Ensuring a fair and equitable selection of students to serve society's health care needs
Ensuring a fair and equitable selection of students to serve society's health care needs
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DOI：
10.1111/medu.12506
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发表时间：
2015-01-01
影响因子：
6
通讯作者：
Tekian, Ara
中科院分区：
文献类型：
--
作者：
Girotti, Jorge A.;Park, Yoon Soo;Tekian, Ara
ObjectivesThis研究旨在评估选择和方案干预指定的有条件录取（CA），这是为了扩大获得医学教育的个人代表性不足的民族，种族和农村群体。进一步的目的是建立实践的原则，旨在增加获得代表性不足的群体的基础上，在2005年CA的方案变化的实证比较，并量化与其implementation.MethodsData相关的成本录取的所有学生在1999年和2009年之间（n=3227）进行了汇编;这些资料包括人口统计资料，大学本科成绩，医学院表现指标，以及有关荣誉，住院实习安排和医学博士学位完成情况的资料。为了检查CA干预的结果，学生被分为两组，分别在1999-2004年和2005-2009年期间通过CA倡议录取，并分析差异。与CA相关的成本也calculated.ResultsThere是274名学生录取通过CA（所有录取的8.5%）在1999-2009年，其中，81.4%是来自代表性不足的民族或种族背景，18.6%是来自农村背景。这些学生比非CA学生有更多的科学课程时间，较低的科学和累积平均成绩（GPA），以及较低的平均医学院入学考试（MCAT）分数。然而，在2005年至2009年期间，CA队列的首次通过率和美国医师执照考试（USMLE）第1步和USMLE第2步临床知识的平均分数显着增加。每名学生产生的额外费用在849美元和3801.ConclusionsInterventions之间，如CA可以显着增加医生队伍的多样性。干预措施必须基于对学术准备的仔细评估，以及有助于成功管理医学教育严格性的能力的非学术因素。此外，学生的选择和随后的专业发展必须培养致力于解决不同社区的医疗保健需求。公平必须被看作是一种手段，增加公平的未来医学生和社区居民，可能受益于最终的服务。
ObjectivesThis study aimed to evaluate a selection and programmatic intervention designated Conditional Admissions' (CA), which is intended to expand access to medical education for individuals from under-represented ethnic, racial and rural groups. Further aims were to establish principles of practice designed to increase access for under-represented groups based on an empirical comparison of programmatic changes made to CA in 2005, and to quantify the costs associated with its implementation.MethodsData for all students admitted between 1999 and 2009 (n=3227) were compiled; these included demographic data, undergraduate college performance grades, medical school performance indicators, and information on honours, residency placement and md degree completion. To examine the outcomes of the CA intervention, students were divided into two cohorts of those admitted through the CA initiative during 1999-2004 and 2005-2009, respectively, and analysed for differences. Costs associated with CA were also calculated.ResultsThere were 274 students admitted through CA (8.5% of all admittances) during 1999-2009; of these, 81.4% were from under-represented ethnic or racial backgrounds and 18.6% were from rural backgrounds. These students had more hours of science coursework, lower science and cumulative grade point averages (GPAs), and lower mean Medical College Admission Test (MCAT) scores than non-CA students. However, first-time pass rates and mean scores on the US Medical Licensing Examination (USMLE) Step 1 and USMLE Step 2 Clinical Knowledge increased significantly in the CA cohort during 2005-2009. Additional costs incurred per student ranged between US$849 and US$3801.ConclusionsInterventions such as CA can significantly increase diversity in the physician workforce. Interventions must be based on careful assessment of academic preparedness, as well as on non-academic factors that contribute to ability to successfully manage the rigors of medical education. Furthermore, the selection and subsequent professional development of students must nurture commitment to addressing the health care needs of diverse communities. Equity must be viewed as a means of increasing fairness for both prospective medical students and the residents of communities that may benefit from the eventual service.Discuss ideas arising from the article at discuss.