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Koenigsman, Sherry Ann. The Lived Experiences of Minority Nursing Students PDF

282 Pages·2017·3.13 MB·English
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Running head: MINORITY NURSING STUDENTS 1 The Lived Experiences of Minority Nursing Students: Perceived Barriers to Success, Strategies for Success, and the Role of Grit A Dissertation submitted by Sherry Ann Koenigsman to College of Saint Mary in partial fulfillment of the requirement for the degree of DOCTOR OF EDUCATION with an emphasis on Health Professions Education This Dissertation has been accepted for the faculty of College of Saint Mary by: Dr. Lois Linden, EdD, RN Dr. Virginia E. Tufano, EdD, MSN, RN Dr. Theresa M. Delahoyde, EdD, RN MINORITY NURSING STUDENTS 2 We hereby certify that this Dissertation, submitted by Sherry Koenigsman, conforms to acceptable standards and fully fulfills the Dissertation requirements for the degree of Doctor of Education from College of Saint Mary Dr. Lois Linden, EdD, RN Chair Dr. Virginia E. Tufano, EdD, MSN, RN Committee Member Dr. Theresa M. Delahoyde, EdD, RN Committee Member MINORITY NURSING STUDENTS 3 Copyright © May, 2017 Sherry Koenigsman MINORITY NURSING STUDENTS 4 Dedication I dedicate this dissertation to my parents, Ben and Ruth Maaske, to my children (Carissa, Kaitlyn, Kelsey, Jessica, and Brent), their spouses (Brandon, Noe, Sean, and Richie), and my grandchildren (Joshua, Moriah, Eva, Chloe, Fiore, Leonie, Adelaide, Elliott, Afton, Edith, and Knox). MINORITY NURSING STUDENTS 5 Acknowledgements I dedicate this dissertation to my parents, Ben and Ruth Maaske, who encouraged me to finish when I was ready to stop, to my children (Carissa, Kaitlyn, Kelsey, Jessica, and Brent), their spouses (Brandon, Noe, Sean, and Richie), and my grandchildren (Joshua, Moriah, Eva, Chloe, Fiore, Leonie, Adelaide, Elliott, Afton, Edith, and Knox), for enriching my life in a thousand ways, to my friends who listened (even when they didn’t want to), and to my dogs for laying at my feet for countless hours while I wrote. I’d like to thank Dr. Lois Linden, who mentored me, as well as the two other members of my committee, Dr. Tufano and Dr. Delahoyde, who took time to read and respond to my work. Also, thanks are due to Jan Rice, the librarian who anticipated my needs and overlooked my deficiencies and Lindsay Kruse, who put my words into figures. The Wayne and Nancy Hester scholarship was much appreciated. Last, but certainly not least, I’d like to thank my co-workers and friends, Julie Skrabal and Sue Pilker, who set deadlines and held me to them, and promised me that someday we would see that light at the end of the tunnel. I would be remiss if I did not express my gratitude to the minority students who took time out of their full schedules to share their experiences with me – some through tears. I am very grateful to them. I would also like to thank God, because He is good. (Psalm 30:5). MINORITY NURSING STUDENTS 6 Table of Contents Abstract ..................................................................................................................................10 CHAPTER I: INTRODUCTION TO THE STUDY .............................................................11 Background………………………………………………… ....................................12 Problem Statement………………………...……… ..................................................27 Deficiencies in the Literature………………………………………………… .........28 Purpose Statement………………………………………………………… ..............29 Research Questions………………………………………………………… ............30 Nature of the Study………………………………………………… ........................30 Theoretical Framework……………………………………………… ......................31 Definition of Terms…..……………………………………………..........................35 Assumptions………………………………………………………………… ...........36 Scope, Limitations, and Delimitations………………………………… ...................37 Significance of the Study…………………………………………… .......................38 Summary……………………………………………………………… ....................38 CHAPTER II: LITERATURE REVIEW ..............................................................................40 History of Minorities in Nursing................................................................................40 Reasons for Retention of Minority Nursing Students ................................................45 Barriers to Success .....................................................................................................66 Strategies to Promote Success ...................................................................................87 Grit and Associated Attributes ...................................................................................135 Summary ....................................................................................................................141 CHAPTER III: THE RESEARCH METHOD ......................................................................144 Research Design.........................................................................................................144 MINORITY NURSING STUDENTS 7 Reflexivity and Bias ...................................................................................................147 Participants/Sample and Setting…………………………………………………....148 Ethical Considerations………………………………………………………….......150 Data Collection Procedures………………………………………………………...151 Data Quality Measures……………………………………………………………..154 Data Analysis Procedures…………………………………………………………..155 Summary……………………………………………………………………………157 CHAPTER IV: RESULTS…. ……………………………………………………………..158 Research Focus……………………………………………………………………..158 Demographics………………………………………………………………………160 Barriers……………………………………………………………………………..160 Strategies for Success………………………………………………………………173 Grit…………………………………………………………………………………190 Summary……………………………………………………………………………203 CHAPTER V: DISCUSSION AND SUMMARY ………………………………..……….205 Research Questions…………………………………………………………………205 Connection to Theoretical Context…………………………………………………224 Implications…………………………………………………………………………227 Limitations of the Study……………………………………………………………230 Recommendations for Further Research……………………………………………231 Summary…………………………………………………………………………….233 Reference ...................................................................................................................236 Appendices .................................................................................................................257 MINORITY NURSING STUDENTS 8 LIST OF FIGURES FIGURE PAGE Figure 1: Proposed Koenigsman’s Model for Minority Students’ Grit and Success Response to Barriers Encountered in Nursing School ............................................…35 Figure 2: MNS14’s Drawing Illustrating Several Barriers Encountered in Nursing School….170 Figure 3: Barrier Totals by Classification of Themes ............................................................…172 Figure 4: Barrier Themes by Response Type ........................................................................…173 Figure 5: MNS7’s Drawing Illustrating the Role of Faith as a Strategy for Success ............…183 Figure 6: Strategy Totals by Classification of Themes ..........................................................…184 Figure 7: Strategy Themes by Response Type ......................................................................…185 Figure 8: MNS13’s Drawing Incorporating Themes Related to Grit ....................................…201. Figure 9: Grit Attribute Totals by Classification of Themes .................................................…202 Figure 10: Grit Themes by Response Type ...........................................................................…203 Figure 11: Comparison Between Barriers and Strategies Identified .....................................…211 Figure 12: Koenigsman’s Model for Minority Students’ Grit and Success in Response to Barriers Encountered in Nursing School ..........................................................…224 Figure 13: Koenigsman’s Proposed Research Application Model for Minority Students’ Grit and Success in Response to Barriers Encountered in Nursing School ..........…233 MINORITY NURSING STUDENTS 9 LIST OF TABLES FIGURE PAGE Table 1: List of Barriers to Success with Citations to Show the Year the Barrier was Identified in the Literature and Whether it was Identified in this 2017 Study………………223 MINORITY NURSING STUDENTS 10 Abstract The education and graduation of minority nursing students is needed to meet the healthcare needs of the people of the United States. However, more minority nursing students are lost to attrition than are white students. The purpose of this study was to seek to understand, from the perspective of the minority nursing students themselves, what barriers they face, their strategies for success, and the role grit plays in their nursing school journey. Barriers identified by the students included: academic, financial, language/communication, discrimination and bias, cultural differences, lack of social support/isolation, family responsibilities, workload, difficulty with time management, fear of not meeting family expectations, death/abandonment of family members, and technology. Strategies for success identified were: financial support; strategies related to academic support; social support; institutional and faculty commitment; mentors, minority faculty, and role models; strategies to address discrimination and bias; appreciation for cultural differences; addressing aspirational barriers; support for demands of family; language and communication support; support of family; time management; faculty advisors; and faith. th Regarding grit, the participants scored nearly in the 70 percentile on the Grit-S scale and described their passion and perseverance in striving to graduate. Schools of nursing may be able to use this information to increase their minority students’ level of grit, and to provide appropriate strategies for success based on the unique barriers faced by minority students at their schools.

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