Linda Stroup, Ph.D., RN Chair, Department of Nursing

Metropolitan State University of Denver July 18, 2014

Importance of a culturally competent healthcare workforce

American Nurses’ Association and The Joint Commission standards for patient care include cultural competence Leininger’s theory for transcultural nursing:

Culturally congruent nursing care improves health and well-being for the patient

In 2010:

16% of U.S. population identified as Hispanic/Latino

3.6% of registered nursing workforce identified as Hispanic/Latino

6% of students enrolled in baccalaureate nursing programs identified as Hispanic/Latino

7.6% of students enrolled in associate degree nursing programs identified as Hispanic/Latino

Predicted that 24.4% of the U.S. population will be Hispanic/Latino by 2050

The purpose of the study was to explore Hispanic/Latino college students’ consideration of nursing as a career choice.

Primary research question: What factors influence Hispanic/Latino college

students’ consideration of nursing as a career choice?

Nine additional research questions related to career

interest, career self-efficacy, demographic variables, factors for success in a nursing program

Previous research studies conducted on factors that impact college enrollment and career development for Hispanic/Latino students:

Gender

Linguistic acculturation

Financial constraints

Immigration status

Mentoring

Role modeling

Family support

Limited research on successful strategies to recruit Hispanic/Latino students to nursing

Limited research on the experience of Hispanic/Latino nursing students

Lack of research on nursing as a career choice by Hispanic/Latino college students

Quantitative study

Non-experimental, associational research design

Non-probability sample was drawn from three comprehensive state universities and one community college

Descriptive and inferential statistics

Three colleges designated as Hispanic Serving Institutions (25% or greater); fourth had enrollment of 19.5% Hispanic students

Sample –

961 students

240 Hispanic/Latino students

Career Search Questionnaire

Developed and tested by Dr. Cristine Roberts

48 Likert-scale items with 5 possible responses to each item

23 items address career interest

25 items address self-efficacy

Demographic section

Additional questions added for this study

Freshman or sophomore level courses

44 class sessions

Survey administered in pencil and paper format

Survey usually administered immediately before or during beginning of class session

Prepared script read to students

Total sample was 961 students

41.2% male, 58.6% female

Age: 18-20 = 53.7%

63.8% were Hispanic/Latino students

Ethnicity/race = 59.7% White (n = 574) 21.7% Hispanic/Latino (n = 240)

English as primary home language = 88.3%

72.5% of Hispanic/Latino students

Nursing, non-nursing healthcare and natural sciences accounted for 46.36% of reported majors

Favorable association between nursing career interest and nursing career self-efficacy may promote student success

CSQ appeared to be useful tool to distinguish between interest in and self-efficacy for nursing and non-nursing careers

Gender not significantly correlated with interest in or self-efficacy for nursing for Hispanic/Latino students

English as primary language in home not significantly correlated with interest in or self-efficacy for nursing for Hispanic/Latino students

Number of credits completed significantly correlated with interest in and self-efficacy for nursing for both Hispanic/Latino and non-Hispanic/Latino students

No significant differences between Hispanic/Latino and non-Hispanic/Latino college student interest in or self-efficacy for nursing as a career choice

Results suggested that lower enrollment of Hispanic/Latino students in nursing programs did not appear to be related to less interest in or self-efficacy for nursing as a career choice

Confidence in completing seven courses that are often pre-requisites for nursing programs

No difference between either groups of students (Hispanic/Latino and non-Hispanic/Latino):

Most confidence in psychology, English and nutrition courses

Least confidence in math and science courses

Interest in a healthcare career

Hispanic/Latino students:

Strongly agreed or agreed = 52.5%

Non-Hispanic/Latino students:

Strongly agreed or agreed = 53.7%

Interest in nursing as a career

Hispanic/Latino students: 19.39%

Non-Hispanic/Latino students: 15.81%

Top four factors identified by both Hispanic/Latino and non-Hispanic/Latino students for success in a nursing program:

- Shadowing a nurse

- Healthcare work experience

- Volunteer experience in healthcare

- Mentoring by nurses

Findings reinforce importance of a rigorous high school curriculum, especially in math and science courses

Hispanic/Latino students equally interested in pursuing healthcare careers as

non-Hispanic/Latino students

Hispanic/Latino students had strong interest in professional healthcare programs, in some cases requiring advanced degrees (physician, physical therapist)

Results suggested that students are unsure about the role of the registered nurse

Desired a professional relationship with a nurse

Responses suggested that students believe experience in the healthcare setting will give them additional practical knowledge and interaction with healthcare providers

Rigorous high school curriculum, especially math and science courses

Linguistic acculturation

Financial constraints

Importance of mentoring and role modeling

Interest in professional healthcare careers by Hispanic/Latino students

Role of gender

Acculturation

CSQ instrument as career advising tool

CSQ scoring matrix

High school academic experience and career advising

Outreach programs to Hispanic/Latino college students

Marketing

Mentoring programs

Nursing program admission criteria

Male Hispanic/Latino college student interest in nursing as a career choice

Investigate whether Hispanic/Latino students are applying to nursing programs

Replicate study with following populations:

Community college students

Private and proprietary school students

Hispanic/Latino individuals employed in entry-level healthcare positions

High school students

Hispanic/Latino college students are equally interested and confident in nursing as a career choice as non-Hispanic/Latino college students

Gender, linguistic acculturation, financial constraints, interest in professional healthcare careers differed from literature

Mentoring, shadowing a nurse, and healthcare/volunteer experience were identified as factors for success in a nursing program

CSQ instrument can be used as advising tool

Chitty, K. K. & Black, B. P. (2011). Professional nursing: Concepts and challenges. Maryland Heights, MO: Saunders.

Leininger, M. & McFarland, M., 2002. Transcultural nursing: Concepts, theories, research & practice. New York: McGraw-Hill.

The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010.

National League for Nursing (2011). Executive summary: Findings from the Annual Survey of Schools of Nursing Academic Year 2009-2010 retrieved from:

http://www.nln.org/researchgrants/slides/exec_summary_0910.pdf

Roberts, C. A., & Ward-Smith, P. (2010). Choosing a career in nursing: Development of a career search instrument. International Journal of Nursing Education Scholarship, 7, 1-18.

U.S. Department of Health and Human Services, Health Resources and Service Administration (2010). The registered nurse population: Findings from the 2008 national sample survey of registered nurses. Washington D.C.: U.S. Department of Health and Human Services, Health Resources and Service Administration.