Leadership 2.0: Nursing's Next Generation

Lessons Learned on Increasing Nursing Student Diversity

Tracy J. Pritchard, PhD; Greer Glazer, RN, CNP, PhD, FAAN; Karen D. Bankston, RN, MSN, PhD, FACHE; Kimberly McGinnis, MA


Online J Issues Nurs. 2020;25(2) 

In This Article

Abstract and Introduction


Colleges and universities are pivotal to successful efforts aimed at achieving greater nursing workforce diversity. In 2013, the College of Nursing at the University of Cincinnati in Cincinnati, Ohio, introduced a multi-faceted program that supports underrepresented racial/ethnic minority and disadvantaged students throughout the four years of the nursing baccalaureate curriculum. The Leadership 2.0: Nursing's Next Generation program has achieved impressive gains in the recruitment, retention, and academic performance of program participants. This article describes key program components and strategies that ensure an integrated program structure. Lessons learned are discussed, including factors that have contributed to the program's success and its ability to meet the academic, professional development, socialization, and financial needs of underrepresented and disadvantaged students


For more than a decade, American nursing and health policy experts have called for increasing the diversity of the nursing workforce to better align with the nation's demographics (Sullivan Commission, 2004; Institute of Medicine [IOM], 2011; Campaign for Action, 2018). These calls for greater diversity are guided in part by research that demonstrated a link between healthcare workforce diversity and improved quality of care (Alegria et al, 2013; Charlot et al., 2015; IOM, 2003; Jackson & Gracia, 2016; Murray & McCrone, 2014; Phillips & Malone, 2014; U.S. Department of Health and Human Services, [DHHS] 2006, 2016), and by a recognition of the opportunities and social benefits that a nursing career offers individuals from underrepresented backgrounds.

Underrepresentation in nursing is particularly notable among Hispanics and Blacks/African Americans (AA), who represent 31.8% of the United States (U.S.) population (U.S. Census Bureau, 2018), but in 2015 represented only 19.5% of registered nurses (Budden, Moulton, Harper, Brunell, & Smiley, 2016; DHHS, 2017). College enrollment statistics indicate that some progress has been made in the profession toward achieving diversity goals as Hispanic and Black/AA minorities comprised 21.1% of undergraduate nursing students in 2016 (American Association of Colleges of Nursing, 2017). However, continued aggressive efforts are needed if the nursing profession is to keep pace with demographic projections, which suggest that the United States will be a minority-majority nation by 2045 (Frey, 2018).

As the gatekeepers to a nursing career, colleges and universities are central to addressing the diversity challenge. In 2004, the Sullivan Commission on Diversity in the Healthcare Workforce spotlighted the importance of making education more attainable and affordable (Sullivan Commission, 2004) and called on academic institutions to remove cultural and logistical barriers to health professions education for minority students. Barriers faced by underrepresented (URE) minority students are many and include finances; a gap in academic preparedness; and feelings of isolation that students may experience in the college setting (Gipson-Jones, 2017; Page & Scott-Clayton, 2016; Seidman, 2005).

Research has identified strategies to address many of these barriers. For example, pipeline and academic enrichment programs targeting URE and disadvantaged high school students have been shown to enhance academic preparation for college and increase the likelihood students will enroll in a health professions program (Brooks Carthon, Nguyen, Chittams, Park, & Guevara, 2014; Loftin, Newman, Gilden, Bond, & Dumas, 2013; Relf, 2016; DHHS, 2016). Scholarships and financial aid are also effective in improving recruitment as well as retention of URE students (Ferrell, DeCrane, Edwards, Foli, & Tennant, 2016; Gates, 2018; Singell, 2004; Swail, Redd, & Perna, 2003), and summer bridge programs offered after high school graduation have been found to help students transition to the college environment and prepare for its academic, social, and financial demands (Ashley, Cooper, Cala, & Brownell, 2017; U.S. Department of Education, 2016; Noone, Carmichael, Carmichael, & Chiba, 2007; Pritchard et al., 2016; Sablan, 2014).

In 2013, the College of Nursing at the University of Cincinnati implemented a multi-faceted program designed to improve the recruitment, academic performance, and retention of URE racial/ethnic minority and disadvantaged nursing students. URE is defined by the program as groups underrepresented in nursing according to race/ethnicity (i.e., Alaska Native, American Indian, Black or African American, Hispanic/Latino, native Hawaiian or Pacific Islander) as well as gender (male). Disadvantaged students include first generation college students and economically disadvantaged students (defined as students eligible for Pell Grants and/or with a family income at or below 200% of the federal poverty level).

The Leadership 2.0/Nursing's Next Generation program incorporated a range of strategies to aid students in overcoming known barriers to obtaining a bachelor of science in nursing (BSN) degree. The program initially focused on recruiting and supporting students through the sophomore year of college. However, after realizing marked improvements in the retention rate and grade point average (GPA) of Leadership 2.0 students, the College of Nursing secured a continuation grant, which allowed it to support students throughout all four years of the BSN program. In this article, the Leadership 2.0 program's key components are described as well as lessons learned about factors that have contributed to its success.