Institute of Education in Medical and Dental Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
Department of Linguistics, School of Language, Literature, Music and Visual Culture, University of Aberdeen, Aberdeen, UK.
Med Educ. 2017 Jun;51(6):598-611. doi: 10.1111/medu.13264. Epub 2017 Feb 22.
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.
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.
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.
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.
在英国，尽管在扩大医学教育机会（WA）方面投入了大量的时间、兴趣和资源，但来自社会经济地位较低群体的人对医学专业的申请仍然很低。这表明，医学院核心的 WA 信息可能在起作用，使其进一步边缘化，而不是对抗这种情况。我们的目的是调查英国医学院通过其网站传达 WA 的价值观的方式，以及这可能如何对谁适合学医产生期望。
我们对英国医学院网站上与 WA 相关的网页进行了批判性话语分析。我们的概念框架是基于福柯的话语理解。分析遵循了 Hyatt 分析框架的改编版本。这包括通过识别 WA 的驱动因素、杠杆和保证来对数据进行语境化处理，然后系统地调查语言特征，以揭示使用的话语及其假设。
“个人社会流动”的话语为 WA 提供了正当理由，认为这是一项支持有学术能力和对医学有承诺的个人的举措，但他们在申请过程中因背景而处于不利地位。这种精英主义话语将 WA 的好处传达为单向流动，医学院为申请人提供机会。相反，将 WA 作为一项有利于患者护理的举措的正当理由被边缘化，在很大程度上被排除在外。通常归因于社会经济地位较低群体学生的替代优势并未被提及，这意味着这些优势没有得到重视。
英国医学院网站上当前的 WA 话语并没有将非传统申请者视为通过多样性为医学带来收益。这可能成为吸引更多不同背景申请者的障碍。医学院应该反思他们的网站话语，批判性地评估目前鼓励来自社会经济地位较低群体的人申请的方法，并考虑积极变革的途径。
