Journal of Nursing Education

Major Article 

Programmatic Evaluation of Holistic Admissions: The Influence on Students

Julie J. Zerwic, PhD, RN, FAHA, FAAN; Linda D. Scott, PhD, RN, NEA-BC, FAAN; Linda L. McCreary, PhD, RN, FAAN; Colleen Corte, PhD, RN, FAAN

Abstract

Background:

Traditional nursing admission processes may pose barriers to enhancing the diversity of the nursing workforce. Holistic admission moves beyond academic metrics to include applicants' experiences, attributes, and abilities.

Method:

Demographic and academic information was examined for students admitted to a Bachelor of Science in Nursing program before and after holistic admission implementation, and a survey was completed by students admitted in 2014 through holistic admission.

Results:

The admission of Hispanic students significantly increased, whereas admissions of non-Hispanic White students significantly decreased. Academic metrics did not change significantly. Students rated the holistic admission process positively, with the interview rated as more valuable than the written application. Some students believed it could have a negative effect on students who were not racial or ethnic minorities.

Conclusion:

Holistic admission may increase the diversity of a nursing class; however, it should be combined with other strategies to build a diverse pipeline. [J Nurs Educ. 2018;57(7):416–421.]

Abstract

Background:

Traditional nursing admission processes may pose barriers to enhancing the diversity of the nursing workforce. Holistic admission moves beyond academic metrics to include applicants' experiences, attributes, and abilities.

Method:

Demographic and academic information was examined for students admitted to a Bachelor of Science in Nursing program before and after holistic admission implementation, and a survey was completed by students admitted in 2014 through holistic admission.

Results:

The admission of Hispanic students significantly increased, whereas admissions of non-Hispanic White students significantly decreased. Academic metrics did not change significantly. Students rated the holistic admission process positively, with the interview rated as more valuable than the written application. Some students believed it could have a negative effect on students who were not racial or ethnic minorities.

Conclusion:

Holistic admission may increase the diversity of a nursing class; however, it should be combined with other strategies to build a diverse pipeline. [J Nurs Educ. 2018;57(7):416–421.]

Diversity in the nursing workforce has not kept pace with diversity in the population. This may derive from a lack of a diverse student population in nursing schools. When considering diversity, the nursing profession has focused almost exclusively on the lack of ethnic and racial minorities and the lack of men. However, more difficult to document is the extent to which other aspects of diversity are represented. Recently, admission practices in nursing schools have been posited as potential barriers to establishing a more diverse student population that might in turn address the diversity issues in the workforce. Traditionally, admission committees have focused on academic metrics, but considering experiences and other attributes may help to achieve a more diverse student body. This broader focus corresponds with the University of Illinois at Chicago's definition of diversity as:

  • The totality of the ways that 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 (University of Illinois at Chicago, 2012).
  • Holistic admission has been suggested as a strategy to admit more diverse nursing students, because this method incorporates applicant experiences and attributes, in addition to academic metrics (DeWitty, 2018).

We developed and implemented at a large college of nursing a holistic admission process based on the American Association of Medical Colleges Holistic Review Project (Scott & Zerwic, 2015). This article reports initial program evaluation outcomes.

Holistic Admission as a Strategy to Admit More Diverse Nursing Students

For more than a decade, as the U.S. population has been growing increasingly diverse. There has been a call to increase the diversity of the health care workforce. In 2004, both the Sullivan Commission (2014) and the Institute of Medicine (2004) issued reports on the lack of minorities in the health professions. Providers from minority groups are more likely to practice in communities of underrepresented individuals (Association of American Medical Colleges, 2014b). In addition, patient outcomes are improved when patients are treated by providers from similar backgrounds (Cooper et al., 2003; Traylor, Schmittdiel, Uratsu, Mangione, & Subramanian, 2010).

Individuals from ethnic and racial minorities make up more than 38% of the population (U.S. Census Bureau, 2015) but only 19% of the nursing workforce (Budden, Zhong, Moulton, & Cimiotti, 2013). African Americans, Hispanics, American Indians, Alaskan Natives, Native Hawaiians, and other Pacific Islanders are underrepresented in the United States nursing work-force and Asians are also considered underrepresented in the advanced practice registered nurse workforce (Relf, 2016). The American Association of Colleges of Nursing has documented an increase in ethnic and racial diversity among nursing students. Currently, 32.3% of students in baccalaureate programs are ethnic or racial minorities (American Association of Colleges of Nursing, 2017). Whether this will result in success to graduation and retention in the workforce is yet unknown.

One tactic has been to increase the numbers of racial and ethnic minorities admitted; however, there is concern that this approach may be vulnerable to legal challenges and it is not inclusive of other diverse groups. As a more thoughtful and systematic approach, holistic admission has been used by several health professions (Urban Universities for Health, 2014). Holistic admission has been widely implemented in medicine and dentistry; recently, schools of nursing have begun to incorporate aspects of holistic admission into their procedures (Relf, 2016).

The three components of holistic admission are experiences, attributes, and academic metrics (Association of American Medical Colleges, 2014a). Institutions that use holistic admission continue to collect data on academic metrics such as grade point average (GPA) and admission tests, but these data comprise only one aspect of the applicant's profile. With holistic admissions, academic metrics alone never determine who among the cadre of qualified applicants will progress in the admission process.

In addition to academic metrics, the breadth and type of experiences that an individual has had provide knowledge, skills, and insights that contribute to his or her learning and that of their fellow students. These experiences could include time spent in another country, community or military service, caregiving for a family member, or leadership on an athletic team. Attributes include characteristics that will contribute to the nursing profession or to the individual's ability to provide care to an underserved population. These attributes could include proficiency in a foreign language, residency in a rural or impoverished community, or being a member of a historically underrepresented group in the nursing profession.

Few studies have examined the extent to which holistic admission is used in nursing, and there is limited literature on the outcomes achieved by institutions that use a holistic admission process (Glazer et al., 2016). In a recent survey of health profession colleges, those that implemented holistic admissions reported an increase in the diversity of their incoming class, positive changes to their learning environment, increased community engagement, enhanced student cooperation and engagement in teamwork, and increased openness to viewpoints that differed from the students' personal perspectives (Urban Universities for Health, 2014).

The University of Illinois at Chicago in 2014 chose to implement a holistic admission process after developing a diversity strategic plan that called for enhancing the diversity of students, faculty, and staff. Faculty and staff who were involved in the admission process that year participated in a 1-day workshop on holistic admissions (Scott & Zerwic, 2015). The undergraduate admission committee analyzed admission practices and implemented several key processes:

  • All applicants that met the prerequisite course work and minimum GPA participated in small-group (four to five students) interviews with standardized questions.
  • Faculty either participated in interviews or reviewed written application materials.
  • Faculty who interviewed or reviewed application materials used a common set of criteria to rate the applicants and were blinded to the other ratings.
  • Interviews were conducted jointly by two faculty members, and written application materials were reviewed independently by two faculty members.
  • Only faculty and staff who had completed holistic admission training participated in the admission process.
  • Each criterion was scored, but no overall score was created to preserve the independence of ratings.
  • Recommendations for or against admission were developed by consensus during discussion of the interviewers' and reviewers' ratings.

A program evaluation was conducted to examine Bachelor of Science in Nursing admission outcomes before and after implementing holistic admission in 2014 and to explore the perspective of the 2014 cohort of students, which was the first group admitted using this process and graduating from the program.

Purpose

The purpose of this program evaluation was to compare demographic characteristics and academic metrics of the admission cohorts before and after holistic admission implementation, and to examine, via survey, students' experiences with the admission process and diversity in the BSN program.

Method

Institutional review board approval was obtained prior to implementation of this program evaluation. Demographic and academic information were obtained from college of nursing databases for students admitted 2 years before holistic admission implementation (2012 to 2013) and 3 years after (2014 to 2016). National Council Licensure Examination for RNs (NCLEX) pass rates were obtained from the Illinois Department of Professional Regulation and Licensing. Time series regression analyses were used to evaluate changes in the variables of interest pre- and postholistic admission implementation.

A website-based program evaluation survey was deployed to examine students' perceptions of the admission process. Inclusion criteria were students in the BSN program on target to graduate in spring 2016 who were admitted in fall 2014 (when holistic admission was implemented). Of the 160 students admitted, 150 were eligible (94% on-time graduation rate), with 72 students choosing to participate for a 48% response rate. In spring 2016 participants completed the survey items, which allowed for fixed and open-ended responses. In addition to brief background information, the survey was designed to gather respondents' perspectives of the admission process, aspects of diversity, and effect on the student experience. All survey data were collected anonymously using a Qualtrics Survey® platform. Individuals could elect to provide contact information; those who did were given a chance to win one of five Amazon gift cards.

Results

Demographic and Academic Evaluation

Table 1 shows demographic data for all students admitted 2012 to 2016. At this university, students are admitted in their junior year after completing 2 years of prerequisite courses. Following the holistic admission implementation, there was a significant change in the race and ethnicity of the cohort of admitted students increased significantly (χ2 = 15.07, p = .005). Admission of Hispanic students from a low of 8.2% in 2013 to 18.9% in 2016 (χ2 = 8.359, p = .004). Admission of non-Hispanic White students decreased significantly from a high of 59.1% in 2013 to 44.4% in 2016 (χ2 = 8.801, p = .003).

Demographic Characteristics of Students Admitted 2012 to 2016

Table 1:

Demographic Characteristics of Students Admitted 2012 to 2016

Table 2 shows admission academic data for students admitted 2012 to 2016 and outcome data (2-year graduation rate and first-time NCLEX pass rate) for students admitted in 2012 to 2014. Because of strong temporal correlations for the outcomes, we used time series regression methods with Newey-West standard errors and frequency weighted estimation to estimate the effect of holistic admissions and avoid potential Type 1 error. There were no significant changes in average admission science GPA, overall GPA, 2-year graduation rate, or first time NCLEX pass rates. For reference, National NCLEX first-time pass rates are shown in the last row of Table 2.

Academic Characteristics and Outcomes of Students Admitted 2012 to 2016 (Before and After Holistic Admission Implementation)

Table 2:

Academic Characteristics and Outcomes of Students Admitted 2012 to 2016 (Before and After Holistic Admission Implementation)

Survey Evaluation

The demographic characteristics of survey participants were similar to the overall admission cohort (Table 1). As shown in Table 3, 90% of respondents indicated that the interview was somewhat (38.89%) to very useful (51.39%) in helping them showcase their talents. Ninety-four percent of respondents indicated that the application was somewhat (58.33%) to very useful (36.11%) in helping them showcase their talents, and 92% indicated that the application helped them to describe their diverse talents beyond academics. Nearly 96% of respondents indicated that they were somewhat to very comfortable in sharing what made them diverse with others during the completion of the nursing program. Finally, 96% of respondents indicated that their courses were somewhat aligned to very aligned with our university's definition of diversity.

Responses to Survey Questions

Table 3:

Responses to Survey Questions

Students also had the opportunity to comment on the application process in response to an open-ended question. One student stated:

[The] interviews allow for a better understanding of the person. I felt that I was more than just an application. Although it is very nerve racking, I do recommend keeping this portion in the process.

Another student commented:

[I] was not able to get any clinical experience before starting the program because of [a] personal situation. The writing exercise, essays, and the interview allowed me to present myself as a competitive candidate.

Several students felt there was too much emphasis on diversity or were concerned about the negative effects of not being from a racial or ethnic minority. These concerns were reflected in statements such as:

  • Acceptance should be made strictly on who is most qualified, nothing else.
  • I hope that people were not chosen simply because of their diversity as opposed to their qualifications.
  • As a Caucasian female, I sometimes felt uneasy about sharing my ethnicity. I felt as though my race had the potential to work against me in the admission process.

Nevertheless, most students were comfortable sharing what made them diverse during the nursing program. One student commented:

I feel like by disclosing my diversity, I am making the class more diverse and bringing a different viewpoint.

Another student stated:

The biggest strength that University of Illinois at Chicago's BSN program had was that its curriculum focused on diversity and creating strong, holistic leaders. I wish I were more prepared on the hard sciences for the NCLEX, but in the end what I learned about diversity isn't something I can just learn from a Kaplan course.

Discussion

For this program evaluation, we examined demographic and academic data of students admitted before and after holistic admission implementation and surveyed graduating students who had been admitted through a holistic review about the admission process. Although many institutions fear that a drop in academic metrics would be bound to follow holistic admission implementation, the admission science and overall GPA for students before and after we implemented holistic admission remained stable. Our finding is consistent with others who have documented either little change in academic metrics or increases in average GPAs and academic success after holistic admission implementation (Felix et al., 2012; Witzburg & Sondheimer, 2013).

There was a significant increase in the number of Hispanic students admitted after holistic admission implementation. Although this increase may be attributed to the holistic admission implementation, it is important to examine these results in the context of other events occurring on our campus and the broader community. In general, our university was seeing an increase in Hispanic students. It may be that we would have seen an increase in admissions of Hispanic students even if we had not implemented holistic admission. A continued evaluation of application, enrollment, and graduation trends will be essential to determine the effect of holistic admissions on the overall diversity of each cohort and the student body.

We saw no significant changes in the number of African American students admitted. It may be that African American students have additional barriers not addressed by holistic admission. For example, we noticed that minority applicants in general were less likely to complete their applications, compared with other prospective students. To address this issue, we implemented application workshops and reminder e-mails to improve application completion rates for the fall 2013 admission cycle. With the holistic admission implementation in fall 2014, we expanded the application workshops to include interview strategies and successful professional presentation and communication styles. After these workshops, there was an increase in application completion across all demographic groups. However, African American students were still less likely to complete their applications than any other group. In the authors' experience, incomplete applications may be due to factors such as failure in required prerequisite courses, lack of self-efficacy to prepare what is perceived to be a successful application into the nursing program, or limited peer and family support through the process. Understanding the barriers is critical prior to implementing effective solutions.

It is also important to note that the increase in the number of Asian students did not significantly change over time. Nevertheless, these students comprised the second largest minority group among our cohort of students and add to the diversity of the class, as well as the student body.

Before holistic admission implementation, similar to other schools we experienced a drop in NCLEX first-time pass rates that was attributed to changes in the difficulty of the examination implemented by the National Council of State Boards of Nursing (2017). As a result, there was concern that a holistic admissions process could further negatively affect NCLEX pass rates. However, we saw a rise in pass rates that was likely attributed to adding student success strategies that included additional test-taking opportunities for students.

Diversity at University of Illinois at Chicago has a broad definition; nevertheless, students' comments on surveys indicated that they equated the concept of diversity to race and ethnicity. It is important that, in the future, we more clearly articulate our broader perspective of diversity and disseminate that information to a wide audience.

Holistic admission has been proposed as a strategy to diversify student bodies in hopes of diversifying the health care workforce. However, holistic admission is only effective if a diverse pool of prospective students submits applications. Therefore, holistic admission must be used in conjunction with other strategies that build the pipeline to the health profession programs (Grumbach & Mendoza, 2008). Several recent initiatives advocate for the use of holistic admission, particularly in nursing. This includes the American Association of Colleges of Nursing's seminars and toolkit, as well as the Health Resources & Services Administration's (2016) Nursing Workforce Diversity Program requirement that all funded programs must use holistic admission as one of five required strategies. Institutions may be reluctant to adopt holistic admission because of concerns related to its time-intensive nature, potential liability concerns, limited information on how to implement the process, and lack of data on outcomes achieved. Research studies will help identify best practices related to holistic admission, as well as effective strategies that improve holistic admission's time- and cost-effectiveness.

Some aspects of student diversity were not specifically asked about in this program evaluation, including religion, socioeconomic status, sexual identity, and disabilities. The data presented focus largely on the first class admitted with holistic admission. In addition, we were unable to obtain comparative data from the group of applicants who were not admitted. Therefore, it is difficult to determine whether certain groups of applicants continue to be disadvantaged, even with holistic admission. This program evaluation focused on students who were admitted and matriculated. It also will be important in the future to examine students who were offered admission but chose not to enroll, as well as the retention rate of students admitted.

Conclusion

Holistic admission demonstrates promise as a strategy for diversifying the student population that might in turn address the diversity issues in the workforce, particularly in nursing.

Holistic admission expands the admission process to focus on experiences and attributes, as well as academic metrics. Holistic admission may allow diverse applicants opportunities to demonstrate attributes and experiences that will help them be successful nursing students—important aspects that traditional admissions processes would miss. Participants in this study perceived that they were given more opportunities to increase their consideration as competitive candidates. Nevertheless, holistic admission is only one strategy and should not be relied on in isolation to result in a more diverse nursing workforce. Included in the set of strategies is the commitment to providing a safe and supportive learning environment, so that once a diverse cohort of students is admitted, they are nurtured and prepared to join the ranks of our profession. This is an example of one institution's implementation of holistic admission. There have been many lessons learned over time. These include the importance of including more than academic metrics to consideration of applicants, the need to educate students about the value of diversity to the learning environment, and the complexity of capturing the diversity of the student body beyond traditional metrics of race, ethnicity, and gender.

References

  • American Association of Colleges of Nursing. (2017). 10 years of race/ ethnicity data. Retrieved from http://www.aacnnursing.org/Portals/42/News/Surveys-Data/EthnicityTbl.pdf
  • Association of American Medical Colleges. (2014a). About holistic admissions. Retrieved from https://www.aamc.org/initiatives/holisticreview/
  • Association of American Medical Colleges. (2014b). Analyzing physician workforce racial and ethnic composition associations: Geographic distribution. Analysis in Brief, 14(9).
  • Budden, J., Zhong, E., Moulton, P. & Cimiotti, J. (2013). Front matter. Journal of Nursing Regulation, 4(2), S1. doi:10.1016/S2155-8256(15)30138-1 [CrossRef]
  • Cooper, L.A., Roter, D.L., Johnson, R.L., Ford, D.E., Steinwachs, D.M. & Powe, N.R. (2003). Patient-centered communication, ratings of care, and concordance of patient and physician race. Annals of Internal Medicine, 139, 907–915. doi:10.7326/0003-4819-139-11-200312020-00009 [CrossRef]
  • DeWitty, V. (2018). Holistic review in admissions: A strategy to diversify the nursing workforce. Journal of Nursing Education, 57, 195–196. doi:10.3928/01484834-20180322-01 [CrossRef]
  • Felix, H., Laird, J., Ennulat, C., Donkers, K., Garrubba, C., Hawkins, S. & Hertweck, M. (2012). Holistic admissions process: An initiative to support diversity in medical education. The Journal of Physician Assistant Education, 23, 21–27. doi:10.1097/01367895-201223030-00004 [CrossRef]
  • Glazer, G., Clark, A., Bankston, K., Danek, J., Fair, M. & Michaels, J. (2016). Holistic admissions in nursing: We can do this. Journal of Professional Nursing, 32, 306–313. doi:10.1016/j.profnurs.2016.01.001 [CrossRef]
  • Grumbach, K. & Mendoza, R. (2008). Disparities in human resources: Addressing the lack of diversity in the health professions. Health Affairs (Project Hope), 27, 413–422. doi:10.1377/hlthaff.27.2.413 [CrossRef]
  • Health Resources & Services Administration. (2016). Nursing workforce diversity program. Retrieved from https://bhw.hrsa.gov/fundingopportunities/default.aspx?id=71a65b17-a6c8-45cf-a944-99b0d256fcef
  • Institute of Medicine. (2004). In the nation's compelling interest: Ensuring diversity in the health care workforce. Washington, DC: National Academies Press.
  • National Council of State Boards of Nursing. (2017). NCLEX pass rates. Retrieved from https://www.ncsbn.org/10645.htm
  • Relf, M.V. (2016). Advancing diversity in academic nursing. Journal of Professional Nursing, 32, S42–S47. doi:10.1016/j.profnurs.2016.02.010 [CrossRef]
  • Scott, L.D. & Zerwic, J. (2015). Holistic review in admissions: A strategy to diversify the nursing workforce. Nursing Outlook, 63, 488–495. doi:10.1016/j.outlook.2015.01.001 [CrossRef]
  • Sullivan Commission. (2014). Missing persons: Minorities in the health professions. A report of the Sullivan Commission on Diversity in the Healthcare Workforce. Retrieved from http://www.aacn.nche.edu/media-relations/SullivanReport.pdf
  • Traylor, A.H., Schmittdiel, J.A., Uratsu, C.S., Mangione, C.M. & Subramanian, U. (2010). Adherence to cardiovascular disease medications: Does patient-provider race/ethnicity and language concordance matter?Journal of General Internal Medicine, 25, 1172–1177. doi:10.1007/s11606-010-1424-8 [CrossRef]
  • United States Census Bureau. (2015). Quick facts: United States. Retrieved from https://www.census.gov/quickfacts/table/PST045215/00
  • University of Illinois at Chicago. (2012). A mosaic for UIC transformation. Retrieved from https://diversity.uic.edu/diversity-strategic-plan/
  • Urban Universities for Health. (2014). Holistic admissions in the health professions. Retrieved from http://urbanuniversitiesforhealth.org/media/documents/holisticadmissionsinthehealthprofessions.pdf
  • Witzburg, R.A. & Sondheimer, H.M. (2013). Holistic review: Shaping the medical profession one applicant at a time. New England Journal of Medicine, 368, 1565–1567. doi:10.1056/NEJMp1300411 [CrossRef]

Demographic Characteristics of Students Admitted 2012 to 2016

Demographic Variables Before Holistic Admissions After Holistic Admissions Survey Respondents (Students Admitted in 2014), N = 72 Significance


Students Admitted in 2012, N = 160 Students Admitted in 2013, N = 159 Students Admitted in 2014, N = 160 Students Admitted in 2015, N = 158 Students Admitted in 2016, N = 169
Gender
  Female 133 (80.6%) 130 (81.3%) 137 (85.6%) 126 (80.8%) 144 (85.2%) 60 (83.3%) χ2 = .144 (p = .704)
Race χ2 = 15.07a (p = .005)
  Hispanic 19 (11.9%) 13 (8.2%) 24 (14.7%) 29 (18.4%) 32 (18.9%) 18 (25%) χ2 = 8.359 (p = .004)
  African American 12 (7.5%) 15 (9.4%) 18 (11%) 9 (5.7%) 14 (8.3%) 10 (13.9%) χ2 = .002 (p = .961)
  Asian 29 (18.1%) 30 (18.9%) 32 (19.6%) 43 (27.2%) 42 (24.9%) 18 (25%) χ2 = 3.288 (p = .070)
  White non-Hispanic 93 (58.1%) 94 (59.1%) 85 (52.1%) 75 (47.5%) 75 (44.4%) 31 (43.1%) χ2 = 8.801 (p = .003)
Two or more races 4 (2.5%) 4 (2.5%) 1 (⩽ 1%) 1 (⩽ 1%) 5 (3%) 0 b
Unknown 1 (⩽ 1%) 3 (1.9%) 0 1 (⩽ 1%) 1 (⩽ 1%) 0 b

Academic Characteristics and Outcomes of Students Admitted 2012 to 2016 (Before and After Holistic Admission Implementation)

Academic and Outcome Variables Students Admitted in 2012, N = 160 Students Admitted in 2013, N = 159 Students Admitted in 2014, N = 160 Students Admitted in 2015, N = 158 Students Admitted in 2016, N = 169 Significance
Mean science grade point average at admission 3.38 3.69 3.60 3.35 3.36 t = −1.57 (p = .215)
Mean overall grade point average at admission 3.54 3.73 3.55 3.55 3.52 t = −1 (p = .391)
Two-year graduation rate 91.9% 88% 87.7% 89% NA t = 1.33 (p = .315)
NCLEX first-time pass rate at University of Iowa College of Nursing 68% 75% 80% 88% NA t = 1.58 (p = .114)
National NCLEX first-time pass ratea 84.93% 87.49% 87.80% 87.11% NA

Responses to Survey Questions

Survey Question Survey Responses, n (%)

Very Useful Somewhat Useful Not at all Useful Unsure
How useful was the interview in helping you showcase your talents? 37 (51.39) 28 (38.89) 5 (6.94) 2 (2.78)
How useful was the application in helping you showcase your talents? 26 (36.11) 42 (58.33) 1 (1.39) 3 (4.17)

Very Helpful Somewhat Helpful Not at all Helpful Unsure

Did the application process help you to describe your diverse talents beyond academics? 25 (34.25) 42 (57.53) 4 (5.48) 2 (2.78)

Very Comfortable Somewhat Comfortable Not at All Comfortable Unsure

How comfortable were you in sharing your diversity with others during the completion of the nursing program? 55 (77.46) 13 (18.31) 2 (2.78) 1 (1.39)

Well Aligned Somewhat Aligned Not at All Aligned Unsure

How well did the classes align with the College's definition of diversity? 40 (54.79) 30 (41.10) 2 (2.78) 1 (1.39)
Authors

Dr. Zerwic is Kelting Dean and Professor, University of Iowa College of Nursing, Iowa City, Iowa; Dr. Scott is Dean and Professor, School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin; Dr. McCreary is Clinical Associate Professor, Department of Health Systems Science, Associate Dean for Global Health, Co-Director, PAHO/WHO Collaborating Centre for International Nursing Development in Primary Health Care, and Dr. Corte is Associate Professor and Department Head, Health Systems Science, Director of PhD Program, University of Illinois at Chicago College of Nursing, Chicago, Illinois.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Julie J. Zerwic, PhD, RN, FAHA, FAAN, Kelting Dean and Professor, University of Iowa College of Nursing, 50 Newton Road, 494 CNB, Iowa City, IA 52246; e-mail: Julie-zerwic@uiowa.edu.

Received: November 17, 2017
Accepted: March 27, 2018

10.3928/01484834-20180618-06

Sign up to receive

Journal E-contents