Initiatives aimed at retaining ethnically diverse student nurses in undergraduate programmes: An integrative review

Follow-Up of a Program to Improve Undergraduate and Graduate Nursing Student Diversity

BACKGROUND

Underrepresented student recruitment is critical to resolve persistent gaps in workforce diversity in the United States.

PURPOSE

Prenursing and nursing students participated in a nursing workforce diversity program designed to recruit and graduate underrepresented students, which provided academic and student support, financial support, and mentoring. A follow-up study was conducted to identify the impact of the program.

METHODS

Participants were surveyed about educational and employment information, perceptions about factors that contributed to success, benefits of the program, and educational experience. Descriptive summaries of data and thematic analysis of qualitative comments occurred.

RESULTS

Financial support, program quality, mentoring, career guidance, and meeting basic security needs were the strongest factors contributing to success. Program benefit themes included: feeling empowered, encouraging success, building confidence, and easing financial strain. Negative experiences with discrimination and bias were reported.

CONCLUSIONS

Cocurricular support can help facilitate belonging. Scholarship awards communicate belief in student success, which impacts confidence and achievement.

Supporting students to return to study following course interruption (SuTuRe)

BACKGROUND

The pre-registration BSc Nursing course in the UK is renowned for being challenging due to its requirement for 2300 hours each for theoretical and practice-based learning. It is therefore inevitable that some students may need to interrupt their study at some point during the course. In many cases, these students do not return and leave the course, which has an impact on the future nursing workforce.

AIMS

To examine the reasons why pre-registration student nurses interrupt their studies and consider ways to enable them to return successfully and complete the course.

METHODS

The research project was based in one higher education institution (HEI) in the North West region of England. Interrupted students due to return to study in semester 1 of the 2022/23 academic year (n=95) were invited to participate in semi-structured interviews.

FINDINGS

Health, including mental health was the dominant factor leading to the interruption of study for the students.

CONCLUSION

This research has led the HEI to introduce an improved support package for students. Alongside other recommendations it is hoped the changes will reduce attrition and lead to an improved interruption/return-to-study experience.

Factors Influencing Retention among Regional, Rural and Remote Undergraduate Nursing Students in Australia: A Systematic Review of Current Research Evidence

BACKGROUND

This systematic review aimed to explore the factors influencing retention among regional, rural, and remote undergraduate nursing students who were enrolled in Australian universities.

METHODS

Mixed-methods systematic review. A+ Education, CINAHL, Education Resources Information Center (ERIC), Education Research Complete, JBI EBP database, Journals@Ovid, Medline, PsycINFO, PubMed, and Web of Science were systematically searched from September 2017 to September 2022 to identify eligible English-language studies. The methodological quality of the included studies was critically assessed using the Joanna Briggs Institute's critical appraisal tools. Descriptive analysis with a convergent segregated approach was conducted to synthesize and integrate the results from the included studies.

RESULTS

Two quantitative and four qualitative studies were included in this systematic review. Both the quantitative and qualitative findings demonstrated that additional academic and personal support was essential for improving retention among undergraduate nursing students from regional, rural, and remote areas in Australia. The qualitative synthesis also highlighted many internal (e.g., personal qualities, stress, ability to engage with classes and institutions, time management, lack of confidence, cultural well-being, and Indigenous identity) and external factors (e.g., technical difficulties, casual tutors, different competing demands, study facilities, and financial and logistical barriers) that influenced retention among undergraduate nursing students from regional, rural, and remote areas in Australia.

CONCLUSIONS

This systematic review demonstrates that identifying potentially modifiable factors could be the focus of retention support programs for undergraduate nursing students. The findings of this systematic review provide a direction for the development of retention support strategies and programs for undergraduate nursing students from regional, rural and remote areas in Australia.

Students' perceptions of belonging in the School of Nursing at a regional university in Australia

BACKGROUND

Attrition in pre-registration nursing degrees is a global issue. Students' perceptions of belonging is a factor that influences attrition.

OBJECTIVE

The objective of this study was to evaluate students' perception of belonging to a School of Nursing, as well as their intention to complete the pre-registration Bachelor of Nursing (BN) program following implementation of the Initiatives for Retention (IR) intervention.

DESIGN

A prospective cross-sectional survey of student nurses was undertaken using an online questionnaire.

SETTING

A large regional university in Australia.

PARTICIPANTS

Pre-registration nursing students.

METHODS

Perceptions of Belonging were evaluated using the 24-item Belonging questionnaire comprising three subscales. Data were analysed using SPSS version 25. Pearson's correlation, Student's t-tests and one way ANOVA were used to assess associations and differences in belonging scores and student demographics, study status and participation in the Initiatives for Retention (IR) intervention.

RESULTS

A total of 201 students responded to the voluntary questionnaire. The mean score for overall Belonging was 70.5 (maximum obtainable 96), mean Scores for University affiliation, University support and acceptance, and staff relations with students were 34.7, 24.1 and 11.8 respectively. Female students, those who were studying at the university for less than a year and those who participated in the IR intervention activities reported significantly higher University Belonging scores compared to their contemporaries. Logistic regression revealed that students studying the BN course for more than 3 years (OR: 0.43 95% CI 0.20-0.93, p = 0.031), and those employed (OR: 0.435, 95% CI 0.16-0.16, p = 0.022) were significant predictors of not attending the IR sessions. There were no significant differences in overall University Belonging scores based on other demographic characteristics and, study status. The majority of the students (84%) stated that they plan to continue and complete the BN program.

CONCLUSIONS

Measures designed to develop student involvement may positively contribute a successful relationship between the institution and the student, increasing the students' sense of belonging and decreasing attrition among student nurses.

PRACTICE IMPLICATIONS

Initiatives for Retention (IR) facilitate a greater sense of belonging in nursing students hence Schools of Nursing should consider embedding such strategies.

Strategies for retention of nursing students: A scoping review

Retention of students in nursing programs is a costly concern that affects the supply and demand of nurses to the healthcare system. Successful retention strategies require consideration of social and academic institutional systems with attention to student integration in a program. This systematic review explores implemented retention strategies in nursing programs worldwide and provides guidance for nursing programs and researchers considering the retention question. Joanna Briggs Institute scoping review methods informed this review. CINAHL, ERIC, PsychINFO, and MEDLINE, databases were searched from January 1998 to December 2019. Data was extracted from 112 full text papers and dissertations. Papers were of varying quality and inconsistently evaluated, usually lacking theoretical grounding. Student participants in strategies were preselected by racial minority status or through various markers of academic performance. Retention strategies described in the literature are single program and multifactorial, with mentorship, study skills, literacy and language approaches, and tutoring the most common components. Reports of graduation rates or attrition rates through comparison with a pre-strategy time period or a comparison group were the most informative evaluations. Whole-program strategies that provided pathway options to students based on reading assessments or other academic criteria were the most comprehensive and effective strategies presented in the literature.

Mentoring to engage diverse undergraduate nursing students in honors research

BACKGROUND

A diverse workforce is necessary to reflect our communities and impact the health disparities of our increasingly diverse populations. Students from ethnic minority and socioeconomically disadvantaged backgrounds face many challenges and barriers to their academic success. Faculty must try new ways of supporting the engagement of this student population to positively affect quality outcomes for the entire community.

METHODS

High-performing students were recruited from undergraduate research courses to participate in a study to determine how honors research mentoring programs affect the engagement of undergraduate nursing students from ethnic minority and socioeconomically disadvantaged backgrounds.

FINDINGS

Study participants who were mentored for 3 years had a retention rate of 98%, compared to a rate of 73% in the year before the start of the mentoring initiative with faculty. NCLEX (National Council Licensure Examination)-RN pass rates were 95% for those in the mentoring program, compared to 84% for those not mentored. Of the students completing the program and passing the NCLEX-RN, 100% are employed in the local community.

CONCLUSIONS

A competent and diverse nursing workforce is a priority for eliminating health disparities in rural and underserved communities. Supporting ethnic minority and socioeconomically disadvantaged students is valuable to bridging this gap and positively influencing our communities.

The Lived Experience of Nursing Students with Culturally and Linguistically Diverse (CALD) Backgrounds in Italy: A Descriptive Phenomenological Study

Introduction: In recent decades, Italy has been exposed to significant migrant flows resulting from political and economic instability in neighbouring countries. As a result, there has been an increased amount of cultural and linguistic diversity (CALD) among nursing students. The aim of this study was to explore the experience of CALD nursing students as lived in the Italian nursing programmes. Method: A descriptive phenomenological method was used in 2017 with the involvement of a purposeful sample of 21 CALD nursing students in five Italian Bachelor of Nursing Science campuses. Data were collected using semistructured interviews; the subsequent content analysis was conducted by two independent researchers. Results: CALD nursing students reported having lived a transformative experience based on seven themes, from “living in the middle, between belonging and detachment” to “acquiring cultural awareness and cultural sensitivity.” Discussion: Dealing with linguistic and cultural differences can affected CALD students’ academic success, but also encourages them to develop awareness and cultural sensitivity by influencing their peers and the environment of the nursing programme. Therefore, having CALD students is a great value for nursing programmes. Nursing programmes should embody the values of cultural sensitivity and acceptance, including them as a nursing care value and as a concrete strategy to support CALD students. They should also develop strategies to promote the knowledge and responsibilities of nurses among CALD students and increase cultural sensitivity among faculty members at different levels.

Continued Influence of an English-as-an-Additional-Language Nursing Student Support Group

BACKGROUND

English-as-an-additional-language (EAL) nursing students are more likely to experience academic challenges than traditional nursing students whose primary language is English. To support EAL student success, a novel support group was established to address both the academic and nonacademic issues faced by these students.

METHOD

A hermeneutic approach was used to explore the perceived influence of a nursing student support group on EAL student success in a Canadian undergraduate nursing setting. Through individual interviews, a rich understanding of the lived experience of EAL nursing students was obtained.

RESULTS

The EAL Nursing Student Support Program provided a holistic approach to EAL student success, encompassing both academic and psychosocial support provisions embedded in discipline-specific curricula. Individual interviews regarding support group provisions revealed the perceived importance of balance, resiliency, helping others, culture, a safe place, social aspects, and group environment.

CONCLUSION

The continued success of this program necessitates the funding of this support group and other disciplinary support programs that provide comprehensive, discipline-specific approaches to EAL support, arguing against the centralized model of academic aid seen in many postsecondary institutions. [J Nurs Educ. 2019;58(11):647-652.].