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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