Teachers and Teaching Research Centre, School of Education, University of Newcastle, Callaghan, New South Wales, Australia.
School of Education, Western Sydney University, Kingswood, New South Wales, Australia.
Med Educ. 2018 Feb;52(2):227-238. doi: 10.1111/medu.13480. Epub 2017 Nov 9.
Students from lower socio-economic status backgrounds continue to be under-represented in medical education. Although various initiatives have been implemented by universities to widen participation, their effectiveness and their timing remain contentious. Prior studies have primarily focused on students already on a medical pathway, with little analytical attention given to the aspirations of primary and secondary school-aged students. The aim of this study was to identify the characteristics of students who express early interest in medicine and ascertain the degree to which diversification of the future medical student cohort is indicated.
As part of a longitudinal study of educational and occupational aspirations (2012-2015), students in Years 3-12 (n = 6492) from government schools in New South Wales, Australia, completed an annual online survey. Their individual responses were linked with prior academic achievement and demographic data. Logistic regression models were used to examine the significance of student- and school-related variables as predictors of interest in medicine.
Significant predictors were: being in the early years of secondary school, possessing high cultural capital, coming from a language background other than English, being female, and perceiving oneself as 'well above average' relative to peers. Socio-economic status was a significant predictor when examined independently, but not when all variables were considered in the full regression model.
For medical schools seeking to widen participation, this study underscores the importance of recognising the intersection of other factors with socio-economic status and how they contribute to students' aspirational biographies. If medical schools are to select from a more diverse range of applicants, recruitment strategies must take into account the discursive positioning of the discipline. Sustained outreach into primary and secondary schools may be critical to interrupting the current social reproduction of medical schooling.
来自社会经济地位较低背景的学生在医学教育中仍然代表性不足。尽管大学已经实施了各种举措来扩大参与面，但它们的效果和时机仍存在争议。先前的研究主要集中在已经在医学道路上的学生身上，很少有分析关注到中小学生的愿望。本研究旨在确定表达对医学早期兴趣的学生的特征，并确定未来医学生群体多样化的程度。
作为对教育和职业愿望的纵向研究的一部分（2012-2015 年），来自澳大利亚新南威尔士州政府学校的 3-12 年级（n=6492）的学生完成了一项年度在线调查。他们的个人回答与之前的学业成绩和人口统计数据相关联。使用逻辑回归模型来检验学生和学校相关变量作为对医学感兴趣的预测因子的重要性。
显著的预测因子包括：处于中学早期、拥有较高的文化资本、来自英语以外的语言背景、女性、以及相对于同龄人自我感觉“远高于平均水平”。社会经济地位是一个显著的预测因子，但当所有变量都被纳入完整的回归模型时，它就不再显著了。
对于寻求扩大参与面的医学院校来说，这项研究强调了认识到其他因素与社会经济地位的交叉点以及它们如何影响学生的抱负传记的重要性。如果医学院校要从更多样化的申请者中进行选择，那么招聘策略必须考虑到学科的话语定位。持续向中小学进行宣传可能是打破当前医学教育的社会再生产的关键。
