UC Davis

The United States nursing workforce faces a dual crisis: a growing shortage of nurses and a persistent lack of racial and ethnic diversity that undermines health equity. Structural barriers rooted in the K–12 public education system — including inequitable resource distribution, harmful social scripts about who belongs in healthcare, and limited mentorship — suppress the self-efficacy and career aspirations of students from historically marginalized communities. While pathway programs have successfully diversified the workforces of engineering, medicine, and dentistry, rigorous evidence for nursing-specific pathway programs remains scarce.This dissertation examines whether the Summer Health Institute for Nursing Exploration and Success (SHINES), a two-week immersive nursing pathway program at the University of California, Davis, increases students’ self-efficacy, sense of belonging, and readiness to pursue nursing. Grounded in Social Cognitive Career Theory (SCCT) and the principles of Cultural Humility, SHINES serves high school and early community college students recruited from historically redlined, under-resourced communities. The study employed an exploratory, descriptive qualitative design, conducting eight focus groups with 29 SHINES alumni from the 2022–2025 cohorts. Data were analyzed using Braun and Clarke’s thematic analysis approach.Three themes emerged from the data. The first, From Uncertainty to Direction, describes how participants developed clarity about the nursing role and the multiple pathways into the profession. The second, The Nursing ‘Why’, captures the development of a personal and professional motivation for nursing, fueled by hands-on clinical experiences, exposure to diverse nurse role models, and a health equity curriculum. The third, Readiness for the Nursing Journey, reflects participants’ growing confidence in navigating the educational decisions required to become nurses. Across all three themes, participants reported meaningful increases in perceived self-efficacy and belonging — both theorized by SCCT as essential antecedents to career commitment.Findings suggest that immersive, equity-focused pathway programs may cultivate the upstream conditions needed to grow and diversify the nursing workforce. This study offers a methodological framework for linking early educational interventions to long-term workforce outcomes and contributes to a nascent but critical evidence base for nursing pathway programs. Implications for nurse educators, program designers, and policymakers are discussed.