PDF(Pubmed)
Abstract：
BACKGROUND: Nontraditional students bring to medicine inherent characteristics and perspectives that enrich the learning environment and contribute to expanding diversity in medicine. However, research has shown that these students, by virtue of their sociodemographic backgrounds, face unique challenges in medical education, which ultimately place them at a disadvantage compared to their peers. The purpose of this study is to explore relationships between sociodemographic characteristics, stress, and academic performance, in the context of outcomes that may be undermining efforts to diversify the physician workforce.
METHODS: Using a retrospective observational cohort methodology, we examined institutional and USMLE exam performance data in conjunction with Perceived Stress Scale-4 survey results from six cohorts of students at Kirk Kerkorian School of Medicine at UNLV (n = 358). Using independent samples t-test, mean stress and academic performance were compared between four sociodemographic groups: first-generation college students, underrepresented in medicine (URM), socioeconomically disadvantaged, and age 30 + at matriculation. Results were considered significant where P ≤ .05.
RESULTS: First-generation college students had significantly higher stress at the end of third year clerkships (mean 7.8 vs. 6.8, P* = .03). URM students had significantly lower scores on preclinical exams (mean 81.37 vs. 83.07, P* = .02). The students who were age 30 + at matriculation had significantly lower exam scores on all academic performance measures.
CONCLUSIONS: Our results echo historic trends in academic performance for racial and ethnic minority students, and we present recent evidence of academic performance disparities based on age at matriculation. Residency program directors continue to use test scores as a primary metric to screen applicants and thus, poor academic performance has profound consequences on career trajectory. Finally, significantly higher stress in the first-generation students may be evidence of underlying psychological distress. Expanding the sociodemographic diversity among physicians, and by extension, medical students, has long been recognized as fundamental to addressing inequities in healthcare. However, results from our study suggest that aspects of medical education are unfavorable and disadvantageous for first-generation, URM, and older medical students. A deeper understanding of the interplay between sociodemographic characteristics and success in medical school is paramount as we pursue diversity in medicine.
METHODS: Using a retrospective observational cohort methodology, we examined institutional and USMLE exam performance data in conjunction with Perceived Stress Scale-4 survey results from six cohorts of students at Kirk Kerkorian School of Medicine at UNLV (n = 358). Using independent samples t-test, mean stress and academic performance were compared between four sociodemographic groups: first-generation college students, underrepresented in medicine (URM), socioeconomically disadvantaged, and age 30 + at matriculation. Results were considered significant where P ≤ .05.
RESULTS: First-generation college students had significantly higher stress at the end of third year clerkships (mean 7.8 vs. 6.8, P* = .03). URM students had significantly lower scores on preclinical exams (mean 81.37 vs. 83.07, P* = .02). The students who were age 30 + at matriculation had significantly lower exam scores on all academic performance measures.
CONCLUSIONS: Our results echo historic trends in academic performance for racial and ethnic minority students, and we present recent evidence of academic performance disparities based on age at matriculation. Residency program directors continue to use test scores as a primary metric to screen applicants and thus, poor academic performance has profound consequences on career trajectory. Finally, significantly higher stress in the first-generation students may be evidence of underlying psychological distress. Expanding the sociodemographic diversity among physicians, and by extension, medical students, has long been recognized as fundamental to addressing inequities in healthcare. However, results from our study suggest that aspects of medical education are unfavorable and disadvantageous for first-generation, URM, and older medical students. A deeper understanding of the interplay between sociodemographic characteristics and success in medical school is paramount as we pursue diversity in medicine.
摘要：
背景：非传统学生带来了医学的固有特征和观点，丰富了学习环境，并有助于扩大医学的多样性。然而,研究表明，这些学生，由于他们的社会人口学背景，面对医学教育的独特挑战，这最终使他们与同龄人相比处于劣势。这项研究的目的是探讨社会人口统计学特征之间的关系，压力，和学习成绩，结果可能会破坏使医生队伍多样化的努力。
方法：使用回顾性观察队列方法，我们结合来自UNLV的KirkKerkorian医学院6组学生的感知压力量表-4调查结果(n=358),检查了机构和USMLE考试表现数据.使用独立样本t检验，比较了四个社会人口统计学群体的平均压力和学习成绩：第一代大学生，在医学中代表性不足(URM)，社会经济上处于不利地位，30岁以上入学。当P≤0.05时，结果被认为是显著的。
结果：第一代大学生在第三年结束时的压力明显更高（平均7.8vs.6.8，P*=.03）。URM学生在临床前考试中的分数明显较低（平均81.37vs.83.07，P*=.02）。30岁以上的学生在所有学业成绩指标上的考试成绩均显着较低。
结论：我们的结果反映了种族和少数民族学生学习成绩的历史趋势，我们提供了基于入学年龄的学习成绩差异的最新证据。居住计划主管继续使用考试成绩作为筛选申请人的主要指标，因此，糟糕的学业成绩会对职业发展轨迹产生深远的影响。最后,第一代学生的压力显着增加可能是潜在的心理困扰的证据。扩大医生之间的社会人口统计学多样性，引申开来,医学生,长期以来，人们一直认为这是解决医疗保健不平等的基础。然而,我们的研究结果表明，医学教育方面对第一代是不利和不利的，URM,和年长的医学生。当我们追求医学多样性时，对社会人口统计学特征与医学院成功之间的相互作用有更深入的了解是至关重要的。
方法：使用回顾性观察队列方法，我们结合来自UNLV的KirkKerkorian医学院6组学生的感知压力量表-4调查结果(n=358),检查了机构和USMLE考试表现数据.使用独立样本t检验，比较了四个社会人口统计学群体的平均压力和学习成绩：第一代大学生，在医学中代表性不足(URM)，社会经济上处于不利地位，30岁以上入学。当P≤0.05时，结果被认为是显著的。
结果：第一代大学生在第三年结束时的压力明显更高（平均7.8vs.6.8，P*=.03）。URM学生在临床前考试中的分数明显较低（平均81.37vs.83.07，P*=.02）。30岁以上的学生在所有学业成绩指标上的考试成绩均显着较低。
结论：我们的结果反映了种族和少数民族学生学习成绩的历史趋势，我们提供了基于入学年龄的学习成绩差异的最新证据。居住计划主管继续使用考试成绩作为筛选申请人的主要指标，因此，糟糕的学业成绩会对职业发展轨迹产生深远的影响。最后,第一代学生的压力显着增加可能是潜在的心理困扰的证据。扩大医生之间的社会人口统计学多样性，引申开来,医学生,长期以来，人们一直认为这是解决医疗保健不平等的基础。然而,我们的研究结果表明，医学教育方面对第一代是不利和不利的，URM,和年长的医学生。当我们追求医学多样性时，对社会人口统计学特征与医学院成功之间的相互作用有更深入的了解是至关重要的。
