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弥合差距:理解英国黑人和少数族裔医学生表现的障碍和促进因素。

Bridging the gap: Understanding the barriers and facilitators to performance for Black, Asian and Minority Ethnic medical students in the United Kingdom.

机构信息

Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.

Department of Education, University of Oxford, Oxford, UK.

出版信息

Med Educ. 2024 Apr;58(4):443-456. doi: 10.1111/medu.15246. Epub 2023 Oct 8.

Abstract

INTRODUCTION

Differential attainment is a well-known phenomenon in medical education. Despite a strong impetus for institutions and researchers to move away from a 'student deficit model' when exploring the attainment gap, little attention has been given to understanding the experiences of Black, Asian and Minority Ethnic (BAME) medical students. Informed by the social construction of learning theory, this is the first national study to explore how multiple dimensions of the medical school environment impact academic performance of BAME undergraduate medical students across the UK.

METHODS

Using a sequential explanatory mixed-methods approach, the authors conducted a survey and facilitated three focus groups across medical schools in the UK between 2020-2021. Participants self-identified as being from BAME backgrounds. Quantitative analyses included descriptive statistics and bivariate analyses. Qualitative data were analysed using thematic analysis, subsequently identifying inductive themes.

RESULTS

Three hundred sixty-two respondents completed the Phase 1 survey, and 17 participants participated in the Phase 2 focus groups. Although both survey and focus group participants identified facilitators to learning such as supportive relationships, students reported facing numerous barriers that they felt impeded their learning and performance. These barriers included limited access to educational resources, and undiversified curricula and medical school populations. Students also described both experiencing and witnessing various forms of racism throughout their educational journeys.

DISCUSSION

Students encountered various difficulties throughout their medical training that they felt impacted their learning and performance. This study offers novel insights into the experiences of BAME students and builds upon previous research. It also reveals the pervasive nature of racism within medical schools, highlighting the urgent need for institutional changes. Educators and institutions must go beyond merely recognising these barriers and facilitators; they must proactively innovate and adapt. In doing so, they pave the way for inclusive learning environments that truly foster a sense of belonging for BAME students.

摘要

简介

在医学教育中,差异成就(differential attainment)是一个众所周知的现象。尽管机构和研究人员在探索成就差距时强烈希望摆脱“学生不足模式”,但很少有人关注理解黑人和少数族裔(BAME)医学生的经历。本研究以学习的社会建构理论为指导,是首次在全国范围内探索英国各医学院校环境的多个维度如何影响 BAME 本科医学生的学业成绩。

方法

采用顺序解释性混合方法,作者于 2020-2021 年在英国的医学院校进行了一项调查,并组织了三次焦点小组讨论。参与者自我认定为 BAME 背景。定量分析包括描述性统计和双变量分析。定性数据分析采用主题分析,随后确定了归纳主题。

结果

362 名受访者完成了第 1 阶段的调查,17 名参与者参加了第 2 阶段的焦点小组讨论。尽管调查和焦点小组的参与者都确定了支持性关系等促进学习的因素,但学生报告说他们面临着许多障碍,这些障碍阻碍了他们的学习和表现。这些障碍包括获取教育资源的机会有限,课程和医学院校群体缺乏多样性。学生还描述了他们在整个教育过程中经历和目睹的各种形式的种族主义。

讨论

学生在整个医学培训过程中遇到了各种困难,他们觉得这些困难影响了他们的学习和表现。本研究为 BAME 学生的经历提供了新的见解,并建立在以前的研究基础上。它还揭示了种族主义在医学院校中的普遍存在,强调了机构变革的迫切需要。教育者和机构不能仅仅认识到这些障碍和促进因素;他们必须积极创新和适应。通过这样做,他们为真正为 BAME 学生营造归属感的包容学习环境铺平了道路。

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