Abstract
Workforce diversity reduces health care disparities and enhances patientcentred
care. Holistic admission review (HAR) in student nurse selection has been
proposed to increase diversity in nursing. Nursing has been slow in the uptake of HAR.
Additionally, South Africa nursing programme admissions primarily emphasise academic
metrics. The focus on academic measures leads to the exclusion of academically successful,
diverse and competent candidates.
Objectives: This study sought to analyse the concept of HAR in the context of nursing
education, addressing the question of the conceptual meaning of HAR in this context.
Method: Walker and Avant’s eight-step concept analysis framework was implemented to
establish a clear understanding of HAR. A scoping review, using Preferred Reporting Items
for Systematic reviews and Meta-Analyses guidelines, was conducted across 10 databases and
institutional repositories. Sources were screened using Covidence, and data extraction
followed the conceptual analysis framework.
Results: Out of 8558 screened sources, 84 were included in the analysis. Holistic admission
review requires policies to address the use of a diverse selection committee using a standardised
rubric to assess both cognitive and non-cognitive attributes.
Conclusion: Holistic admission review is triggered by a lack of diversity and bias in selection
processes. The HAR framework consists of four phases and ultimately fosters an inclusive
student body equipped to deliver high-quality patient care. Holistic admission review
enhances student retention, empowers future leaders and strengthens the nursing workforce.
Contribution: This concept analysis will refine the research questions for subsequent phases,
including exploring HAR’s meaning and developing a nursing education model for equitable
student selection in South Africa.