Academic journal article Nursing Education Perspectives

Baccalaureate Minority Nursing Students Perceived Barriers and Facilitators to Clinical Education Practices: An Integrative Review

Academic journal article Nursing Education Perspectives

Baccalaureate Minority Nursing Students Perceived Barriers and Facilitators to Clinical Education Practices: An Integrative Review

Article excerpt


AIM This integrative review synthesized baccalaureate minority nursing students' perceptions of their clinical experiences.

BACKGROUND The diversity of the nursing workforce does not mirror the United States population. Attrition rates of minority nursing students remain higher than rates for White students. Literature examining facilitators and barriers to minority student success predominantly focuses on academic factors, excluding those relevant to clinical education.

METHOD An integrative review using literature from nursing and education.

FINDINGS Three common perceived barriers were identified: discrimination from faculty, peers, nursing staff, and patients; bias in faculty grading practices; and isolation.

CONCLUSION Although little is known about the relationship between clinical failures and overall attrition, this review provides evidence that minority students encounter significant barriers in clinical education. To increase the diversity of the nursing workforce, faculty must address these issues and make modifications to ensure an equal opportunity at a quality education for all students.

KEY WORDS Minority Nursing Student--Diversity--Nursing Education--Clinical Nursing


The diversity of the current nursing workforce does not mirror that of the United States population (Melillo, Dowling, Abdallah, Findeisen, & Knight, 2013). Minority nurses are underrepresented, comprising only 16.8 percent of the nursing population, whereas the total US population is 22.3 percent minority (US Census Bureau, 2013; US Department of Health and Human Services, 2010). A recent census report projected that, by 2043, racial and ethnic minorities will make up over half of the population (, 2010).

A culturally diverse nursing workforce is necessary to meet the health care needs of this increasingly diverse population. Improvements in nursing workforce diversity and cultural competence education for health care providers are among the most potentially effective interventions needed to reverse the numerous differences found in the quality of health care provided to racial and ethnic minorities (Pacquaio, 2007). National organizations, including the National League for Nursing (NLN), the American Association of Colleges of Nursing (AACN), the Institute of Medicine (IOM), and the American Nurses Association (ANA), agree that increasing the racial and ethnic diversity of students in nursing programs is a high priority (AACN, 2009; American Nurses Association, 2011; Institute of Medicine, 2011; Loftin, Newman, Dumas, Gilden, & Bond, 2012; NLN, 2010). Therefore, it is important to identify and address both facilitators and perceived barriers to the success of minority nursing students in all aspects of their nursing education.

Barriers to successful completion of a nursing program for minority nursing students include financial and work issues (Amaro, Abriam-Yago, & Yoder, 2006), inadequate academic preparation and study skills (Amaro et al., 2006), lack of support from family, role models, or mentoring (Amaro et al., 2006; Taxis, 2006; Villarruel, Canales, & Torres, 2001), and experiences with discrimination and isolation in the clinical setting (Sedgwick, Oosterbroek, & Ponomar, 2014). These barriers have contributed to a disparity in the nursing profession and resulted in attrition rates as high as 85 percent in minority student populations (Gardner, 2005; Giddens, 2008; Taxis, 2006).

Efforts to admit, retain, and graduate minority nursing students have resulted in increases in the number of minority students graduating from BSN programs overall, from 24.6 percent in 2009 to 28.4 percent in 2013 (AACN, 2009-2013). Despite these efforts, attrition rates continue to be a concern as the number of Black and Hispanic nursing students graduating from BSN programs continues to fluctuate (AACN, 2009-2013; Coleman, 2008; Jeffreys, 2012; Taxis, 2006). …

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