In the United States, the racial demographics of the RN workforce do not reflect the diversity found in the overall population. According to the U.S. Census Bureau (2019), the diversity of the general population is 63.7% Caucasian and 36.3% a minority race. In the U.S. RN workforce, 33.1% are racially diverse. The state of Nebraska has less diversity, with only 6% of racially diverse RNs serving a population that has 20% racial diversity (Nebraska Center for Nursing, 2019). In response to these statistics, the University of Nebraska Medical Center College of Nursing (UNMC CON) enacted The Generation Link to Learn (LTL) project to promote the success of racially diverse and educationally disadvantaged nursing students with the goal of increasing the number of racially diverse RNs in the region.
The UNMC CON Northern Division campus is located in a region that has experienced growth in the Hispanic population, most of which come from educationally disadvantaged backgrounds. The faculty desired to have students enrolled in the baccalaureate nursing (BSN) degree program who represent the regional diversity to receive support to promote success in their program of study. A recent literature review indicated that students from an underrepresented population report a lack of connectedness or welcoming environment within their campus community and that they feel unprepared for success within the nursing program (Alicea-Planas, 2017). The principal investigator and program coordinator/academic coach (PC/AC) of the LTL project thought that these racially diverse and educationally disadvantaged students could be successful in their program of study and become our future nursing workforce if they received financial support and academic coaching (Banister, Bowen-Brady, & Winfrey, 2014; Bryer, 2012; Cascoe, Stanley, Stennett, & Allen, 2017; Nowell, Norris, Mrklas, & White, 2017; Pitt, Powis, Levett-Jones, & Hunter, 2012). Therefore, this UNMC CON created an academic coaching program to support educationally disadvantaged and racially diverse students. Through a Health Resources & Services Administration (2014) Nursing Workforce grant, Generation LTL formed the foundation for developing and enacting multiple academic coaching strategies and financial support to promote student success in the BSN program of study for the years 2015–2017.
On notification of the Health Resources & Services Administration grant award in June 2015, the PC/AC determined that the first award year would serve as a pilot for grant activities on two of the five UNMC CON campuses that had the most educationally disadvantaged and diverse student populations. According to the Health Resources and Services Administration (2014), individuals from educationally disadvantaged backgrounds may or may not represent minorities but come from environments in which the development of knowledge, skills, and abilities for success in health professions have presented a barrier to success.
Processes involved with the grant were honed and ultimately prepared for distribution across all five CON campuses during the second award year (Figure 1). To begin the process of recruitment of students into the LTL grant, all junior-level BSN students were presented with information about the grant's purpose. Students received a disclosure statement that informed them of the requirements for being educationally disadvantaged, and students self-identified by circling the criteria that was listed on the form. The student self-disclosure forms were scored by the PC/AC using a point system that summed the total number of educationally disadvantaged and diversity characteristics. Those with the highest scores were identified and interviewed to determine their willingness to engage in the LTL activities.
Academic coaching process.
Students were informed that participation in the LTL academic coaching program included (a) scholarships, (b) active involvement as a student mentor for one new nursing student reaching the second year of the program, (c) meeting with an assigned faculty member at a mutually agreeable time to facilitate success in the nursing program, (d) completing journaling on “the good, the bad, and the unexpected” on a monthly basis, (e) participating in an externship during the summer session between the first and second year of the program, (f) assisting with a 2-day summer camp held at their division's campus for high school students interested in nursing, (g) seeking assistance from student services for referral if counseling services were needed, (h) seeking help from the reference librarian as needed, (i) following all policies as outlined in the UNMC CON student handbook, and (j) preparing an online presentation at the completion of the BSN program on YouTube to share how the grant program helped them to reach their career goals.
Academic Support Strategies
A variety of support strategies (e.g., listening, journaling, stress reduction, mentoring, study skills, and financial assistance) were implemented for the LTL grant recipients via the use of an AC. On implementation of LTL, the PC/AC immediately brought the first year LTL recipients together each week to listen to their concerns and provide support. This information was confidentially shared with the LTL grant team so student needs could be addressed. During the weekly listening sessions, students expressed concerns, discussed solutions for academic challenges they were experiencing, obtained guidance for communicating with faculty, received encouragement, discussed time management strategies, and received peer support. Of note, after the first semester was completed, an offer by the PC/AC to discontinue the weekly meetings was strongly opposed by the LTL recipients. Students stated that the sessions were helpful for the support they received and provided a chance for all of them to meet with their LTL peers. Listening was a critical tool, as the PC/AC strived to communicate empathy, caring, support, discussion, problem solving techniques, and equality during the sessions.
During the first year of the grant, LTL grant recipients reported the good, the bad, and the unfamiliar in monthly journal entries which became an aspect of focused discussions between the grant recipients and the PC/AC. Although students had the opportunity to voice concerns at the weekly listening sessions, the journals were found to be valuable to learn what specific support activities were helpful and provided a voice to the student who was uncomfortable in sharing an opposing viewpoint to peers in the group setting. Journals were summarized without disclosure of authors and were used for the grant reporting and as a means to guide development of student support activities.
In addition to journaling and listening, the grant facilitated a speaker who addressed the use of HeartMath® ( https://www.heartmath.com/) to help students manage stress and anxiety. This specialist provided a workshop to students on the use of stress reduction strategies to help reduce feelings of stress in an ongoing, moment-by-moment process. In addition, faculty were informed that students needed weekly reminders to use the techniques to manage their stress and anxiety. These techniques provided students with tools to manage emotions when in stressful situations in their BSN program of study. Students reported that they used these strategies in stressful clinical situations, as well as during stressful testing times in theory courses.
The LTL grant included opportunities for students to be paired with an upperclassman BSN student mentor. Activities were scheduled throughout the 2-year period of the grant—with use of the local student nursing organization—in order for LTL students to have the opportunity to learn about success strategies and successful career navigation skills from their peers. Although mentoring with an RN was more challenging, due to scheduling conflicts, the student facilitators—who were RNs working on graduate degrees—often served as both AC and mentor to the LTL students.
Academic coaching was also provided by graduate assistants assigned as grant student facilitators. Academic coaching was introduced to the students as the process of identifying student learning needs and using that information to guide development of an implementation plan that provided students with an opportunity for success in the BSN program. A lesson plan for coaching sessions was developed. Starting on the first week of classes, the sessions began with how to get organized, what acronyms are used in nursing, and how to read, study, and take notes for classes. The sessions were held at least weekly in group and individual sessions. Students were required to attend the sessions if their success was threatened (based on test or clinical performance). A spreadsheet was used by the student facilitators to document the students' course scores and the need to attend coaching sessions. A calendar of group, online, and individual sessions with the AC was provided to all students each semester. All students were invited to sign up for these sessions via an online website.
Technology was an important part of the academic coaching process. Graduate assistants and student facilitators developed a variety of online learning activities using Quizlet, an online flashcard and learning platform. Moreover, the use of Face-book® Messenger was discovered as a valuable communication tool that students used to ask ACs brief questions. The AC also developed a Facebook group, which allowed a private area for students to ask their peers or the academic coaches questions. The group was not open to any faculty members.
Students in the LTL grant received financial assistance intended to cover the costs of tuition or living expenses during the period of the grant. Students in the LTL grant commented that this scholarship immediately removed their sense of pressure of needing to work for the sole purpose of paying for their education and living expenses.
At the conclusion of the 2-year grant period, 88% (24 of 27) of the LTL students successfully completed the BSN program. During the first pilot year, data were collected from recipients of the grant scholarships, faculty, and graduate assistants who worked with scholarship students to guide the ongoing plan for student success. After the best supportive activities were identified, an academic coaching manual for faculty and students was developed and distributed to all five campuses. The manual included strategies and activities for student success, resources for best practices, and activities that use technology for today's learner. This manual was created to assist all students currently enrolled in the BSN program.
Feedback on coaching sessions, as well as other grant activities, was gathered through formative and summative evaluations conducted by the project director. The evaluations were comprised of listening sessions to authenticate the learners' lived experiences. These sessions focused on the same criteria students used for journaling (the good, the bad, the unexpected). One theme that generated much discussion among LTL grant students was the challenge of moving to a new community away from family and friends for the purpose of pursuing the BSN degree. Grant recipients reported feeling lonely and isolated during the first year of the BSN program, which was perceived as a threat to the success of students from diverse backgrounds. Most of the recipients' homes were more than 100 miles away, and with the rigors of the nursing program and distance, they missed the local support of friends and family. Knowing there were recreational activities in the community did not mean that these LTL students would participate. One student explained that it was difficult to attend an activity alone, so she did not attend these events.
As a result of this discovery, a new program called Link+Ed was developed with the assistance of a local church and campus ministry. Volunteers and interested students participated in a social event that included a hosted meal the evening before fall classes began. Each party had been informed of the intent of the program with frequently asked questions, distributed prior to the social event. Personal interests or hobbies of participants were communicated through ribbons attached to name tags. A rotating speed session format was used to allow students and potential support individuals to visit and determine their possible match. In addition, one grant recipient served as a “champion” for the Link+ED program. In her role, she encouraged her peers to get involved in the project and to sign up to get matched with a family. Throughout the year, these matched student and family pairs attended social events together periodically, including a dinner out, movie night, or text messaging each other as a form of communication. Although contact with these families varied, students reported that it was of great benefit to have this connection. Having a relationship with someone in the community helped them to have a sense of place and belonging while in the BSN program.
Another important finding from the LTL—gathered through formative and summative communication—was the influence of a peer mentor. The LTL students reported that having an upperclassman serve as a mentor was important to their success as a BSN student. The communication between LTL and peer mentor was one in which LTL students felt comfortable asking questions they felt were too simple to ask in a formal learning environment.
Undergraduate nursing students are faced with overwhelming amounts of information. College students often approach tasks haphazardly or become overwhelmed with the large amount of information to learn (Cascoe et al., 2017). Schouwenburg, Lay, Pychyl, and Ferrari (2004) suggested that students can learn how to enhance self-control and prevent distraction, such as training oneself to study in a library, work with a clean desk, and study with the door closed. Equally important is to teach students how to improve abilities in planning and organization by setting proximal sub goals for their academic work and to set reasonable expectations about the amount of time needed to complete a given task (Ariely & Wertenbroch, 2002).
The Academic Coaching Program that was used in the LTL project created a partnership with students to identify their learning needs and implement coaching strategies to assist the student best to reach their fullest academic potential. Weekly meetings were essential so that relationships were fostered, and honest communication could emerge between the coach and the student. As noted by Freeman and All (2017), mandatory sessions with the academic coach were needed in this LTL project so that the coach could identify risks and take action with the student early in the process.
The AC in the LTL project expanded traditional education by assisting student improvement of professional interpersonal communication skills and nursing skill performance. The Coach encouraged the student to become more aware of personal strengths, values, and interests to engage the student, facilitate academic planning, and enhance academic performance. Support was offered through one-to-one mentoring and in small group settings, which helped LTL students to build their self-competence and improve comprehension of learning material.
As noted in this project from the feedback provided by LTL students, the use of a peer mentor (Bryer, 2012) promoted the development of trusting relationships, whereby students could learn socialization to the role of a student and successful program navigation skills in the BSN program. The peer group mentor helped students learn how to manage stress and how to cope with changes in learning a new role. This is congruent with Bryer (2012), who stated that a peer group assists students to learn effective strategies for coping with the multitude of changes that are a normal part of learning something new.
Other aspects of the academic coaching program—such as listening and journaling—provides opportunities for students to reflect and communicate with others regarding good, bad, and unfamiliar events while in the BSN program. These activities help the student to successfully cope with the changes they experience in a BSN program of study.
Early identification of students who come from diverse and/or educationally disadvantaged backgrounds and implementing strategies aimed for promoting their success is vital to student satisfaction, success, and eventually as a means of diversifying the nursing workforce. The use of multiple supports embedded in the role of the academic coaching program combined with financial assistance are effective strategies to assist educationally disadvantaged and minority students.
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