Progress and Pitfalls in Underrepresented Minority Recruitment: METHODS

11 Nov

Instrument Development

In developing the American Medical Student Association Diversity Survey (AMSA-DS), we first conducted a review of the relevant literature using a Medline search for combinations of the following key words: “underrepresented minorities,” “medical school admissions,” “diversity,” “recruitment,” “retention” and “representation.” Included were all articles, both research studies and commentary, published between 1985 and 2000 and having any discussion of minority representation in medical schools. A summary of the findings in these articles with an annotated bibliography were presented to AMSA’s Diversity Coalition, a group of eight membership-based medical associations with a stated commitment to diversity in their mission statement (Table 1). Representatives of these organizations drafted the AMSA-DS. In the fall of 2001, the instrument was pilot-tested at four medical schools. The deans of students at each of these schools were asked to comment on content, length and clarity of the survey and survey items. Based on their feedback, the instrument was revised by modifying some questions, adding certain items and excluding other questions. The final survey contained 100 items and took approximately 20 minutes to complete [instrument available from Carrasquillo (author)]. Survey items included:

1. A list of 37 potential barriers to URM recruitment with respondents being asked to check all that applied to their school;
2. A list of 11 URM recruitment programs with respondents being asked to: a) note whether the program was in place at their institution and b) rate the effectiveness of the program byusing a modified four-point Likert scale (not effective, effective, very effective and don’t know). The survey also included one question asking for an overall assessment of the school’s success in the recruitment of URM students on a scale of 1 to 10 (10 being best). Lastly, we undertook this project during a nationwide discussion led by the Association of American Medical Colleges on redefining and expanding the term “underrepresented minority.” Therefore, an additional question asked medical schools if they would like to target for recruitment any of several listed additional minority and disadvantaged groups [other minorities (e.g. Asians, non-URM Hispanics), women, gay/lesbian/transgender students, disabled, economically disadvantaged, second-career professionals and an open-ended question on other groups]. Medication you can afford finasteride online

In spring 2002, we mailed the AMSA-DS and an accompanying letter signed by the presidents of AMSA and the Student National Medical Association (SNMA) to the deans of student affairs of all 144 accredited allopathic and osteopathic medical schools. Deans were asked to identify their school by name for purposes of follow-up only, with assurance of confidentiality. In many cases, the survey was forwarded to the dean of admissions or minority affairs faculty who responded to the survey. A postcard reminder was sent at the four-week mark and the instrument was faxed to schools at the eight-week mark with telephone follow-up. Schools responded to the instrument via mail or fax. The data collection period was closed 10 weeks after the initial mailing. Surveys were collected by independent consultants at the School of Public Policy at George Mason University and entered into a database with identifying information removed. Because the goal of the study was to assess the viewpoints and efforts of schools struggling with enrollment of traditional URM students, we did not include schools who already enrolled a high proportion of URM students. Thus, schools indicating that they were a historically black medical school or located in Puerto Rico were excluded from this analysis.

Table 1. Organizations that participated in the American Medical Student Diversity Coalition
1. Student National Medical Association
2. National Medical Association
3. National Network of Latin American Medical Students
4. National Hispanic Medical Association
5. American Medical Student Association
6. American Medical Women’s Association
7. Association of American Indian Physicians
8. Gay and Lesbian Medical Association
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We compared differentials in characteristics among responding and nonresponding medical schools using Chi-squared analyses. We analyzed the percentage of URM students at each school as a continuous variable, and correlates of URM enrollment with categorical variables were examined using t tests with Bonferoni adjustment for multiple comparisons. We present descriptive data on existing initiatives at medical schools to recruit URM, perceived barriers to enrollment of URM and interest in recruiting other minority students as percentages. Self-reported success at recruiting URM students was not normally distributed (as determined with visual examination of data plots and the Wilk-Shapiro test). Thus, we used Spearman correlation coefficients to examine the association between self-reported success and the percentage of URM students at each school. All analyses were performed using SAS v8.