a competency the field has assumed and theorizes a mechanism it has used but not justified, offering nurse educators a theoretically grounded, testable foundation for teaching structural perception. We also subject the framework to critique, including the risk that adding another model to a crowded field could individualize what is ultimately an institutional problem.
SN - 1320-7881
SN - 1440-1800
ER -