Dr. Pamela Cook of the Augusta University College of Nursing shares details of the College's holistic review process and challenges overcome in their journey to holistic admission.

1. Our Journey to Holistic Admissions
Pamela P. Cook, DNP, RN, NE-BC
Assistant Dean, Student Services
Augusts University, College of Nursing
Augusta Georgia

2. 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.

3. 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

4. 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.

5. Motivations for Adopting Holistic Review
Review 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/PST045215/13
The Henry J. Kaiser Family Foundation, 2014.
http://kff.org/health-reform/fact-sheet/the-georgia-health-care-landscape/

6. Motivations for Adopting Holistic Review
Review of State / County Data
Georgia
White 62%AA 32% White 40%AA 56%
Richmond County
Georgia Data (2015). https://georgiadata.org/

7. 0
50
100
150
200
250
300
350
2006 2007 2008 2009 2010
AA
Cauc
94.2%
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/

8. Motivations for Adopting Holistic Review
National Sample of Registered Nurses
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
2000 2004 2008 2012
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.

9. Motivations for Adopting Holistic Review
AACN Data for BSN Programs
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
120.0%
2011 2012 2013 2014
White non-White
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

10. Motivations for Adopting Holistic Review
Institute 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.

11. Motivations for Adopting Holistic Review
Themes 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.

12. Implementation
Summary -- 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.

13. Application Changes
Essay
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.
Questions
1) Are you the first generation of your family to enroll in
an institution of higher education?
2) Are you a first generation college student in your family?

14. 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.

15. 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.

16. Implementation
Definition -- 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.

17. 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

18. Institution
Mission
Change in Admission Practice
4 Areas of Focus
Applicant
Academic
Diversity
Under
represented
Out of
State

19. 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 StateInstitution
Specific

20. 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

21. 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.

22. Outcomes
Holistic
Review
Robust
admission
process
Increased
knowledge
Increased
access to
program
Goals
achieved

23. Outcomes
0 5 10 15 20 25
2015
2014
2013
2012
2011
OOS Diversity AA Gender

24. Questions

25. Thank you