Effect of pipelines on enrollment of underrepresented students in healthcare: A systematic review

Study Design: Systematic review. Objective: To evaluate the effectiveness of pipelines in increasing enrollment of underrepresented students into graduate healthcare programs. Materials and Methods: Eight databases (CINAHL, Medline, Nursing and Allied Health Premium, OVID, ScienceDirect, Education Index, Proquest, Google Scholar) were searched in October 2021. Inclusion criteria: studies investigating the effect of pipeline programs on enrollment of underrepresented students in individual graduate healthcare programs within the USA. Studies evaluating a pipeline program where students went on to be enrolled at another institution were excluded. Two reviewers screened articles, extracted data and assessed study quality, with a third reviewer resolving disputes. Primary data collected was percentage of underrepresented students enrolled per cohort. Additional data included the profession of the healthcare program, entrance point into the pipeline and interventions used in the pipeline. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for pre/post studies with no control group. Results: After duplicates were removed, 1524 studies were evaluated, with five studies included. Following initiation of a pipeline, fifteen institutions reported increased enrollment of underrepresented students, three reported decreased enrollment, and one reported no change. All studies were of low quality for drawing associative conclusions. Conclusion: Pipelines may be effective at increasing underrepresented students enrolled in graduate healthcare programs. Results are limited in scope, representing only medical and dental programs, and lacking in long-term outcomes.