This document discusses the University of Illinois at Chicago (UIC) College of Nursing's implementation of holistic review in their admissions process. It provides background on the need for a more diverse nursing workforce and student body. The UIC College of Nursing transformed their admissions process through holistic review, which considers a variety of factors beyond grades and test scores. This includes structured interviews, application reviews by trained faculty reviewers, and looking at ratings from multiple perspectives. Since implementing holistic review, the UIC College of Nursing has seen increases in the admission of males and underrepresented minority students. The document discusses challenges of holistic review and maintaining commitment to the process over time.

1. Linda Scott, PhD, RN, NEA-BC, FAAN
Associate Professor and Associate Dean for Academic Affairs
Julie Zerwic, PhD, RN, FAHA, FAAN
Professor and Executive Associate Dean
Leading the Way:
Holistic Review in Nursing at
UIC College of Nursing

3. “The fact that the nation’s health professions
have not kept pace with changing
demographics may be an even greater cause of
disparities in health access and outcomes than
the persistent lack of health insurance for tens
of millions of Americans. Today’s physicians,
nurses, and dentists have too little resemblance
to the diverse populations they serve, leaving
many Americans feeling excluded by a system
that seems distant and uncaring.”
(Missing Persons: Minorities in the Health Professions, 2004).

4. UIC definition of diversity:
 “The totality of the ways people are similar
and different, including race, ethnicity,
class, gender, sexual orientation and
identity, disability, national origin and
citizenship status, age, language, culture,
religion, and economic status, particularly
when those similarities and differences
are used as a basis for unfair advantage
and inequity." (A Mosaic for UIC Transformation, 2012)

5. …to transform health,
health care, and policy
through knowledge
generation and
translation and through
education of future
leaders from diverse
backgrounds
UIC College of Nursing Mission

6. Illinois Nurse Workforce
 186,514 active registered nurses
 Racial/ethnic background
– Black/African American = 10.6%
– Asian = 5.1%
– Hispanic = 7%
 Males = 6%

7. Importance of a Diverse Class
 Mission alignment and professional
commitment.
 A diverse learning environment benefits
all students.
 Provides a rich teaching/learning milieu
that homogenous backgrounds cannot.
 Diverse health professionals can
improve health inequities.

8. Diversity Matters: CON DSTP
 URM will reflect our constituent pool
 Recruit 15% men
 Recruit students with disabilities
 Recruit students who identify as lesbian, bi-
sexual, gay, and transgender

9. Diversity Matters: College of Nursing
Students by Ethnicity
Race
CON
Graduate
CON
Undergraduate
Chicago* Illinois* National*
White 71% 57% 45% 72% 78%
Black 6% 6% 33% 15% 13%
Hispanic 8% 11% 29% 16% 17%
Asian 8% 17% 6% 5% 5%
Multi-Race 2% 3% 3% 2% 2%

10. Importance of a Diverse Class
 Mission alignment and professional
commitment.
 A diverse learning environment benefits
all students.
 Provides a rich teaching/learning milieu
that homogenous backgrounds cannot.
 Diverse health professionals can
improve health inequities.

11. Motivation to Change
 A perception that students in pre-nursing
at UIC who were underrepresented
minorities were unable to be granted
admission.
 Faculty perception that we had a very
diverse student body.
 Underrepresented minority students were
less likely to persevere through the
application process.

12. Additional Motivators
 Significant variation between reviewers.
 Advance practice nursing programs had
very few underrepresented minority
students.
 Implicit criteria that were not shared or
endorsed by faculty.

13. Holistic Review Intervention
 Opportunity to change our recruitment
strategies
 Transform the application process
– Reduce barriers
– Increase complete applications
– Value added
 Change internal and external perceptions

16. What is holistic admissions?
 Comprehensive, individualized review of
each applicant.
 Balances experiences, attributes, and
academic metrics.
 Utilizes data from a variety of sources.
 Shifts the focus from the individual’s
potential success as a student to the
individual’s potential success as a
member of the nursing profession.

17. Faculty Engagement & Buy-In
 Workshop training sessions
– Set the stage/ground rules for the conversation
– Explore the influence of assumptions and
beliefs
 Minimize undue influence in admissions
– Self awareness
– Question the source of negative reactions
– Reserve judgments until after all data is
reviewed
– Be open to others’ viewpoints

18. GPA Admission test scores Languages Science GPA
Sexual identity
Work ethic
Leadership qualities
Ability to work with
others

19. One door to be coming a nurse

20. What changed in our process?
 All qualified applicants received an
interview
 Interview questions were structured
 BSN applicants completed an in-person
writing assignment
 Interviews and applications were rated
by two independent reviewers

21. What changed in our process?
 Interviews and application review by
faculty who had participated in holistic
admissions training.
 Reviewers were blinded to the other
materials they were not rating.
 The ratings were not averaged, rather
they were looked at in totality.

22. Admission Decisions
 Two ratings for the interview (comments
and name of reviewer)
 Two ratings for the application review
(comments and name of reviewer)
 Overall GPA
 Science GPA
 Gender
 Race/ethnicity

23. Admission Decisions
 We did multiple sorts
based on the different
criteria:
– Interview scores from
highest to lowest
(discrepancies
between reviewers
were examined)
– Application scores
from highest to lowest
– GPA

24. Challenges and Considerations
 Continual need for faculty and staff
training
– New employees
– Continuing employees
 Maintaining commitment to the process
– Resources
– Time
– Desire to streamline

25. 2016 Admission Cycle
Degree Eligible Not Eligible Grand Total
(BSN) Bachelor of
Science in Nursing 271 226 495
(DNP) Doctor of Nursing
Practice 248 56 304
(PhD) Doctor of
Philosophy 21 5 26
Graduate Entry Master of
Science 229 63 292
Master of Science 41 30 71
Grand Total 810 380 1190

26. Challenges and Considerations
 Implications for student support
– Once admitted do you have the support
systems for all students to succeed?
 Curriculum assessment/revision
– Do you have content in the curriculum that
allows you to teach to the diversity of the
student body?

27. Comparison of 2015 UIC Nursing
Students by Race/Ethnicity
Race CON
Graduate
CON
Undergraduate
Chicago Illinois National
White non-
hispanic
65.4% 50.6% 45.0% 71.5% 72.4%
Black 8.0% 8.4% 32.9% 14.5% 12.6%
Hispanic 8.2% 15.7% 28.9% 15.8% 16.3%
Asian 9.6% 20.1% 5.5% 4.6% 4.8%
NHPI <.1% 0.2% 0.0% 0.0% 0.2%
AIAN 0 0 0.5% 0.3% 0.9%
Two or more 1.6% 2.57% 2.7% 2.3% 2.9%

28. Admission Data
Males Admitted by Year URMs Admitted by Year

29. Program Evaluation Process
 Student surveys
 Faculty perceptions
 Comparative cohort analysis
 Institutional data

30. The Future of Nursing at UIC
Meeting the Challenge through Holistic Review