A Model for Postdoctoral Education That Promotes Minority and Majority Success in the Biomedical Sciences

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.

Applying a Conceptual Framework to Maximize the Participation of Diverse Populations in Cancer Clinical Trials

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.

PATIENT ENGAGEMENT AND MEANINGFUL USE: ASSESSING THE IMPACT OF THE EHR INCENTIVE PROGRAM ON CULTURAL COMPETENCE IN HEALTHCARE

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.

Doctors of tomorrow: An innovative curriculum connecting underrepresented minority high school students to medical school

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.

"Biomedical Workforce Diversity: The Context for Mentoring to Develop Talents and Foster Success Within the 'Pipeline'"

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.

Coaching to Augment Mentoring to Achieve Faculty Diversity: A Randomized Controlled Trial

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.

A Randomized Controlled Trial of Mentoring Interventions for Underrepresented Minorities

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.

The culture of mentoring: Ethnocultural empathy and ethnic identity in mentoring for minority girls

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

Understanding the Leaky Pipeline: Perceived Barriers to Pursuing a Career in Medicine or Dentistry Among Underrepresented-in-Medicine Undergraduate Students

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.

Barriers Influencing the Success of Racial and Ethnic Minority Students in Nursing Programs

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.

Can You Keep Them? Strategies to Attract and Retain Nursing Students From Diverse Populations: Best Practices in Nursing Education

There have been a number of articles addressing diversity in nursing programs and the nursing workforce. However, few of the programs have reviewed the best practices to attract and retain nursing students. This article delineates a number of programs and then makes suggestions for the best practices for nursing schools.

Short- and Long-Term Outcomes of Student Field Research Experiences in Special Populations

Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

Mentoring Strategies and Outcomes of Two Federally Funded Cancer Research Training Programs for Underrepresented Students in the Biomedical Sciences

The US is experiencing a severe shortage of underrepresented biomedical researchers. The purpose of this paper is to present two case examples of cancer research mentoring programs for underrepresented biomedical sciences students. The first case example is a National Institutes of Health/National Cancer Institute (NIH/NCI) P20 grant titled "South Carolina Cancer Disparities Research Center (SC CaDRe)" Training Program, contributing to an increase in the number of underrepresented students applying to graduate school by employing a triple-level mentoring strategy. Since 2011, three undergraduate and four graduate students have participated in the P20 SC CaDRe program. One graduate student published a peer-reviewed scientific paper. Two graduate students (50 %) have completed their master's degrees, and the other two graduate students will receive their degrees in spring 2015. Two undergraduate students (67 %) are enrolled in graduate or professional school (grad./prof. school), and the other graduate student is completing her final year of college. The second case example is a prostate cancer-focused Department of Defense grant titled "The SC Collaborative Undergraduate HBCU Student Summer Training Program," providing 24 students training since 2009. Additionally, 47 students made scientific presentations, and two students have published peer-reviewed scientific papers. All 24 students took a GRE test preparation course; 15 (63 %) have applied to graduate school, and 11 of them (73 %) are enrolled in grad./prof. school. Thirteen remaining students (54 %) are applying to grad./prof. school. Leveraged funding provided research-training opportunities to an additional 201 National Conference on Health Disparities Student Forum participants and to 937 Ernest E. Just Research Symposium participants at the Medical University of South Carolina.

Natural Mentoring Relationships and the Adjustment to College among Underrepresented Students

This study investigated associations between natural mentoring relationships and academic performance via psychological distress among underrepresented college students attending an elite predominantly White institution (PWI). Specifically, this study explored whether the quantity of natural mentors possessed upon college entry, the retention of natural mentors across the first year of college, and overall changes in the number of natural mentors possessed during the first year of college predicted improvements in students' semester grade point averages (GPAs) via reductions in psychological distress. Participants in this study included 336 first-year undergraduate students attending a selective PWI. Students were eligible to participate in this study if they were first-generation college students, students from economically disadvantaged backgrounds, or students from underrepresented racial/ethnic minority groups. Results of this study indicated that a greater number of retained natural mentoring relationships across the first year of college were associated with improvements in students' GPAs via reductions in symptoms of depression from the Fall to Spring semester. The results of this study suggest that institutional efforts to support the maintenance of preexisting mentoring relationships may be an effective approach to promoting the academic success of underrepresented college students during the first year of college.

Broadening Participation of Women and Underrepresented Minorities in STEM through a Hybrid Online Transfer Program

The Microbiology and Cell Science (MCS) Department at the University of Florida (UF) developed a new model of a 2 + 2 program that uses a hybrid online approach to bring its science, technology, engineering, and mathematics (STEM) curriculum to students. In this paradigm, 2-year graduates transfer as online students into the Distance Education in MCS (DE MCS) bachelor of science program. The program has broadened access to STEM with a steadily increasing enrollment that does not draw students away from existing on-campus programs. Notably, half of the DE MCS students are from underrepresented minority (URM) backgrounds and two-thirds are women, which represents a greater level of diversity than the corresponding on-campus cohort and the entire university. Additionally, the DE MCS cohort has comparable retention and academic performance compared with the on-campus transfer cohort. Of those who have earned a BS through the DE MCS program, 71% are women and 61% are URM. Overall, these data demonstrate that the hybrid online approach is successful in increasing diversity and provides another viable route in the myriad of STEM pathways. As the first of its kind in a STEM field, the DE MCS program serves as a model for programs seeking to broaden their reach.

Increasing URM Undergraduate Student Success through Assessment-Driven Interventions: A Multiyear Study Using Freshman-Level General Biology as a Model System

Xavier University of Louisiana leads the nation in awarding BS degrees in the biological sciences to African-American students. In this multiyear study with ∼5500 participants, data-driven interventions were adopted to improve student academic performance in a freshman-level general biology course. The three hour-long exams were common and administered concurrently to all students. New exam questions were developed using Bloom's taxonomy, and exam results were analyzed statistically with validated assessment tools. All but the comprehensive final exam were returned to students for self-evaluation and remediation. Among other approaches, course rigor was monitored by using an identical set of 60 questions on the final exam across 10 semesters. Analysis of the identical sets of 60 final exam questions revealed that overall averages increased from 72.9% (2010) to 83.5% (2015). Regression analysis demonstrated a statistically significant correlation between high-risk students and their averages on the 60 questions. Additional analysis demonstrated statistically significant improvements for at least one letter grade from midterm to final and a 20% increase in the course pass rates over time, also for the high-risk population. These results support the hypothesis that our data-driven interventions and assessment techniques are successful in improving student retention, particularly for our academically at-risk students.

Analysis of Postdoctoral Training Outcomes That Broaden Participation in Science Careers

Postdoctoral training is an optimal time to expand research skills, develop independence, and shape career trajectories, making this training period important to study in the context of career development. Seeding Postdoctoral Innovators in Research and Education (SPIRE) is a training program that balances research, teaching, and professional development. This study examines the factors that promote the transition of postdocs into academic careers and increase diversity in science, technology, engineering, and mathematics. Data indicate that SPIRE scholars (n = 77) transition into faculty positions at three times the national average with a greater proportion of underrepresented racial minorities (URMs) and females represented among SPIRE scholars. Logistic regression models indicate that significant predictors are the intended career track at the start of the postdoctoral training and the number of publications. Factors necessary for successful transition are teaching experience as independent instructors, professional development opportunities, and the experience of balancing teaching with research. Scholars' continued commitment to increasing diversity in their faculty roles was demonstrated by their attainment of tenure-track positions at minority-serving institutions, continued mentorship of URMs, and engagement with diversity initiatives. These results suggest that a postdoctoral program structured to include research, teaching, and diversity inclusion facilitates attainment of desired academic positions with sustained impacts on broadening participation.

Medical education resources initiative for teens program in baltimore: A model pipeline program built on four pillars

BACKGROUND

Less than 6% of U.S. medical school applicants are African-American. The lack of diversity among physicians, by race as well as other measures, confers a negative impact on the American healthcare system because underrepresented minority (URM) physicians are more likely to practice in underserved communities and deliver more equitable, culturally competent care.

METHODS

MERIT (Medical Education Resources Initiative for Teens) is a nonprofit organization based in Baltimore, Maryland, USA. MERIT prepares URM high school students for health careers by providing a holistic support system for seven consecutive years. The program model, which utilizes weekly Saturday sessions, summer internships, and longitudinal mentoring, is built on four foundational pillars: (1) Ignite the Fire, (2) Illuminate the Path, (3) Create the Toolkit, and (4) Sustain the Desire.

RESULTS

Since 2011, MERIT has supported 51 students in the Baltimore City Public School System. For the past two years, 100% (n = 14) of MERIT seniors enrolled in universities, compared to only 20.2% of Baltimore City students overall. While it is too early to know whether MERIT alumni will realize their goals of becoming healthcare professionals, they are currently excelling in universities and over 75% (n = 17) are still planning to pursue graduate degrees in health-related fields.

DISCUSSION

After piloting an effective program model, MERIT now has three key priorities moving forward: (1) Creating a sustainable and thriving organization, (2) increasing the number of scholars the program supports in Baltimore, and (3) expanding MERIT to other cities.

INCREASING THE REPRESENTATION OF THE BLACK POPULATION IN THE HEALTH PROFESSIONS IN CANADA

Increased representation of the Black population in the health care system is central to decrease health disparities, enhance access to services, and improve health outcomes and quality of care. Current strategies for recruitment and retention of the Black population in higher education in the health fields are explored. The added value of mentorship programs are presented as a promising approach for addressing the high rates of attrition of the Black population in health professional education institutions.

FACULTY DIVERSITY AND TENURE IN HIGHER EDUCATION

There is a need for minority faculty in higher education due to the increase in minority high school graduates and higher education enrollees. Faculty members who are tenured have the ability to advocate for cultural equality in their institutions and serve as mentors for students. Minority faculty whose tenured process is hindered by inequality may also be unable to become a proper mentor for minority students. The purpose of this paper is to identify why faculty diversity will lead to increased student success and comfort, minority mentors, minority research, and equity advocacy, and representation from all minority groups.

Preparation of Underrepresented Males for Scientific Careers: A Study of the Dr. John H. Hopps Jr. Defense Research Scholars Program at Morehouse College

Equal representation within higher education science, technology, engineering, and mathematics (STEM) fields and the STEM workforce in the United States across demographically diverse populations is a long-standing challenge. This study uses two-to-one nearest-neighbor matched-comparison group design to examine academic achievement, pursuit of graduate science degree, and classification of graduate institution attended by students participating in the Hopps Scholars Program (Hopps) at Morehouse College. Hopps is a highly structured enrichment program aimed at increasing participation of black males in STEM fields. Morehouse institutional records, Hopps Program records, and National Student Clearinghouse data were used to examine differences between Hopps and non-Hopps STEM graduates of Morehouse. Two-way sample t tests and chi-square tests revealed significant differences in academic achievement, likelihood of STEM degree pursuit, and the classification of graduate institutions attended by Hopps versus non-Hopps students. Hopps Scholars were significantly more likely than non-Hopps STEM graduates both to pursue STEM doctoral degrees and to attend doctoral-granting institutions with higher research activity. The Hopps Program's approach to training black male students for scientific careers is a model of success for other programs committed to increasing the number of black males pursuing advanced degrees in STEM.

Science That Matters: The Importance of a Cultural Connection in Underrepresented Students' Science Pursuit

Recent research suggests that underrepresented minority (URM) college students, and especially first-generation URMs, may lose motivation to persist if they see science careers as unable to fulfill culturally relevant career goals. In the present study, we used a mixed-methods approach to explore patterns of motivation to pursue physical and life sciences across ethnic groups of freshman college students, as moderated by generational status. Results from a longitudinal survey (N = 249) demonstrated that freshman URM students who enter with a greater belief that science can be used to help their communities identified as scientists more strongly over time, but only among first-generation college students. Analysis of the survey data were consistent with content analysis of 11 transcripts from simultaneously conducted focus groups (N = 67); together, these studies reveal important differences in motivational characteristics both across and within ethnicity across educational generation status. First-generation URM students held the strongest prosocial values for pursuing a science major (e.g., giving back to the community). URM students broadly reported additional motivation to increase the status of their family (e.g., fulfilling aspirations for a better life). These findings demonstrate the importance of culturally connected career motives and for examining intersectional identities to understand science education choices and inform efforts to broaden participation.

Improving Underrepresented Minority Student Persistence in STEM

Members of the Joint Working Group on Improving Underrepresented Minorities (URMs) Persistence in Science, Technology, Engineering, and Mathematics (STEM)-convened by the National Institute of General Medical Sciences and the Howard Hughes Medical Institute-review current data and propose deliberation about why the academic "pathways" leak more for URM than white or Asian STEM students. They suggest expanding to include a stronger focus on the institutional barriers that need to be removed and the types of interventions that "lift" students' interests, commitment, and ability to persist in STEM fields. Using Kurt Lewin's planned approach to change, the committee describes five recommendations to increase URM persistence in STEM at the undergraduate level. These recommendations capitalize on known successes, recognize the need for accountability, and are framed to facilitate greater progress in the future. The impact of these recommendations rests upon enacting the first recommendation: to track successes and failures at the institutional level and collect data that help explain the existing trends.