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

282 Pages·2017·3.13 MB·English

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.