The Relationship Between Marginality and Minority Status in Undergraduate Nursing Students

Purpose: Research conducted over the last several decades suggests that the nursing workforce remains largely Caucasian and female; as such, there is a strong probability that nurses will not be concordant with the diverse U.S. population they serve (AHRQ, 2012; IOM, 2011). The fact that the nation’s healthcare professionals are not culturally concordant with the populations they serve has been shown to be a more significant cause of health disparities than the lack of health insurance for millions of Americans (AHRQ, 2012; Levesque, 2015). The homogeneity of the nursing profession is largely a direct result of the significantly higher attrition rates that minority nursing students experience when compared to non-minority students (Loftin, Newman, Dumas, Gilden, & Bond, 2012; McDermott-Levy, 2011; Shelton, 2012). The purpose of this study was to investigate the relationship between marginality and minority status in undergraduate nursing students enrolled in one of the four universities in XXXX that offer a baccalaureate nursing program.

Methods: A non-experimental, descriptive correlational design was used for data collection. Participants (n= 331) completed a demographic survey and marginality was measured using the Koci marginality Index-70. The demographic variables of race/ethnicity, sexual orientation, gender, and age were investigated in relation to marginality.

Results: Results indicate that there was a statistically significant difference in mean scores for minority (M= 177.5, SD= 29.3) versus non-minority undergraduate nursing students (M= 166.4, SD= 18.1); t(329)= 4.3, p < =.001. Furthermore, acial/ethnic minorities scored significantly higher on the KMI-70 (M= 199.1, SD= 27.4) when compared to non-minority participants (M= 166.3, SD= 27.4); t(329)= -9.9, p ≤ .001. Further analysis of race/ethnicity revealed that participants who identified as ENNL reported higher marginality scores (M= 186.9, SD= 33.6) when compared to scores obtained from participants whose primary or native language is English (M= 170.3, SD= 23.2); t(329)= -2.4, p= .037. A t-test was also computed to determine if sexual minorities experience higher levels of marginalization than non-minorities. Results did not reveal any statistically significant differences between sexual minority (M= 178.8, SD= 33.7) and non-minority participants (M= 170.3, SD= 23.0); t(328)= -1.5, p =.112 with regard to KMI-70 scores.

A t-test was computed to determine if male participants experience higher levels of marginalization than female participants. Results suggest that there was no statistically significant difference in mean scores for male participants (M=166.1, SD= 25.6) versus female participants (M=171.6, SD= 23.5); t(329)= -1.4, p= .428.

A t-test was conducted to evaluate differences in mean scores for traditional-aged and non-traditional-aged participants. Results indicate that there was no significant difference in KMI-70 scores for non-traditional participants (M= 166.9, SD= 19.8) when compared to traditional-aged participants (M=171.8, SD= 24.6); t(329)= 1.5, p= .111. A one-way ANOVA was then conducted to investigate further the differences in mean scores between the different age groups with regard to KMI-70 scores. Results indicate that there is no significant difference in marginality scores between participants with respect to age, F (4,326) = .63, p= .640. Results of the ANOVA are presented in Table 4.

Conclusion: Despite the fact that a great deal of attention has been placed on diversifying the nursing profession, the field remains very homogenous with regards to race, gender, and sexual orientation. The findings from this research study suggest that marginalization remains a significant issue for minority students throughout their nursing education. The continued homogeneity of the nursing profession has implications for the health of the U.S. population as well. Despite decades of attending to both the cultural competence of health care providers and diversity of healthcare clients, minimal inroads have been made using cultural competency to address health disparities (Drevdahl et al, 2008; Truong et al., 2014). As population demographics continue to shift rapidly, it is imperative that the field of nursing better represent the individuals for which they are caring.