University of Alabama School of Medicine, VH 107 K, 1720 2nd Avenue South, Birmingham, AL, 35294-0019, USA.
Adv Health Sci Educ Theory Pract. 2018 Aug;23(3):487-498. doi: 10.1007/s10459-017-9807-9. Epub 2017 Dec 29.
Diversity in the physician workforce lags behind the rapidly changing US population. Since the gateway to becoming a physician is medical school, diversity must be addressed in the admissions process. The Association of American Medical Colleges has implemented a Holistic Review Initiative aimed at assisting medical schools with broadening admission criteria to include relevant, mission-driven attributes and experiences in addition to academic preparation to identify applicants poised to meet the needs of a diverse patient population. More evidence is needed to determine whether holistic review results in a more diverse selection process. One of the keys to holistic review is to apply holistic principles in all stages of the selection process to ensure qualified applicants are not overlooked. This study examines whether the use of holistic review during application screening at a new medical school increased the diversity of applicants selected for interview. Using retrospective data from the first five application cycles at the Oakland University William Beaumont School of Medicine (OUWB), the author compared demographic and experiential differences between the applicants selected using holistic review, including experiences, attributes and academic metrics, to a test sample selected solely using academic metrics. The dataset consisted of the total group of applicants selected for interview in 2011 through 2015 using holistic review (n = 2773) and the same number of applicants who would have been selected for an interview using an academic-only selection model (n = 2773), which included 1204 applicants who were selected using both methods (final n = 4342). The author used a combination of cross-tabulation and analysis of variance to identify differences between applicants selected using holistic review and applicants in the test sample selected using only academics. The holistic review process yielded a significantly higher than expected percent of female (adj. resid. = 13.2, p < .01), traditionally underrepresented in medicine (adj. resid. = 15.8, p < .01), first generation (adj. resid. = 5.8, p < .01), and self-identified disadvantaged (adj resid. = 11.5, p < .01) applicants in the interview pool than selected using academic metrics alone. In addition, holistically selected applicants averaged significantly more hours than academically selected students in the areas of pre-medical school paid employment (F = 10.99, mean difference = 657.99, p < .01) and community service (F = 15.36, mean difference = 475.58, p < .01). Using mission-driven, holistic admissions criteria comprised of applicant attributes and experiences in addition to academic metrics resulted in a more diverse interview pool than using academic metrics alone. These findings add support for the use of holistic review in the application screening process as a means for increasing diversity in medical school interview pools.
医生劳动力的多样性落后于美国人口的快速变化。由于成为医生的途径是医学院，因此多样性必须在招生过程中得到解决。美国医学院协会已经实施了一项整体审查计划，旨在帮助医学院扩大录取标准，除了学术准备外，还包括相关的、以使命为导向的属性和经验，以确定有能力满足多样化患者群体需求的申请人。需要更多的证据来确定整体审查是否会导致更具多样性的选择过程。整体审查的关键之一是在选择过程的所有阶段应用整体原则，以确保有资格的申请人不会被忽视。本研究考察了在一所新医学院的申请筛选过程中使用整体审查是否会增加入选面试的申请人的多样性。作者使用奥克兰大学威廉·博蒙特医学院（OUWB）前五个申请周期的回顾性数据，将使用整体审查选择的申请人的人口统计学和经验差异与仅使用学术标准选择的申请人进行了比较。该数据集包括 2011 年至 2015 年期间使用整体审查选择参加面试的总申请人（n=2773）和使用仅学术选择模型（n=2773）本应入选面试的相同数量的申请人，其中包括 1204 名同时使用两种方法入选的申请人（最终 n=4342）。作者使用交叉表和方差分析的组合来确定使用整体审查选择的申请人与仅使用学术选择的测试样本中的申请人之间的差异。整体审查过程产生的女性比例（调整后的 resid. = 13.2%，p <.01）、医学领域代表性不足的申请人比例（调整后的 resid. = 15.8%，p <.01）、第一代申请人比例（调整后的 resid. = 5.8%，p <.01）和自我认定的弱势群体申请人比例（调整后的 resid. = 11.5%，p <.01）明显高于仅使用学术标准选择的申请人。此外，与仅通过学术标准选择的学生相比，整体选择的申请人在医学院面试中平均接受的医学前带薪工作（F=10.99，平均差异=657.99，p <.01）和社区服务（F=15.36，平均差异=475.58，p <.01）方面的时间明显更多。使用以使命为导向的、由申请人属性和经验以及学术标准组成的整体招生标准，比仅使用学术标准产生了更具多样性的面试池。这些发现为在申请筛选过程中使用整体审查作为增加医学院面试池多样性的一种手段提供了更多支持。
