Access and Success
Access and Success focuses on access to the nursing school, inclusion and belonging, and success of historically underrepresented and marginalized groups. Nursing schools must critically examine the structures, policies, practices, and attitudes to ensure access, retention, and success for all faculty, students, and staff.
The design of an effective recruitment strategy should be driven by the mission of the educational institution and aligned to reflect the targeted population of potential students. Recruitment efforts and activities should be designed to improve the ability to attract a diverse population and more firmly establish a continuing pipeline of possible students. A first step to enhancing success is an active recruitment plan that does not end with admission to the university but with a successful career in nursing that reflects the values of diversity, equity, and inclusion. Ensuring a diverse student body requires numerous strategies, both formal and informal, that will be described in this section.
Developing a Recruitment Plan
How does my school define diversity?
Is there an organizational culture at my institution that actually promotes diversity?
|Recruitment Plan Development
What is your current pool of candidates both locally and nationally?
|What goals for underrepresented students do you and your school want to set?
|Laying the Groundwork in Selecting Recruitment Tactics
What is your program currently doing to recruit underrepresented students?
|What resources do you need to meet your diversity goals?
|Implementing the Plan
What messages do you want to convey to potential students?
|Through which strategies will your messages be most effectively delivered?
|Evaluation and Adjustments
How will you measure success?
Were you able to increase the amount of (a) interest in
the program and (b) accepted candidates?
|Did those candidates eventually matriculate?
Offered at all levels of education, pipeline programs are intended to target, enroll, and support to graduation those students underrepresented in the profession, including lowincome students and men, with the goal of increasing their representation in the field.
- Pipeline programs can be offered through partnerships, including between academic institutions and high schools (or school districts). These programs may be funded through grants, such as the Health Resource Service Administration (HRSA) Nursing Workforce Diversity grant, universities, health professions schools or schools of nursing.
- Programs typically include on-campus experiences where students receive course work in math, science, and English, in addition to time spent in human anatomy lab, simulation lab, and the hospital setting. Faculty, students, and health professionals from racially and ethnically diverse backgrounds serve as role models and mentors.
- Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all racially and ethnically diverse populations.
- Brooks Carthon, L, M., Nguyen, T-H., Chittams, J., Park, E., & Guevara, J. (2014). Measuring success: Results from a national survey of recruitment and retention initiatives in the nursing workforce. Nursing Outlook, 62(4), 259-267. doi: 10.1016/j.outlook.2014.04.006
Articulation agreements between colleges and universities provide a streamlined pathway that promotes educational advancement opportunities for registered nurses. These agreements support education mobility and facilitate the seamless transfer of academic credit between associate degree (ADN) and baccalaureate (BSN) nursing programs and may include programs with progression through master’s and doctoral level programs. Typically negotiated by faculty from both types of academic institutions, these renewable agreements help to ensure equivalency between community college and university courses.
Articulation agreements among nursing education programs fall within three general categories: Mandated, Statewide, and Individual. For more infromation, view AACN's Articulation Agreements Fact Sheet.
AACN has compiled the following resources related to articulation agreements among nursing education programs:
Internal and External Relationships and Partnerships
Structured partnerships are an effective mechanism for expanding access to schools of nursing and meeting clinical needs.
- Sustained relationships and partnerships can go far in creating successful pathways for entry into nursing school.
- Connect with guidance counselors, instructors in health professions programs, university level health professions programs, academic advising centers, affinity groups, and racially and ethnically diverse organizations.
- Academic-service partnerships are strategic relationships between educational and clinical practice settings that are established to advance their mutual interests related to practice, education, and research. They may serve to attract employees to advancing their education in the nursing profession
- AACN Academic-Practice Partnerships Tool Kit
Historically Black Colleges and Universities (HBCUs)
Winston-Salem State University
Community Outreach and Partnerships
Service learning is an educational method that promotes community involvement and partnerships and can introduce and attract members of the community to careers in nursing.
- Faculty may initiate outreach, or community agencies may contact nursing programs to create a service-learning partnership.
- Student organizations may complete service projects in the community, targeting diverse communities.
View Required Readings [PDF]
Financial Aid, Scholarships, and Grants
Dedicated funding is an effective mechanism for building a more diverse and inclusive academic nursing community. Many historically underrepresented students may face other challenges that prevent entry into nursing programs. The financial burden of nursing school’s additional clinical fees, books, uniforms, testing costs, etc. might make nursing education seem impossible. This may be especially true for those who are first generation college attendees.
- Access in this case would include dissemination of information relevant to financial aid, such as scholarships and grants early in the process, even at the high school level
- Accessible online chat sessions with financial aid representatives
- Assistance with filling out scholarship applications
- Structured formal programs/strategies to enhance success of the minority student within the nursing unit must be well thought out and supported, but also shared with prospective students as they are gaining access to the nursing program.
- Nursing programs partnering with institutions financial aid office to consider the elevated cost of nursing education compared to other majors.
Recruitment also should include attention to students who may already be on the university campus. Programs that bring pre-nursing or undeclared majors to the school of nursing are another strategy that might improve access to the nursing program by diverse students. Programs such as weekend visitation options, minority weekends, summer bridge programs, or other programs specifically targeted to diverse students are good opportunities with which to partner. If no such programs exist on the broader campus, investigate how one might be developed by the nursing unit for targeted populations.
Another area for recruitment of prospective diverse students is minority serving four-year colleges without nursing programs, such as historically black colleges and universities or colleges that serve predominantly Hispanic or Native Americans.
Word of mouth from students who have had a great experience is an excellent recruitment strategy for underrepresented students. In addition, remember to stay connected to alumni.
View References [PDF]
Admission to nursing education programs must be designed to result in a student body that represents all areas of diversity and inclusion of individuals who are often marginalized.
Holistic review is a university or nursing program admissions strategy that assesses an applicant’s unique experiences alongside traditional measures of academic achievement such as grades and test scores. It is designed to help universities consider a broad range of factors reflecting the applicant’s academic readiness, contribution to the incoming class, and potential for success both in school and later as a professional. Many colleges and universities have employed a holistic admission process to assemble a diverse class of students with the background, qualities, and skills needed for success in the profession.
View References [PDF]
Schools of nursing cannot bring students into their programs without recognizing the factors that contribute to racial, socioeconomic, and gender gaps in student outcomes and then committing to supporting students in their needs. Programs and strategies to enhance success of all students within the school must be well planned, supported, and shared with prospective students as they are gaining access to nursing programs.
Be deliberate and intentional in your efforts. Pay attention to:
- The climate and culture of your school
- Factors that affect retention of racially and ethnically diverse and marginalized students
- Issues of first-generation college students
- Policies that may impact access, retention, and inclusion
Student Success Centers and Academic Coaching
- Student success centers offer specific interventions to identify gaps in student learning and support diverse learners academically. Specific interventions are used to enhance the student experience.
- Academic coaching, peer mentoring, peer-to-peer learning, personal tutoring, and supplemental instruction are approaches that may be offered through the student success center.
- Academic coaches may use an early alert system to identity students who may be at-risk of failure in nursing courses. Most institutions that use early-alert systems see some positive impact on retention rates -- but these may be more modest increases than they expected, and they often do not recognize how long it takes for a system to start working.
- Academic coaches intervene early by scheduling an initial assessment to identify risk factors for academic success.
- Individual coaching sessions focus on time management, testing strategies, test anxiety, reading comprehension, and critical thinking skills.
- Non-cognitive factors that may impede positive student learning outcomes (e.g., chronic conditions and learning disabilities).
- Implement interdisciplinary student success conferences to develop retention and success plans.
- Akos, P., Greene, J.A., & Fotheringham, E. (2020). The promise of non-cognitive factors for underrepresented students. Journal of College Student Retention: Research, Theory & Practice. Retrieved from https://doi.org/10.1177/1521025120935111
- Connelly, L., Kathol, L., Peterson Truksa, V., Miller, J., Stover, A., & Otto, E. L. (2019). The academic coach: A program for nursing student success. Journal of Nursing Education, 58(11), 661-664. https://doi.org/10.3928/01484834-20191021-09
- Broussard, L., & White-Jefferson, D. (2018). Use of academic coaches to promote student success in online nursing programs. Teaching and Learning in Nursing, 13(4), 223-225. https://doi.org/10.1016/j.teln.2018.05.007
- Byrd, D. A., Meing, V.B. (2020). Student success centers in nursing education: A case study example. Journal of Nursing Education, 59(7), 396-399. DOI: 10.3928/01484834- 20200617-08
- Jackson, N. M. (2019, August 19). 2 big ways campus offices are collaborating in the name of student success. University Business.
Academic Advising and Mentoring
Academic advising may be performed in schools of nursing by professional advisors, faculty advisors, or both. The responsibilities of the academic advisor include recommending courses and scheduling, developing plans of study, personal counseling professional career counseling, and appropriate referrals.
Mentoring has come to mean someone who gives guidance, shares knowledge, and imparts wisdom. In academia, however, the term often gets diluted to refer to an advisor—someone who helps undergraduate students choose the right courses to graduate or oversees doctoral projects to completion. True mentors do much more, from serving as role models to helping incubate research projects to bringing protégés into a network of colleagues. Good mentoring takes much time and energy, yet compared with obtaining grants and publishing papers, mentoring often does not yield academic recognition.
- Be clear about the relationship. The first stepping-stone to becoming an exceptional mentor is determining what you want your relationship with a mentee to be.
- Take the time. According to experienced mentors, by far the most important thing great mentors do is simply make time for their mentee
- Learn to listen and offer support. Successful mentors listen to what a mentee is asking for and do not project what they think they should be asking.
- Let the relationship grow. The best mentorships become more friendly and mutual over time, so allow this relationship to evolve naturally
- A recent study by the American Psychological Association found that members of Generation Z—those between ages 15 and 21—are more stressed than adults overall about issues in the news, such as the separation and deportation of immigrant and migrant families (57 percent of Gen Z versus 45 percent of all adults reported the issue is a significant source of stress) and sexual harassment and assault reports (53 percent versus 39 percent).
- Generation Z is significantly more likely (27 percent) than other generations, including millennials (15 percent) and Gen Xers (13 percent), to report their mental health as fair or poor, the survey found. They are also more likely (37 percent), along with millennials (35 percent), to report they have received treatment or therapy from a mental health professional, compared with 26 percent of Gen Xers, 22 percent of baby boomers and 15 percent of older adults.
- Money and work continued to top the list of significant stressors tracked annually by the Stress in America survey for adults overall. Nearly two-thirds of adults (64 percent) reported money and work each to be a stressor. A new question added this year asking about additional sources of stress revealed that for more than 3 in 10 Gen Zs, personal debt (33 percent) and housing instability (31 percent) were significant sources of stress, while nearly 3 in 10 (28 percent) cited hunger or getting enough to eat.
- A second study by Bai, Larcombe and Booker reported results of a survey of 2776 student to the question: What can be done to improve student wellbeing? Students 29 made diverse recommendations that fell into seven categories: Academic teachers and teaching practices; student services and support; environment, culture, and communication; course design; program administration; assessment; and student society activities. The authors recommended that educators and administrators can play important roles to better support student wellbeing and preventing the high rates of psychological distress. Seeking and acting on students’ suggestions fosters students’ sense of inclusion and empowerment and is critical given that the goal of improving student mental wellbeing can only be achieved through an effective partnership between students and nursing school faculty and staff.
- A wellness program should be available to reach students with concerns or crises. Faculty and staff need to be aware of wellness programs on campus and refer/connect students as needed.
- Partnership with wellness majors on campus where nursing students are recipients of services.
View References [PDF]
Affinity groups are formed around a shared identity or common goal. Bringing together students with common backgrounds, interests, or orientations builds community among non-dominant groups and fosters inclusion and awareness in the broader community.
View References [PDF]
Non-Academic Factors Impacting Retention, Persistence, and Success
Recognizing the Impact of Bias and Stereotyping
Bias as defined by the University of California San Francisco is a prejudice in favor of or against one thing, person, or group compared with another usually in a way that is considered to be unfair. Biases may be held by an individual, group, or institution and can have negative or positive consequences. Bias may be Conscious (also known as explicit bias) or Unconscious bias (also known as implicit bias).
It is important to note that biases, conscious or unconscious, are not limited to ethnicity and race. Faculty cannot ignore bias and stereotyping and its impact on Access and Success. Bias is a natural, automatic favoring of an individual or group over another. Bias whether unintentional, implicit or explicit is automatic, associative, and adaptive and may influence the decision-making process. Bias and stereotypes may be directed toward diversity attributes, including race, ethnicity, age, gender identification, sexual orientation, and class, which in turn could affect recruitment, admissions, and retention. School of nursing leaders must acknowledge that bias exists and devote resources to ongoing faculty and staff training and development. This is especially true for implicit bias training. It is known that our implicit biases can derail our best explicitly stated intentions for fairness and equity. Faculty and staff must be aware of the detrimental effects the various forms of bias.
Additional resources and training on unconscious bias can be found here.
Source: Project Implicit
The Society for Human Resources Management (SHRM) offers these suggestions to reduce unconscious bias in hiring and selection process:
- Awareness training for members of the search and selection committees.
- Re-work your job description to review biased words or phrases.
- Blind the resume review process.
- Standardize the interview process
View Require Readings [PDF]
View References [PDF]