Centre for Healthcare Education Research and Innovation (CHERI), Institute of Education for Medical and Dental Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
School of Language, Literature, Music and Visual Culture, University of Aberdeen, Taylor Building, Kings College, Aberdeen, AB24 3UB, UK.
Adv Health Sci Educ Theory Pract. 2018 Aug;23(3):513-531. doi: 10.1007/s10459-018-9809-2. Epub 2018 Jan 24.
Despite repeated calls for change, the problem of widening access (WA) to medicine persists globally. One factor which may be operating to maintain social exclusion is the language used in representing WA applicants and students by the gatekeepers and representatives of medical schools, Admissions Deans. We therefore examined the institutional discourse of UK Medical Admissions Deans in order to determine how values regarding WA are communicated and presented in this context. We conducted a linguistic analysis of qualitative interviews with Admissions Deans and/or Staff from 24 of 32 UK medical schools. Corpus Linguistics data analysis determined broad patterns of frequency and word lists. This informed a critical discourse analysis of the data using an "othering" lens to explore and understand the judgements made of WA students by Admissions Deans, and the practices to which these judgments give rise. Representations of WA students highlighted existing divides and preconceptions in relation to WA programmes and students. Through using discourse that can be considered othering and divisive, issues of social divide and lack of integration in medicine were highlighted. Language served to reinforce pre-existing stereotypes and a significant 'us' and 'them' rhetoric exists in medical education. Even with drivers to achieve diversity and equality in medical education, existing social structures and preconceptions still influence the representations of applicants and students from outside the 'traditional' medical education model in the UK. Acknowledging this is a crucial step for medical schools wishing to address barriers to the perceived challenges to diversity.
尽管一再呼吁变革，但全球范围内扩大医学入学机会（WA）的问题仍然存在。一个可能导致社会排斥的因素是，医学院的把关者和招生院长在代表 WA 申请人和学生时使用的语言。因此，我们研究了英国医学招生院长的制度话语，以确定在这种情况下，WA 的价值观是如何在这个语境中被传达和呈现的。我们对来自 32 所英国医学院的 24 所医学院的招生院长和/或工作人员进行了定性访谈的语言分析。语料库语言学数据分析确定了频率和词汇列表的广泛模式。这为数据的批判性话语分析提供了信息，使用“他者化”的视角来探索和理解招生院长对 WA 学生的判断，以及这些判断所产生的实践。WA 学生的代表性突出了 WA 项目和学生的现有分歧和成见。通过使用可以被认为是“他者化”和分裂的话语，突出了医学领域的社会分裂和缺乏融合的问题。语言强化了预先存在的刻板印象，在医学教育中存在着明显的“我们”和“他们”的论调。即使在医学教育中存在实现多样性和平等的驱动力，但英国现有的社会结构和成见仍然影响着对来自“传统”医学教育模式之外的申请人和学生的代表性。承认这一点是希望解决多样性感知挑战的医学院的关键一步。
