The importance of a health care workforce that mirrors the diversity of the population is essential to provide culturally competent care. The Hispanic/Latino population is one of the largest and fastest-growing ethnic minority groups in the United States. According to the U.S. Census Bureau, 16% of the U.S. population identify as Hispanic/Latino (U.S. Department of Health and Human Services, Health Resources and Service Administration [HHS/HRSA], 2010). By 2060, it is expected that approximately 29% of the population will be Hispanic/Latino (Colby & Ortman, 2015). Thus, the importance of having Hispanic/Latino individuals in nursing and other health care-related positions cannot be overemphasized.
Despite efforts to have a culturally diverse nursing work-force, there is a significant gap between the percentage of the U.S. population who identify as Hispanic/Latino and the percentage of Hispanic/Latino RNs. In 2008, slightly more than 15% of the U.S. population was Hispanic/Latino (HHS/HRSA, 2010). At the same time, only 3.6% of RNs were Hispanic/Latino, indicating a significant disparity between the Hispanic/Latino population and the RN workforce (HHS/HRSA, 2010).
Although there has been growth in the Hispanic/Latino undergraduate college population (Fry & Lopez, 2012), Hispanic/Latino students remain significantly underrepresented in prelicensure nursing programs (National League for Nursing [NLN], 2013). Hispanic/Latino students are among the most underrepresented of all minorities in nursing education. In 2010, slightly less than 27% of students enrolled in prelicensure nursing programs were members of a minority group compared with almost 37% of the U.S. population (NLN, 2011). Of these, Hispanic/Latino students comprised just 7.6% of nursing students in associate degree programs and 6% of students in baccalaureate nursing programs (NLN, 2011). If the nursing workforce is to mirror the demographics of the U.S. population, then a greater number of Hispanic/Latino college students need to be enrolled in nursing programs.
Although college enrollment of Hispanic/Latino students is increasing, Hispanic/Latino students continue to face challenges as they pursue a college education. Among these challenges are lack of completion of a rigorous high school academic track, language barriers, immigration status, the cost of higher education, difficulty navigating college admission policies and procedures, degree of acculturation, and perceptions of self-efficacy (Abrego & Gonzales, 2010; Becerra, 2010; Brown, Santiago, & Lopez, 2003; Cerna, Pérez, & Sáenz, 2009; Gándara, 2010; Gushue, Clarke, Pantzer, & Scanlan, 2006; Nuñez & Kim, 2012; Oseguera, Locks, & Vega, 2009; Rivera, Chen, Flores, Blumberg, & Ponterotto, 2007).
A critical factor for a diverse nursing workforce is diversity in the nursing student population. The literature supports the need to address the issue of increased diversity of students enrolled in nursing programs (Barbee & Gibson, 2001; Coffman, Rosenoff, & Grumbach, 2001; Milone-Nuzzo, 2007; Seago & Spetz, 2005). Underrepresentation of minority groups enrolled in nursing programs also results in decreased numbers of minority nurses in graduate nursing programs, contributing to a shortage of diverse nursing faculty (Zuzelo, 2005). A number of reasons have been identified for the relatively low number of minority students in nursing programs that largely mirror the barriers identified for Hispanic/Latino students noted above: lack of rigorous high school preparation, lack of scholarships and financial aid to help defray costs, lack of role models, restrictive admissions policies, language barriers, and negative or discriminative treatment by administrators and faculty (Coffman et al., 2001; Gilchrist & Rector, 2007; Herrera, 2012; Jimenez, 2012; Naylor & Sherman, 1988; Samson, 2004).
Although research has been conducted on career development and college enrollment of Hispanic/Latino students and the experiences of Hispanic/Latino students enrolled in nursing programs, little research has been conducted on nursing as a career choice by Hispanic/Latino college students. The focus of this study was to address this gap in the research by examining career interest in and self-efficacy for a career in nursing, and factors viewed as facilitators or barriers by Hispanic/Latino college students interested in nursing as a career choice. The purpose of the study was to determine whether Hispanic/Latino college students are interested in nursing as a career choice and have feelings of self-efficacy for tasks associated with nursing. Another aim of the study was the identification of factors that Hispanic/Latino students believe will help them be successful in a nursing program.
The sample for this study was drawn from students enrolled in freshman- or sophomore-level courses at a community college and three comprehensive state universities in the western United States. A nonprobability, convenience sampling method of the accessible population was used to collect the data. Cross-sectional survey data were collected and analyzed for this study. Institutional review board approval was obtained from all of the participating institutions.
The four research sites were all located within one state in the western United States. Institution A was an urban, comprehensive state university located in a large metropolitan city with an enrollment of approximately 23,000 students. Institution B was a comprehensive state university located in the southwestern, rural area of the state with an enrollment of approximately 3,700 students. Institution C was a regional, comprehensive state university located in the southern area of the state with an enrollment of approximately 5,600 students. Institution D was a community college located in the northern area of the state with an enrollment of approximately 8,000 students.
Three of the four colleges and universities were designated as Hispanic Serving Institutions (HSIs) by the Hispanic Association of Colleges and Universities. The definition of an HSI is “colleges, universities, or systems/districts where total Hispanic enrollment constitutes a minimum of 25% of the total enrollment” (Hispanic Association of Colleges and Universities, n.d., para. 1). The fourth institution had a Hispanic student enrollment of 19.5% and was seeking HSI designation. Drawing the sample from these institutions increased the probability of surveying a sufficient number of Hispanic/Latino students to ensure sufficient power for statistical analysis.
Data were collected from volunteer students enrolled in freshman- or sophomore-level college courses who were age 18 and older. A total of 44 class sessions were included in the study. Courses selected for the study included Introduction to Nutrition, Introduction to Speech, General Biology, Anatomy and Physiology, English, and Psychology. Students in the sample had many different declared majors, including undeclared majors.
The Career Search Questionnaire (CSQ) developed by Dr. Cristine Roberts was used to collect data (Roberts & Ward-Smith, 2010). The CSQ was developed in response to the lack of a quantifiable method to identify incoming college students who have the likelihood of success in a nursing career. The instrument was designed to differentiate between interest in activities associated with nursing as a career and non-nursing careers, and between feelings of self-efficacy for nursing activities from those of other careers. Both constructs of interest and self-efficacy have been identified in research studies as important concepts impacting career choice among nurses (Roberts & Ward-Smith, 2010).
The CSQ consists of 48 Likert-scale items with five possible responses to each item. Twenty-three items address career interest, with 10 being related to activities associated with nursing. Twenty-five survey items address the construct of self-efficacy, with 13 items being related to self-confidence in completing activities associated with nursing.
The survey instrument also includes a section to collect demographic data. The data collected include self-reporting of gender, age, primary race/ethnicity, whether English is the primary language spoken at home, parental college attendance, financial loans to attend college, number of completed college credits, and college major at the time of survey administration.
The instrument used for this study consists of the original CSQ questionnaire subscales and items. Two modifications were made to the demographic section of the questionnaire. The list of college majors was modified, and a question was added to differentiate between students enrolled in a university or community college. Four additional questions were added to the survey instrument to determine confidence in completing seven courses that are frequently prerequisites for admission to prelicensure nursing programs, interest in a health care career, interest in nursing as a career, and factors perceived as necessary to be successful in a nursing program.
Data were collected using a paper-and-pencil survey when students were together for class. A total of 1,013 surveys were administered at the four research sites. The actual sample in the study was 961 participants, for a response rate of 94.9%.
The overall question that guided this research study was: What factors influence Hispanic/Latino college students’ consideration of nursing as a career choice? Six research questions were identified for this study:
- Research question 1: What relationship if any exists between interest in and self-efficacy for nursing as a career choice among Hispanic/Latino and non-Hispanic/Latino college students?
- Research question 2: How do each of the following variables—gender, age, English as the primary language spoken in the home, parent college attendance, financial loans for college, and number of completed college credits—correlate with Hispanic/Latino and non-Hispanic/Latino college students’ interest in nursing as a career choice?
- Research question 3: How do each of the following variables—gender, age, English as the primary language spoken in the home, parent college attendance, financial loans for college, and number of completed college credits—correlate with Hispanic/Latino and non-Hispanic/Latino college students’ self-efficacy for nursing as a career choice?
- Research question 4: Do Hispanic/Latino college students differ significantly from non-Hispanic college students in their interest in nursing as a career choice?
- Research question 5: Do Hispanic/Latino college students differ significantly from non-Hispanic/Latino college students in their self-efficacy for nursing as a career choice?
- Research question 6: What factors are identified as necessary by Hispanic/Latino and non-Hispanic/Latino college students to be successful in a nursing program?
Data analysis occurred in two stages. Descriptive statistics were calculated using information from the demographic section of the survey. Nominal variable data analysis included frequencies and percentages. Inferential statistics were used to analyze research questions one through five. Statistical analyses were conducted at α = 0.05. Descriptive statistics were used to analyze research question six.
Demographic information was collected in the first section of the survey instrument. The Table summarizes student characteristics.
Student Characteristics (N = 961)
When asked if English was the primary language spoken in the home, 88.3% (n = 849) of participants responded yes, 11.2% (n = 108) responded no, and 0.4% (n = 4) chose not to respond. The majority of the Hispanic/Latino students (72.5%, n = 174) indicated English was the primary language spoken in the home. A majority of students (60.9%, n = 585) reported they had financial loans to attend college. Notably, a greater percentage of Hispanic/Latino students were ages 18 to 20 (63.8%) than the overall percentage (53.7%) of participants in the sample. Comparisons between students attending the community college and the universities were not made because of the small number of community college students in the sample (n = 59).
Relationship Between Interest and Self-Efficacy for Nursing
Two-tailed Pearson correlations were conducted to determine the relationship between the variables nursing career interest and nursing career self-efficacy for the Hispanic/Latino and non-Hispanic/Latino participants. A positive, statistically significant correlation was found between nursing career interest and nursing career self-efficacy (r = 0.598, p < 0.01) for Hispanic/Latino college students. A statistically significant correlation between nursing career interest and nursing career self-efficacy (r = 0.590, p < 0.01) also was found for the non-Hispanic/Latino participants.
Relationship of Demographic Variables to Nursing Career Interest
Associational statistics were conducted to explore the relationship of demographic variables with interest in and self-efficacy for nursing as a career choice for the Hispanic/Latino and non-Hispanic/Latino students. Pearson product moment correlations were used to analyze the data. Results of the data analysis indicated that two variables, age (r = 0.285) and credits completed (r = 0.232), were significantly correlated with interest in nursing as a career choice by the Hispanic/Latino college students. Credits completed (r = 0.187) and gender (r = 0.182) were positively correlated with interest in nursing as a career by the non-Hispanic/Latino students. However, the effect size was small to medium for both groups of students, suggesting a weak but statistically significant relationship between the variables and interest in nursing as a career choice.
Relationship of Demographic Variables to Nursing Career Self-Efficacy
Pearson product-moment correlations were conducted to investigate the association of the demographic variables with nursing career self-efficacy. Only two variables were positively correlated with nursing career self-efficacy for Hispanic/Latino students. Credits completed was positively correlated with nursing career self-efficacy (r = 0.290), and age also was positively correlated with nursing career self-efficacy for Hispanic/Latino college students (r = 0.272).
Two variables, language spoken at home and credits completed, correlated with nursing career self-efficacy (p < 0.01). Credits completed was positively correlated with nursing career self-efficacy (r = 0.236). Language also was positively correlated with nursing career self-efficacy for non-Hispanic/Latino college students (r = 0.137). According to Cohen (as cited in Gliner, Morgan, & Leech, 2009), effect sizes of approximately 0.10 are considered small or smaller than typical and effect sizes of approximately 0.3 are typical in the behavioral sciences, indicating a statistically significant but weak relationship between the demographic variables and nursing self-efficacy.
The variables gender and financial loans to attend college were significantly correlated (p < 0.05) with nursing career self-efficacy. Gender (r = 0.077) and loans (r = 0.084) were positively correlated with nursing career self-efficacy; however, both effect sizes were small, indicating a weak relationship among the variables. Thus, non-Hispanic/Latino students who were women, spoke English at home, had loans, and had more credits completed tended to have higher nursing career self-efficacy.
Comparison Between Interest in and Self-Efficacy for Nursing as a Career Choice
Independent t tests were conducted to investigate whether there was a difference between Hispanic/Latino and non-Hispanic/Latino college students’ interest in a career in nursing and feelings of self-efficacy for nursing. Interest in nursing was determined by using the items on the CSQ that corresponded to this variable. There was no significant difference between Hispanic/Latino and non-Hispanic/Latino college students’ interest in nursing as a career choice, t(925) = −0.812, p = 0.807. Similarly, results of an independent t test analysis indicated there were no significant differences between Hispanic/Latino students and non-Hispanic/Latino students in their self-efficacy for nursing as a career choice, t(920) = −0.276, p = 0.72.
Factors Identified for Success in a Nursing Program
Students were asked to rate their confidence level in being successful in eight courses that are often required prerequisite courses for admission to a nursing program. Hispanic/Latino and non-Hispanic/Latino students rated having the greatest confidence in the ability to be successful in Introductory Psychology, Human Growth and Development, Nutrition, and English Composition courses. Anatomy and Physiology, Statistics, Microbiology, and Chemistry were the courses cited by the greatest percentage of students in both groups as having the least amount of confidence to successfully complete.
All students then were asked to answer a survey question about their interest in a health care career. Of students thinking about a health care career, 52.5% (n = 126) of Hispanic/Latino students agreed or strongly agreed that they were considering a health care career compared with 53.7% (n = 382) of non-Hispanic/Latino students, indicating a similar level of interest for both groups of students.
The final question asked students who were interested in nursing to identify factors that were needed to be successful in a nursing program. Descriptive statistics were used to analyze student responses to this survey question. The top four responses chosen by both the Hispanic/Latino students and non-Hispanic/Latino students were: shadowing a nurse at work to see what he or she does, health care work experience, volunteer experience in health care, and mentoring by nurses. These responses indicated a common theme that students were seeking information about what nurses actually do in their workplace and desired to be exposed to the health care work environment through paid or volunteer experience. Factors not rated as highly by both groups of students included financial assistance, family support, and child care assistance.
Results from this study demonstrated a moderately strong relationship between nursing career interest and nursing career self-efficacy for both Hispanic/Latino and non-Hispanic/Latino students. The relationship between nursing career interest and nursing career self-efficacy was slightly stronger for the Hispanic/Latino students in the sample. Overall, these results indicated that students who were interested in nursing as a career choice also had a sense of confidence in completing associated nursing-related activities. These results can be viewed as a favorable association that may support the likelihood of student success in a nursing career.
Gender was not significantly correlated with nursing career interest among the Hispanic/Latino students, suggesting that there is similar interest among both Hispanic/Latino male and female students in nursing as a career choice. This finding was surprising given that nursing is traditionally a female-dominated profession. In contrast, gender was significantly associated with interest in nursing for the non-Hispanic/Latino students.
Another notable finding was there was no correlation between English as the primary language spoken in the home and Hispanic/Latino students’ interest in and self-efficacy for nursing. This finding suggested that home language for Hispanic/Latino college students was not a factor related to students’ interest in nursing as a career choice as measured by the CSQ.
As with nursing career interest, there was no difference between male and female Hispanic/Latino students and their feelings of self-efficacy for activities associated with nursing as a career choice. There also was no statistically significant correlation between English as the primary language spoken in the home and nursing career self-efficacy, indicating that home language for Hispanic/Latino students was not related to their feelings of self-efficacy for accomplishing activities associated with a career in nursing.
A potential reason for lower enrollment of Hispanic/Latino students in nursing programs could be less interest in the activities associated with nursing as a career choice. In this study, no statistically significant difference was found between Hispanic/Latino and non-Hispanic/Latino college students’ interest in nursing as a career choice. This result suggested that lower enrollments of Hispanic/Latino students in nursing programs is not related to less interest in activities associated with nursing as a career choice.
Both groups of students identified the same top factors they believed would facilitate success in a nursing program: shadowing a nurse at work to see what he or she does, health care work experience, volunteer experience in health care, and mentoring by nurses were the top four choices by both groups of students. These factors clearly indicated that students believed the important facilitators for success in a nursing program centered on more information about the health care work environment and the role of the RN. Shadowing a nurse at work and mentoring by a nurse involve establishing a professional relationship with a nurse to receive information and support in professional role development. Students considering nursing as a career choice may be unsure what the role of the nurse entails, and they believe that direct contact with nurses would provide them with the opportunity to see firsthand the role of the RN.
The other two top choices, health care work experience and volunteer experience in health care, pointed to the need for further information about the role of the nurse within that environment. Students may view health care work or volunteer experience as giving them additional practical knowledge and perhaps even skills to be successful in a nursing program, such as interacting with other health care workers and patients.
These findings are supported by the literature that identified mentoring and role modeling as impacting the choice of a career by Hispanic/Latino students. Mentors can provide coaching to help students make decisions about career choices. Shinnar (2007) stated that mentors can provide encouragement and information about career options for Hispanic/Latino students. Role models can have a significant effect on career decision, particularly if the individual builds a high-quality relationship with the role model (Perrone, Zanardelli, Worthington, & Chartrand, 2002).
Overall, Hispanic/Latino and non-Hispanic/Latino students felt the most confident in their ability to successfully complete the nonscience and nonmath prerequisite courses. They did not feel nearly as confident in being able to successfully complete math and science courses. This finding was of concern given that math and science courses often are required for application to nursing programs, as well as being important knowledge needed by both nursing students and practicing nurses. These findings reinforced the importance of a rigorous high school curriculum, preferably with a science and math focus, to help students feel confident in their ability to successfully complete college-level math and science courses that are necessary for admission to nursing programs.
Although financial assistance was identified by both Hispanic/Latino and non-Hispanic/Latino students as necessary to successfully complete a nursing program, it was not listed as one of the top four factors. Perhaps the students in the study had previously addressed the issue of financing their education since they were enrolled in college at the time of this study and therefore would have previously determined financial resources to attend college.
Results from this study can be used in several ways by high school counselors, college and university academic advisors, and nursing education programs. This study suggests the CSQ instrument can be used as a career screening and advising tool for students, particularly those who might be considering a health care or nursing career. The instrument is relatively short and easy to administer, and provides initial feedback for students in the career decision-making process.
Results of this study reinforced the importance of the high school academic experience in the career-advising process. Study results supported the need for a rigorous high school curriculum to prepare students to be successful in college, particularly math and science courses.
Information from this study can be used by nursing education to support the goal of a diverse nursing workforce. With the knowledge that many Hispanic/Latino college students are interested in activities related to nursing, nursing programs can provide outreach programs to these students about nursing as a career choice. Nursing program information materials, including Web pages and brochures, could be designed to include images of both male and female Hispanic/Latino students.
There are several additional strategies that nursing programs can take to facilitate Hispanic/Latino students’ interest in nursing as a career choice. Mentoring programs could be established for prospective Hispanic/Latino nursing students. Nursing programs could consider healthcare work and volunteer experience in program admission criteria as a strategy to increase applicant knowledge of the role of RNs.
Recommendations for Further Research
There are several additional groups that could be included in future research studies to determine consideration of nursing as a career choice. Future research could include more students from community colleges. Hispanic/Latino students often begin their higher education pathways at a community college (Arbona & Nora, 2007). Surveying a greater number of Hispanic/Latino community college students could provide additional information about nursing career interest and self-efficacy, as well as factors these students believe would help them be successful in a nursing program. These results would provide a comparison between students enrolled at community colleges and 4-year institutions.
Future research also could include current Hispanic/Latino health care providers who are employed in related occupations, including medical assistants, nursing assistants, and non-licensed patient care assistants, to determine consideration of nursing as a career choice. This research could provide insight into strategies that might promote nursing as a career choice for individuals in entry-level health care occupations.
Additional areas for future research include exploring the relationship between high school math and science preparation and nursing as a career choice. Future research could focus on Hispanic/Latino and non-Hispanic/Latino students who have applied to nursing programs to determine factors that impact program acceptance. In addition, a larger sample size and more robust sampling techniques would strengthen future studies.
Overall, the findings from this study indicated that Hispanic/Latino students were just as interested in and had high feelings of confidence about activities associated with nursing as a career choice compared with non-Hispanic/Latino college students. Few statistically significant differences were found in the data analysis for either group of students. One exception was the finding that gender was not statistically significant for Hispanic/Latino students, which suggests gender was not a predictive variable for interest in activities associated with nursing among Hispanic/Latino students. Shadowing a nurse at work to see what he or she does, health care work experience, volunteer experience in health care, and mentoring by nurses were identified by Hispanic/Latino students as the factors most important to be successful in a nursing program. This study provided evidence-based results that can be used by high school counselors, college and university academic advisors, and nursing programs to successfully promote nursing as a career choice by Hispanic/Latino college students.
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Student Characteristics (N = 961)
|Student Characteristic*||n||Sample (%)|
|Race and ethnicity|
| African American||64||6.7|
| 18 to 20||516||53.7|
| 21 and older||441||45.9|
|Parents attended college|