People of color often seek medical care from health providers who are of the same racial, cultural, or ethnic background. For example, African American nurses are more trusted among the African American community to provide more culturally competent care, especially when they focus on primary prevention and health promotion (Jean-Baptiste, 2019). Although an understanding of cultural diversity plays an important role in determining patients' health care needs and patients' response to health care, the U.S. health care workforce currently lacks cultural and racial diversity to meet these needs (Goode & Landfeld, 2018). Given that the U.S. racial and ethnic minority population is projected to continue increasing rapidly in the coming decades, it is imperative for the health care workforce to transform to better reflect the country's diverse demographics and health care needs (Phillips & Malone, 2014).
Health care providers of similar cultural and ethnic backgrounds are more likely to understand the needs of those of similar backgrounds. The nursing profession is making great strides to improve workforce diversity. Workforce diversity can be defined as similarities and differences among those you may work with. Those similarities and differences can be identified as age, race, and gender. However, graduation rates do not mirror recruitment success. Research has shown that a variety of barriers may hinder African American students from successfully completing a Bachelor of Science in Nursing program (Loftin et al., 2012). One of these barriers is isolation, in which African American nursing students feel a lack of belonging and that they do not fit in, and it often leads to stress (White & Fulton, 2015). These feelings of isolation are drawn from a lack of diversity in programs that cause African American nursing students to believe that they are alone in their journey (Payton et al., 2013).
Mentorship has been considered a fundamental step in professional and personal development (Burgess et al., 2018). Mentorship involves communication, role modeling, engagement, and guidance. Nursing research has shown that formal mentorship can help nursing students to become more engaged nurses, attain advanced degrees in nursing, and pursue nursing research, education, and policy (Nelson et al., 2018). Both the mentor and mentee can grow and develop personally and professionally throughout the mentorship experience. Based on the hope that mentorship could benefit African American nursing students, an African American student nurse mentorship program, Moving Forward Together, was formed. The program linked each African American nursing student with an African American mentor and also provides regular programming focused on overcoming common barriers. The goal of the program is to promote successful unit progression and course completion within the nursing major with ultimate college degree completion.
To learn what aspects of the program improve student success, we conducted a pilot study. We specifically asked participating undergraduate and graduate African American nursing students to share their thoughts on the perceptions of the mentoring relationship and overall satisfaction within the program.
The African American Student Nurse Mentorship Program
The Moving Forward Together African American student nurse mentorship program was founded in September 2017. Moving Forward Together aims to positively influence the lives of African American nursing students by providing support, fostering character development, enhancing leadership skills, and building self-confidence. In the signature experience of the program, faculty and nurse leaders from the community mentor students to enhance their intellectual curiosity as well as their professional skills. In the founding cohort, there were 32 mentors (African American nurses within New Jersey, Pennsylvania, Maryland, and Delaware) involved, along with 25 mentees (African American college nursing students).
Each year, at the start of the fall semester, the mentorship program invites all incoming freshman nursing students who identify themselves as African American and/or Black to join the mentorship program. An email is also sent out to those students who are already participating in the mentorship program (sophomores, juniors, seniors) to review their current matches. At the same time, the mentorship program connects with African American nurses who hold a Bachelor's, Master's, and/or Doctorate's degree to serve as mentors. A leadership workshop and information session are offered to those nurses who are interested in learning more about becoming a mentor. The leadership workshop includes guest speakers who converse on topics such as Defining Your Purpose, Mentorship, and Developing Your Mission Statement. At the information session, material is provided that includes the roles and responsibilities of being a mentor. The material includes a handbook created by the founder, which contains the mission, vision, qualifications, and responsibilities for the mentor and mentee.
The Moving Forward Together committee, which is composed of individuals from different departments including Diversity and Inclusion and Educational Opportunity Fund, identifies willing and qualified mentors. A fall networking event is scheduled for students and those who are interested in becoming a mentor. Additionally, forms are completed by both the mentors and mentees that identify the interests and goals of each individual. The committee then meets and assigns the mentor and mentee. Each month, the mentor is responsible for contacting the mentee by telephone, text, and or email to provide encouragement and role modeling. One-hour, monthly workshops are also held on campus for the students.
With the guidance of systems theory, we used a concurrent nested mixed-method, purposeful, and criterion-sampling technique for this pilot study. Mentorship is a system of input, throughput, and output. Input represents the group members involved in the mentorship program (mentors, mentees, and committee members). Throughput involves the various interactions among the mentors and mentees. Some of those interactions include workshops, networking events, Skype™, emails, and telephone calls. Finally, output symbolizes the outcomes of being involved in the mentorship program. Outcomes include progression, graduation, and success on the NCLEX®. Systems theory enables the researchers to understand the components and dynamics of the client systems to interpret any problems that may arise and develop interventions for program improvement (Friedman & Allen, 2014). The questionnaire was based on the systems theory to identify inputs, throughputs, and outputs.
The study incorporated an online survey including both open- and closed-ended questions. The data collection process took place over 1 month. Based on response data, the qualitative results were given more emphasis in gaining insight into the perceptions of mentoring. Inclusion criteria specified that participants needed to be involved in the mentorship program and identify as Black and/or African American.
Institutional review board approval was obtained at the institution. Prior to sending out the consent form and survey, an email was sent to the mentors and mentees requesting their participation. After institutional review board approval was obtained, an email that described the study was sent to all eligible participants and requested informed consent. The 16-question online survey was estimated to take 15 minutes to complete. The survey was sent to 57 mentors and mentees. In all, 31 individuals (17 mentors [16 undergraduate and 1 graduate nursing student] and 14 mentees) participated in the survey (response rate = 54.4%).
Thematic Content Analysis
Data were captured by electronic survey software (Qualtrics®) and saved in a pdf format. Quantitative data were analyzed using SPSS® (version 25.0). The qualitative analysis consisted of strategically analyzing the data collected, aggregating words into categories, and creating themes. Data were reanalyzed by a second checker experienced in research but not involved in this research study to ensure themes were accurate.
The 31 respondents consisted of 29 women and 2 men. Mentors included 16 women and 1 man; mentees included 1 man and 13 women. The analysis of the responses, a variety of codes, themes, and categories were developed. Four major themes directly expressed by the participants emerged: challenges to successful mentorship, desire for guidance, collaboration and sharing of knowledge, and positive outcomes.
Theme 1: Challenges to Successful Mentorship
Many responses addressed challenges that the mentor/mentee participants encountered to maintaining a consistent mentorship relationship.
Communication. Several participants felt that communication between the mentor and mentee was too limited and attributed this lack of communication to time. Some participants noted their busy work and family schedules made it impossible for them to attend Moving Forward Together events and workshops. A few participants were estranged in their relationship with their mentor/mentee and struggled to find ways to communicate with their mentor/mentee. Although communication was identified as a challenge to some mentors and mentees, it is important to note that 77% of participants contacted their mentor/mentee between three and 10 times per semester. Most (70%) of the participants also stated that they had a close relationship with their mentor/mentee when asked if they were comfortable communicating with their match.
Distance. All mentee participants were students at a single institution. However, the mentors were widely located in New Jersey, Pennsylvania, Delaware, Maryland, and North Carolina. Distance played a vital role in the communication between both parties. Even with today's technology, having a personal face-to-face interaction was preferable among participants.
Theme 2: Desire for Guidance
Mentees reported that they desired studying tips, support, and guidance from their mentors. Seven of 31 respondents mentioned guidance as one of the essential components of mentorship. Meanwhile, mentees sought guidance from their mentors academically and professionally. Many of the respondents viewed mentorship as a symbiotic relationship in which the mentor provides guidance based on experience and the mentee contributes to the mentors' feelings of self-belonging. Seventy-seven percent of the mentees indicated the mentorship program helped them to excel in their current role. Moreover, the mentees felt the mentorship experiences met their needs and expectations. One respondent noted, “Simply put, to me, mentorship means guidance. Not someone who dictates what you need to do in order to be successful, rather someone who will help you make a plan, encourage, and support you in your journey toward personal and academic success.”
Theme 3: Collaboration and Sharing of Knowledge
Mentorship allows mentors to share their own knowledge and give advice from their own life experiences. This fosters collaboration between both the mentor and mentee to reach one's goals. Our survey results showed that collaboration and the sharing of knowledge increased many of the African American nursing students' levels of self-confidence and self-belonging. Regarding what it means to be a mentor, one mentor stated, “Sharing my wisdom, experience, and knowledge. Being a role model to have them see they can do it. Going out of my way to connect my mentee to opportunities.”
Theme 4: Positive Outcomes
The fourth thematic category that emerged from participant's responses addressed the positive outcomes of the mentor/mentee experience. Key responses reported increased development, growth, and reflection; appreciating having someone to listen to them; and feeling understood and enjoying face-to-face time. Several respondents mentioned that they appreciated the encouragement and motivation that both mentors and mentees were able to share. One participant commented:
She was friendly and open to learning. Her attitude was great, and she really just wanted to do her best. I appreciated my mentor building my self-confidence, the laughs, encouragement, continuous support, beautiful recommendation letters, helping me find a summer job, and being an awesome person.
Responses were difficult to obtain within the indicated 1-month time frame because many participants were on summer break and may have been less likely to respond. The authors recognize that they may have their own biases. Therefore, it is imperative to use reflective practice and bracket their feelings.
The authors understand that race alone is not the sole determinant of successful mentorship for students from underrepresented minority groups. To ensure that best practices are developed and implemented, the following recommendations can be implemented based on our findings: (a) mentors should receive mandatory training to incorporate and define a mentor/mentee relationship; (b) workshops should be offered to mentors/mentees to assist in answering questions, networking, and develop strong bonds between the mentor/mentee; (c) quarterly evaluations of the mentoring relationship can help to ensure that the mission is being fulfilled; and (d) monthly workshops should be provided to mentees, featuring African American leaders as guest speakers who can offer insight into leadership, advancement, and keys to success. Additionally, future research should be conducted to discover the best practices for mentoring nursing students of color, how the nature of communication may play a role of the satisfaction with the mentor/mentee interactions, and the barriers African American nursing students may face and ways to overcome them.
Lack of diversity within the profession of nursing will continue to be an obstacle if strategies that support success among diverse nursing students are not implemented. It is evident that mentoring relationships can assist in building self-confidence, socialization skills, developing a sense of belonging, collaboration, and enhancing one's knowledge base. Nursing programs must commit to appreciating diversity and various strategies that will assist in the retention of those students. In the long run, mentoring African American nursing students benefits not only the schools of nursing and the students, but also patients. Increasing diversity in nursing can assist in bridging current gaps in care and promote better patient outcomes and health for all.
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