Marketing Department, King's College London, London, UK.
Centre for Rheumatic Diseases, King's College London, London, UK.
BMJ Open. 2022 Dec 15;12(12):e066886. doi: 10.1136/bmjopen-2022-066886.
Quantify differential attainment by ethnicity in undergraduate medical assessments and evaluate whether institutional efforts to reduce the attainment gap have had impact.
Observational cohort study.
A single UK MBBS medical programme.
Pseudonymised data of adults aged ≥18 years enrolled in one of the UK MBBS medical programmes between 2012 and 2018. Ethnicity was self-declared during enrolment as White, Asian, Black, mixed and other.
Module mark (distinction, merit, pass, fail) graded according to a variety of assessments, including single best answer examinations, objective structured clinical examinations and coursework submissions. All modular assessments are graded as a percentage. Logistic regression models were used to calculate relative risk ratio to study the association between ethnicity and attainment gap over a calendar and scholastic year. Models were adjusted for age, gender, social deprivation and scholastic year of study.
3714 student records were included. In the sample, 2134 students (57%) were non-white. The proportion of non-white students increased from 2007 (49%) to 2018 (70%). Mean age was 18 (IQR 18-21) and 56.6% were females. Higher proportion of non-white students 218 (24.8%) were from more deprived backgrounds versus white 76 (14.8%). Compared with non-white, there were no significant differences in the proportion of students failing assessments. However, white students were more likely to achieve merit (relative risk ratio 1.29 (95% CI 1.08 to 1.45)) or distinction (1.69 (95% CI 1.37 to 2.08)). Differences in attainment gap have remained unchanged over time, and for black students, attainment gap grew between their first and final year of study.
A similar proportion (97%) of non-white and white students had a passing score, but attainment gap for higher grades persists over years despite widespread efforts in medical schools to diminish the attainment gap linked to ethnicity. Our findings are from a single institution, thus affecting generalisability.
量化不同种族在本科医学评估中的差异，并评估机构为缩小成绩差距所做的努力是否产生了影响。
观察性队列研究。
英国 MBBS 医学课程中的一个单一课程。
2012 年至 2018 年间入读英国 MBBS 医学课程的成年人的匿名数据，年龄≥18 岁。种族在入学时自行申报为白人、亚洲人、黑人、混血儿和其他。
根据多种评估方式（包括单项最佳答案考试、客观结构化临床考试和课程作业提交）对模块分数（优秀、良好、及格、不及格）进行分级。所有模块评估均按百分比分级。使用逻辑回归模型计算相对风险比，以研究在日历年和学年中种族与成绩差距之间的关联。模型根据年龄、性别、社会贫困程度和学年进行调整。
共纳入 3714 名学生的记录。在样本中，2134 名学生（57%）是非白人。非白人学生的比例从 2007 年（49%）增加到 2018 年（70%）。平均年龄为 18 岁（IQR 18-21），其中 56.6%为女性。来自较贫困背景的非白人学生比例较高，218 人（24.8%）与白人学生 76 人（14.8%）相比。与非白人学生相比，成绩不及格的学生比例没有显著差异。然而，白人学生更有可能获得优秀（相对风险比 1.29（95%CI 1.08 至 1.45））或卓越（1.69（95%CI 1.37 至 2.08））。多年来，成绩差距一直没有变化，而且黑人学生在第一学年和最后一学年之间的成绩差距有所扩大。
尽管医学院为缩小与种族相关的成绩差距做出了广泛努力，但非白人学生和白人学生的及格率（97%）相似，但高等级的成绩差距仍持续多年存在。我们的研究结果来自单一机构，因此影响了其普遍性。
