A. Teherani is professor, Department of Medicine, education scientist, Center for Faculty Educators, and director of program evaluation, University of California, San Francisco, School of Medicine, San Francisco, California; ORCID: http://orcid.org/0000-0003-2936-9832. E. Harleman is professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. K.E. Hauer is professor, Department of Medicine, and associate dean for competency assessment and professional standards, University of California, San Francisco, School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0002-8812-4045. C. Lucey is professor of medicine, executive dean, and vice dean for education, University of California, San Francisco, School of Medicine, San Francisco, California.
Acad Med. 2020 May;95(5):724-729. doi: 10.1097/ACM.0000000000003219.
Membership in the Alpha Omega Alpha Honor Medical Society (AΩA) is a widely recognized achievement valued by residency selection committees and employers. Yet research has shown selection favors students from racial/ethnic groups not underrepresented in medicine (not-UIM). The authors describe efforts to create equity in AΩA selection at the University of California, San Francisco, School of Medicine, through implementation of a holistic selection process, starting with the class of 2017, and present outcomes.Informed by the definition of holistic review, medical school leaders applied strategic changes grounded in evidence on inclusion, mitigating bias, and increasing opportunity throughout the AΩA selection process. These addressed increasing selection committee diversity, revising selection criteria and training committee members to review applications using a new instrument, broadening student eligibility and inviting applications, reviewing blinded applications, and making final selection decisions based on review and discussion of a rank-ordered list of students that equally weighted academic achievement and professional contributions.The authors compared AΩA eligibility and selection outcomes for 3 classes (2014-2016) during clerkship metric-driven selection, which prioritized academic achievement, and 3 classes (2017-2019) during holistic selection. During clerkship metric-driven selection, not-UIM students were 4 times more likely than UIM students to be eligible for AΩA (P = .001) and 3 times more likely to be selected (P = .001). During holistic selection, not-UIM students were 2 times more likely than UIM students to be eligible for AΩA (P = .001); not-UIM and UIM students were similarly likely to be selected (odds ratio = .7, P = .12)This new holistic selection process created equity in representation of UIM students among students selected for AΩA. Centered on equity pedagogy, which advocates dismantling structures that create inequity, this holistic selection process has implications for creating equity in awards selection during medical education.
阿尔法欧米茄阿尔法荣誉医学协会（AΩA）的会员资格是一项广泛认可的成就，受到住院医师选拔委员会和雇主的重视。然而，研究表明，选拔偏向于来自医学领域代表性不足的种族/族裔群体（非代表性群体）的学生。作者描述了在加利福尼亚大学旧金山医学院通过实施整体选拔过程来实现 AΩA 选拔公平的努力，该过程始于 2017 年，并介绍了成果。在整体审查的定义的指导下，医学院领导应用了基于包容性、减轻偏见和增加机会的战略变革，贯穿整个 AΩA 选拔过程。这些变革包括增加选拔委员会的多样性、修订选拔标准和培训委员会成员使用新工具审查申请、扩大学生资格并邀请申请、审查盲审申请以及根据对学术成就和专业贡献进行加权的学生排名列表进行最终选拔决策。作者比较了 3 个班级（2014-2016 年）在以学业成绩为重点的实习医师指标驱动选拔期间的 AΩA 资格和选拔结果，以及 3 个班级（2017-2019 年）在整体选拔期间的 AΩA 资格和选拔结果。在实习医师指标驱动选拔期间，非代表性群体学生获得 AΩA 资格的可能性是非代表性群体学生的 4 倍（P =.001），被选中的可能性是其 3 倍（P =.001）。在整体选拔期间，非代表性群体学生获得 AΩA 资格的可能性是非代表性群体学生的 2 倍（P =.001）；非代表性群体和代表性群体学生被选中的可能性相似（优势比=.7，P =.12）。这种新的整体选拔过程在 AΩA 选拔中创造了代表性群体学生的公平代表权。以公平教学法为中心，该教学法主张拆除造成不公平的结构，这种整体选拔过程对医学教育中奖项选拔的公平性具有影响。
