Title: Prevalence of Nursing Students with Background Check Findings in Midwestern US Universities
Name: Christopher Peters
Primary Presenters: Christopher Peters
College of Nursing
Research Doctorate (PhD)
Faculty Sponsor(s): Kim Litwack, PhD, RN, FAAN, APNP
Abstract
Purpose: To describe the prevalence of students with background findings in nursing programs set in large public universities in the Midwestern US.
Background: Background checks have been used in nursing and allied health education for over 15 years to evaluate whether a student is thought to pose a risk to the public due to prior involvement with law enforcement. Little is known about the prevalence of students in nursing education with findings, or how those findings are used to evaluate risk.
Sample: Aggregated, de-identified results of 22,628 background checks were evaluated for the years 2014-2019 from five nursing programs set in large public universities in the Midwestern United States.
Method: Descriptive statistics were used to analyze the data in Microsoft Excel.
Results: This study provides the first multi-year, multi-site descriptive data for nursing students with background findings in large public universities in the Midwestern US. 22,628 background checks were conducted across five programs over six years. 858 checks revealed prior involvement with law enforcement, 3.79% of students (range 0.26%-10.18%, SD 2.2%). Findings ranged from misdemeanor-level substance abuse to felonies and violence. 59% of records were found to be missing key details, such as disposition of the case. Background checks which are incomplete may be of questionable value for public protection, but still act as a deterrent to students from communities disproportionately impacted by systemic racism in law enforcement. Implications for future research include determination of how these findings indicate public risk and how the background check process impacts recruitment.
Keywords: nursing student, background check, criminal record
https://sites.uwm.edu/healthresearchsymposium/files/formidable/2/PETERS-2021-Prevalence-of-Nursing-Students-with-Background-Findings.pdf
Chris, I am so impressed with how you compressed two hours’ worth of content into three minutes without losing meanng. You have set up such a strong socially conscious argument here. One thing that strikes me is how you have used no significant differences in students’ academic performance and NCLEX pass rate if they did or didn’t have background check findings. That implies they met the ethical comportment and performance in clinical, which is huge.
Often we ignore things that aren’t “statistically significantly different” as a byproduct of training in research design and EBP. I’m not sure why? Does it seem uninteresting? or unimportant? Or is there so much publication bias? It’s not just me, right?
No. It’s not just you.
The results of students with and without background findings on the NCLEX exam and persistence to graduation is an interesting finding to be sure. Keep in mind that this is drawn from the work of Smith, et al., (2013). While it was composed of over 3,000 students, it was from a single state with a unique regulatory structure. We don’t know if that single cohort would be representative of a larger population of nursing students.
Your argument about statistical significance is important. Even though there was no difference in pass rates or program completion, it would be of interest to determine “WHY not?” Completing your BSN degree may supply important ethical development to a student, or rehabilitation may demonstrate they are no longer at risk. Which comes first? Does one contribute to the other? We do not yet know.
Thanks for your comments.
-Chris Peters
Sorry my earlier comment showed as “anonymous!” I forgot to fill out my name- somehow I thought that would autopopulate from my single signin.
You raise an important issue here “Completing your BSN degree may supply important ethical development to a student, or rehabilitation may demonstrate they are no longer at risk.” It’s correlation only- no directionality or causality. As a nursing instructor, I certainly hope that completing a nursing program affects a student’s affective development, especially now that science and reasoning ability seems to have trumped caring in the students that are drawn to nursing programs (just my personal observation). Chris, you really have raised some important, far-reaching issues with your topic! This could be a whole lifetime program of research for you!
The NCSBN (2020) states “Fitness to practice comprises the requisite skills, knowledge, competence, health, and character to practice within the nursing profession. This may include evidence of moral character such as criminal background checks and references.(p. 9)”
In my opinion, students enter nursing education with health and character. It is through education and socialization that they acquire skills, knowledge and competence. It remains to be studied if the student’s moral character prior to admission is changed through education and socialization to the profession’s code of ethics.
Thanks for your comments, I would indeed like this to be a whole program of research!
– Chris Peters
____________________________________________________________________________________________
National Council of State Boards of Nursing. (2020). A global profile of nursing regulation, education, and practice. Journal of Nursing Regulation, 10(Special Issue), 1–116. https://www.ncsbn.org/14401.htm
What do you think contributed to the high percentage of background findings between 2015 and 2017? How come the background checks where incomplete? Thank you for this study.
Thank you so much for your comment.
At this time, I cannot say why background findings increased between 2015-2017. Unemployment at that time was falling, which meant more individuals were entering the job market. It is possible that increased competition for jobs encouraged people with background findings to enter nursing. For many years, news about the nursing shortage and the profession’s high wages and bright job outlook was well publicized. This may have also drawn persons into nursing. The trend could also mirror increasing levels of policing in communities resulting in the increase in nursing mirroring the population at large. Finally, increased storage and access of background check documents via computer mean that it is easier to find records than ever.
In my opinion, these are possible reasons which could explain the increase. Additional study of these variables may show changing conditions correlate with the rise, then decline of findings.
– Chris Peters
Background checks were incomplete because civil servants in the court system are often overworked. They prioritize uploading major convictions findings from closed cases. They frequently do not provide full accounts of cases where charges are dropped, dismissed or not prosecuted. This was identified as far back as 2005 in the work of Alley, et al.
It has a significant impact on students who must satisfy the demands of schools or clinical sites for final disposition of their case. They must go back to the courthouse and pay fees to have official copies of court documents printed. It can be time consuming and expensive (I think I’ve heard $1/page). More importantly, it re-establishes the stigma of having been involved with law-enforcement in a guilty until proven innocent way. While I am not aware of any data on it, I would think that would have a significant deterrent effect on students.
-Chris Peters
This is excellent Mr. Peters. We need to look at reasons that stop someone from applying to nursing programs.
Nursing has a diversity problem. Despite acknowledging the problem for years, little real change has occurred to make our profession more attractive and more accessible. If underrepresented communities are deterred by the application process we need to examine how to turn that barrier into a portal.
Disparate impacts of policing on underrepresented young people create the kind of background findings that, in my experience, are unlikely to impact admission or clinical placement. But if those potential applicants think they will not be admitted because they do not know the finding is insignificant it has the same impact as an absolute bar.
Nursing represents employment where individuals can earn a living wage in a trusted profession. It should be accessible to anyone who wishes to learn the knowledge, skills and ethics of the profession.
Thank you so much for your comment.
– Chris Peters
Great work, Chris. You cited a study that found a 14% rate of background checks. Did that study have differences in its design (sample, setting, analysis approach) that are important for comparing your study to these published findings that could account for your study’s lower rate of findings?
Yes. The study which found 14% was drawn from a sample over 10 years old and from a Southern US state with a unique regulatory structure. Those single state findings may be of limited generalizibility to Midwestern states in the late 2010s where my samples were from.
Another possibility is that students from large public universities in my sample differed in a significant way from all students in that statewide sample.
Thanks for your comment!
– Chris Peters
Chris,
Your research builds on past work, uses existing data, provides useful information for UWM and similar nursing programs, and raises questions needing further investigation – awesome scholarship!
Your graphic is engaging and represents the topic of nursing students facing background checks.
What I found most significant was the preponderance of substance use findings on background checks along with your discussion of how these arrests disproportionately affect BIPOC students.
i share your concern that students might be discouraged from applying to the nursing program or turned away from clinical settings because of background of a substance use (or other) arrest. Patient and family safety must be prioritized, but your data suggests that background checks must be critically evaluated as a tool.
Your presentation was thorough and balanced.
Voice over was clear. I watched and listened twice.