Role of students' context in predicting academic performance at a medical school: a retrospective cohort study

Equity with equality? Contextualising everyone can widen participation in medical school admissions

Widening participation outcomes in admissions to UK medical schools have not changed 2007-2018, partly due to inequity in selection. This study models the effects of changing selection, using a novel method of contextualising applicants, on widening participation. We studied 1084 English school leaver applicants to a single medical school over two years, using data from their public exams taken 2 years pre-application (GCSE) and recent admissions test (UCAT). Widening participation was defined by postcode. We modelled two shortlists for a pre-determined number of 500; one ranked on UCAT total score, and the other on a metric that contextualised applicants' GCSE grades against their schools' average GCSE performance. There was a significant difference in the postcode-defined widening participation characteristics of the two shortlists; 46% by contextualisation and 32.2% by UCAT (Chisquare p < 0.00001). As widening participation covers 42% of postcodes, the "contextualise everyone" method achieves equity. Conventionally, contextual admissions identify individuals belonging to under-represented groups and gives them preferential treatment. Changing the rules for everyone, by using a relative attainment instead of simple absolute attainment metric, benefits from treating applicants equally; and could promote equity through widening participation.

Self-efficacy and confidence of medical students with prior scribing experience: A mixed methods study

PURPOSE

Medical scribing is an increasingly common way for pre-medical students to gain clinical experience. Scribes are a valuable part of the healthcare team and have high rates of matriculation into health professional programs. Little is known about the effects of scribing on the success of the student. This manuscript aims to determine the effect of scribing experience on clinical self-efficacy during medical school.

PARTICIPANTS AND METHODS

Perceived clinical self-efficacy was evaluated with validated survey questions using a 5-point Likert-type scale as well as free text responses. The survey was completed by 175 medical students at the Frank H. Netter, MD School of Medicine. Statistical analysis was conducted using SPSS. As part of the mixed methods study, free text responses were analyzed using thematic analysis.

RESULTS

Quantitative results showed no statistical difference in perceived clinical self-efficacy between medical students with scribing experience and those without. Analysis of free text responses showed that medical students believed their scribing experience improved comfort in the clinical setting and increased familiarity with medical terminology.

DISCUSSION AND CONCLUSIONS

Medical students with scribing experience did not demonstrate greater clinical self-efficacy than their peers without scribing experience. However, medical students with scribing experience have a perceived value of their pre-medical scribing experience on their success in medical school.

Student selection to a rural veterinary school. 2: predictors of student performance and attrition

OBJECTIVE

To evaluate the extent to which current selection processes at Charles Sturt University, New South Wales, Australia, predict performance within and attrition from the veterinary degree program.

DESIGN

Retrospective evaluation of application details and student performance data.

METHODS

Database records of 424 students entering the veterinary program were retrieved from university records, including all students graduating (n = 356) or leaving the program without completing (n = 68) between 2005 and 2016. Demographic data were related to results of selection processes and achievement within the degree using univariable and multivariable general linear and logistic regression analyses.

RESULTS

The grade point average achieved over the 6 years of the degree was influenced by academic achievement prior to entry, gender (females performed ≈ 2% better than males) and interview scores. Preceptor evaluation of final-year clinical performance was associated with interview scores, gender (males performed ≈ 4% better than females) and residential address at the time of application. Attrition for personal reasons was more common for female students and students who had completed a prior degree, and students who experienced academic or personal attrition had lower written application scores. Factors that have been previously linked to poor academic outcomes, including rural or low socioeconomic background, were not associated with adverse student outcomes.

CONCLUSION

Selection processes did not systematically disadvantage students admitted to the degree program. Gender differences in personal attrition and academic and clinical performance warrant further evaluation. Factors in addition to academic aptitude predicted student success.

Student selection to a rural veterinary school. 1: applicant demographics and predictors of success within the application process

OBJECTIVE

To determine demographic details of applicants to the veterinary degree program at and relate this information to student selection processes.

DESIGN

Retrospective evaluation of applicant data.

METHODS

Database records of 4042 applicants to the veterinary program (2006-2016) were retrieved from university records. Summary statistics were used to determine basic demographic data, which were related to pre-entry academic achievement and results of selection processes using univariable and multivariable analyses.

RESULTS

The number of applications, interviews and acceptance of offers fluctuated but did not vary substantively for the duration of the study. Gender, rurality (as assessed by residential and school postcodes), socioeconomic background, academic background and pre-entry academic achievement all significantly influenced written application and interview scores in the multivariate models. Rural background, written application score, number of applications, pre-entry academic history and achievement significantly affected the chances of receiving an interview. Chances of receiving an offer and subsequent program entry were significantly influenced by academic background, interview score and pre-entry academic achievement. Male applicants were more likely to receive an offer, but gender had no effect on program entry. Rural residential and school background was associated with significantly reduced ATAR in comparison with city-based applicants.

CONCLUSION

Selection processes effectively identified applicants with demographic backgrounds and life experiences consistent with the School's commitment to the veterinary needs of rural and regional Australia. Findings support the provision of an academic loading for the ATAR results of rural students. Effects of these selection outcomes on student performance should be evaluated.

The relationship between school type and academic performance at medical school: a national, multi-cohort study

OBJECTIVES

Differential attainment in school examinations is one of the barriers to increasing student diversity in medicine. However, studies on the predictive validity of prior academic achievement and educational performance at medical school are contradictory, possibly due to single-site studies or studies which focus only on early years' performance. To address these gaps, we examined the relationship between sociodemographic factors, including school type and average educational performance throughout medical school across a large number of diverse medical programmes.

METHODS

This retrospective study analysed data from students who graduated from 33 UK medical schools between 2012 and 2013. We included candidates' demographics, pre-entry grades (adjusted Universities and Colleges Admissions Service tariff scores) preadmission test scores (UK Clinical Aptitude Test (UKCAT) and Graduate Medical School Admissions Test (GAMSAT)) and used the UK Foundation Programme's educational performance measure (EPM) decile as an outcome measure. Logistic regression was used to assess the independent relationship between students' background characteristics and EPM ranking.

RESULTS

Students from independent schools had significantly higher mean UKCAT scores (2535.1, SD=209.6) than students from state-funded schools (2506.1, SD=224.0, p<0.001). Similarly, students from independent schools came into medical school with significantly higher mean GAMSAT scores (63.9, SD=6.9) than students from state-funded schools (60.8, SD=7.1, p<0.001). However, students from state-funded schools were almost twice as likely (OR=2.01, 95% CI 1.49 to 2.73) to finish in the highest rank of the EPM ranking than those who attended independent schools.

CONCLUSIONS

This is the first large-scale study to examine directly the relationship between school type and overall performance at medical school. Our findings provide modest supportive evidence that, when students from independent and state schools enter with similar pre-entry grades, once in medical school, students from state-funded schools are likely to outperform students from independent schools. This evidence contributes to discussions around contextualising medical admission.