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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Amos, Andrew James Lee, Kyungmi Sen Gupta, Tarun Malau-Aduli, Bunmi S. |
| Abstract | Purpose There is growing concern that inequities in methods of selection into medical specialties reduce specialist cohort diversity, particularly where measures designed for another purpose are adapted for specialist selection, prioritising reliability over validity. This review examined how empirical measures affect the diversity of specialist selection. The goals were to summarise the groups for which evidence is available, evaluate evidence that measures prioritising reliability over validity contribute to under-representation, and identify novel measures or processes that address under-representation, in order to make recommendations on selection into medical specialties and research required to support diversity. Method In 2020–1, the authors implemented a comprehensive search strategy across 4 electronic databases (Medline, PsychINFO, Scopus, ERIC) covering years 2000–2020, supplemented with hand-search of key journals and reference lists from identified studies. Articles were screened using explicit inclusion and exclusion criteria designed to focus on empirical measures used in medical specialty selection decisions. Results Thirty-five articles were included from 1344 retrieved from databases and hand-searches. In order of prevalence these papers addressed the under-representation of women (21/35), international medical graduates (10/35), and race/ethnicity (9/35). Apart from well-powered studies of selection into general practice training in the UK, the literature was exploratory, retrospective, and relied upon convenience samples with limited follow-up. There was preliminary evidence that bias in the measures used for selection into training might contribute to under-representation of some groups. Conclusions The review did not find convincing evidence that measures prioritising reliability drive under-representation of some groups in medical specialties, although this may be due to limited power analyses. In addition, the review did not identify novel specialist selection methods likely to improve diversity. Nevertheless, significant and divergent efforts are being made to promote the evolution of selection processes that draw on all the diverse qualities required for specialist practice serving diverse populations. More rigorous prospective research across different national frameworks will be needed to clarify whether eliminating or reducing the weighting of reliable pre-selection academic results in selection decisions will increase or decrease diversity, and whether drawing on a broader range of assessments can achieve both reliable and socially desirable outcomes. |
| Related Links | https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-021-02685-w.pdf |
| Ending Page | 17 |
| Page Count | 17 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14726920 |
| DOI | 10.1186/s12909-021-02685-w |
| Journal | BMC Medical Education |
| Issue Number | 1 |
| Volume Number | 21 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2021-08-24 |
| Access Restriction | Open |
| Subject Keyword | Medical Education Theory of Medicine Bioethics Diversity Justice Equity Specialist selection Residency Bias Gender Ethnicity Application Matching Theory of Medicine/Bioethics |
| Content Type | Text |
| Resource Type | Article |
| Subject | Education Medicine |
| Journal Impact Factor | 2.7/2023 |
| 5-Year Journal Impact Factor | 3.4/2023 |
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