Persistence in the face of self doubt: The experiences of African American and Hispanic women in selective healthcare programs

Increasing diversity and growing numbers of minority populations in the United States have led to the need for a more diverse healthcare workforce. Diversity is especially important in healthcare where patient outcomes or recovery can be affected by the patient-caregiver relationship. In spite of the growing need for diverse employees, the literature reports a long history of low minority student completion rates as compared to white students in selective healthcare programs.;The purpose of this study was to gain an understanding of the experiences of eight African American and Hispanic women who persisted in selective programs at two campuses of a Midwestern career college. The initial framework for this study was multiculturalism but as the study evolved, it became clear that the findings were situated in the literature on support networks of kith and kin, connected knowing, and the importance of caring relationships.;The subjects in this study were enrolled in the caring professions of nursing, occupational therapy, orthotics and prosthetics, physical therapist assistant, and surgical technology programs. To qualify for their programs, the women had to successfully complete prerequisite coursework and apply for selection. If seats were limited in any of the programs, competition was based on grade point averages.;This study has a qualitative framework and is a phenomenology, which uses a psychological approach. The method of data collection was multiple semi-structured interviews of individual students. The interviews were audiotape-recorded and transcribed following the interviews.;The major themes that emerged from the women's stories told of complex lives that revolved around family, high levels of stress, the importance of support networks, and motivation in spite of self-doubt. The women's perceptions that they were neglecting their roles as women and "good" wives and mothers lead to self-doubt. However, relationships of kith and kin appeared to provide the women with the support they needed and motivated them to persist.;Conclusions of this study demonstrated a strong connection between the women's support networks and their ability to persist; relationships based on care empowered the women as well as motivated them; and the women's strong connections to their helping professions made it possible for them to visualize future benefits for themselves and their families.;Although colleges would prefer clear and inexpensive solutions to increase student retention rates and graduation, this study demonstrates that persistence is a complex problem. The reason retention is complex is secondary to the fact that students are complex. Colleges must understand their students from the time of admission and provide support throughout their college experiences. This support should come in the form of nurturing, which the students experience through caring relationships.