Holistic Admissions: Could You Be Biased?

Advancing health professions education: a review of holistic admissions and competency-based admissions practices

In this review, we gathered information about competency-based admissions and holistic admissions related to healthcare education to understand current practices better and offer recommendations within the healthcare education field. A literature search was conducted to gather peer-reviewed articles detailing information related to competency-based admissions and holistic admissions that have been implemented in healthcare education, including medical schools, nursing schools, dental schools, and other allied health fields. After screening and the addition of articles through ancestral search, 166 articles were included in this systematic review. The articles were coded for information related to definitions of competency-based admissions and holistic admissions, specific desired competencies, procedures to evaluate these competencies, outcomes of these practices, and the success of admitting well-prepared students using these practices. Results show there is wide variation in established definitions and desired competencies. Similarly, there was some variation in methods for evaluating these competencies with some common practices identified. Lastly, little evidence demonstrates the effectiveness of admitting students who are well-prepared for their programs when competency-based or holistic admissions are employed. There is a need for future research to establish a standard definition for both competency-based admissions and holistic admissions. Desired competencies should be established based on the program's mission and vision statements for what type of students they want to admit. Lastly, future research needs to focus on the long-term outcomes of implementing these practices.

Integrating Implicit Bias Training for Undergraduate Holistic Admission Reviewers

BACKGROUND

The need to create a diverse nursing work-force has increased the use of a holistic admission process across the country. Holistic admission processes alone are insufficient to addressing bias that may have unintentional impact on the review process. Intentionality with implicit bias training is necessary to create a more equitable admission process.

METHOD

Integration of implicit bias training was multipronged and included overview information and individual activities, including the practice of reviewing applicants. Data from the practice reviews were aggregated and used for small group discussion.

RESULTS

Since integration of implicit bias training, overall admission rates for underrepresented racial and ethnic applicants increased from 14.5% in 2019 to 29.1% in 2022.

CONCLUSION

While other factors cannot be ruled out in contributing to the increased diversity, the integration of implicit bias education and bias-mitigating strategies throughout the required training for holistic admission reviewers is beneficial to increasing diversity in nursing admissions. [J Nurs Educ. 2025;64(2):128-131.].

Addressing Bias in the Occupational Therapy Admissions Process

This study investigated the impact of a workshop in reducing unconscious bias in admissions committee members of an occupational therapy program to determine if workshop participation increased the number of underrepresented students in the program. A convenience sample of 50 committee members was used. A Wilcoxon matched pairs signed rank test indicated a significant increase in the post-test survey question scores. A chi-square test of independence revealed a significant increase in the number of students in the program from underrepresented groups. These results suggest that an online workshop can reduce perceived bias and increase diversity in an occupational therapy program.

Extended Complicated Punishment: Nursing Students' Experiences of a Transition Program

BACKGROUND

A diverse nursing workforce depends on whether higher education is accessible to historically disadvantaged students and whether such students are supported to achieve success. In South Africa, the Extended Curriculum Program (ECP) is a transition degree program created to widen access and success for underrepresented groups, including those aspiring to become nurses. This qualitative study explored the experience of nursing students in an ECP at a South African university.

METHOD

Written reflections were collected from 16 nursing students in the ECP.

RESULTS

Four main themes emerged following thematic analysis: ECP selection process, emotional reaction to ECP placement, ECP as another experience, and acceptance and moving forward. Students reported an altered sense of belonging as the result of hostility from peers and faculty, making social and academic integration challenging.

CONCLUSION

Students who gain access to nursing programs and the nursing workforce through transition degree programs may be at risk of low self-efficacy. [J Nurs Educ. 2022;61(8):477-482.].