Publishing giant Pearson has amended a nursing textbook to remove a section on how minority groups, including Jews, deal with pain after complaints that it was “racist”.

In a chapter headed "Diversity and culture", the book claimed Jewish people “may be vocal and demanding of assistance” and “believe pain must be shared and validated by others”.

Black people were said to “often report higher pain intensity than other cultures” while Hispanics “believe that pain is a form of punishment and must be endured if they are to enter heaven".

The textbook, called Nursing: A Concept-Based Approach to Learning, Volume I, was published for the United States market, but was also available in Canada and Australia.

Shocked readers tweeted that the observations were “offensive and racist”.

In a statement Pearson said: “While differences in cultural attitudes towards pain are an important topic in medical programmes, we presented this information in an inappropriate manner. We apologise for the offence this has caused and we have removed the material in question from current versions of the book, electronic versions of the book and future editions of this text.

"In addition, we now are actively reviewing all of our nursing curriculum products to identify and remove any remaining instances of this inappropriate content that might appear in other titles.

"We appreciate the concern shown by the students who raised this issue."