Creating a Diverse Nursing Program: Rural Pipeline Programs Best Practices

CREATING A DIVERSE NURSING PROGRAM: RURAL PIPELINE PROGRAMS BEST PRACTICES

PIPELINE OVERVIEW

One of the stated goals of the New Mexico Nursing Education Consortium is to increase workforce diversity by improving nursing education for minorities, particularly in rural areas. This goal is aligned with goals for the Academic Progression in Nursing (APIN) grant from the Robert Wood Johnson Foundation, to increase number of underrepresented nurses in New Mexico with BSN degrees. This includes: male, African American, Hispanic, Native American, disabled, First Generation College, socioeconomically disadvantaged.

Educational pipeline interventions are often listed as a promising practice in order to increase the number of underrepresented populations in any healthcare field. According to the 2010 issue paper Building a 21st Century Health Care Workforce in a Diverse Rural State: A Funder’s Perspective & Evaluation Framework for Innovation & Impact of Health Career Pipeline Programs, “pipeline” programs have emerged as viable pathways to health careers for high-school and pre professional college students, especially among racial and ethnic minority students in an attempt to diversify the health care workforce”. (Schleder, 2010)

There are two types of pipeline programs; stand alone or independent programs and those that are part of a partnership. Many health profession schools may offer programs, which stand alone or are independent of the community in which they serve, and include minimal participation with local schools or community organizations besides an access point for participants. These programs tend to focus more on the individual student instead of a defined, targeted population. (Patterson, 2006)

Partnership programs tend to represent a level of commitment from both the health professions school and the public schools system and community organizations. They tend to work with a more narrowly defined population, and can include multiple approaches in the development and implementation of the pipeline. These programs tend to work with students in the K-12 students as well as those who recently entered college. (Holley, K. 2013) Community-Campus Partnerships for Health (CCPH) defines a partnership as a “close mutual cooperation between parties having a common interests, responsibilities, privileges and power”. Over the last 15 years, CCPH has studied, examined, engaged in, and evaluated what makes partnerships work, sustain authenticity, and achieve the change they want to see in their community.

BEST PRACTICES OF SUCCESSFUL PARTNERSHIP PIPELINE PROGRAMS

Below is a list of ten characteristics of successful pipeline programs. This list includes: Authentic Partnerships, resources, alignment, multi-dimensional, mentoring, family and community engagement, underrepresented representation, responsive admission criteria, cultural competence, and sustainability.

This list is not intended to be inclusive of all pipeline programs, but highlight the characteristics of a successful pipeline programs which have been used in addressing access to healthcare careers by underrepresented groups and rural communities. By focusing on broad practices and guidelines, instead of specific strategies, it allows for communities to develop culturally competent and responsive pipeline programs to address their own unique needs within their own capacity. (Table 1) Table 1: Characteristics of Successful Partnership Pipeline Programs

CHARACTERISTIC GUIDELINES DESCRIPTION/ EXAMPLES

An Authentic Partnership is based on the following guiding principles, processes, experiences and outcomes:

1. Serves a specific purpose and has agreed upon mission, goals, and values and is characterized by mutual trust, respect, Pipeline programs genuineness and commitment. should strive to utilize authentic partnerships 2. Builds each program/partners strengths and whenever possible to assets, but also addresses needs and AUTHENTIC ensure that they are increases the capacity of all partners. PARTNERSHIPS able to address the barriers to participation 3. Balances power and shares resources in collaborative, among partners. culturally responsive and reciprocal ways. 4. Relationships are focused, open, honest, respectful and ethical; trust building, acknowledging of history; and committed to mutual learning and sharing credit.

5. Develops meaningful outcomes that are tangible and relevant to the community they serve.

Pipeline programs 1. At least one fulltime employee that works to should share resources develop and support the pipeline program. and responsibility as much as possible. 2. The program should be imbedded in the Programs that are institutional hierarchy and structure. RESOURCES strategically planned and have 3. Each partnering organization should have demonstrated solid institutional support (financial resources and commitment human resources) in order to be effective. throughout all levels of the institution are more likely to succeed.

ALIGNMENT Pipeline programs should be aligned with 1. The Accreditation Commission for Education both the mission of the in Nursing (ACEN) lists one of its goals to institution, program and “foster educational equity, access, opportunity accrediting body. and mobility, and preparation for employment based upon type of nursing education”.

2. The Commission on Collegiate Nursing Education (CCNE) identifies some of its principle values as encouraging programs that develop graduates who are effective professionals and socially responsible citizens.

3. Most institutions of higher education have missions to serve the communities in which they reside; therefore the development of pipeline programs to promote inclusion of underrepresented populations assist in meeting that mission.

Multi-Dimensional Pipeline programs include, but are not limited to:

1. Strengthening participants’ academic skills.

2. Provide an introduction to campus life. Pipeline programs 3. Aid in the development of self-esteem, sense should be consistently MULTI-DIMENSIONAL of purpose and cultural awareness. multi-dimensional. Programs should begin Additional strategies may also include: early and persist through out schooling. 1. Family and community support and involvement.

2. Hands-on learning, career exposure and opportunities to engage with current students and faculty.

Pipeline programs should review admission criteria and when possible develop a holistic admissions RESPONSIVE program, with less ADMISSION CRITERIA focus on test scores and other academic indicators, which do not necessarily measure intelligence or competence.

CULTURAL Pipeline programs COMPETENCE should address the 1. Shows current students how they can assist experiences of the their own communities. targeted populations, not simply provide 2. Provides local community members with blanketed experiences. opportunity to see healthcare professionals who Research has shown have similar backgrounds and values as themselves. that increased family, 3. In addition to the development of community peer and community specific clinical sites, program visibility in the support can lead to targeted community is also a way to promote positive educational access to health careers. Examples could outcomes (Holley, include hosting immunization clinic at a local 2013). school or daycare or working with afterschool programs to conduct hearing and vision screening.

Programs should use evidence based strategies and practices. Regardless of the size and level of SUSTAINABILITY resources, successful pipeline programs are able to clearly state their goals and objectives.

BIBLIOGRAPHY

Community-Campus Partnership for Health, Board of Directors. (2013). Position Statement on Authentic Partnerships.

Holley, K. A. (2013). Rural Minority Student Engagement with a Healthcare Pipeline Program. Journal of Research in Rural Education.

Jacoby, B. (2003). Building Partnerships for Service-Learning. Jossey-Bass.

Oregon Health Authority, O. o. (2012). Strategies for Pipeline Programs. Retrieved from Oregon.gov: http://www.oregon.gov/oha/oie/Documents/Strategies_for_PipelineProgs.pdf

Patterson, D. a. (2006, June). Promoting Minority Access to Health Careers through Health Professions-Public School Partnerships: A Review of the Literature. Academic Medicine, 81(6), S5 - S10.