Ballejos Marlene P, Rhyne Robert L, Parkes Jay
a Department of Family and Community Medicine , University of New Mexico , Albuquerque , New Mexico , USA.
Teach Learn Med. 2015;27(2):155-62. doi: 10.1080/10401334.2015.1011649.
CONSTRUCT: The objective of this study was to evaluate the impact of varying the relative weights of cognitive versus noncognitive admission criteria on the proportion of underrepresented minorities admitted to medical school. It answers the question, "Can medical schools increase the admission rates of underrepresented minority (URM) students by balancing cognitive criteria with the experiences, attributes, and metrics of noncognitive data in the admission process?"
U.S. demographics are shifting, and by 2042 ethnic minority groups will make up approximately 50% of the population. Increasing diversity of the U.S. population foreshadows the need to increase the number of physicians from underrepresented minorities to help address healthcare disparities that are on the rise.
A cohort of three medical school applicant classes (2007-2009) was used to model the impact on URM admission rates as the relative weights of cognitive and noncognitive admission criteria were varied. This study used the minimum admission standards established for the actual incoming classes. The URM rate of admission to medical school was the outcome. Cognitive criteria included Medical College Admission Test scores and grade point averages. Noncognitive criteria included four categories: background and diversity, interest and suitability for a career in medicine, problem-solving and communication skills, and letters of recommendation.
A cohort of 480 applicants from the three applicant classes were enrolled in the study. As the weighting scheme was varied from 50% cognitive/50% noncognitive weights to 35%/65%, the proportion of URM students accepted to medical school increased from 24% (42/177) to 30% (57/193; p < .001). Hispanic and Native American acceptance rates increased by 5.1% and 0.7%, respectively.
Admission rates of URM students can be increased by weighting noncognitive higher relative to cognitive criteria without compromising admission standards. Challenging conventional practice in the admissions process may improve health disparities and diversify the physician workforce.
构建：本研究的目的是评估改变认知与非认知录取标准的相对权重对医学院录取的代表性不足少数族裔比例的影响。它回答了这样一个问题：“医学院能否通过在录取过程中平衡认知标准与非认知数据的经验、属性和指标，来提高代表性不足少数族裔（URM）学生的录取率？”
美国人口结构正在发生变化，到2042年，少数族裔群体将占人口的近50%。美国人口日益多样化预示着需要增加来自代表性不足少数族裔的医生数量，以帮助解决不断上升的医疗保健差距问题。
使用三个医学院申请者班级（2007 - 2009年）的队列来模拟随着认知和非认知录取标准的相对权重变化对URM录取率的影响。本研究采用了为实际入学班级设定的最低录取标准。医学院的URM录取率为结果。认知标准包括医学院入学考试成绩和平均绩点。非认知标准包括四类：背景与多样性、对医学职业的兴趣与适合性、解决问题和沟通能力以及推荐信。
来自这三个申请者班级的480名申请者参与了本研究。当权重方案从50%认知/50%非认知权重变为35%/65%时，被医学院录取的URM学生比例从24%（42/177）增加到30%（57/193；p <.001）。西班牙裔和美国原住民的录取率分别提高了5.1%和0.7%。
相对于认知标准增加非认知标准的权重可以提高URM学生的录取率，而不影响录取标准。在录取过程中挑战传统做法可能会改善健康差距，并使医生队伍多样化。
