URM Students Research Articles

Assessment of Psychometric Properties of an Oral Health Care Measure of Cultural Competence Among Dental Students Using Rasch Partial Credit Model.

Reliability, validity, and feasibility of the only validated oral health care measure of cultural competence, the Knowledge, Efficacy, and Practices Instrument (KEPI), have been confirmed. However, the instrument's psychometric properties including item and person reliability, category response functioning, and scale targeting, as well as differential scale functioning for subgroups, have not yet been examined. The aim of this study was to test the psychometric properties of KEPI among dental students using Rasch Partial Credit Model to determine if this model provided broader valid information that cannot be demonstrated according to Classical Test Theory. A total 1,290 dental students in the first or final semester at four U.S. dental schools were invited to participate in the study in 2016. Of those, 1,231 individuals completed the survey, for a 95.4% response rate. The participants were 613 males and 618 females and 889 non-underrepresented minority (URM) and 342 URM students. The Rasch Partial Credit Model assessed the psychometric properties of KEPI's 20 items/three subscales. Differential scale functioning was found in the Culture-Centered Practice and Efficacy of Assessment subscales. Four items were endorsed differentially by gender; four items were endorsed differentially by URM/non-URM students. This study examined the psychometric properties of the KEPI using Rasch analysis to assess differential item functioning by dental student gender and race. The results provided valid evidence for the high internal reliability, measurement properties, and unidimensionality for the KEPI domains, ideal targeting, and well response category functioning, showing that the KEPI is a reliable instrument for measuring the subscales Knowledge of Diversity, Culture-Centered Practice skills, and Efficacy of Assessment for health care providers.

Predicting Law School Enrollment: The Strategic Use of Financial Aid to Craft a Class

In this study, we explore what factors predict student decisions to enroll at law schools and how the probability of enrollment varies across students with various profiles and conditions. To find the predictors of enrollment and differences in the probability of enrollment across groups, we employ a logistic regression model using the institutional data obtained from one of the top-ranked law schools in the nation. After estimating the logistic regression model, the probabilities of enrollment are calculated for students with specific profiles and conditions based on the coefficients generated by the logistic regression analysis. The findings reveal many factors that are associated with the probability of enrollment at this law school. Particularly, students with higher academic qualifications, underrepresented minority status, the most selective undergraduate school, STEM background, and previous applicant status have a lower probability of enrollment compared to their respective counterparts. Simulation analysis findings show that the increase in financial aid does not increase the probability of enrollment for URM students and that out-of-state and international students are more sensitive to financial aid increases than in-state students. Admissions and enrollment management offices at individual institutions could apply this exercise with their own data to understand who is more or less likely to enroll and how their students with various profiles respond differently to various financial aid offers and recruitment efforts. It is our hope that this article is used as an example to other law schools to leverage their institutional data to create enrollment models that will help make more effective admission decision making.

The Health Equity Scholars Program: Innovation in the Leaky Pipeline

Despite attempts to increase enrollment of under-represented minorities (URMs: primarily Black/African American, Hispanic/Latino, and Native American students) in health professional programs, limited progress has been made. Compelling reasons to rectify this situation include equity for URMs, better prepared health professionals when programs are diverse, better quality and access to health care for UMR populations, and the need for diverse talent to tackle difficult questions in health science and health care delivery. However, many students who initiate traditional "pipeline" programs designed to link URMs to professional schools in health professions and the sciences, do not complete them. In addition, program requirements often restrict entry to highly qualified students while not expanding opportunities for promising, but potentially less well-prepared candidates. The current study describes innovations in an undergraduate pipeline program, the Health Equity Scholars Program (HESP) designed to address barriers URMs experience in more traditional programs, and provides evaluative outcomes and qualitative feedback from participants. A primary outcome was timely college graduation. Eighty percent (80%) of participants, both transfer students and first time students, so far achieved this outcome, with 91% on track, compared to the campus average of 42% for all first time students and 58-67% for transfers. Grade point averages also improved (p=0.056) after program participation. Graduates (94%) were working in health care/human services positions and three were in health-related graduate programs. Creating a more flexible program that admits a broader range of URMs has potential to expand the numbers of URM students interested and prepared to make a contribution to health equity research and clinical care.

Walking the Path Together from High School to STEM Majors and Careers: Utilizing Community Engagement and a Focus on Teaching to Increase Opportunities for URM Students

Despite decades of efforts to increase the participation of women and people from underrepresented minority groups (URM) in science and math majors and careers, and despite the increasing diversification of the US population as a whole (Planty et al in National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education, Washington, DC, 2008), participation in STEM majors and STEM careers (including STEM teaching) remains stubbornly male and white (Landivar in American Community Survey Reports, ACS-24, U.S. Census Bureau, Washington, DC, 2013; National Science Foundation and National Center for Science and Engineering Statistics in Special Report NSF 15-311, Arlington, VA, 2015). This paper describes a project with two central goals: (1) to provide opportunities for URM high school students to engage in authentic science and math inquiry with the support of skilled college undergraduate mentors in the hope that these experiences will encourage these high school students to choose and persist in pursuing careers in STEM fields and, even if they do not choose those careers, to feel confident making complex, science or math-based decisions in their everyday lives and (2) to help the mentors (young people, mostly STEM majors) see teaching as a vital, intellectually challenging career that can provide them the opportunity to work for social justice in their communities. While it is unlikely that any one experience will help young people overcome the long odds that face them as they consider either path, our analysis suggests that projects of this kind can make a meaningful contribution to the effort.

Engaging Diverse Students in Statistical Inquiry: A Comparison of Learning Experiences and Outcomes of Under-Represented and Non-Underrepresented Students Enrolled in a Multidisciplinary Project-Based Statistics Course

Introductory statistics needs innovative, evidence-based teaching practices that support and engage diverse students. To evaluate the success of a multidisciplinary, project-based course, we compared experiences of under-represented (URM) and non-underrepresented students in 4 years of the course. While URM students considered the material more difficult than non-URM students, URM students demonstrated similar levels of increased confidence in applied skills and interest in follow up courses as non-URM students. URM students were found to be twice as likely as non-URM students to report that their interest in conducting research increased. Increasing student confidence and interest gives all students a welcoming place at the table that will afford the best hope for achieving the kind of statistical literacy necessary for interdisciplinary research.

The Role of Altruistic Values in Motivating Underrepresented Minority Students for Biomedicine.

Understanding how cultural values influence undergraduate students' science research experiences and career interest is important in efforts to broaden participation and to diversify the biomedical research workforce. The results from our prospective longitudinal study demonstrated that underrepresented minority student (URM) research assistants who see the altruistic value of conducting biomedical research feel more psychologically involved with their research over time, which, in turn, enhances their interest in pursuing a scientific research career. These altruistic motives are uniquely influential to URM students and appear to play an important role in influencing their interest in scientific research careers. Furthermore, seeing how research can potentially affect society and help one's community does not replace typical motives for scientific discovery (e.g., passion, curiosity, achievement), which are important for all students. These findings point to simple strategies for educators, training directors, and faculty mentors to improve retention among undergraduate URM students in biomedicine and the related sciences.

Preparing minority scientists and engineers (220.1)

African Americans comprise about 14 percent of college students in the U.S. but earn only ~ 7 percent of bachelors degrees and ~3 percent of doctoral degrees in STEM fields. We have developed a system for diversifying our undergraduate and graduate STEM programs that focuses on high expectations and achievement. More than 1200 students have participated in the undergraduate Meyerhoff Scholars Program since its inception in 1988. More than 90% of the participants who graduated received STEM degrees, with > 40% matriculating to top PhD or MD‐PhD programs, 20% to STEM Masters programs, and 20% entered professional (mainly MD) programs. The talent pool is large: we typically receive more than 2,200 nominations and more than 500 applications annually (about half URM students), mainly from Maryland and the Mid‐Atlantic area. URM participation in STEM PhD programs has also increased dramatically over the past 15 years (from 3% to 17%), and URM PhD production has increased from 3 graduates in the 10 years preceding our program to more than 50 graduates over the past 10 years. The program currently includes 80 URM doctoral students, and the retention rate over the past 8 years is greater than 90%. More than 40 former UMBC undergraduate and graduate students now hold academic faculty positions in the U.S. The program components of the undergraduate and graduate programs should be replicable at other interested academic institutions.

Preparing Underrepresented Students of Color for Doctoral Success: The Role of Undergraduate Institutions

Introduction Numerous education stakeholders have acknowledged the absence of minority faculty within the academy (Knowles & Harleston, 1997; Moody, 2004; Myers & Turner, 2004; Tierney & Sallee, 2008), an observation that has often been publicly attributed to the small number of doctoral degree recipients of color. Significantly, the number of doctoral degree recipients from American universities has increased by approximately 3.5 percent since 1958, when the Survey of Earned Doctorates (SED) first began collecting data (Hoffer et al., 2006). Commensurate with this overall growth are increases in the number of doctoral degrees conferred upon underrepresented minority (1) students (URM): according to the Integrated Postsecondary Education Data System [IPEDS] (National Center for Education Statistics [NCES], 2009), the number of doctorates attained by Asian/Pacific Islanders, African Americans, Latina/os, and American Indian/Alaskan Natives doubled between the 1980s and 2005 (Schmitt, 2005). In this article, we explore the role of undergraduate institutions in preparing URM students for doctoral success and describe the baccalaureate origins of doctoral degree recipients of color in the United States. Aggregate descriptive data provide evidence that racial/ethnic diversification of the professoriate is in progress; however, gains by group vary considerably. In the past twenty years the increases in doctoral degree attainment for Asian/Pacific Islanders (2), Latina/os, African Americans, and Native American/American Indians between 1986 and 2006 were 194, 140, 101, and 19 percent, respectively (Hoffer, Hess, Welch, & Williams, 2007). Thus, while the overall gains seem favorable, it is important to note that certain minority populations are not gaining as quickly as others. Additionally, there remains a substantial gap between the number of URM and White doctoral degree recipients (Hoffer et al., 2007). In fact, although White doctoral degree attainment only increased by three percent between 1986 and 2006 (from 20,640 to 21,280), Whites still represent approximately 80 percent of all doctoral degrees conferred in the United States (Hoffer et al., 2007). Of note is the reality that the vast majority of doctoral degrees for all racial/ethnic groups are produced at a relatively small number of institutions. Although 417 institutions conferred at least one doctoral degree in 2006, the top ten institutions produced 47 percent of the 45,596 doctoral degree conferred that year (Hoffer et al., 2007). A similar trend exists for URM doctoral degree recipients. Between 2002 and 2006, 30 percent of all doctorates awarded to Asians/Pacific Islanders, 24 percent of doctorates awarded to all Native Americans/American Indians, 21 percent of doctorates awarded to Latina/os, and 18 percent of doctorates awarded to African Americans were granted by just 10 institutions, per ethnic/racial group relatively few (Hoffer et al., 2007). Along these lines, the gap in doctoral degree attainment between students of color and Whites attending highly selective doctoral degree-granting institutions is particularly wide (Brazziel & Brazziel, 1997; Hood & Freeman, 1995). For example, in 2007, African Americans and Latina/os each made up only three percent of doctoral degree recipients at Ivy League universities; Asian/Pacific Islanders comprised only six percent (NCES, 2009). This is especially important because research suggests that individuals attending highly selective graduate programs may be more likely to enter academe (Eide, Brewer, & Ehrenberg, 1998). In sum, the data suggest that the increase in URMs receiving doctoral degrees has improved the academy's opportunities to diversify, making more URMs eligible for faculty positions than ever before. Yet despite the consistent, albeit small, progress in the number of URMs receiving doctoral degrees, challenges remain in converting those URM doctoral degree recipients into faculty members, which has implications for education as well as public policy. …

Do Research Activities During College, Medical School, and Residency Mediate Racial/Ethnic Disparities in Full-Time Faculty Appointments at U.S. Medical Schools?

To determine whether postsecondary research experiences (in college, medical school, and residency) and other variables mediate racial/ethnic disparities in U.S. medical school graduates' full-time faculty appointments in academic medicine. Individualized, deidentified records for 1994-2000U.S. medical school matriculants who graduated with MDs before 2005, completed graduate medical education before 2009, and had data for all variables were examined for potential mediators of racial/ethnic disparities in full-time faculty appointments using the SAS macro "MEDIATE" for estimation and statistical inference. Controlling for gender, parents' occupation, and graduation year, the authors estimatedthe effects of potential mediators in separate models comparing Asian/Pacific Islander (PI) versus underrepresented minority (URM; including African American, Hispanic, and Native American/Alaska Native) graduates and white versus URM graduates. Of 82,758 eligible graduates, 62,749 (75.8%) had complete data; of these, 11,234 (17.9%) had full-time faculty appointments, including 18.4% (7,848/42,733) of white, 18.8% (2,125/11,297) of Asian/PI, and 14.5% (1,261/8,719) of URM graduates. Proportion of total race/ethnicity effect on full-time faculty appointment explained by all mediators was 66.0% (95% CI, 44.7%-87.4%) in a model comparing Asians/PIs with URMs and 64.8% (95% CI, 52.2%-77.4%) in one comparing whites with URMs. Participation in postsecondary research activities, authorship during medical school, academic achievement, and faculty career intentions at graduation were among the significant mediators explaining the effect of race/ethnicityonfull-time faculty appointment. Postsecondary research experiences for URM students are among the mediators of racial/ethnic disparities in full-time faculty appointments and, therefore, may increase academic medicine faculty diversity.

Self‐Efficacy Ratings of URM Students who Return to a STEM Summer Research Program

The Opportunities in Genomics Research (OGR): Undergraduate Scholars program is a comprehensive, research‐intensive summer program focuses on increasing the number of underrepresented minorities in genomics and related areas. To assess the unique features of OGR, students were given pre‐ and post‐ evaluations at the start and end of the 8‐week program (n=44). Focus groups were conducted to address specific program components. Students were also tracked yearly using an online tracking system, iBiosketch. The groups of students were defined as return students (more than one summer with OGR), first‐time students (first research experience was OGR) or non‐return (only one summer with OGR). Our data shows that students who were return or first‐time students served as co‐authors of publications at 11.4 % compared to 4.5% non‐return students. Using a Likert scale, confidence ratings in areas such as: interpreting data, communicating scientific findings orally, reading and interpreting literature, trended toward an increase in confidence for return students compared to others. While these studies are ongoing, our data indicate that there may be tangible benefits for URM students to return to a summer program that helps retain them in the STEM pipeline.

How Can We Ease the Social Isolation of Underrepresented Minority Students?

In Reply: We agree with Dr. Boateng and Dr. Thomas that social isolation is an important barrier to success among underrepresented minority students (URMs), and we feel for their frustration at the complexity and slow progress on this important issue. Cultural distance for URM students is likely greater than for non-URM students and can affect socialization and interpersonal skills that are valued during medical school such as networking, self-promotion, and reflection. Curricula that foster cultural competency, explore issues of diversity, and promote professionalism are essential to prepare students to care for patients of all backgrounds and circumstances. However, students' problems with interprofessional behavior, social norms, and support mechanisms cannot be fully modified through curricular changes. Nor can medical school curricula overcome, or be responsible to teach methods to overcome, cultural and social barriers due to socioeconomic status, cultural distance, and social norms. These complex barriers make themselves known through negative social and psychological experiences that students have encountered throughout their lives. Strategies to deal with these barriers are much more specific to the individuals involved and cannot be addressed through melding and generalizing students' experiences in a structured manner. But there are ways that medical schools can help. For example, schools can offer support through increasing the number of URM students, having student activities about diversity, and providing social and cultural outlets. Also, having a place where students feel comfortable discussing their experiences of cultural and social barriers is critically important. And helping students address frustrations with poor clinical evaluations and learn concrete approaches to improve the evaluations is also essential. Other approaches include having well-staffed offices for diversity, having student societies, and encouraging students to use their external support systems, including family and religion. We encourage medical schools to simultaneously focus on curriculum and “downstream” social factors important for URM students' success. Medical schools are optimally positioned to partner on a long-term basis with local pipeline institutions and form new models for the future. We should not be discouraged and should continue to improve student1 and faculty diversity2 and seek innovative strategies to ensure academic success for URM students. Kara Odom Walker, MD, MPH, MSHS Assistant clinical professor, Department of Family and Community Medicine, University of California, San Francisco, School of Medicine, San Francisco, California; [email protected]. Gerardo Moreno, MD, MSHS Assistant clinical professor, Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.

The Role of Enrichment Programs in Strengthening the Academic Pipeline to Dental Education

Academic enrichment programs can be essential to efforts by dental schools to recruit and enroll underrepresented minority students (URM). Many summer academic enrichment programs provide additional preparation and support to URM students in the sciences. They often address barriers to student achievement such as unevenness in academic preparation, less rigorous educational background, family influence on preparation aspiration and success, unease in a new setting, and lack of professional role models. To be successful, these programs must address both the academic and social complexities of URM students and often require a range of programs to meet the specific needs of different student groups.

The Leaky Pipeline: Factors Associated With Early Decline in Interest in Premedical Studies Among Underrepresented Minority Undergraduate Students

To determine the causes among underrepresented racial and ethnic minority groups (URM) of a decline in interest during the undergraduate years in pursuing a career in medicine. From fall 2002 through 2007, the authors conducted a longitudinal study of 362 incoming Stanford freshmen (23% URM) who indicated on a freshman survey that they hoped to become physicians. Using a 10-point scale of interest, the authors measured the change in students' levels of interest in continuing premedical studies between the beginning of freshman year and the end of sophomore year. Follow-up interviews were conducted with 68 participants, approximately half of whom had experienced decreases in interest in continuing as premeds, and half of whom who had experienced increases in interest. URM students showed a larger decline in interest than did non-URM students; women showed a larger decline than did men, independent of race or ethnicity. The authors found no association between scholastic ability as measured by SAT scores and changes in level of interest. The principal reason given by students for their loss of interest in continuing as premeds was a negative experience in one or more chemistry courses. Students also identified problems in the university's undergraduate advising system as a contributor. Largely because of negative experiences with chemistry classes, URM students and women show a disproportionate decline in interest in continuing in premedical studies, with the result that fewer apply to medical school.

What Enhances Underrepresented Minority Recruitment to Dental Schools?

This study examined the factors influencing the proportion of underrepresented minority students (URM) in dental schools. Using a comprehensive recruitment model, it considered the relative importance of community characteristics (population demographics, oral health policies, dental care system, and university environment), dental school characteristics (Pipeline-supported, mission, and financing), and community-based dental education (CBDE) characteristics of the dental school on recruitment of URM students. Data come from a national survey of dental school seniors and a variety of publicly available sources. Three outcome variables measure URM recruitment: percent URM, percent Hispanic, and percent African American in the first year of dental school. Multivariable results revealed that the most important factors predicting a higher percent URM in first-year classes were a higher proportion of URM clinical faculty and graduating students' perceptions that their clinical rotation experience improved their ability to care for diverse groups. For percent Hispanic in the first year, a higher proportion of URM clinical faculty and students spending more time in clinical rotations predicted greater Hispanic recruitment. Graduating students' perceptions that they were less prepared to treat diverse groups were directly associated with the proportion of Hispanic students in the class. For a higher percent of African Americans in the first-year class, the most important factors were a higher proportion of blacks in the county, support from the national Pipeline program, and graduating students' perceptions of better preparedness to integrate cultural differences into treatment planning. Higher total financial aid awarded by the school was negatively associated with recruitment of African Americans. Results suggest some improved URM recruitment strategies for dental schools.

Pipeline, Profession, and Practice Program: Evaluating Change in Dental Education

This article describes the conceptual and analytical framework that will be used to assess the effectiveness of the Pipeline, Profession, and Practice: Community-Based Dental Education Program. The evaluation will use a mixed method qualitative and quantitative data collection, analysis, and triangulation. Baseline measures are reported using data from the 2003 ADEA survey of dental school seniors. Baseline measures show the dental schools are confronting a major recruitment challenge that will require short and long pipeline efforts to attract and retain underrepresented and low-income (URM/LI) persons. Gaps were found between the perceptions of URM and non-URM students in the adequacy of the curricula. The majority of all seniors described the current extramural clinical rotations as positive experiences, but URMs were more likely to report the experience improved their ability to care for diverse groups.

Evaluation of an early medical school selection program for underrepresented minority students.

To evaluate the academic performance in the first two years of medical school of underrepresented minority students (URMS) who participated in an early identification and admission program. The study involved 39 early-selection URM students who entered one medical school from 1992 through 1999. Successful completion of the first two years of medical school and passing the United States Medical Licensure Examination (USMLE) Step 1 were correlated with Scholastic Aptitude Test I (SAT I) scores and Medical College Admission Test (MCAT) scores. The students were required to maintain an overall grade-point average of at least 3.0 on a 4.0 scale to remain in the program. Students who had combined scores of at least 900 on the SAT I and total scores of at least 18 on the three multiple-choice sections of the MCAT had more success completing the first two years of medical school and passed USMLE Step 1 with greater frequency than did those students who scored at lower levels on these tests. An early-selection program for URM students can identify early in their academic careers students who can complete the first two years of medical school and pass the USMLE Step 1.