When Holistic Admissions Review Is Not Enough: Barriers to Diversity

Abstract

Background: Patient populations are increasingly diverse; however, the health care workforce often fails to reflect the diversity of the populations it serves. Holistic admission review (HAR) has been proposed as a strategy to diversify the student body and create a more diverse workforce. Method: This article describes the development, application, and evaluation of a holistic admissions process for freshman undergraduates admitted directly to a College of Nursing located in a nonaffirmative action state. Results: There was an increase in the diversity of applicants; however, the selected metric of SAT (Scholastic Aptitude Test)/ACT (American College Test) scores resulted in a decrease in the number of qualified applicants. This decrease disproportionately affected underrepresented students, illustrating that the inability to consider race, ethnicity, or gender continues to restrict the admission of a diverse student body even with HAR. Conclusion: Our findings highlight the need to consider all aspects of HAR, particularly the effect of the chosen metrics on the applicant pool. [ J Nurs Educ . 2022;61(7):375–382.]