Institute of Medical Education Research Rotterdam (IMERR), Erasmus MC - University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Med Educ. 2015 Jan;49(1):124-33. doi: 10.1111/medu.12536.
Medical schools in Western societies seek measures to increase the diversity of their student bodies with respect to ethnicity and social background. Currently, little is known about the effects of different selection procedures on student diversity.
This prospective cohort study aimed to determine performance differences between traditional and non-traditional (i.e. ethnic minority and first-generation university candidates) medical school applicants in academic and non-academic selection criteria.
Applicants in 2013 (n = 703) were assessed on academic and non-academic selection criteria. They also completed a questionnaire on ethnicity and social background. Main outcome measures were 'not selected' (i.e. failure on any criteria), 'failure on academic criteria' and 'failure on non-academic criteria'. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression analysis for ethnic subgroups (Surinamese/Antillean, Turkish/Moroccan/African, Asian, Western) compared with Dutch applicants, adjusted for age, gender, additional socio-demographic variables (first-generation immigrant, first-generation university applicant, first language, medical doctor as parent) and pre-university grade point average (pu-GPA). Similar analyses were performed for first-generation university applicants.
Compared with Dutch applicants, Surinamese/Antillean applicants underperformed in the selection procedure (failure rate: 78% versus 57%; adjusted OR 2.52, 95% CI 1.07-5.94), in particular on academic criteria (failure rate: 66% versus 34%; adjusted OR 3.00, 95% CI 1.41-6.41). The higher failure rate of first-generation university applicants on academic criteria (50% versus 37%; unadjusted OR 1.66, 95% CI 1.18-2.33) was partly explained by additional socio-demographic variables and pu-GPA. The outcome measure 'failure on non-academic criteria' showed no significant differences among the ethnic or social subgroups.
The absence of differences on non-academic criteria was promising with reference to increasing social and ethnic diversity; however, the possibility that self-selection instigated by the selection procedure is stronger in applicants from non-traditional backgrounds cannot be ruled out. Further research should also focus on why cognitive tests might favour traditional applicants.
西方社会的医学院校正在寻求措施，以增加其学生群体在种族和社会背景方面的多样性。目前，人们对不同选拔程序对学生多样性的影响知之甚少。
本前瞻性队列研究旨在确定传统和非传统（即少数民族和第一代大学生）医学专业申请人在学术和非学术选拔标准上的表现差异。
2013 年的申请人（n=703）根据学术和非学术选拔标准进行评估。他们还完成了一份关于种族和社会背景的问卷。主要观察指标是“未被选中”（即在任何标准上失败）、“学术标准失败”和“非学术标准失败”。使用逻辑回归分析估计了不同种族亚组（苏里南/荷属安的列斯群岛、土耳其/摩洛哥/非洲、亚洲、西方）与荷兰申请人相比的优势比（OR）及其 95%置信区间（CI），调整了年龄、性别、其他社会人口统计学变量（第一代移民、第一代大学生、第一语言、医生父母）和大学预科平均绩点（pu-GPA）。对第一代大学生申请者也进行了类似的分析。
与荷兰申请人相比，苏里南/荷属安的列斯群岛申请人在选拔程序中表现不佳（失败率：78%对 57%；调整后的 OR 2.52，95%CI 1.07-5.94），尤其是在学术标准上（失败率：66%对 34%；调整后的 OR 3.00，95%CI 1.41-6.41）。第一代大学生申请者在学术标准上的高失败率（50%对 37%；未调整的 OR 1.66，95%CI 1.18-2.33）部分归因于其他社会人口统计学变量和 pu-GPA。种族或社会亚组之间在“非学术标准失败”这一观察指标上没有显著差异。
在非学术标准上没有差异是令人鼓舞的，因为这有助于增加社会和种族多样性；然而，不能排除选拔程序的自我选择对非传统背景的申请人的影响更强的可能性。进一步的研究还应关注为什么认知测试可能有利于传统申请人。
