A tertiary approach to improving equity in health: quantitative analysis of the Māori and Pacific Admission Scheme (MAPAS) process, 2008-2012.
A tertiary approach to improving equity in health: quantitative analysis of the Māori and Pacific Admission Scheme (MAPAS) process, 2008-2012.
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DOI：
10.1186/s12939-015-0133-7
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发表时间：
2015-01-20
影响因子：
4.8
通讯作者：
Reid P
中科院分区：
文献类型：
--
作者：
Curtis E;Wikaire E;Jiang Y;McMillan L;Loto R;Airini;Reid P
要实现土著和少数民族人口的保健公平，就需要发展一支族裔多样化的保健工作队伍。这项研究探讨了新西兰奥特亚罗瓦奥克兰大学（UOA）针对毛利人和太平洋岛屿族裔申请人的护理、药学和健康科学（医学的前身）高等教育录取方案。应用认知和非认知的选择工具，包括多个迷你面试（MMI），检查。以土著Kaupapa毛利人方法为指导，对2008-2012年毛利人和太平洋岛屿族裔接纳计划进行分析。多元逻辑回归模型被用来确定最终的MAPAS建议的最佳起点的健康专业研究，即“CertHSc”（健康科学证书，桥接/基础），“学士”（学位水平）或“非FMHS”（医学和健康科学学院）的入学变量的预测效果。回归分析控制了访谈年份、性别和血统。在918名受调查者中，毛利人占35%（319人），太平洋岛屿族裔占58%（530人），毛利人/太平洋岛屿族裔占7%（68人）;离校生占71%（653人）;女性占72%（662人）。平均排名得分为167/320，比保证的FMHS学位提供低40-80个学分。不到一半的受访者被推荐为“CertHSc”47%（428），“学士”13%（117）和“非FMHS”38%（332）作为最佳起点。学士学位推荐与接触任何2门科学（OR：7.897，CI：3.855-16.175; p < 0.0001），更高的等级分数（OR：1.043，CI：1.034-1.052; p < 0.0001）和MAPAS数学测试的更高分数（OR：1.043，CI：1.028-1.059; p < 0.0001）之间存在强相关性。MMI电台有混合协会，学术准备和职业抱负更一致地与建议相关。我们的调查结果引起了人们对中等教育部门是否有能力为毛利族和太平洋岛屿族裔学生进行卫生专业学习做好充分准备的关注。建议为土著和少数民族卫生工作队伍的发展，采用多种选择工具（认知和非认知）的综合高等教育录取程序，并提供其他入学途径。在平等和土著文化背景下应用MMI可以支持对申请人在高等教育学习中取得成功的潜力进行全面评估。新的MAPAS录取程序可以为其他希望通过以公平为目标的录取程序扩大参与的高等教育机构提供一个范例。
Achieving health equity for indigenous and ethnic minority populations requires the development of an ethnically diverse health workforce. This study explores a tertiary admission programme targeting Māori and Pacific applicants to nursing, pharmacy and health sciences (a precursor to medicine) at the University of Auckland (UoA), Aotearoa New Zealand (NZ). Application of cognitive and non-cognitive selection tools, including a Multiple Mini Interview (MMI), are examined. Indigenous Kaupapa Māori methodology guided analysis of the Māori and Pacific Admission Scheme (MAPAS) for the years 2008–2012. Multiple logistic regression models were used to identify the predicted effect of admission variables on the final MAPAS recommendation of best starting point for success in health professional study i.e. ‘CertHSc’ (Certificate in Health Sciences, bridging/foundation), ‘Bachelor’ (degree-level) or ‘Not FMHS’ (Faculty of Medical and Health Sciences). Regression analyses controlled for interview year, gender and ancestry. Of the 918 MAPAS interviewees: 35% (319) were Māori, 58% (530) Pacific, 7% (68) Māori/Pacific; 71% (653) school leavers; 72% (662) females. The average rank score was 167/320, 40–80 credits below guaranteed FMHS degree offers. Just under half of all interviewees were recommended ‘CertHSc’ 47% (428), 13% (117) ‘Bachelor’ and 38% (332) ‘Not FMHS’ as the best starting point. Strong associations were identified between Bachelor recommendation and exposure to Any 2 Sciences (OR:7.897, CI:3.855-16.175; p < 0.0001), higher rank score (OR:1.043, CI:1.034-1.052; p < 0.0001) and higher scores on MAPAS mathematics test (OR:1.043, CI:1.028-1.059; p < 0.0001). MMI stations had mixed associations, with academic preparation and career aspirations more consistently associated with recommendations. Our findings raise concerns about the ability of the secondary education sector to prepare Māori and Pacific students adequately for health professional study. A comprehensive tertiary admissions process using multiple tools for selection (cognitive and non-cognitive) and the provision of alternative entry pathways are recommended for indigenous and ethnic minority health workforce development. The application of the MMI within an equity and indigenous cultural context can support a holistic assessment of an applicant’s potential to succeed within tertiary study. The new MAPAS admissions process may provide an exemplar for other tertiary institutions looking to widen participation via equity-targeted admission processes.
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