Passing With Flying Colors

Fact #1: Registered nurses comprise the largest portion of the health care work force in the United States.1 Fact #2: Of the nearly 2.7 million licensed RNs in this country, only 13% come from racial or ethnic minority backgrounds.2 Fact #3: Twenty-five percent of the total U.S. population—i.e., one out of four Americans—is non-Caucasian.3 Fact #4: Within the next 25 years, the ethnic and racial minority population of the U.S. is projected to increase at a faster rate than the nation’s Caucasian population.1,4

These statistics dramatically illustrate America’s urgent need to develop a more diverse nursing work force that is able to provide culturally and linguistically competent care to our increasingly multicultural population. This means not only increasing the number of minority nurses but also ensuring that nurses of all races and ethnicities are thoroughly prepared to care for patients from widely diverse backgrounds and cultures.

One place to start is by making sure that our nursing schools’ curricula truly reflect the cultural differences of our country’s wide spectrum of racial and ethnic populations. Although curricula may contain accurate cultural terminology, they often lack the qualities that enable students to understand different cultures and their health care needs. When revising curricula to incorporate a multicultural perspective, it is crucial to include in-depth information on cultural factors,6, 7 such as:

• environmental control (e.g., the practice of folk medicine or use of traditional healers) 8
• biological (physical and genetic) differences among cultural groups, which can include not only body build, skin color and hair texture, but also healing responses, susceptibility to disease and nutritional variations8
• social organizations, such as families, that shape an individual’s cultural development, beliefs and responses to major life events
• space and time orientation (e.g., some cultures are future-oriented and concerned with long-range planning while others focus on the present).

In addition, communication is an integral part of nursing practice. To communicate effectively with patients from diverse cultures, nurses must have knowledge of different languages, verbal and nonverbal behaviors, use of silence and attitudes about eye contact. They must understand not only what is communicated but also how it is communicated.

Evening Up the Score

While much has been written about incorporating cultural competency into nursing school curricula, one area that has received little attention is faculty-generated classroom testing. Because test scores play a significant role in student evaluations, it is important to utilize test questions that are as culturally unbiased as possible.

Educators must keep in mind that nursing students come from a diverse range of cultural backgrounds and may lack the necessary experience to perform well on tests if these cultural differences are not taken into account. In fact, a faculty’s failure to recognize the potential for bias in classroom testing can adversely affect minority students’ ability to succeed in the nursing program.

This inability to do well on tests is not due to lack of intelligence, but instead may result from a lack of necessary learned behaviors, or from differences in thinking patterns between cultures.9 For example, the Native American student has learned by stories, legends and role modeling.9 This nonlinear way of learning allows for more than one right answer,9 as opposed to the multiple-choice testing format customarily used in nursing schools. As a result, Indian students may have difficulty not only in learning but also in expressing their knowledge and understanding test questions.

Fortunately, most students are capable of learning test-taking skills if they are given the opportunity. It is the faculty’s responsibility to provide this opportunity—for example, by making tutoring available, within or outside of the nursing department, to help students identify and strengthen areas that need further development, such as writing, studying and time management. Providing these options for minority students does not mean lowering standards; rather, it means that mechanisms should be in place to enable faculty to refer students for additional help if it is needed.

A Culturally Sensitive Approach to Testing

What can nursing schools do to ensure that faculty-generated tests are not inadvertently biased against minority students? One solution is to use culturally sensitive standardized test questions. While these may be hard to find, one helpful resource is the National League for Nursing (, which is striving to make standardized tests culturally sensitive by reviewing them for potential bias. Another recommendation is to have culturally diverse groups of students and faculty evaluate potential test questions.

Within the larger context of providing a culturally sensitive learning experience for all nursing students, it is important to use clinically focused scenarios and class exercises that relate to multicultural issues, and to select textbooks, journal articles and reference materials that reflect cultural diversity. The following texts are recommended for their culturally diverse content:

• Spector, R.E. (1996). Cultural Diversity in Health and Illness (4th edition). Stamford, Conn.: Appleton & Lange.
• Kelly, M.L. & Fitzsimons, V.M. (2000). Understanding Cultural Diversity: Culture, Curriculum, and Community in Nursing. Sudbury, Mass.: Jones & Bartlett.
• Bennett, C.I. (1999). Multicultural Education: Theory and Practice (4th edition). Boston: Allyn & Bacon.

Finally, inviting culturally diverse guest speakers to discuss culture-specific behaviors and customs can be excellent way to help both students and faculty broaden their understanding of cultural differences.


1. Moses, E.B. (1992, March). Nursing Facts: From the American Nurses Association.

2. U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing (2000, March). Preliminary Findings, National Sample Survey of Registered Nurses.

3. U.S. Census Bureau (2001, March). Census 2000 Brief: Overview of Race and Hispanic Origin.

4. U.S. Census Bureau (1995, August). Selected Social and Economic Characteristics for the 25 Largest American Indian Tribes: 1990.

5. U.S. Census Bureau (1997, October 31). Facts for Native American Month (November 1-30).

6. McCarthy, M. (1996). “Travelers From Many Lands: The Impact of Culture.” In Carson, V.B. & Arnold, E.N. (Eds.), Mental Health Nursing: The Nurse-Patient Journey (1st edition). Philadelphia: W.B. Saunders.

7. Strasser, J., Maurer, F.A., & Kavanagh, K.H. (1995). “The Relevance of Culture and Values for Community Health Nursing” (ibid.)

8. Spector, R.E. (1996). Cultural Diversity in Health and Illness (4th edition). Stamford, CT: Appleton & Lang.

9. Crow, K. (1993). “Multiculturalism and Pluralistic Thought in Nursing Education: Native American Worldview and the Nursing Academic Worldviews.” Journal of Nursing Education.

Recruiting and Retaining Minority Nursing Faculty

Recruiting and Retaining Minority Nursing Faculty

When Dr. Margaret Moss, RN, earned her doctorate in nursing science from the University of Texas Health Science Center at Houston, she became part of a very small and select group: minority nurses who hold terminal degrees.

Moss is one of only 14 American Indian nurses in the entire country who hold doctoral degrees and the numbers for other minority groups aren’t much better. These statistics mean that nursing programs looking to increase the diversity of their faculty face keen competition for professors like Moss. With such a small pool of qualified candidates to draw from, nursing schools that hope to recruit minority and male faculty–and even more importantly, to retain them–must be active, committed and, above all, sincere.

According to the minority nursing professors interviewed for this article, the number one rule faculty search committees should keep in mind is: Hire for ability, not color or gender. In fact, they caution, focusing your search activities on ethnicity or gender alone will drive away minority applicants instead of attracting them.

“Show an interest in the person’s knowledge rather than just the color of their skin,” advises Moss, an assistant professor at the University of Minnesota School of Nursing in Minneapolis. She stresses the importance of being familiar with the candidate’s accomplishments, experience and expertise and being able to discuss them intelligently. If a candidate gets the impression that you only want him or her because of race or gender, don’t expect a “yes” to your offer.

“People can see right through that and they won’t accept it,” Moss says.

Kevin Mallinson, RN, PhD, AACRN, an assistant professor at Georgetown University in Washington, D.C., agrees. “If a school wants to attract male faculty members, for me that would mean they wouldn’t make an issue out of the fact that I’m male,” he argues. “I don’t want a search committee saying, ‘we really want a man here.’”

Mallinson joined the faculty at Georgetown in August 2003. The fact that he was a man was not an issue in the recruiting process, he says. But that hasn’t always been the case. He recalls sitting in on a meeting at another nursing school where the program’s recruiting success was measured solely on the number of men and people of color who were hired as faculty members.

Instead of demonstrating that the institution values diversity, comments like that undervalue the contributions of the minority faculty recruited, Mallinson believes. “It made us feel as though we weren’t recruited because we were great researchers or because of our teaching background,” he says. “We were only recruited for our color or gender.”

The Comfort Factor

While you don’t want to make candidates feel that having X number of minority or male professors is of paramount importance to your program, you do want them to feel comfortable about joining your faculty. For many minority professors, that means not being one-of-a-kind.

“In all the nursing programs I had been in as a professor or a student, I had never encountered an American Indian faculty member,” Moss recalls. The fact that the University of Minnesota had two other Native nurses on the faculty drew her to the campus.

Even though she herself is Caucasian, Sandra Edwardson, RN, PhD, dean of the University of Minnesota School of Nursing, realizes the importance of helping new minority faculty members establish cultural connections so that they don’t feel like they’re alone in a crowd. “I know it’s a pretty lonely existence to be the only person of your race at a school,” she explains.


Suggestions from the NLN

The National League for Nursing’s Task Group on Recruitment and Retention of Students has been charged with developing guidelines for recruiting and maintaining a diverse student population in nursing. While the Task Group is not yet ready to release formal guidelines, Chief Program Officer Theresa M. Valiga, RN, EdD, FAAN, notes that one key factor in attracting more minority and male students to nursing schools is the presence of a diverse faculty population. She offers these suggestions for recruiting and retaining minority nursing faculty:

1. Make sure there is a commitment on the part of the university to provide adequate support (time, money, staff) for the recruitment process.

2. Develop a recruitment communications package containing information about the university’s minority community, including statistics on the number of minority students and information about area housing, churches and schools.

3. Develop and include information on employment opportunities for spouses.

4. Share information and schedules for local minority cultural events and festivals that would be of interest to the targeted minority population(s).

5. Form an advisory board composed of members of the minority groups being recruited.

6. Establish an environment of open communication among administrators and other faculty. A forum in which minority faculty can interact with each other can also provide an avenue of acceptance.

7. Provide mentors, both internal and external, for recruited minority faculty members.

8. Help faculty and staff recognize and embrace cultural differences.

At her program, Edwardson encourages faculty search committees to be creative in linking minority candidates to the community off-campus. “Here in Minnesota, we have an uphill battle in trying to recruit faculty of color, particularly if they’re coming from warm southern climates,” she says. “In addition to linking them with individuals on campus, we try to make sure they have some social time during the recruiting process to spend with representatives of the local minority community of which they may become a part. That way, they understand what it’s like to live in this northern, homogeneous city. That’s a strategy that has worked fairly well for us.”

Edwardson also encourages other deans at the university to make plans that will help new minority faculty members connect easily with other people of their race, ethnicity or gender on campus, regardless of what academic department they’re affiliated with.

“Another strategy to deal with the potential isolation is to bring together minority students and faculty with other people of color here in the academic health center and even the university at large,” she notes. “They may not be in the same discipline, but they can still share their problems and successes. It’s a good way for mentoring to happen.”

Target Your Marketing Plan

Diane Oates, president of Academic Diversity Search, Inc., a Webster, N.Y.-based firm that specializes in connecting minority candidates with academic institutions, has one word of advice for majority nursing schools that hope to attract minority faculty members: talk. Talk to minority nursing associations often. Talk about your program, your current faculty and their accomplishments, and your plans for the future.

“The most important thing that universities can do is make sure they are talking to the audiences they want to reach,” she advises. “You’ve got to work to get the word out to the right audience.”

That means advertising in journals and publications that are read by minority nursing faculty and graduate students, Oates says. It also means getting out of your office and seizing opportunities to meet potential candidates face-to-face at nursing conferences and meetings.

The search for qualified minority faculty members should go on even when you don’t have an open position, she adds. “You’ve got to be looking constantly. Talk to everybody you can about your program.”

Be honest if you’re not currently looking for faculty, but be open to planting seeds of interest that could pay off in the future. The young minority or male master’s candidate you meet at next weekend’s conference could be the country’s leading pediatric nursing researcher 10 years from now.

Fill your Rolodex with the names of potential candidates and keep in contact with those you meet. It may be just passing along an article of interest or sharing news about a grant opportunity. When the time comes for you to fill a position, tap into that network and let your contacts of all races know about an opening.

As a founder of the Association of Black Nursing Faculty, Sallie Tucker-Allen, RN, PhD, FAAN, has seen this networking approach work many times in that organization. “If positions are open, we spread the word [to our members],” she says. That’s advertising you can’t buy.

Improving Your Image

Nursing is a small world, and news–both good and bad–travels quickly. If your attempts to attract a more diverse faculty through networking and advertising aren’t working, perhaps your institution has a bad reputation for not being welcoming to minority faculty in the past. Recruiting minority and male faculty will be particularly difficult if the school has had an all-white or all-female teaching force for years, or if it’s perceived as being too large and impersonal.

Tucker-Allen, who is director of the Methodist School of Nursing in Peoria, Ill., and former assistant dean of Chicago State University’s nursing program, says minority professors will avoid any college or university perceived as operating with a “revolving door,” an unwritten but still enforced policy at some schools.

“They bring you in, but they make no effort to support you and have no intention of tenuring you,” she explains. “In six years, you’re gone and someone else comes on board. On the books, the program has always had a minority faculty member.”

Once a program has gained such a reputation, attracting minority faculty can be difficult, even if the school is now making an effort to correct the situation by shedding its old policies and embracing diversity. But that doesn’t mean it can’t be done.

“There has to be a visible commitment starting at the top,” Tucker-Allen emphasizes. “It must start with a commitment from the dean and the president of the university because they control the funds and have to be willing to invest the money needed.”

Oates adds that this commitment to faculty diversity must not only run up the school’s chain of command but also run down it. Faculty members at all levels must buy into the diversity initiative and be willing to welcome, support, mentor and learn from new faculty members that happen to be of a different race or gender.

“People that report to the dean must understand how important diversity is,” she says. “They need to know why diversity is what’s best for the university and the students. You have to show them how it will make the program stronger.”

One way to do that, says Tucker-Allen, is to keep the diversity recruiting process open to everyone. Get both majority and minority faculty members and administrators actively involved in your efforts.

Once you’ve sold your diversity initiative inside your institution, go to great lengths to spread the word off-campus to the national nursing community. “Be prepared to tell minority nurses in academia what your program has to offer them and what sets you apart from their perspective,” Oates says.

If you’re not sure what that perspective is, ask. If necessary, bring in a consultant, preferably someone who is a member of the targeted minority group. According to Tucker-Allen, one mistake too many nursing schools make is bringing in outside consultants that do not represent minority populations.

“White faculty members and white consultants will not give you the solution,” she believes. “They are not going to say the same things that a black or Hispanic consultant would say.”

Put Your Money Where Your Mouth Is

Some minority nursing educators who have been on both sides of the academic hiring process think nursing schools might do better to abandon all the talk in favor of some high-profile action.

“If you’re serious [about attracting minority faculty], look at salaries, especially if you want to lure faculty members from other schools,” says Tucker-Allen. “Most black nursing faculty have traditionally taught at historically black colleges and they are probably tenured. They’re not going to leave that unless there’s a really good carrot at the end of your stick.”

Money may be the carrot of choice for many candidates, but it’s not the only one. Tucker-Allen suggests that nursing programs offer incentives such as the opportunity to do post-doctoral work and receive funding for research projects. “You have to look at the [candidate] pool and see what people really want,” she stresses. “Even though someone may have tenure in their current position, the person may be amenable to change if the right conditions are there.”

Established minority faculty members can also be lured away by nursing schools that have demonstrated a strong and sincere interest in minority health issues.

“In general, [minority] faculty researchers are interested in health disparity issues,” Moss explains. “Programs that target those issues are attractive.” One of the deciding factors in her decision to join the University of Minnesota, which has a Center for Nursing Research on Elders, was knowing that her own area of research interest–health care for American Indian elders–would be able to expand and be supported there.

Since such research projects are long-term and require financial support, a school’s encouragement of this type of faculty research conveys that the program is serious about eliminating health disparities and serving minority communities. It also helps assure newly hired minority faculty members that their expertise will be highly valued. Universities that fail to fully utilize the specialized knowledge and interests of minority faculty risk losing them.

But at more and more schools, the quest for a diverse nursing faculty that reflects the increased racial, cultural and gender diversity of the student population is creating unprecedented opportunities for minority educators interested in shaping the future of the next generation of nurses. As Mallinson says, “When it comes to being a faculty member and being a male, I could go anywhere. The world is open to me and that’s a wonderful feeling.”

How Do You Solve the Minority Nursing Faculty Shortage? Put Them Online!

Although many nursing schools around the country have successfully increased the racial and ethnic diversity of their student populations, there is still a severe shortage of minority nursing faculty. According to the American Association of Colleges of Nursing, less than 10% of the nation’s nursing educators are people of color. Even worse, many of these minority professors are rapidly nearing retirement age. How can nursing education meet the needs of a more culturally diverse generation of students when there just aren’t enough culturally diverse faculty to go around?

One school that has come up with an innovative solution to the minority faculty shortage is the School of Nursing at Thomas Edison State College in Trenton, N.J. The college has received a $600,000 grant from the Health Resources and Services Administration (HRSA) to recruit and prepare minority nurse educators for online teaching. Training existing minority faculty to teach in distance learning programs will make these educators accessible to more students from all over the country, especially those in remote or rural areas. It will also help reduce the retirement brain drain by enabling minority faculty to extend their tenure in the profession, at least on a part-time basis, after they reach retirement age.

The school plans to recruit 45 minority nurse educators for the program during the next three years. Candidates must have an MSN degree or higher and will complete the college’s 32-week Certificate in Distance Education Program. Upon completion, they will teach one 12-week online nursing course at the college and will then be able to bring their distance education skills back to their own local institutions. The grant will also be used to create a database of minority distance educators, which will be made available to nursing schools throughout the country.

“The potential benefit of educating minority nurse faculty in online pedagogy is vast,” says Susan O’Brien, EdD, RN, dean of the School of Nursing at Thomas Edison State College. “We anticipate that the number of students and nursing schools impacted by this program will increase exponentially as the minority nurse educators recruited and educated through this grant begin to use and share their online skills.” If you’re an eligible nurse educator interested in participating in this program, contact the college at [email protected].