Maximizing an urban secondary and post-secondary partnership to align educational expectations and student success.

Students from public urban secondary schools in the United States are often academically underprepared for post-secondary education. There are multiple social and structural factors contributing to this including living in communities where there are high rates of poverty, insufficient funding for public urban schools, and lack of rigor in their curriculum. Urban public post-secondary institutions struggle to bridge the gap to support students who are underprepared and in need of educational, financial, and social assistance. The purpose of this paper is to describe a partnership that was created between a public urban high school and a neighboring public urban university to address the issues underrepresented racially and ethnically (URE) diverse students encounter in order to not only better prepare them for the transition to post-secondary education, but to help them succeed once they arrive on campus. This partnership demonstrates that community cooperation to bridge the gap to support students who are underprepared is possible and benefits everyone involved. Preparing urban students for the successful transition to post-secondary education, particularly in the area of health professions can have a long-term impact on reducing racial inequities in health care.

The University of Cincinnati College of Nursing Case Study: Bias and Discrimination in the Nursing Learning Environment.

The purpose of this case study is to outline strategies employed by the University of Cincinnati's College of Nursing (CoN) to increase underrepresented racial and ethnic (URE), and economically and educationally disadvantaged student acceptance, presence, inclusion, and success. The case study method was used to examine strategies used at the CoN to address bias and discrimination, identify student success strategies for URE students, and outline college initiatives to facilitate an inclusive environment. CoN leadership has instituted several programs involving faculty and students in efforts to decrease bias and discrimination and promote inclusion. They continue to engage faculty and others in adding to and improving their efforts. This is a process of culture change and must involve everyone. CoN leadership is committed to both demonstrating by example and holding all accountable for progressively improved continued efforts to create a more inclusive environment.

Dedicated education units: Redirecting for success.

This process paper describes the evolution and growth of Dedicated Education Units through an academic-practice partnership at a college of nursing and urban medical center. This collaboration marked a period of rapid expansion from a single unit pilot dedicated education unit to five within a six-year timeframe. During the expansion from the pilot phase to creation of the dedicated units, it was determined that success in one unit did not translate to success in others. Using Tuckman's Group Development Theory as a lens for analysis of barriers and facilitators, suggested oversight and monitoring parameters were identified and include: (1) a dedicated clinical faculty coordinator is a necessity; (2) clearly defined dedicated education unit vision and goals need to be articulated to all; (3) a unit must commit to providing dedicated education unit clinical experiences only; (4) designated resources are needed for attending to staff and student scheduling requirements; (6) established and barrier-free clinical instructor educational support for nurse educator transition; (7) an objective evaluation plan with established benchmarks, (8) a need to evaluate the coordinator role as partnerships expand to multiple units, and (9) awareness of potential storming among new and experienced dedicated education units.

Maximizing Effectiveness of the Holistic Admission Process: Implementing the Multiple Mini Interview Model.

BACKGROUND: Nursing programs have responsibility to become more holistic in admission practices, ensuring they admit applicants based on more than grades and test scores to determine the best fit for their program. PROBLEM: One frequently cited holistic admissions barrier is incorporating qualitative measurement of applicant characteristics through interviews. Finding the best interview model is a challenge, depending on a program's intent to learn about applicants. APPROACH: This article describes the planning and implementation process for incorporating the Multiple Mini Interview (MMI) model into an existing holistic nursing program admission process. OUTCOMES: MMI model implementation resulted in more congruency in student attributes with the college vision, mission, and values and increased diversity. CONCLUSION: An efficient, well-organized MMI interview model was implemented, allowing achievement of overall admission goals and ensuring selected applicants demonstrate attributes aligned with college values and vision and increased diversity.

How older adults with multimorbidity manage their own care within a formal care coordination program?

As the number of older adults with multimorbidity increases, care coordination programs are being designed to streamline the complex care older adults receive from multiple providers by improving health and reducing unnecessary costs. Well-coordinated care requires actions by both patients and providers. Yet little attention is paid to the what older adults do to manage their own care alongside a formal Care Coordination Program (CCP). This paper presents a qualitative descriptive study that explored what actions older adults took on their own to manage their care. Findings from this study identified that there were two actions older adults took to manage their care; they lived within their limits and they lived with grit. This study suggests that by recognizing what older adults do to self-manage their care within the context of a CCP, nurses can build on older adults' actions and provide person-centered strategies for care coordination.

Increasing healthcare workforce diversity: Urban universities as catalysts for change.

Increasing the diversity of the healthcare workforce is often cited as a strategy for reducing racial and ethnic health disparities. Colleges and universities are uniquely positioned to influence workforce diversity through their recruitment, admissions, and student support practices, and by partnering with community groups to improve the pipeline of underrepresented racial/ethnic (URE) students pursuing health careers and influence workforce diversity practices in healthcare institutions. In this article, the authors describe a multifaceted initiative implemented by the Academic Health Center (AHC) at the University of Cincinnati (UC) that sought to address each of these areas. The initiative was led by the dean of the College of Nursing and a professor from the College of Medicine, who served as co-principal investigators. Within the university, UC identified improving health disparities and workforce diversity as central to its mission, adopted holistic admissions practices, used social media to strengthen outreach to URE students, and created a diversity dashboard to monitor diversity efforts. Additionally, UC partnered with community groups to expand pipeline programs for URE students and worked with a community advisory board to engage the region's health systems in evaluating their workforce diversity efforts. Within the College of Nursing, the initiative resulted in increased applications from students at pipeline schools, a larger number of URE student admissions, and increased faculty diversity.

An Academic-Community Partnership to Improve Health Care Workforce Diversity in Greater Cincinnati: Lessons Learned.

BACKGROUND: The University of Cincinnati (UC) participated in a learning collaborative aimed at preparing a culturally sensitive, diverse, and prepared health workforce. OBJECTIVES: Describe the development, accomplishments, and lessons learned of an academic-community partnership vested in improving health care workforce diversity and health disparities in the Greater Cincinnati region. METHODS: Researchers created a Community Advisory Board (CAB) consisting of university, community, and health system representatives. The CAB addressed gaps in workforce diversity data and catalyzed the formation of new regional partnerships, resulting in a multipronged strategy for improving health workforce diversity and health disparities. LESSONS LEARNED: The academic-community partnership was enhanced by composition of the CAB and inclusion of diverse, credible, and collaborative partners; cultural humility by academic researchers; establishment of trust and respect; and a shared commitment to common goals. CONCLUSIONS: By sharing decision making with the CAB, academic researchers expanded their engagement and influence on community issues.

An evaluation of forums for discussions on inclusion in a college of nursing.

BACKGROUND: The lack of diversity in the nursing profession could be an outcome of unconscious biases. Forums allowing the personal reflection and discourse of these unconscious biases are needed in order for a diverse and inclusive learning environment to exist. PURPOSE: The purpose of this study was to describe the experiences of students, staff, faculty members, and guests participating in a forum on diversity and inclusion. METHODS: An exploratory design was used to understand the experiences of college of nursing students, staff, faculty members, and guests who participated in a diversity and inclusion intervention sponsored by the college of nursing's Diversity Advisory Council. Attendees to 12 diversity book club, movie night, and speaker series' sessions completed a program evaluation tool. Responses to open-ended items were analyzed using a constant comparative analysis method.Responses from 197 participants were analyzed. Eight book club, seven movie night, and six speaker series' themes were derived from the data including Humanness is Universal, Personal Connection, The Problem, Awareness of Disparity, Make a Difference, and No Change. DISCUSSION: Participants at each session critically dialogued about their conscious and unconscious biases. The study findings show that participants also were able to document changes to their knowledge, attitudes, and behaviors in relation to the historically oppressed populations focused on during the intervention activities. CONCLUSION: Education entertainment as used in this study was a valuable mechanism for hosting conversations about diversity and inclusion.

Transforming Nursing Education With Apple Technology.

The widespread adoption of technology has the potential to redefine nursing education. Currently, there is limited knowledge of how to implement technological advancements in nursing curricula. This article describes 1 college's journey to transform nursing education through leadership, professional development, and innovative learning and teaching. The iPad opens the classroom experience to resources and learning opportunities for students. Facilitating the culture change required to adopt the iPad as a teaching and learning tool required a supportive vision, strong leadership, commitment to provide adequate technological support, early adopters, and planning.

Holistic Admissions in Nursing: We Can Do This.

UNLABELLED: Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. PURPOSE: The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. METHODS: A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. RESULTS: One overarching category from Phase 1 was identified, which was the lack of nursing schools' knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone's buy-in is required, the need for a model, and a need for training. CONCLUSION: The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of holistic admissions review among nursing deans; obtaining buy-in and support for holistic admissions review and conducting a self-assessment of current admissions practices; providing nursing administrators, faculty, and staff with diversity training; and conducting further research to identify factors most critical for success in nursing. Although the transition to a holistic admissions process requires some effort, arming ourselves with the appropriate tools will mitigate barriers during implementation.

Evaluation of a Summer Bridge: Critical Component of the Leadership 2.0 Program.

BACKGROUND: Summer bridges facilitate the transition from high school to college. Although many schools employ summer bridges, few have published outcomes. This article's purpose is to share preconceptions of college by underrepresented and disadvantaged nursing students and describe important elements and long-term impact of a summer bridge, a component of the Leadership 2.0 program. METHOD: A longitudinal study design was used to collect baseline, short-term, and long-term post-summer bridge data. Methods included pre- and postsurveys, interviews, and focus groups. RESULTS: After bridge completion, students felt more prepared for the nursing program. Students ranked socialization components as most important. The summer bridge had lasting impact through the first year, where grade point average and retention of underrepresented and disadvantaged bridge students was comparable to the majority first-year students. CONCLUSION: The summer bridge was effective in preparing nursing students for the first year of college. Through holistic evaluation, unique aspects of socialization critical to student success were uncovered.

How many schools adopt interviews during the student admission process across the health professions in the United States of America?

Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.

Israeli registered nurse workforce.

This commentary on the article by Nirel, Riba, Reicher and Toren, "Registered nurses in Israel - workforce employment characteristics and projected supply", describes major findings from this important Israeli study and links findings to other nursing workforce studies worldwide. Israeli projections include a 25% decrease in RNs in the workforce by 2028; the greater likelihood of leaving the progression of young nurses compared to older nurses, and the greater likelihood of leaving the profession by those nurses with no advanced training. Suggestions are made for future workforce analysis to triangulate economic analysis and policy planning, work design, and workforce management; for policy and planning and budget allocation at the macro level to go hand-in-hand with work design and management strategies at the micro level; and for the development of a national nursing workforce plan for investment and reform with a timeline and specific dates for accomplishing separate goals for recruitment and retention.This is a commentary on http://www.ijhpr.org/content/1/1/11/.

Effects of a multicomponent wellness intervention on dyslipidemia among overweight adolescents.

Behavioral changes are the first line of treatment for dyslipidemia in adolescents, but outcome data on the effectiveness of this approach are inconsistent. This study aims to assess the effect of a 13-week multicomponent wellness intervention program, which included weekly nutrition classes and structured cardiovascular, flexibility, and strength training on dyslipidemia in nine overweight/obese [body mass index (BMI) > or = 85th percentile] and nine lean (BMI <85th percentile) adolescents. Clinical measurements and lipid profile assessment were performed before and after the intervention. At the completion of the study, the overweight/obese adolescents demonstrated a 15% increase in high-density lipoprotein cholesterol (HDL-C) levels (mean, 47 +/- 8 vs. 54 +/- 5 mg/dL), whereas there was no improvement in BMI or other measurements. The participants in the lean group showed no change in their anthropometric and serum parameters. A multicomponent wellness intervention resulted in a significant increase of cardioprotective HDL-C levels, which have been associated with coronary health in adulthood.

Partnering and leadership: core requirements for developing a dedicated education unit.

Preparing new nurses to practice independently and provide safe and effective care has always been a priority for nurse leaders in academe and service but is becoming more of a challenge as patient acuity intensifies and care systems become more complex. Recent reports by the Carnegie Foundation and by the Institute of Medicine and RWJF call for nurse leaders to improve how nurses are prepared and educated by reducing the gap between classroom and clinical teaching and making better use of resources and partnerships available in the community. The development of a dedicated education unit is one strategy to address this gap.