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Estrada M, Hernandez PR, Schultz PW. A Longitudinal Study of How Quality Mentorship and Research Experience Integrate Underrepresented Minorities into STEM Careers. CBE LIFE SCIENCES EDUCATION 2018; 17:17/1/ar9. [PMID: 29351912 PMCID: PMC6007776 DOI: 10.1187/cbe.17-04-0066] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 05/12/2023]
Abstract
African Americans, Latinos, and Native Americans are historically underrepresented minorities (URMs) among science, technology, engineering, and mathematics (STEM) degree earners. Viewed from a perspective of social influence, this pattern suggests that URMs do not integrate into the STEM academic community at the same rate as non-URM students. Estrada and colleagues recently showed that Kelman's tripartite integration model of social influence (TIMSI) predicted URM persistence into science fields. In this paper, we longitudinally examine the integration of URMs into the STEM community by using growth-curve analyses to measure the development of TIMIS's key variables (science efficacy, identity, and values) from junior year through the postbaccalaureate year. Results showed that quality mentorship and research experience occurring in the junior and senior years were positively related to student science efficacy, identity, and values at that same time period. Longitudinal modeling of TIMSI further shows that, while efficacy is important, and perhaps a necessary predictor of moving toward a STEM career, past experiences of efficacy may not be sufficient for maintaining longer-term persistence. In contrast, science identity and values do continue to be predictive of STEM career pathway persistence up to 4 years after graduation.
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Hall AK, Mills SL, Lund PK. Clinician-Investigator Training and the Need to Pilot New Approaches to Recruiting and Retaining This Workforce. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1382-1389. [PMID: 28767499 PMCID: PMC5625951 DOI: 10.1097/acm.0000000000001859] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Clinician-investigators, also called physician-scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers. These challenges include the duration of required clinical training, limited or discontinuous research opportunities, high levels of educational debt, balancing the dual obligations and rewards of clinical care and research, competition for research funding, and the need for leadership development after training. Women and individuals from underrepresented racial and ethnic groups comprise a small percentage of this workforce.The authors summarize the recent literature on training for clinician-investigators, emphasizing approaches with encouraging outcomes that warrant broader implementation. Using this overview as background, they convened three workshops at the National Institutes of Health in 2016 to identify and refine key priorities for potential new pilot programs to recruit and retain the clinician-investigator workforce. From these workshops emerged three priorities for future pilot programs: (1) support for research in residency, (2) new research on-ramps for health professionals at multiple career stages, and (3) national networks to diversify and sustain clinician-investigator faculty. Implementation of any pilot program will require coordinated commitment from academic health centers, medical licensing/certification boards, professional societies, and clinician-investigators themselves, in addition to support from the National Institutes of Health.
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Parkhurst DC, Kayingo G, Fleming S. Redesigning Physician Assistant Education to Promote Cognitive Diversity, Inclusion, and Health Care Equity. J Physician Assist Educ 2017; 28 Suppl 1:S38-S42. [PMID: 28961621 DOI: 10.1097/jpa.0000000000000128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Bass RK. Role of Advocacy in the Future of Physician Assistant Education. J Physician Assist Educ 2017; 28 Suppl 1:S4. [PMID: 28961612 DOI: 10.1097/jpa.0000000000000152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Andriole DA, Yan Y, Jeffe DB. Mediators of Racial/Ethnic Disparities in Mentored K Award Receipt Among U.S. Medical School Graduates. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1440-1448. [PMID: 28767497 PMCID: PMC5617780 DOI: 10.1097/acm.0000000000001871] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Mentored K (K01/K08/K23) career development awards are positively associated with physicians' success as independent investigators; however, individuals in some racial/ethnic groups are less likely to receive this federal funding. The authors sought to identify variables that explain (mediate) the association between race/ethnicity and mentored K award receipt among U.S. Liaison Committee for Medical Education-accredited medical school graduates who planned research-related careers. METHOD The authors analyzed deidentified data from the Association of American Medical Colleges and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination II grants database for a national cohort of 28,690 graduates from 1997-2004 who planned research-related careers, followed through August 2014. The authors examined 10 potential mediators (4 research activities, 2 academic performance measures, medical school research intensity, degree program, debt, and specialty) of the association between race/ethnicity and mentored K award receipt in models comparing underrepresented minorities in medicine (URM) and non-URM graduates. RESULTS Among 27,521 graduates with complete data (95.9% of study-eligible graduates), 1,147 (4.2%) received mentored K awards (79/3,341 [2.4%] URM; 1,068/24,180 [4.4%] non-URM). All variables except debt were significant mediators; together they explained 96.2% (95%, CI 79.1%-100%) of the association between race/ethnicity and mentored K award. CONCLUSIONS Research-related activities during/after medical school and standardized academic measures largely explained the association between race/ethnicity and mentored K award in this national cohort. Interventions targeting these mediators could mitigate racial/ethnic disparities in the federally funded physician-scientist research workforce.
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Alexander K, Fahey Palma T, Nicholson S, Cleland J. 'Why not you?' Discourses of widening access on UK medical school websites. MEDICAL EDUCATION 2017; 51:598-611. [PMID: 28229477 DOI: 10.1111/medu.13264] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/12/2016] [Accepted: 12/15/2016] [Indexed: 05/16/2023]
Abstract
CONTEXT In the UK, applications to medicine from those in lower socio-economic groups remain low despite significant investments of time, interest and resources in widening access (WA) to medicine. This suggests that medical schools' core messages about WA may be working to embed or further reinforce marginalisation, rather than to combat this. Our objective was to investigate how the value of WA is communicated by UK medical schools through their websites, and how this may create expectations regarding who is 'suitable' for medicine. METHODS We conducted a critical discourse analysis of the webpages of UK medical schools in relation to WA. Our conceptual framework was underpinned by a Foucauldian understanding of discourse. Analysis followed an adapted version of Hyatt's analytical framework. This involved contextualising the data by identifying drivers, levers and warrants for WA, before undertaking a systematic investigation of linguistic features to reveal the discourses in use, and their assumptions. RESULTS Discourses of 'social mobility for the individual' justified WA as an initiative to support individuals with academic ability and commitment to medicine, but who were disadvantaged by their background in the application process. This meritocratic discourse communicated the benefits of WA as flowing one way, with medical schools providing opportunities to applicants. Conversely, discourses justifying WA as an initiative to benefit patient care were marginalised and largely excluded. Alternative strengths typically attributed to students from lower socio-economic groups were not mentioned, which implies that these were not valued. CONCLUSIONS Current discourses of WA on UK medical school websites do not present non-traditional applicants as bringing gains to medicine through their diversity. This may work as a barrier to attracting larger numbers of diverse applicants. Medical schools should reflect upon their website discourses, critically evaluate current approaches to encouraging applications from those in lower socio-economic groups, and consider avenues for positive change.
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Geller PA, Bonacquisti A, Barber J, Yeakel LH. Increasing racially and ethnically underrepresented women in medical school through an innovative program. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:187-189. [PMID: 28553829 PMCID: PMC5457788 DOI: 10.5116/ijme.5918.b789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 05/14/2017] [Indexed: 06/07/2023]
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Michalec B, Martimianakis MAT, Tilburt JC, Hafferty FW. Why It's Unjust to Expect Location-Specific, Language-Specific, or Population-Specific Service from Students with Underrepresented Minority or Low-Income Backgrounds. AMA J Ethics 2017; 19:238-244. [PMID: 28323604 DOI: 10.1001/journalofethics.2017.19.3.ecas1-1703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this case we meet Amanda, a medical student of Native and Latin American ethnicity who receives financial aid. Her friends are surprised by her interest in an elite residency program. They suggest, rather, that with her language skills, ethnic background, and interest in social justice, she has a responsibility to work with underserved patient populations. In our commentary, we consider issues raised by the case and explore Amanda's friends' underlying expectations and assumptions that perpetuate the very inequities that the resolution of the case purports to address. We also identify the role of privilege and address the "burden of expectation" that appears to be associated with underrepresented minority (URM) medical students and normative assumptions about their career paths.
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Mosdøl A, Lidal IB, Straumann GH, Vist GE. Targeted mass media interventions promoting healthy behaviours to reduce risk of non-communicable diseases in adult, ethnic minorities. Cochrane Database Syst Rev 2017; 2:CD011683. [PMID: 28211056 PMCID: PMC6464363 DOI: 10.1002/14651858.cd011683.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Physical activity, a balanced diet, avoidance of tobacco exposure, and limited alcohol consumption may reduce morbidity and mortality from non-communicable diseases (NCDs). Mass media interventions are commonly used to encourage healthier behaviours in population groups. It is unclear whether targeted mass media interventions for ethnic minority groups are more or less effective in changing behaviours than those developed for the general population. OBJECTIVES To determine the effects of mass media interventions targeting adult ethnic minorities with messages about physical activity, dietary patterns, tobacco use or alcohol consumption to reduce the risk of NCDs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, ERIC, SweMed+, and ISI Web of Science until August 2016. We also searched for grey literature in OpenGrey, Grey Literature Report, Eldis, and two relevant websites until October 2016. The searches were not restricted by language. SELECTION CRITERIA We searched for individual and cluster-randomised controlled trials, controlled before-and-after studies (CBA) and interrupted time series studies (ITS). Relevant interventions promoted healthier behaviours related to physical activity, dietary patterns, tobacco use or alcohol consumption; were disseminated via mass media channels; and targeted ethnic minority groups. The population of interest comprised adults (≥ 18 years) from ethnic minority groups in the focal countries. Primary outcomes included indicators of behavioural change, self-reported behavioural change and knowledge and attitudes towards change. Secondary outcomes were the use of health promotion services and costs related to the project. DATA COLLECTION AND ANALYSIS Two authors independently reviewed the references to identify studies for inclusion. We extracted data and assessed the risk of bias in all included studies. We did not pool the results due to heterogeneity in comparisons made, outcomes, and study designs. We describe the results narratively and present them in 'Summary of findings' tables. We judged the quality of the evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. MAIN RESULTS Six studies met the inclusion criteria, including three RCTs, two cluster-RCTs and one ITS. All were conducted in the USA and comprised targeted mass media interventions for people of African descent (four studies), Spanish-language dominant Latino immigrants (one study), and Chinese immigrants (one study). The two latter studies offered the intervention in the participants' first language (Spanish, Cantonese, or Mandarin). Three interventions targeted towards women only, one pregnant women specifically. We judged all studies as being at unclear risk of bias in at least one domain and three studies as being at high risk of bias in at least one domain.We categorised the findings into three comparisons. The first comparison examined mass media interventions targeted at ethnic minorities versus an equivalent mass media intervention intended for the general population. The one study in this category (255 participants of African decent) found little or no difference in effect on self-reported behavioural change for smoking and only small differences in attitudes to change between participants who were given a culturally specific smoking cessation booklet versus a booklet intended for the general population. We are uncertain about the effect estimates, as assessed by the GRADE methodology (very low quality evidence of effect). No study provided data for indicators of behavioural change or adverse effects.The second comparison assessed targeted mass media interventions versus no intervention. One study (154 participants of African decent) reported effects for our primary outcomes. Participants in the intervention group had access to 12 one-hour live programmes on cable TV and received print material over three months regarding nutrition and physical activity to improve health and weight control. Change in body mass index (BMI) was comparable between groups 12 months after the baseline (low quality evidence). Scores on a food habits (fat behaviours) and total leisure activity scores changed favourably for the intervention group (very low quality evidence). Two other studies exposed entire populations in geographical areas to radio advertisements targeted towards African American communities. Authors presented effects on two of our secondary outcomes, use of health promotion services and project costs. The campaign message was to call smoking quit lines. The outcome was the number of calls received. After one year, one study reported 18 calls per estimated 10,000 targeted smokers from the intervention communities (estimated target population 310,500 persons), compared to 0.2 calls per estimated 10,000 targeted smokers from the control communities (estimated target population 331,400 persons) (moderate quality evidence). The ITS study also reported an increase in the number of calls from the target population during campaigns (low quality evidence). The proportion of African American callers increased in both studies (low to very low quality evidence). No study provided data on knowledge and attitudes for change and adverse effects. Information on costs were sparse.The third comparison assessed targeted mass media interventions versus a mass media intervention plus personalised content. Findings are based on three studies (1361 participants). Participants in these comparison groups received personal feedback. Two of the studies recorded weight changes over time. Neither found significant differences between the groups (low quality evidence). Evidence on behavioural changes, and knowledge and attitudes typically found some effects in favour of receiving personalised content or no significant differences between groups (very low quality evidence). No study provided data on adverse effects. Information on costs were sparse. AUTHORS' CONCLUSIONS The available evidence is inadequate for understanding whether mass media interventions targeted toward ethnic minority populations are more effective in changing health behaviours than mass media interventions intended for the population at large. When compared to no intervention, a targeted mass media intervention may increase the number of calls to smoking quit line, but the effect on health behaviours is unclear. These studies could not distinguish the impact of different components, for instance the effect of hearing a message regarding behavioural change, the cultural adaptation to the ethnic minority group, or increase reach to the target group through more appropriate mass media channels. New studies should explore targeted interventions for ethnic minorities with a first language other than the dominant language in their resident country, as well as directly compare targeted versus general population mass media interventions.
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Goth US, Bergsli O, Johanesen EM. Integration of ethnic minorities during group-work for vocational teachers-in-training in health studies. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:31-36. [PMID: 28132033 PMCID: PMC5276708 DOI: 10.5116/ijme.5862.505a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To determine how to enhance integration of minority students in health education, and thereby improve intercultural communication skills and cultural sensitivity in a sample of health teacher students in Norway. METHODS After a group-work intervention and for a period of six months afterwards we followed an "action research" approach and observed 47 health teachers-in-training in their first year at the Oslo and Akershus University College during classroom interactions. Data were qualitative and comprised student self-reports and survey results along with observations from three teachers, the authors of the study. Data were analyzed using a constant comparative approach with opinion categorization and an open coding procedure, with separate analyses performed on observations from minority students, majority students, and teachers. RESULTS Both ethnic majority and minority students experienced an increase in intercultural knowledge and problem-solving ability after the experience of an early intervention in their first academic year of tertiary education. Students reacted favorably to the intervention and noted in class assessments both the challenges and rewards of overcoming cultural barriers. Teacher observation notes confirmed that early intervention led to an increase in interaction and cross-cultural engagement between minority and majority students compared to previous years' classes without the intervention. CONCLUSIONS Early classroom intervention to promote intercultural engagement can prevent clique formation along majority/minority lines. The method used here, tailored group assignments in ethnically diverse working groups at the very beginning of students' tertiary academic career, can be an effective approach to cultivating attitudes and skills fostering intercultural awareness and sensitivity.
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Segarra VA, Carrero-Martínez F, Shugart E. The Minorities Affairs Committee of the American Society for Cell Biology-Fostering the Professional Development of Scientists from Underrepresented Minority Backgrounds. CBE LIFE SCIENCES EDUCATION 2017; 16:16/2/le1. [PMID: 28389427 PMCID: PMC5459262 DOI: 10.1187/cbe.16-10-0288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
As part of its mission, the American Society for Cell Biology (ASCB) works to increase diversity in the scientific workforce, in part through the work of its Minorities Affairs Committee. It is for this reason that the ASCB was happy to welcome the special September 2016 issue of CBE-Life Sciences Education (LSE) focused on broadening participation. As a response to this special issue, we update our ASCB community and LSE readership on the society's efforts to broaden participation of underrepresented minorities in the biological sciences.
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Ballen CJ, Wieman C, Salehi S, Searle JB, Zamudio KR. Enhancing Diversity in Undergraduate Science: Self-Efficacy Drives Performance Gains with Active Learning. CBE LIFE SCIENCES EDUCATION 2017; 16:16/4/ar56. [PMID: 29054921 PMCID: PMC5749958 DOI: 10.1187/cbe.16-12-0344] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 07/03/2017] [Accepted: 07/11/2017] [Indexed: 05/18/2023]
Abstract
Efforts to retain underrepresented minority (URM) students in science, technology, engineering, and mathematics (STEM) have shown only limited success in higher education, due in part to a persistent achievement gap between students from historically underrepresented and well-represented backgrounds. To test the hypothesis that active learning disproportionately benefits URM students, we quantified the effects of traditional versus active learning on student academic performance, science self-efficacy, and sense of social belonging in a large (more than 250 students) introductory STEM course. A transition to active learning closed the gap in learning gains between non-URM and URM students and led to an increase in science self-efficacy for all students. Sense of social belonging also increased significantly with active learning, but only for non-URM students. Through structural equation modeling, we demonstrate that, for URM students, the increase in self-efficacy mediated the positive effect of active-learning pedagogy on two metrics of student performance. Our results add to a growing body of research that supports varied and inclusive teaching as one pathway to a diversified STEM workforce.
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Aikens ML, Robertson MM, Sadselia S, Watkins K, Evans M, Runyon CR, Eby LT, Dolan EL. Race and Gender Differences in Undergraduate Research Mentoring Structures and Research Outcomes. CBE LIFE SCIENCES EDUCATION 2017; 16:ar34. [PMID: 28550078 PMCID: PMC5459252 DOI: 10.1187/cbe.16-07-0211] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 02/09/2017] [Accepted: 02/16/2017] [Indexed: 05/11/2023]
Abstract
Participating in undergraduate research with mentorship from faculty may be particularly important for ensuring the persistence of women and minority students in science. Yet many life science undergraduates at research universities are mentored by graduate or postdoctoral researchers (i.e., postgraduates). We surveyed a national sample of undergraduate life science researchers about the mentoring structure of their research experiences and the outcomes they realized from participating in research. We observed two common mentoring structures: an open triad with undergraduate-postgraduate and postgraduate-faculty ties but no undergraduate-faculty tie, and a closed triad with ties among all three members. We found that men and underrepresented minority (URM) students are significantly more likely to report a direct tie to their faculty mentors (closed triad) than women, white, and Asian students. We also determined that mentoring structure was associated with differences in student outcomes. Women's mentoring structures were associated with their lower scientific identity, lower intentions to pursue a science, technology, engineering, and mathematics (STEM) PhD, and lower scholarly productivity. URM students' mentoring structures were associated with higher scientific identity, greater intentions to pursue a STEM PhD, and higher scholarly productivity. Asian students reported lower scientific identity and intentions to pursue a STEM PhD, which were unrelated to their mentoring structures.
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Williams SN, Thakore BK, McGee R. Providing Social Support for Underrepresented Racial and Ethnic Minority PhD Students in the Biomedical Sciences: A Career Coaching Model. CBE LIFE SCIENCES EDUCATION 2017; 16:16/4/ar64. [PMID: 29196425 PMCID: PMC5749966 DOI: 10.1187/cbe.17-01-0021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 09/07/2017] [Accepted: 09/11/2017] [Indexed: 05/23/2023]
Abstract
Improvement in the proportion of underrepresented racial and ethnic minorities (URMs) in academic positions has been unsatisfactory. Although this is a complex problem, one key issue is that graduate students often rely on research mentors for career-related support, the effectiveness of which can be variable. We present results from a novel academic career "coaching" intervention, one aim of which was to provide supplementary social support for PhD students, particularly those from underrepresented backgrounds. Coaching was delivered both within small groups and on an individual basis, with a diverse group of coaches and students coming from many universities. Coaches were provided with additional diversity training. Ninety-six semistructured interviews with 33 URM students over 3 years were analyzed using a qualitative framework approach. For most of the URM PhD students, coaching provided social support in the form of emotional, informational, and appraisal support. Coaching groups provided a noncompetitive environment and "community of support" within which students were able to learn from one another's experiences and discuss negative and stressful experiences related to their graduate school, lab, or career plans. This coached peer group model is capable of providing the social support that many URM students do not find at their home universities.
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Eisen A, Eaton DC. A Model for Postdoctoral Education That Promotes Minority and Majority Success in the Biomedical Sciences. CBE LIFE SCIENCES EDUCATION 2017; 16:16/4/ar65. [PMID: 29196426 PMCID: PMC5749967 DOI: 10.1187/cbe.17-03-0051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/21/2017] [Accepted: 09/19/2017] [Indexed: 05/12/2023]
Abstract
How does the United States maintain the highest-quality research and teaching in its professional science workforce and ensure that those in this workforce are effectively trained and representative of national demographics? In the pathway to science careers, the postdoctoral stage is formative, providing the experiences that define the independent work of one's first faculty position. It is also a stage in which underrepresented minorities (URMs) disproportionately lose interest in pursuing academic careers in science and, models suggest, a point at which interventions to increase proportions of URMs in such careers could be most effective. We present a mixed-methods, case study analysis from 17 years of the Fellowships in Research and Science Teaching (FIRST) postdoctoral program, to our knowledge the largest and longest continuously running science postdoctoral program in the United States. We demonstrate that FIRST fellows, in sharp contrast to postdocs overall, are inclusive of URMs (50% African American; 70% women) and as or more successful in their fellowships and beyond as a comparison group (measured by publication rate, attainment of employment in academic science careers, and eventual research grant support). Analysis of alumni surveys and focus group discussions reveals that FIRST fellows place highest value on the cohort-driven community and the developmental teaching and research training the program provides.
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Napoles A, Cook E, Ginossar T, Knight KD, Ford ME. Applying a Conceptual Framework to Maximize the Participation of Diverse Populations in Cancer Clinical Trials. Adv Cancer Res 2016; 133:77-94. [PMID: 28052822 PMCID: PMC5542779 DOI: 10.1016/bs.acr.2016.08.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The underrepresentation of ethnically diverse populations in cancer clinical trials results in the inequitable distribution of the risks and benefits of this research. Using a case study approach, we apply a conceptual framework of factors associated with the participation of diverse population groups in cancer clinical trials developed by Dr. Jean Ford and colleagues to increase understanding of the specific strategies, and barriers and promoters addressed by these strategies, that resulted in marked success in accrual of racially and ethnically diverse populations in cancer clinical research. Results indicate that the studies presented were able to successfully engage minority participants due to the creation and implementation of multilevel, multifaceted strategies that included: culturally and linguistically appropriate outreach, education, and research studies that were accessible in local communities; infrastructure to support engagement of key stakeholders, clinicians, and organizations serving minority communities; testimonials by ethnically diverse cancer survivors; availability of medical interpretation services; and providing infrastructure that facilitated the engagement in clinical research of clinicians who care for minority patient populations. These strategic efforts were effective in addressing limited awareness of trials, lack of opportunities to participate, and acceptance of engagement in cancer clinical trials. Careful attention to the context and population characteristics in which cancer clinical trials are conducted will be necessary to address disparities in research participation and cancer outcomes. These studies illustrate that progress on minority accrual into clinical research requires intentional efforts to overcome barriers at all three stages of the accrual process: awareness, opportunity, and acceptance of participation.
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Watters A, Bergstrom A, Sandefer R. PATIENT ENGAGEMENT AND MEANINGFUL USE: ASSESSING THE IMPACT OF THE EHR INCENTIVE PROGRAM ON CULTURAL COMPETENCE IN HEALTHCARE. JOURNAL OF CULTURAL DIVERSITY 2016; 23:114-120. [PMID: 29694753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper examines the importance and increasing need for health care practitioners to develop cultural competence in an effort to engage patients in their care to minimize the health disparities that are found in predominately ethnic minority populations. Although Meaningful Use requires data collection related to race and ethnicity, there is no evidence to support that the data is being used to engage patients in a culturally competent way. Lessons learned from the field of education regarding strategies used to develop cultural competence in the teaching profession can be applied in the health care field. This paper argues that cultural competence and patient engagement are clearly linked.
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Derck J, Zahn K, Finks JF, Mand S, Sandhu G. Doctors of tomorrow: An innovative curriculum connecting underrepresented minority high school students to medical school. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2016; 29:259-265. [PMID: 28406112 DOI: 10.4103/1357-6283.204219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Racial minorities continue to be underrepresented in medicine (URiM). Increasing provider diversity is an essential component of addressing disparity in health delivery and outcomes. The pool of students URiM that are competitive applicants to medical school is often limited early on by educational inequalities in primary and secondary schooling. A growing body of evidence recognizing the importance of diversifying health professions advances the need for medical schools to develop outreach collaborations with primary and secondary schools to attract URiMs. The goal of this paper is to describe and evaluate a program that seeks to create a pipeline for URiMs early in secondary schooling by connecting these students with support and resources in the medical community that may be transformative in empowering these students to be stronger university and medical school applicants. METHODS The authors described a medical student-led, action-oriented pipeline program, Doctors of Tomorrow, which connects faculty and medical students at the University of Michigan Medical School with 9th grade students at Cass Technical High School (Cass Tech) in Detroit, Michigan. The program includes a core curriculum of hands-on experiential learning, development, and presentation of a capstone project, and mentoring of 9th grade students by medical students. Cass Tech student feedback was collected using focus groups, critical incident written narratives, and individual interviews. Medical student feedback was collected reviewing monthly meeting minutes from the Doctors of Tomorrow medical student leadership. Data were analyzed using thematic analysis. RESULTS Two strong themes emerged from the Cass Tech student feedback: (i) Personal identity and its perceived effect on goal achievement and (ii) positive affect of direct mentorship and engagement with current healthcare providers through Doctors of Tomorrow. A challenge noted by the medical students was the lack of structured curriculum beyond the 1st year of the program; however, this was complemented by their commitment to the program for continued longitudinal development. DISCUSSION The authors propose that development of outreach pipeline programs that are context specific, culturally relevant, and established in collaboration with community partners have the potential to provide underrepresented students with opportunities and skills early in their formative education to be competitive applicants to college and ultimately to medical school.
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McGee R. "Biomedical Workforce Diversity: The Context for Mentoring to Develop Talents and Foster Success Within the 'Pipeline'". AIDS Behav 2016; 20 Suppl 2:231-7. [PMID: 27424004 DOI: 10.1007/s10461-016-1486-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Like all biomedical research fields, AIDS research needs the broadest diversity of experiences and perspectives among researchers in the field if creative advancements are to be achieved. Mentors and mentoring are the most important vehicles by which the talents of young scientists are developed. However, mentoring as a teaching and learning paradigm is very complex and idiosyncratic, and often inadvertently fails to provide the same quality and quantity of opportunity to aspiring scientists who are 'different' from those doing the mentoring. This article provides a theoretical and practical framework for understanding how differences of race, ethnicity, gender, skin color, social status and other identifiable characteristics can play into scientific development during mentoring 'within the pipeline'. It also serves as a foundation upon which mentoring in AIDS is considered by subsequent papers in this series. Finally, it goes beyond mentoring to propose systematic coaching as an effective complement to research mentoring to promote success, especially for individuals from underrepresented groups.
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Williams SN, Thakore BK, McGee R. Coaching to Augment Mentoring to Achieve Faculty Diversity: A Randomized Controlled Trial. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:1128-35. [PMID: 26675187 PMCID: PMC4909583 DOI: 10.1097/acm.0000000000001026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE The Academy for Future Science Faculty (the Academy) is a novel coaching intervention for biomedical PhD students designed to address limitations in previous efforts to promote faculty diversity. Unlike traditional research mentoring, the Academy includes both group and individual coaching, coaches have no research or evaluation roles with the students, and it is based on social science theories. The authors present a qualitative case study of one of the coaching groups and provide statistical analyses indicating whether one year in the Academy effects students' perceptions of the achievability and desirability of an academic career. METHOD The authors tested (July 2012-July 2013), with Northwestern University ethical approval, the Academy via a longitudinal randomized controlled trial. Participants were 121 latter-stage biomedical PhD students. The authors collected data via questionnaires, interviews, and meeting recordings. RESULTS The case study shows how group career coaching can effectively supplement traditional one-to-one research mentoring; provide new role models for underrepresented minority students; and provide theory-based lenses through which to engage in open conversations about race, gender, and science careers. Repeated-measures analysis of variance showed that perceived achievability increased in the Academy group from baseline to one-year follow-up (mean, 5.75 versus 6.39) but decreased in the control group (6.58 versus 5.81). Perceived desirability decreased significantly less (P < .05) in the Academy group (7.00 versus 6.36) than in the control group (7.83 versus 5.97). CONCLUSIONS Early results suggest that an academic career coaching model can effectively supplement traditional research mentoring and promote persistence toward academic careers.
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Lewis V, Martina CA, McDermott MP, Trief PM, Goodman SR, Morse GD, LaGuardia JG, Sharp D, Ryan RM. A Randomized Controlled Trial of Mentoring Interventions for Underrepresented Minorities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:994-1001. [PMID: 26717501 PMCID: PMC4925237 DOI: 10.1097/acm.0000000000001056] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE To conduct a randomized controlled trial to evaluate the effects of different mentoring interventions on the basic psychological need satisfaction of underrepresented minorities and women in academia. METHOD Participants were 150 mentor/protégé dyads from three academic medical centers and eight other colleges and universities in western and central New York, randomized from 2010 to 2013 into mentor training (using principles of self-determination theory); peer mentoring for protégés; mentor training and peer mentoring for protégés combined; or control/usual practice. Protégé participants were graduate students, fellows, and junior faculty who were from underrepresented groups based on race, ethnicity, gender, or disability.The primary analysis was a comparison of intervention effects on changes in protégés' satisfaction of their basic psychological needs (competence, autonomy, and relatedness) with their mentor. They completed a well-validated, online questionnaire every two months for one year. RESULTS There was no significant effect at the end of one year of either mentor training or peer mentoring on protégés' psychological basic need satisfaction with mentor specifically or at work in general. Exploratory analyses showed a significant effect of the mentor-based intervention on the protégés' overall psychological need satisfaction with their mentor at two months, the time point closest to completing mentor training. CONCLUSIONS This randomized controlled trial showed a potential short-term effect of mentor training on changing basic psychological need satisfaction of underrepresented scholars with their mentors. Despite the lack of sustained effect of either mentor training or peer mentoring, these short-term changes suggest feasibility and potential for future study.
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Peifer JS, Lawrence EC, Williams JL, Leyton-Armakan J. The culture of mentoring: Ethnocultural empathy and ethnic identity in mentoring for minority girls. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2016; 22:440-446. [PMID: 26866520 DOI: 10.1037/cdp0000078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Many mentoring programs place minority group mentees with majority group mentors. These programs aim to promote beneficial outcomes for their diverse participants. The present study explores mentors of color and White mentors' ethnocultural empathy and ethnic identities in association with their minority group mentees' ethnic identities. METHOD Our study examined 95 mentoring pairs of middle school girls of color and college student women from both majority and minority group cultural backgrounds. RESULTS A series of linear regressions revealed an association between mentors' ethnocultural empathy and EI exploration/commitment and minority group mentees' ethnic identity exploration, regardless of the mentors' majority group status. CONCLUSIONS The results of this preliminary study suggest that mentors' cultural identity and empathy may be linked with mentees' willingness to explore their own ethnic identities. We discuss the implications for mentoring programs that seek to build participants' ethnic identities and ethnocultural empathy. (PsycINFO Database Record
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Freeman BK, Landry A, Trevino R, Grande D, Shea JA. Understanding the Leaky Pipeline: Perceived Barriers to Pursuing a Career in Medicine or Dentistry Among Underrepresented-in-Medicine Undergraduate Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:987-93. [PMID: 26650673 DOI: 10.1097/acm.0000000000001020] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PURPOSE Representation of persons from diverse backgrounds remains a persistent challenge for medicine and dentistry workforces. Past research has focused on quantifying factors such as markers of educational achievement to explain the difficulty of increasing diversity within the professions. There has been less effort toward understanding the perspectives of undergraduate students on the threshold of applying to medical/dental school about distinct barriers to pursuing a medical or dental career and continuing through the training pipeline. METHOD In 2012 and 2013, the authors conducted a qualitative study of undergraduate students participating in the Tour for Diversity in Medicine, a program where minority physicians and dentists visit colleges with large fractions of minority students to encourage careers in the health professions. Focus groups were convened during the visits to examine perceived barriers to pursuing careers in medicine and dentistry and challenges identified through thematic content analysis. RESULTS Eighty-two students participated in discussions at 11 colleges visited between September 2012 and February 2013. Students described challenges including inadequate institutional resources (e.g., sparse clinical opportunities), strained personal resources (e.g., conflict arising from familial pressure), inadequate guidance and mentoring to assist with key career decisions, and societal barriers. For participants, these challenges caused them to question the viability of persisting in the pipeline to a medical or dental career. CONCLUSIONS Solving the issue of diversity in medicine and dentistry is multifaceted, but elucidated challenges from the undergraduate student perspective offer targeted areas where intervention may help remedy barriers and decrease pipeline leakiness.
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Gardner J. Barriers Influencing the Success of Racial and Ethnic Minority Students in Nursing Programs. J Transcult Nurs 2016; 16:155-62. [PMID: 15764639 DOI: 10.1177/1043659604273546] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Racial and ethnic minority students have high attrition rates in nursing school. This article describes a qualitative study that explored 15 minority nursing students’ experiences while enrolled in a predominantly White nursing program. In-depth interviews were conducted and eight themes emerged: loneliness and isolation, differentness, absence of acknowledgment of individuality from teachers, peers’ lack of understanding and knowledge about cultural differences, lack of support from teachers, coping with insensitivity and discrimination, determination to build a better future, and overcoming obstacles. This article provides a voice for minority nursing students whose experiences have not been heard. By understanding these students’ experiences and perspectives, nursing educators may be better able to meet their educational needs and increase graduation rates.
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