Barriers and facilitators for Native Americans' access to and completion of nursing education: A PRISMA-guided scoping review.

Abstract

<h4>Aim</h4>To explore barriers and facilitators influencing Native American students' access to and completion of nursing education.<h4>Background</h4>Native American students remain underrepresented in nursing. Persistent challenges in academic preparation, financial support and culturally unresponsive learning environments contribute to disparities in entry and completion of nursing programs. Culturally grounded supports may improve educational outcomes.<h4>Design</h4>This scoping review was conducted using PRISMA-ScR guidelines and Arksey and O'Malley's five-stage framework.<h4>Methods</h4>A comprehensive search was conducted across PubMed, CINAHL, Health Source, Education Source, ERIC, Education Database, ProQuest and Google Scholar. Eligible studies (n = 36) were published in English between 1980 and 2024 and included findings related to Native American participation in nursing education. Data were extracted and synthesized using a descriptive analytical framework.<h4>Results</h4>Barriers were organized into five categories: academic under preparation, financial hardship, cultural misalignment in curricula and institutional climate, lack of social support and limited access to culturally responsive infrastructure. Facilitators included structured academic support, culturally grounded institutional programs, family and community encouragement, peer and Indigenous mentorship and financial assistance aligned with cultural values. Few studies disaggregated outcomes specifically for Native American students.<h4>Conclusion</h4>Native American students face persistent, multifaceted barriers to entering and completing nursing programs. However, culturally tailored interventions, particularly those combining academic, financial and cultural support, can promote retention and success. Nursing education programs should embed culturally responsive strategies and strengthen institutional commitment to supporting Native students.