Diversity In Medical Education Research Articles

Social Diversity in Focus: Assessing the Impact of Socioeconomic Backgrounds and Work Experience on Psychological Well-Being and Academic Confidence Among German First-Year Medical Students

This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psychological constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < 0.001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = −6.690, p < 0.001), competence in natural sciences (t(321.045) = −3.178, p = 0.002), and online competence (t(319.429) = −2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < 0.001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < 0.001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from −0.235 to −0.404, p < 0.001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying experiences. The study highlights the value of a comprehensive approach in medical education, considering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.

Diversifying Skin Tone Representation in Medical School Dermatology Curriculum

AbstractThe lack of diversity in medical education contributes to disparities in dermatologic health outcomes, particularly for patients of color. This study evaluates second-year medical students’ comfort in diagnosing conditions in skin of color (SOC) and explores strategies to improve their confidence. We hypothesize that a curriculum enriched with SOC representation will enhance diagnostic skills. Surveys from Fall 2020 and Fall 2022 showed increased student comfort in diagnosing SOC. Fall 2022 students, exposed to more diverse dermatologic photos, demonstrated greater confidence. These findings underscore the necessity of integrating SOC content into medical curricula to address healthcare disparities.

Exploring the implicit meanings of 'cultural diversity': a critical conceptual analysis of commonly used approaches in medical education.

Existing approaches to cultural diversity in medical education may be implicitly based on different conceptualisations of culture. Research has demonstrated that such interpretations matter to practices and people concerned. We therefore sought to identify the different conceptualisations espoused by these approaches and investigated their implications for education. We critically reviewed 52 articles from eight top medical education journals and subjected these to a conceptual analysis. Via open coding, we looked for references to approaches, their objectives, implicit notions of culture, and to implementation practices. We iteratively developed themes from the collected findings. We identified several approaches to cultural diversity teaching that used four different ways to conceptualise cultural diversity: culture as 'fixed patient characteristic', as 'multiple fixed characteristics', as 'dynamic outcome impacting social interactions', and as 'power dynamics'. We discussed the assumptions underlying these different notions, and reflected upon limitations and implications for educational practice. The notion of 'cultural diversity' challenges learners' communication skills, touches upon inherent inequalities and impacts how the field constructs knowledge. This study adds insights into how inherent inequalities in biomedical knowledge construction are rooted in methodological, ontological, and epistemological principles. Although these insights carry laborious implications for educational implementation, educators can learn from first initiatives, such as: standardly include information on patients' multiple identities and lived experiences in case descriptions, stimulate more reflection on teachers' and students' own values and hierarchical position, acknowledge Western epistemological hegemony, explicitly include literature from diverse sources, and monitor diversity-integrated topics in the curriculum.

Advancing equity in spine surgery: unraveling the impact of affirmative action reversal

Affirmative action has been pivotal in addressing historical and systemic discrimination, particularly within healthcare. This paper delves into the impact of affirmative action policies on diversity in spine surgery, elucidating their critical role in fostering inclusivity and equal opportunities for individuals of underrepresented racial and ethnic groups. Historically, affirmative action has been instrumental in breaking down barriers to education and careers in medicine. Landmark cases such as Brown v. Board of Education have been influential in shaping these policies. However, the recent reversal of affirmative action poses a substantial threat to diversity in medical school admissions, potentially diminishing the presence of minority groups in spine surgery.We examine the historical foundation and transformative impact of affirmative action, focusing on key legal cases and their influence on educational and professional inclusivity. The current landscape of diversity in medical education and spine surgery highlights the role of affirmative action in cultivating an inclusive workforce. Counterarguments to affirmative action are critically evaluated, emphasizing the extensive benefits of diversity in enhancing patient care, driving research innovation, and informing policy advocacy. To counteract the adverse effects of the affirmative action reversal, we propose proactive initiatives, including targeted support for college students, medical students, residents, and practicing surgeons. These strategies are designed to ensure the recruitment and retention of a diverse workforce in spine surgery, thereby enriching patient care and advancing the field.

Developing a Diverse, Equitable, and Inclusive Curriculum for Trainees

The importance of diversity in medical education has become increasingly clear with strong evidence showing its benefits in helping to reduce healthcare disparities and mortality, increase access to medical care, increase the number of clinicians practicing in medically underserved and rural communities, increased patient trust, improvement in patient-physician relationships, and better financial outcomes for health systems. As leaders in graduate medical education, the Teaching and Training Committee of the American Association for Geriatric Psychiatry (AAGP) proposed the creation and development of a curriculum that fosters an inclusive learning environment for our fellows, promotes open dialogue among everyone involved in the clinical process, and establishes anti-bias principles as integral parts of geriatric psychiatry education. The AAGP Diversity, Equity, and Inclusion (DEI) Curriculum Development subcommittee was established to carry out this task. Themes to be explored include ageism, racism and bias, social determinants of health, cultural humility, ethics of decision making in older adults, substance use, neurobiology of stress, the mental health of minoritized older adults, psychosocial and cultural aspects of aging, and laws that impact this population.This session details the process of establishing this important curricular thread as a template or framework that can be used in Geriatric Psychiatry training programs throughout the country and, in acknowledgement of the importance of the workforce that cares for older adults, ensures that it is practical and applicable to clinicians in non-academic settings. The panelists will highlight DEI curricular development in one fellowship program from the view of a trainee, the impact on recruiting a more representative workforce, and how to improve trainee and faculty engagement within and across programs.This presentation is sponsored by the Teaching and Training Committee.

Geospatial Analysis of the Proportion of Persons Defined as Underrepresented in Medicine for Each Medical School and Their Surrounding Core-Based Statistical Area.

The current approach to increasing diversity in medical education fails to consider local community demographics when determining medical school matriculation. We propose that medical schools better reflect their surrounding community, both because racially/ethnically concordant physicians have been shown to provide better care and to repair the historical and current racist impacts of these institutions that have criminalized, displaced, and excluded local Black and Brown communities. In this study, we used geospatial analysis to determine that medical school enrollments generally fail to reflect their surrounding community, represented as their core-based statistical area, within which the individual medical schools reside.

Integrating diversity into the medical curriculum

In the field of medical education, diversity refers to the presence and representation of persons from a diversified range of personal backgrounds, experiences, and characteristics across the student community, faculty members, and employees in the institution. The scope of diversity in medical education is immense and it plays a vital role in creating an effective learning environment. Once students are exposed to a group of diverse students and patients during their undergraduate training, there is a significant improvement in cultural competence, which becomes crucial in our mission to deliver patient-centered care. Considering the merits of diversity in the medical curriculum for medical students, there is an indispensable need to take specific measures to ensure that diversity is integrated in the curriculum, as it will also ensure the delivery of equitable and culturally competent medical care. As important is to ensure the integration of diversity into medical curriculum, equal importance has to be given to the measurement of various initiatives that have been taken to promote diversity in medical education. In conclusion, diversity in medical education is the need of the hour to create a fruitful learning environment for medical students. This calls for the need to take measures for the integration of diversity into the medical curriculum and subsequently identify strategies and indicators to measure and monitor the progress of diversity initiatives in medical institutions.

Diversity in Medical Education: A Review Article

Background: Medical education and training differ substantially throughout the world. Several teaching approaches have been used in medical education, which is a dynamic area of educational research. Objective: To assess the process of medical education, its development, and related obstacles to having proper and enhanced medical education, as well as improvement in various aspects related to medical education. Conclusion: Medical educational programs play a critical role in preparing individuals for careers in medicine. These programs offer an organized curriculum that comprises preclinical & clinical education, electives and specialized training, professional development, and research. Keywords: Medical education, Problems, difficulties, upgrading.

The added value of free preparatory activities for widening access to medical education: a multi-cohort study

BackgroundMedical schools are reported to be less accessible to students with non-traditional backgrounds. These students face barriers when applying for and transitioning to medical school, which may be reduced by offering free preparatory activities. By equalizing access to resources, these activities are expected to reduce disparities in selection outcomes and early academic performance. In the present study, four free institutionally-provided preparatory activities were evaluated by comparing the demographic composition of participating and non-participating applicants. Additionally, the association between participation and selection outcomes and early academic performance was investigated for subgroups (based on sex, migration background and parental education).MethodsParticipants were applicants to a Dutch medical school in 2016-2019 (N = 3592). Free preparatory activities included Summer School (N = 595), Coaching Day (N = 1794), Pre-Academic Program (N = 217), and Junior Med School (N = 81), supplemented with data on participation in commercial coaching (N = 65). Demographic compositions of participants and non-participants were compared using chi-squared tests. Regression analyses were performed to compare selection outcomes (curriculum vitae [CV], selection test score, probability of enrolment) and early academic performance (first-course grade) between participants and non-participants of demographic subgroups, controlling for pre-university grades and participation in other activities.ResultsGenerally, no differences in sociodemographic compositions of participants and non-participants were found, but males participated less often in Summer School and Coaching Day. Applicants with a non-Western background participated less often in commercial coaching, but the overall participation rate was low and participation had negligible effects on selection outcomes. Participation in Summer School and Coaching Day were stronger related with selection outcomes. In some cases, this association was even stronger for males and candidates with a migration background. After controlling for pre-university grades, none of the preparatory activities were positively associated with early academic performance.ConclusionsFree institutionally-provided preparatory activities may contribute to student diversity in medical education, because usage was similar across sociodemographic subgroups, and participation was positively associated with selection outcomes of underrepresented and non-traditional students. However, since participation was not associated with early academic performance, adjustments to activities and/or curricula are needed to ensure inclusion and retention after selection.

The Effects of Humor in Clinical Settings on Medical Trainees and the Implications for Medical Educators: A Scoping Review.

Clinical settings represent the site of patient care and clinical training for medical students and residents. Both processes involve social interaction, and humor is a fundamental component of social interaction that remains underexplored in medical education. This study investigated the impact of humor on medical trainees in the context of the clinical learning environment and examined the implications for medical educators. Following scoping review methodology, the authors systematically searched six databases and Google Scholar in February 2021 and March 2022. Articles were screened and selected according to inclusion/exclusion criteria, and findings from included articles were synthesized using procedures of metasynthesis. Fifteen articles met inclusion criteria. Six themes emerged relating to the functions and effects of humor in clinical training settings: (1) managing emotions; (2) demarcating insider vs outsider status; (3) facilitating camaraderie; (4) ensuring conformity; (5) negotiating power differentials; and (6) fostering discrimination. The use of humor by medical educators plays an integral role in trainees' everyday experiences. Positive humor helps with coping and communication, while negative humor serves as an indirect medium for communicating ridicule and prejudice. Further research drawing on social psychology theories may identify ways to reduce effects of negative humor and promote well-being and diversity in medical education. The online version contains supplementary material available at 10.1007/s40670-023-01769-0.

EDITORIAL COMMENT

Gender bias within surgical subspecialties is striking and multifactorial in nature.1 Identification of potential upstream causes is important to shift trends towards diversity in medical education and surgical trainees. This study astutely quantifies the gender representation from mainstream information sources, where a significantly higher proportion of men are featured in educational content rendering a larger viewership for male educators and narrators. From the author's analysis and interpretation, gender bias amongst urologic educational content may impact the pipeline of trainees into formal medical training.

The quest for greater equity: a national cross-sectional study of the experiences of Black Canadian medical students.

Black medical students have been consistently underrepresented in Canadian medical schools, and data on the impact of discrimination on their medical education remain limited. In this cross-sectional study, we aimed to investigate the experiences of Black medical students through the Black Medical Students' Association of Canada (BMSAC). We developed a 63-item instrument around the domains of inclusion and diversity, wellness, discrimination, career advancement and diversity in medical education. The anonymous web-based questionnaire was sent to 128 medical students and first-year residents from all 17 Canadian medical schools via the BMSAC listserv. We obtained frequencies for demographic data and self-reported experiences. We received 52 responses. Of respondents, 59% had at least 1 personal encounter with discrimination in medical school. Discrimination was experienced in both clinical and academic contexts, notably from patients, peers and hospital staff. Students further along in their medical training were more likely to endorse having experienced discrimination in medical school. Most respondents had positive experiences with academic and clinical inclusion, as well as resiliency in the face of discrimination. However, most respondents had negative experiences relating to reporting discrimination, their well-being, career advancement, sentiments of minority tax and low diversity in medical education. We found that discrimination has important implications on the learning experiences of Black medical students surveyed from the BMSAC. This directly challenges the notion that Canadian medical schools are impervious to racism and highlights the need for advocacy and systemic changes to eliminate institutional racism.

Barriers to Diversity in Medical Education and Ways to Address Them

The need for diversity in medicine has gained increased attention in the last few years, with many medical schools and graduate medical education (GME) programs developing initiatives to address this (1). However, there has been only a modest change in attracting those underrepresented in medicine (URiM) and others from diverse backgrounds. By the year 2050, racial and ethnic minorities are projected to be the majority of the population, so it is critical that the workforce in healthcare is representative of the patients being treated (2).

A Consideration for Intersectional Framing Within Physiological Training

ObjectivesPrevious scholars have identified the need to increase diversity in medical education in terms of diversifying the student base, cultural competency curricula, and increasing health equity (Awosogba et al 2015; Sharma 2019; Hordjik 2019; Muntinga et al 2016). Establishing an intersectional theoretical framework, and other feminist theoretical frameworks, within medical education has been put forth, however literature indicates there are many obstacles in optimizing this implementation (Sharma 2019). In line with Bentabos et al (2014), we argue that much can be gained from addressing health equity at the biomedical undergraduate level, as healthcare is an institution of workers beyond the medical field (e.g. clinical research). Further, we posit that, given AAMC data points (AAMC Diversity in Medicine: Facts and Figures 2019), addressing diversity at the medical education level addresses the problem too late. Finally, the traditional medical education environment likely does not provide space to adequately develop a critical framing of cultural competency (Moore 2007; Muntinga et al 2016). As such, the purpose is to demonstrate how intersectional framing embedded within the Health Disparities track of a Biomedical Research Certificate provides a multidimensional analytical tool able to equip health & care workers, including future medical students to: (1) Increase a diversity minded environment in medical education. (2) Apply reflective and reflexive tools to professional and graduate biomedical aimed curricula thus impacting the organizational discourse overall.MethodsThematic analysis applied to Intersectional Methodology to identify the interaction of curricula content and scaffolded collaborative learning through the Research‐Intensive Community (RIC) Model (Desai et al 2008). The major themes we seek to identify and reflect upon are the Guideposts of Intersectionality laid out by Collins and Bilge (2016). The research question we seek to answer is: how does intersectional curricula within the RIC model interact to create a reflexive lens that can identify and act on inequity at the micro, macro and meso level. Practical Implications:The framework provided here can supply a starting point of implementation that goes beyond an additive framework or simple gesture to intercategorization.

Neurodiversity in medical education: How can we improve postgraduate learning for neurodiverse doctors?

Recently, there has been an important drive to increase diversity in medical education, which could potentially translate to improved outcomes for patients. Despite this, evidence on how to support neurodiverse doctors is limited. In this article the author reflects on their experience of postgraduate medical education as a doctor with Attention Deficit Hyperactivity Disorder (ADHD) and considers how the learning environment can be improved to help neurodiverse doctors reach their potential. This includes increasing the diversity of senior role models, using a cognitive apprenticeship model, employing teaching strategies which allow learners to elaborate their individual thought processes, and providing appropriate timely feedback.

Color lines: Disparities in pharmacy treatment, education, and practice

Color lines: Disparities in pharmacy treatment, education, and practice

NMA, NextGenU.org, and Enhancing Diversity in Medical Education Through Pipeline and Parallel Programs

NMA, NextGenU.org, and Enhancing Diversity in Medical Education Through Pipeline and Parallel Programs

How Financial Aid Policy Shortchanges American Healthcare

Issue Medical school debt is increasing. This trend may reduce access to medical school at a time of historic recognition of the need for greater openness and diversity in medical education by disadvantaging candidates who are underrepresented in medicine. The effects of high education-related debt for medical school needs greater consideration. Evidence: The implementation staircase model is employed as lens for understanding the impact of debt on trainees who are underrepresented in medicine and the healthcare system overall. Higher debt burdens are associated with worse mental health outcomes and increased odds of attrition in medical school. Trainees cite debt as a concern in considering primary care careers. Those with greater debt are less likely to pursue or remain in academic careers. Implications: The current financial aid system’s reliance on high debt burden undermines goals to improve the representation of underrepresented candidates in primary care and academic medicine. Alternative models requiring less debt could facilitate the creation of a more diverse workforce in healthcare.

Focusing on Diversity: A Regional Internal Medicine Residency Viewpoint on Underrepresented Minority Support, Retention, and Mentoring.

While the overall percentage of residents who withdraw (2.7%) or take extended leave (1.0%) are low, subgroup analysis has found that minority physicians are approximately 30% more likely to withdraw from residency than their white counterparts and 8 times more likely to take extended leave of absence. With ongoing national efforts to support diversity in medical education through increased recruitment of underrepresented in medicine (UiM) students to residency programs, there is paucity of data identifying specific experiences challenging or contributing to their overall resiliency. Better understanding of the lived experience of UiM residents will allow residency programs to create successful curricular programing and support structures for residents to thrive. We sought to understand UiM internal medicine residents' experiences during residency training. We used a retrospective review of focus group transcripts of UiM internal medicine residents from 5 academic institutions in 2017 (4 in North Carolina and 1 in Georgia). Of 100 self-identified UiM residents from 5 institutions, 59 participated in the focus groups. Using a consensus-based review of transcripts, 25 distinct codes in 8 parent code categories were determined. Two primary themes emerged: resilience and isolation. Three secondary themes-social support, mentorship, and external expectations and/or biases-served as mediators for the primary themes. UiM residents who became or were already resilient commonly experienced isolation at some time in their medical career, specifically during residency. Moreover, they could be influenced and positively or negatively affected by social support, mentorship, and external expectations and biases.

Belonging, Respectful Inclusion, and Diversity in Medical Education.

Belonging, Respectful Inclusion, and Diversity in Medical Education.