Our Journey to Holistic Admissions

Pamela P. Cook, DNP, RN, NE-BCAssistant Dean, Student ServicesAugusts University, College of NursingAugusta Georgia

Objectives

• Describe the school’s motivations for adopting holistic review and the process of obtaining buy-in.

• Describe specific changes to admissions policy and practice that occurred.

• Describe mission-based criteria used during admissions, including specific applicant experiences, attributes, and academic metrics.

• Reflect upon challenges encountered and solutions developed to address the challenges.

• Describe lessons learned.

Augusta University (AU)

• Located in Augusta, Georgia in the Southern region of the U.S.• Founded in 1828• 9 colleges and schools and 127 Academic Programs• 8,400 students enrolled fall 15• 4th public research university in the state• Only public institution with an integrated academic health

center• Flagship nursing school

• 850 students fall 15• 9 programs – undergraduate, graduate, doctoral

Augusta University Fast Facts, http://www.augusta.edu/about/fastfacts.php

Motivations for Adopting Holistic Review

• Diversity Work Group Established • Recommendations

– Incorporate into the Strategic Plan. – Embrace diversity and be an agent for social, cultural,

and economic change and growth. – Address diversity and inclusion opportunities within the

academic programs, recruitment, service, outreach, scholarly activities and faculty development.

– Develop an Office of Diversity and Inclusion.

Motivations for Adopting Holistic ReviewReview of State Data

• 1m migrated to the state making GA the 8th most populous state• 70% of the counties are rural (<35,000) – twice the national

average• 80% are HPSAs / 89% all or part MUA/Ps• 1 of 23 states with largest African American population• 1 in 11 foreign born / 1 of 8 speak a language other than English• Wide disparities exists in poverty rates by race/ethnicity and age• 1 in 5 Georgians are uninsured which is 7th highest rate in country• GA ranks 46th, the bottom quartile in health care access and

affordability

U.S. Census Bureau (2015). https://www.census.gov/quickfacts/table/PST045215/13The Henry J. Kaiser Family Foundation, 2014. http://kff.org/health-reform/fact-sheet/the-georgia-health-care-landscape/

Motivations for Adopting Holistic Review

Review of State / County Data

Georgia

White 62%AA 32%

Hisp 9%

White 40%AA 56%

Hisp 5%

Richmond County

Georgia Data (2015). https://georgiadata.org/

2006 2007 2008 2009 20100

50

100

150

200

250

300

350

AA

Cauc94.2%

5.7%

92.6%

7.3%7.1%

92.9% 93.4%

6.6%

95.3%

4.7%

Motivations for Adopting Holistic Review

CON Admission Data

Augusta University, Institutional Effectiveness, http://www.augusta.edu/ie/

Motivations for Adopting Holistic ReviewNational Sample of Registered Nurses

2000 2004 2008 20120.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

White non-White

87.5%

12.5% 12.2%

87.8%

16.8%

83.2%

19%

81%

1) U.S. Department of Health and Human Services Health Resources and Services Administration (2008). http://www.bhpr.hrsa.gov

2) Budden, J., Zhong, E., Moulton, P. & Cimiotti, J. (July, 2013). Highlights of the national workforce survey of registered nurses. Journal of Nursing Regulation, 4(2), 5-14.

Motivations for Adopting Holistic ReviewAACN Data for BSN Programs

2011 2012 2013 20140.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

72%

28% 28.1%

71.9%

29%

71%

30%

69.9%

AACN (March 2015). Enhancing Diversity in the Nursing Workforce. http://www.aacn.nche.edu/research-data/EthnicityTbl.pdf

Motivations for Adopting Holistic ReviewInstitute of Medicine (IOM), 2002

Warned of “unequal treatment” minorities face when encountering the health care system.

Showed through Health Services research, that minority health professionals are more likely to serve minority and medically underserved populations.

Recommended increasing the number of minority health professionals as a key strategy to help eliminate health disparities.

Motivations for Adopting Holistic ReviewThemes from Research

Individuals educated in diverse settings are far more likely to work and live in racially and ethnically diverse environments after graduation.

Individuals who study and discuss issues related to race and ethnicity in academic courses and interact with a diverse set of peers are better prepared for life in an increasing complex and diverse society.

Increasing the compositional diversity of the student body is essential to create an optimal learning environment.

1) Whitla, D., Orfield, G. et al. (2003). Educational benefits of diversity in medical school: A survey of students. Academic Medicine, 78, 460-466.2) Gurin, P., Dey, EL., et al. (2002). Diversity and higher education: Theory and impact on educational outcomes. Harvard Education Review, 72, 330-366.

ImplementationSummary -- Steps

• Evaluated data, our metric based rubric, & applicant pool.

• Reviewed the literature, IOM report, AACN data, National Data for Registered Nurses, and Strategic Plan.

• Met with Legal Affairs, Office of Diversity Affairs, Medical College, and College of Nursing Dean.

• Defined diversity, minority and under-represented, holistic admission, and holistic review.

• Changed the admission application.

Application ChangesEssay

1) Share life experiences which have influenced your interest in nursing.

2) Describe how your personal strengths, experiences, & aptitude will contribute to your success in nursing school and career in nursing (community service, leadership experience, healthcare experience).

3) Explain the academic challenges, success, or obstacles in your life that impacted your ability to achieve your goals.

Questions4) Are you the first generation of your family to enroll in

an institution of higher education?5) Are you a first generation college student in your family?

Implementation Vision

AU vision for diversity is predicated on the beliefs that:

• industry, intelligence, talent, and skill are not limited by race, gender, sexual orientation, ethnic origin, or culture;

• opportunity for study should be based on factors including a willingness to practice in underserved areas as well as demonstrated academic success;

• motivation, persistence, desire, enthusiasm, and compassion are keys to success.

Implementation Definitions

• “Diversity” is broadly defined. Includes differences related not only to race and ethnicity but also to age, disability, gender, national origin, religion, and sexual orientation. Variation of social, biological, & cultural identities, or the sum total of experiences.

• “Minority" defined as a group that differs from the majority of the population, particularly in terms of religion, culture, ethnic background, race, sexual orientation or physical ability.

• “Underrepresented minority" refers to groups whose presence in different areas is disproportionate when compared to overall population figures—a minority may represent 3 percent of American citizens, but only 0.7 percent of nursing students.

ImplementationDefinition -- Holistic Admission

Flexible, highly individualized process

Evaluation

• Balanced consideration is given to the multiple ways in which applicants may prepare for and demonstrate suitability consideration as students and futures nurses.

• Institution-specific, broad-based, mission driven.

• Applied equitably across the entire candidate pool.

Changes in Admissions Policy and Practice

Aligned the CON’s mission

with the University mission

D/C the metric evaluation tool

Developed new review tool & definitions

Oriented, Trained,

Implemented

Evaluated

Institution Mission

Change in Admission Practice 4 Areas of Focus

Applicant

Academic

Diversity

Under represented

Out of State

Mission-Based Criteria

• Academic ability, GPA, TEAS, types of courses, University, course load, overcame challenges, ‘B’ / ‘C’ grades while working full time or caring for family, references, ability to write, follow instructions, extracurricular activities, and leadership.

Academically Outstanding

• Defined broadly, age >25, gender, nationality, race, 1st generation to go to college, culture, background, life experiences, perspectives, exposure to field, passion / commitment to people, goals, history of serving others, ability to work with others and teams, multi-lingual.

Diversity

• From disadvantaged or under-represented county, medically underserved, health professional shortage area, rural county, commitment to practice in one of these areas, history / experience with disadvantaged populations.

Under-represented

• Out of State Institution Specific

Faculty Challenges Encountered

• Not using a metric driven process• Seeing value • Fear of increasing ‘at risk’ students• Biases and stereotypes / negative comments• Chair remaining neutral / non-defensive• Committee full commitment• Viewing diversity not as an end goal, but a

means to achieving core educational goals• Applicant / Parent Calls as to why they were not

admitted when they had a high GPA

Lessons Learned• Buy-in with African American faculty committee member on

front end, committee chair, and key members who had utilized this format would have facilitated implementation

• All stakeholders at initial orientation meeting (i.e. Dean, Chief Diversity Officer, etc.)

• Committee work-effort increased with reviews• Concurrently or before:

• Develop pipeline programs to increase diverse applicant pool

• Aggressive recruitment • Obtain multi-cultural scholarships• Develop support systems

• Develop mechanism to capture all data on the diversity and not just race, gender, and age.

Outcomes

Holistic Review

Robust admission

processIncreased knowledge

Increased access to program

Goals achieved

Outcomes

2015

2014

2013

2012

2011

0 5 10 15 20 25

OOS Diversity AA Gender

Questions

Thank you