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Sample literature review on retention barriers for minority students in nursing education

Education

Abstract
Minority students that can be targeted for retention programs include students from the African-American, Hispanic, Native American, Filipino and Hawaiian ethnicities. The issues that need to be addressed in order to retain minority students in higher education nursing programs include more academic preparation, more support from faculty, and the availability of health the insurance. The wrong perceptions about nurses start as young as Kindergarten and last through elementary and high school. Long term solutions to the retention problem can start when nursing associations and university departments need to reach out to local school districts by offering help in developing fact based curricula about a nursing career. Career counseling brochures for older students can be designed so that minority students as well as other students will find the materials attractive. Society’s perceptions of nurses must be changed so the benefits of a nursing career are not ignored by minority students. The most attractive short term goal is to build bridges for paraprofessional auxiliary and allied health career workers so they can move into the professional sphere of nursing. Three ways to encourage minority paraprofessionals are to make target support services available, offer stipends and offer scholarships.
The online magazine titled Minority Nurse wants to attract African-American, Hispanic, Asian, Native American and Filipino nurses for their readership audience. Those are the main ethnicities defined under the category of minority students. Swail, Redd and Perna (2003) explained that the following minorities were not retained in higher education programs in large enough numbers: Native American, African American and Hispanic along with disabled students and low income students. On the other hand, white and Asian students have shown high retention levels (Swail, Redd and Perna (2003, p. 5) Ways to retain Hawaiians and other indigenous populations need to be found and applied because they are leaving higher educational programs before completion, too (Jensen, 2011). Another distinction for minority students is based on gender. Men do not enter nursing in numbers matching those of women.
Maintaining a larger number of minority nurses within the nursing pool is necessary to fill America’s needs for nurses. Reaching this goal has not been successful, though, because of the barriers minority students face. Unfortunately, the barriers minority nurses face at work cause many to leave the profession. Minority nurses become discouraged and leave the profession before retirement age.
If well-planned recruitment strategies are targeted at minority high school students, than many of the difficulties could be resolved, and the retention of minority students in nursing education could be greatly improved.
Research studies have found that that the perceptions about the nursing profession in kindergarten, elementary school and high school are negative and they are not based on fact (Dower, McRee, Briggance, & O’Neil, 2001; Greenwald & Davis, 2000).
A Canadian research project evaluated the “ attitudes and perceptions towards men in nursing education” (Bartfay, W. J., Barfay, E., Clow & Wu, 2010). The research was initiated because of the problems recruiting and retaining men as nurses. The authors noted the barriers were educational as well as social, and included the perception that women are supposed to be nurses and men who are nurses are “ effeminate or gay” (Bartfay, W. J., Barfay, E., Clow & Wu,, p. 1). Initiatives are being planned and initiated in order to create a larger population in America’s nursing pool by attracting minority students and then retaining them.
Keller and Collins (2004) carried out a research study titled “ Nursing Education Barriers Survey.” Nursing students who were working on Associate and Baccalaureate degrees participated. Out of the 3, 020 nursing students who participated, 85. 3 percent were female and 14. 6 percent were male (Keller and Collins, p. 7). African American students made up 17. 5 percent of the participant pool, and 2. 0 percent made up the other ethnic origins including Hispanic, Asian and Native American (Keller and Collins, p. 7). The students received a different questionnaire from the faculty. The students were asked to identify the three main barriers that might not allow them to finish their degree. The top three barriers from the student group of participants were reported to be no financial support,, difficulty balancing family, children with their education, and they were not able to work and go to school at the same time. (Keller & Collins, 2004). Keller and Collins (2004) listed, in order of importance, the other barriers the students reported:
– not enough academic preparation,
– no support from their instructors,
– problems with health,
– no health insurance,
– problems associated with the faculty such as not prepared to teach, no concern for students, not thoroughly knowledgeable on the subject, and not organized,
– stress, and
– the requirements for being a full-time student.
The nursing faculty was asked to describe the barriers to student retention that were based on the professional images of nurses. The faculty listed “ poor professional image of nursing” as the most often noted under the topic (Keller and Collins (p. 24).
Learn About Unlimited New Careers in Healthcare (L. A. U. N. C. H). is a California initiative with the goal of sharing accurate information about health career careers to school children. An outreach program carried out by members of the California Health Occupations Students of America (HOSA). Classes from Kindergarten to 12th grade are the focus of the Cal-HOSA initiative. The goal is to prepare and encourage students to pursue health careers at the university level (Dower, McRee, Briggance, & O’Neil, 2001). High school students are encouraged because they are eligible for academic scholarships. The four key parts of the Cal-HOSA initiative include the following features.
– Offer health education curricula with up-to-date facts,
– offer nursing specific academic programs,
– design career counseling materials, and
– develop a link with the community.
A study of standardized achievement test scores demonstrated that the students involved in the HOSA program have higher test scores than students who have not entered the program (Dower, McRee, Briggance, & O’Neil, 2001).
The MSU BSN program in Michigan has extended the idea of early enrollment for students in the Lansing School District. In 2008 students could enter the BSN program when they were juniors in high school. The new plan offers ten disadvantaged students an “ Early Admit option” (Viau, 2011). The category disadvantaged students includes minority students and students from families without the economic resources to send their children to college. The program specifically focuses on retention by providing support in the following ways.
– Summer preparation study program before freshman classes start,
– targeted support services,
– stipends, and
– scholarships (Viau, 2011).
The strategies discussed above address the needs of minority students in a number of ways. Correcting the false perceptions about nursing in the primary and secondary educational system opens up the field to a new pool of recruits. Nursing needs minority students to fill positions and minority students need opportunities for a stable and satisfying career. Therefore educational outreach needs to start with children at a young age before false ideas about nursing become difficult to change.
Jensen (2011, p. 2) noted that high school G. P. A. and financial aid were the number one and number 2 factors that influenced the retention of native Hawaiians. Other important aspects that need to be evaluated for native Hawaiian and other minority students include “ course load, academic self-discipline, a sense of belonging and social connectedness, academic engagement in research or clubs,” support from family and the faculty and finally a sense of belonging to the community which nurtures a feeling of self-importance. Kawakami (1999, p. 26) surveyed Hawaiian educators who emphasized that “ successful learning experiences for Hawaiian students much take place in a culturally authentic physical and social learning environment.”
Paraprofessionals from the auxiliary and allied health care worker sector would be a great solution to the problem to the recruiting of minorities that that is needed (Dower, McRee, Briggance, & O’Neil, 2001. This can be done by changing the perception about nursing by sharing positive and factual information. Financial aid and academic study opportunities would help encourage minority health care workers into nursing. Flexible schedules would help the workers take classes and continue working at the same time.
Bartfay, W. J., Barfay, E., Clow & Wu,, (2010) concludes that in order to successfully retain men in the nursing profession the stereotypes about the nursing profession is only suitable for women must be contradicted. Therefore recruitment advertisements should portray men as nurses and male faculty in nursing higher education programs.
The first three features Cal-HOSA recommended for recruitment and retention involve working with other educational professionals but the fourth feature, developing a link with the community, involves parent and other community members. By including the family and neighbors of a minority student in the initiative, minority students have a local support system in place that would not otherwise be available.
In conclusion, an overall goal of any long term retention goals need to address the mistaken information students in Kindergarten, elementary and high school receive about a nursing career. A curriculum needs to be developed that matches the facts about the modern nursing profession. Career counseling brochures for older students can be designed so that minority students as well as other students will find the materials attractive. Society’s perceptions of nurses must be changed so the benefits of a nursing career are not ignored by minority students. The best short term goal is to offer advantages to auxiliary and allied health care workers such as flexible scheduling, financial aid and non-traditional study opportunities as a bridge from paraprofessional to professional.

References

Bartfay, W., Bartfay, E., Clow, D., Wu, T. (2010). Attitudes and Perceptions towards Men in Nursing Education. The Internet Journal of Allied Health Sciences and Practice. 8(2).
Dower, C., McRee, T., Briggance, B., & O’Neil, E. H. (2001). Diversifying the nursing workforce: A California imperative . CA: California Workforce Initiative. University of California (UCSF) Available online. http://www. futurehealth. ucsf. edu/
Greenwald, H. P., & Davis, R. A. (2000). Minority recruitment and retention in dietetics: Issues and interventions. Journal of American Dietetic Association, 100 , 961-966
Immaculatan, I., Straker, K. C., Landson, M. J., Symes, L., Bernard, L. F., Hughes, L. A. & Carroll, T. L. (2011) An Innovative, Multidisciplinary Strategy to Improve Retention of Nursing Students from Disadvantaged Backgrounds. Nursing Education Perspectives, November 2011, (32)6, 375-379.
Jensen, U. 2011. Factors Influencing Student Retention in Higher Education. Summary of Influential Factors in Degree Attainment and Persistence to Career or Further Education for At-Risk/High Educational Need Students, Pacific Policy Research Center. Honolulu, HI: Kamehameha Schools–Research & Evaluation Division, pp. 1-4, http://www. ksbe. edu/spi/pdfs/retention_brief. pdf
Kawakami, A J. (1999). Sense of place, community, and identity: Bridging the gap between home and school for Hawaiian students. Education and Urban Society, 32(1), 18-40.
Keller, S. D.& Collins, V. B. (2004). Nursing Education Barriers Identification Survey. Mississippi Office of Nursing Workforce, Healthcare Research Group. LLC, Workforce Investment Network in Mississippi.
Swail, W. S., Redd, K. E., & Perna, L. W.. (2002). Retaining minority students in higher education: A framework for success. ASHE-ERIC higher education report, 30(2), eries editor, Kezar, A. J., San Francisco: Wiley Subscription Services.
MinorityNurse. comhttp://www. minoritynurse. com/magazine
Noone, J. (2008), The Diversity Imperative: Strategies to Address a Diverse Nursing Workforce. Nursing Forum, 43: 133–143. doi: 10. 1111/j. 1744-6198. 2008. 00105. x
Vaiu, T. (2011). ‘ Overcoming Educational Barriers.’ Michigan State University (MSU), College of Nursing, http://nursing. msu. edu

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