DNP Scholarly Projects

A Program Innovation to Increase Representation in Nursing Through Early Exposure

Abstract

Background and Rationale: Black men remain profoundly underrepresented in the nursing workforce, comprising 8.4% (Tennessee Department of Health, 2022; U.S. Census Bureau, 2024) of Tennessee's population but only 0.64% (Tennessee Board of Nursing, 2024) of registered nurses. Structural barriers, including limited early exposure, lack of mentorship, and stereotypes, restrict awareness of nursing as a viable and rewarding profession. Upstream interventions targeting middle-school students have been shown to strengthen healthcare interest and diversify future workforce pipelines. Pathways to Purpose, a one-day nursing discovery event implemented in partnership with 100 Kings and NursesMC Nashville, was developed as an evidence-based program innovation to address these disparities.

Aim: The aim of this project was to increase awareness of nursing roles, improve understanding of the profession, and strengthen interest in nursing careers among 7th-grade Black male students participating in the 100 Kings Leadership Development Program.

Design: An exploratory mixed-methods program evaluation guided by the RE-AIM framework was used to assess the impact of the event and inform future scalability. Quantitative pre-/post-tests measured shifts in knowledge, confidence, and career interest, while qualitative reflections captured changes in perceptions and attitudes.

Participants: (N = 27) completed brief pre- and post-event surveys assessing understanding of nurses’ roles, interest in nursing careers, and leadership confidence. Quantitative data were analyzed using SPSS version 29, including a Mann-Whitney U test. Qualitative data emerged from open-ended reflections and student drawings, coded using thematic analysis. Activities included CPR certification, myth-busting sessions, hands-on skills stations, and a Q&A session including a panel of Black male nurses.

Results: Quantitative findings demonstrated meaningful improvements across outcome areas. Understanding of nursing roles and responsibilities increased by 27%, reflecting a measurable gain in confidence related to nursing knowledge. Interest in nursing careers also increased significantly, as confirmed by a statistically significant Mann–Whitney U test (U= 160.5, p = .004). Qualitative findings revealed that students broadened their perspectives beyond initial stereotypes.

Four themes emerged: 1) Movement from stereotypes to professional complexity 2) Skills-based recognition of nursing work 3) Representation matters for inclusion 4) Awareness sparked new or greater career aspiration

Conclusion: Pathways to Purpose effectively increased nursing knowledge, improved attitudes toward the profession, and initiated early career interest among Black male middle-school students. A single six-hour intervention was sufficient to disrupt stereotypes, enhance understanding, and foster meaningful engagement with nursing as a future pathway. Early exposure programs embedded within community-based youth leadership initiatives offer a scalable strategy to strengthen diversity in the nursing pipeline.

References:

Tennessee Board of Nursing. (2024). Nursing license verification. https://tnmap.tn.gov/health/nursing/

Tennessee Department of Health. (2022). Tennessee population by age group, sex, race, and ethnicity.https://www.tn.gov/content/dam/tn/health/documents/population/TN-Population-by- AgeGrp-Sex- Race-Ethnicity-2022.pdf

U.S. Census Bureau. (2024). QuickFacts: Tennessee. https://www.census.gov/quickfacts/fact/table/TN/PST045224

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Date

Winter 12-2-2025

First Advisor

Dr. Kaylyn Bourne

Second Advisor

Dr. David Phillippi

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

Early exposure to nursing; Nursing pipeline; Black male students; Workforce diversity; Minority mentorship; Mixed-methods evaluation; RE-AIM framework; Career interest development

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