Linda Scott, PhD, RN, NEA-BC, FAANAssociate Professor and Associate Dean for Academic Affairs

Julie Zerwic, PhD, RN, FAHA, FAANProfessor and Executive Associate Dean

Leading the Way:Holistic Review in Nursing at

UIC College of Nursing

“The fact that the nation’s health professions have not kept pace with changing demographics may be an even greater cause of disparities in health access and outcomes than the persistent lack of health insurance for tens of millions of Americans. Today’s physicians, nurses, and dentists have too little resemblance to the diverse populations they serve, leaving many Americans feeling excluded by a system that seems distant and uncaring.” (Missing Persons: Minorities in the Health Professions, 2004).

UIC definition of diversity:

“The totality of the ways people are similar and different, including race, ethnicity, class, gender, sexual orientation and identity, disability, national origin and citizenship status, age, language, culture, religion, and economic status, particularly when those similarities and differences are used as a basis for unfair advantage and inequity." (A Mosaic for UIC Transformation, 2012)

…to transform health, health care, and policy through knowledge generation and translation and through education of future leaders from diverse backgrounds

UIC College of Nursing Mission

Illinois Nurse Workforce

186,514 active registered nurses Racial/ethnic background

– Black/African American = 10.6%– Asian = 5.1%– Hispanic = 7%

Males = 6%

Importance of a Diverse Class

Mission alignment and professional commitment.

A diverse learning environment benefits all students.

Provides a rich teaching/learning milieu that homogenous backgrounds cannot.

Diverse health professionals can improve health inequities.

Diversity Matters: CON DSTP

URM will reflect our constituent pool

Recruit 15% men

Recruit students with disabilities

Recruit students who identify as lesbian, bi-sexual, gay, and transgender

Diversity Matters: College of Nursing

Students by Ethnicity  

Race

CON Graduate

CON Undergraduate

Chicago* Illinois* National*

White 71% 57% 45% 72% 78%

Black   6% 6% 33% 15% 13%

Hispanic   8% 11% 29% 16% 17%

Asian 8% 17%   6%   5%   5%

Multi-Race   2% 3%   3%   2%   2%

Importance of a Diverse Class

Mission alignment and professional commitment.

A diverse learning environment benefits all students.

Provides a rich teaching/learning milieu that homogenous backgrounds cannot.

Diverse health professionals can improve health inequities.

Motivation to Change

A perception that students in pre-nursing at UIC who were underrepresented minorities were unable to be granted admission.

Faculty perception that we had a very diverse student body.

Underrepresented minority students were less likely to persevere through the application process.

Additional Motivators

Significant variation between reviewers. Advance practice nursing programs had very few underrepresented minority students.

Implicit criteria that were not shared or endorsed by faculty.

Holistic Review Intervention

Opportunity to change our recruitment strategies

Transform the application process– Reduce barriers– Increase complete applications– Value added

Change internal and external perceptions

What is holistic admissions?

Comprehensive, individualized review of each applicant.

Balances experiences, attributes, and academic metrics.

Utilizes data from a variety of sources. Shifts the focus from the individual’s potential success as a student to the individual’s potential success as a member of the nursing profession.

Faculty Engagement & Buy-In

Workshop training sessions

– Set the stage/ground rules for the conversation

– Explore the influence of assumptions and beliefs

Minimize undue influence in admissions

– Self awareness

– Question the source of negative reactions

– Reserve judgments until after all data is reviewed

– Be open to others’ viewpoints

GPA Admission test scores Languages Science GPA

Sexual identity

Work ethic

Leadership qualities

Ability to work with others

One door to be coming a nurse

What changed in our process?

All qualified applicants received an interview

Interview questions were structured BSN applicants completed an in-person

writing assignment Interviews and applications were rated

by two independent reviewers

What changed in our process?

Interviews and application review by faculty who had participated in holistic admissions training.

Reviewers were blinded to the other materials they were not rating.

The ratings were not averaged, rather they were looked at in totality.

Admission Decisions

Two ratings for the interview (comments and name of reviewer)

Two ratings for the application review (comments and name of reviewer)

Overall GPA Science GPA Gender Race/ethnicity

Admission Decisions

We did multiple sorts based on the different criteria:– Interview scores from

highest to lowest (discrepancies between reviewers were examined)

– Application scores from highest to lowest

– GPA

Challenges and Considerations

Continual need for faculty and staff training– New employees– Continuing employees

Maintaining commitment to the process– Resources– Time– Desire to streamline

2016 Admission Cycle

Degree Eligible Not Eligible Grand Total

(BSN) Bachelor of Science in Nursing 271 226 495

(DNP) Doctor of Nursing Practice 248 56 304

(PhD) Doctor of Philosophy 21 5 26

Graduate Entry Master of Science 229 63 292Master of Science 41 30 71Grand Total 810 380 1190

Challenges and Considerations

Implications for student support– Once admitted do you have the support

systems for all students to succeed?

Curriculum assessment/revision– Do you have content in the curriculum that

allows you to teach to the diversity of the student body?

Comparison of 2015 UIC Nursing Students by Race/Ethnicity

Race CON Graduate

CON Undergraduate

Chicago Illinois National

White non-hispanic

65.4% 50.6% 45.0% 71.5% 72.4%

Black 8.0% 8.4% 32.9% 14.5% 12.6%

Hispanic 8.2% 15.7% 28.9% 15.8% 16.3%Asian 9.6% 20.1% 5.5% 4.6% 4.8%NHPI <.1% 0.2% 0.0% 0.0% 0.2%AIAN 0 0 0.5% 0.3% 0.9%Two or more 1.6% 2.57% 2.7% 2.3% 2.9%

Admission Data

Males Admitted by Year URMs Admitted by Year

Program Evaluation Process

Student surveys

Faculty perceptions

Comparative cohort analysis

Institutional data

The Future of Nursing at UICMeeting the Challenge through Holistic Review