Longitudinal Evaluation of Research Career Intentions among Students Underrepresented in Medicine

医学领域代表性不足的学生研究职业意向的纵向评估

• 批准号: 10750271
• 负责人: Dowin Boatright
• 金额: $ 72.87万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-23 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10750271
• 关键词: Affect; Alaska Native; American; American Indians; Association of American Medical Colleges; Black race; Clinical; Clinical Medicine; Clinical Sciences; Complement; Data; Development; Discrimination; Disparity; Doctor of Philosophy; Engineering; Ethnic Origin; Ethnic Population; Evaluation Research; Evolution; Exclusion; Funding; Future; Growth; Hispanic; Individual; Influentials; Institution; Intention; Interview; Leadership; Measures; Medical Education; Medical Students; Medicine; Mentorship; Methodology; Methods; Native Hawaiian or Other Pacific Islander; Patients; Physicians; Play; Positioning Attribute; Publishing; Qualitative Methods; Race; Reduce health disparities; Reporting; Research; Research Design; Residencies; Role; Sampling; Scholarship; Schools; Scientist; Shapes; Students; Surveys; Time; Training; Underrepresented Populations; Underrepresented Students; United States National Academy of Sciences; United States National Institutes of Health; Work; career; cohort; ethnic diversity; ethnic minority; experience; follow-up; health inequalities; innovation; interest; matriculation; medical schools; novel; perceived discrimination; pressure; programs; racial diversity; racial minority; racial population; racism; success

The physician-scientist workforce struggles to attract racial and ethnic groups historically underrepresented in medicine (URiM), including individuals who are Black, Hispanic, American Indian or Alaskan Native, Native Hawaiian, and other Pacific Islander. Because the national research agenda is often set by those conducting scientific studies, increasing the diversity of the physician-scientist workforce has the potential to bring greater focus on issues that disproportionately affect racial and ethnic minorities. Notably, racial and ethnic minority physician-scientists are more likely to pursue scholarship related to racial/ethnic health inequities. Prior work has demonstrated that research career intentions evolve significantly during medical school and that research career intentions at graduation are associated with tangible downstream measures of research success, including subsequent receipt of NIH funding. Our preliminary data show marked disparities between URiM and non-URiM students in research career intentions during medical school. We propose a 5-year, longitudinal, mixed-methods study to identify trajectories (i.e., evolution over time) of research career intentions, and determinants thereof, in 400 URiM (based on race and ethnicity) students matriculating into MD programs and to compare these with trajectories and determinants in 200 non-URiM students. We will examine experiences at the individual level, such as quality of mentorship and experiences of discrimination, as well as experiences at the institutional level, such as URiM representation in the school's leadership. The aims are to: 1) identify trajectories of research career intentions among URiM students throughout medical school training and make comparisons with trajectories in non-URiM students; 2) identify student- and institutional-level predictors of research career intention trajectories in URiM students and make comparisons with predictors in non-URiM students; 3) use qualitative methods to characterize nuanced, lived experiences related to evolution of research career intentions. Quantitative and qualitative data will be integrated using a convergent approach at the levels of study design, analysis, interpretation, and reporting of results. This study is significant because it will identify potentially influential timepoints and predictors of change in research career intention among URiM MD students that can be used to increase the racial and ethnic diversity of the physician-scientist workforce. This diversity can help mitigate health disparities by broadening the national research agenda and increasing research participation by underrepresented populations. Our assessment of the roles of racism and discrimination in shaping research career intentions is innovative. The impact of our findings will be enhanced by our strong partnerships with national organizations, including medical education leaders at the National Academies of Sciences, Engineering, and Medicine (NASEM) and Association of American Medical Colleges (AAMC) to disseminate our findings. This study will form the basis of a future proposal to conduct follow-up of the cohort assembled in this study through residency and into early- and mid-career positions.

医师科学家劳动力努力吸引种族和种族的人数不足 医学（URIM），包括黑人，西班牙裔，美洲印第安人或阿拉斯加本地人的人 夏威夷人和其他太平洋岛民。因为国家研究议程通常是由指挥的人制定的 科学研究，增加医师科学家劳动力的多样性有可能带来更大的 专注于不成比例地影响种族和少数民族的问题。值得注意的是，种族和少数民族 医师科学家更有可能获得与种族/种族健康不平等有关的奖学金。 先前的工作表明，在医学院期间，研究职业意图发生了很大的发展，并且 毕业时的研究职业意图与切实的下游研究指标有关 成功，包括随后收到NIH资金。我们的初步数据显示 医学院研究职业意图的Urim和非棕褐色学生。 我们提出了一项为期5年的纵向混合方法研究，以识别 研究职业意图及其决定因素，在400个Urim（基于种族和种族）的学生中 在200个非北美 学生。我们将研究个人层面的经验，例如指导质量和经验 歧视以及机构一级的经验，例如学校的Urim代表 领导。目的是：1）确定Urim学生中研究职业意图的轨迹 在整个医学院培训中，并与非乌里姆学生的轨迹进行了比较； 2）识别 乌里姆学生中研究职业意图轨迹的学生和机构级别的预测指标 与非棕色学生的预测因子进行比较； 3）使用定性方法来表征细微差别，生活 与研究职业意图的演变有关的经验。定量和定性数据将集成 在研究设计，分析，解释和结果报告的水平上使用收敛方法。 这项研究很重要，因为它将确定潜在影响的时间点和变化的预测指标 Urim MD学生的研究职业意图，可用于增加种族和种族多样性 医师科学家劳动力。这种多样性可以通过扩大国家来帮助减轻健康差异 研究议程并增加了代表人群不足的研究参与。我们对 种族主义和歧视在塑造研究职业意图中的作用是创新的。我们发现的影响 我们与国家组织的牢固合作伙伴关系将增强 美国国家科学，工程和医学学院（NASEM）和美国医学协会 大学（AAMC）传播我们的发现。这项研究将构成未来的提议的基础 在本研究中通过居住和早期和中期职位组装的队列随访。