Editorial Perspective: When is a ‘small effect’ actually large and impactful?

Carey, Emma; Ridler, Isobel; Ford, Tamsin; Stringaris, Argyris

doi:10.1111/jcpp.13817

Cited by 55 publications

(17 citation statements)

References 19 publications

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“…It is important to note that mean tool scores between marginalized and nonmarginalized groups are statistically significant, but differences and their associated effect sizes are small. Nevertheless, prior research has shown that small differences between groups, even with small effect sizes, can accumulate over time and have substantial influence on real world outcomes . Moreover, the size of differences between groups are similar to results found in other climate surveys used by the AAMC and in prior national studies .…”

Section: Discussionsupporting

confidence: 52%

“…Nevertheless, prior research has shown that small differences between groups, even with small effect sizes, can accumulate over time and have substantial influence on real world outcomes. [31][32][33][34][35] Moreover, the size of differences between groups are similar to results found in other climate surveys used by the AAMC and in prior national studies. 36,37 Future studies of the tool will examine how differences in tool scores influence disparities in consequential student outcomes in the learning environment, including attrition, successful placement into graduate medical education, burnout, and the receipt of academic awards.…”

Section: Discussionmentioning

confidence: 99%

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Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

Boatright,

Nguyen,

Hill

et al. 2024

JAMA Netw Open

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ImportanceCreating an inclusive and equitable learning environment is a national priority. Nevertheless, data reflecting medical students’ perception of the climate of equity and inclusion are limited.ObjectiveTo develop and validate an instrument to measure students’ perceptions of the climate of equity and inclusion in medical school using data collected annually by the Association of American Medical Colleges (AAMC).Design, Setting, and ParticipantsThe Promoting Diversity, Group Inclusion, and Equity tool was developed in 3 stages. A Delphi panel of 9 members identified survey items from preexisting AAMC data sources. Exploratory and confirmatory factor analysis was performed on student responses to AAMC surveys to construct the tool, which underwent rigorous psychometric validation. Participants were undergraduate medical students at Liaison Committee on Medical Education–accredited medical schools in the US who completed the 2015 to 2019 AAMC Year 2 Questionnaire (Y2Q), the administrations of 2016 to 2020 AAMC Graduation Questionnaire (GQ), or both. Data were analyzed from August 2020 to November 2023.ExposuresStudent race and ethnicity, sex, sexual orientation, and socioeconomic status.Main Outcomes and MeasuresDevelopment and psychometric validation of the tool, including construct validity, internal consistency, and criterion validity.ResultsDelphi panel members identified 146 survey items from the Y2Q and GQ reflecting students’ perception of the climate of equity and inclusion, and responses to these survey items were obtained from 54 906 students for the Y2Q cohort (median [IQR] age, 24 [23-26] years; 29 208 [52.75%] were female, 11 389 [20.57%] were Asian, 4089 [7.39%] were multiracial, and 33 373 [60.28%] were White) and 61 998 for the GQ cohort (median [IQR] age, 27 [26-28] years; 30 793 [49.67%] were female, 13 049 [21.05%] were Asian, 4136 [6.67%] were multiracial, and 38 215 [61.64%] were White). Exploratory and confirmatory factor analyses of student responses identified 8 factors for the Y2Q model (faculty role modeling; student empowerment; student fellowship; cultural humility; faculty support for students; fostering a collaborative and safe environment; discrimination: race, ethnicity, and gender; and discrimination: sexual orientation) and 5 factors for the GQ model (faculty role modeling; student empowerment; faculty support for students; discrimination: race, ethnicity, and gender; and discrimination: sexual orientation). Confirmatory factor analysis indicated acceptable model fit (root mean square error of approximation of 0.05 [Y2Q] and 0.06 [GQ] and comparative fit indices of 0.95 [Y2Q] and 0.94 [GQ]). Cronbach α for individual factors demonstrated internal consistency ranging from 0.69 to 0.92 (Y2Q) and 0.76 to 0.95 (GQ).Conclusions and RelevanceThis study found that the new tool is a reliable and psychometrically valid measure of medical students’ perceptions of equity and inclusion in the learning environment.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

Boatright,

Nguyen,

Hill

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…Our post hoc analyses showed just this: children with elevated prenatal risk and/or greater DNA methylation of one or both CpGs were more likely to score in range of mild cognitive delay. Thus, what may be considered a small shift in the absolute value of scores could constitute a meaningful shift in the number of preterm children classified as having a developmental delay or disability (Carey et al, 2023) and who therefore would qualify for additional services or interventions. Thus, small but additive effects are especially important to understand in the context of this high-risk group.…”

Section: Discussionmentioning

confidence: 99%

Contributions of prenatal risk factors and neonatal epigenetics to cognitive outcome in children born very preterm.

Camerota,

Lester,

McGowan

et al. 2024

Developmental Psychology

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Children born less than 30 weeks gestational age (GA) are at high risk for neurodevelopmental delay compared to term peers. Prenatal risk factors and neonatal epigenetics could help identify preterm children at highest risk for poor cognitive outcomes. We aimed to understand the associations among cumulative prenatal risk, neonatal DNA methylation, and child cognitive ability at age 3 years, including whether DNA methylation mediates the association between prenatal risk and cognitive ability. We studied 379 neonates (54% male) born less than 30 weeks GA who had DNA methylation measured at neonatal intensive care unit discharge along with 3-year follow-up data. Cumulative prenatal risk was calculated from 24 risk factors obtained from maternal report and medical record and epigenome-wide neonatal DNA methylation was assayed from buccal swabs. At 3-year follow-up, child cognitive ability was assessed using the Bayley Scales of Infant and Toddler Development (third edition). Cumulative prenatal risk and DNA methylation at two cytosine–phosphate–guanines (CpGs) were uniquely associated with child cognitive ability. Using high-dimensional mediation analysis, we also identified differential methylation of 309 CpGs that mediated the association between cumulative prenatal risk and child cognitive ability. Many of the associated CpGs were located in genes (TNS3, TRAPPC4, MAD1L1, APBB2, DIP2C, TRAPPC9, DRD2) that have previously been associated with prenatal exposures and/or neurodevelopmental phenotypes. Our findings suggest a role for both prenatal risk factors and DNA methylation in explaining outcomes for children born preterm and suggest we should further study DNA methylation as a potential mechanism underlying the association between prenatal risk and child neurodevelopment.

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“…In contrast, citizens reported less encouragement by their PI than non-citizens (particularly non-citizen males who reported the most encouragement). While this effect size was small, it may still have meaningful real-world consequences in some cases [ 68 , 69 ]. This finding is counter to the assumption that PIs would be less supportive of non-citizens.…”

Section: Discussionmentioning

confidence: 99%

Citizenship status and career self-efficacy: An intersectional study of biomedical trainees in the United States

Chatterjee,

Nogueira,

Wefes

et al. 2024

PLoS ONE

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This study examines the intersectional role of citizenship and gender with career self-efficacy amongst 10,803 doctoral and postdoctoral trainees in US universities. These biomedical trainees completed surveys administered by 17 US institutions that participated in the National Institutes of Health Broadening Experiences in Scientific Training (NIH BEST) Programs. Findings indicate that career self-efficacy of non-citizen trainees is significantly lower than that of US citizen trainees. While lower career efficacy was observed in women compared with men, it was even lower for non-citizen female trainees. Results suggest that specific career interests may be related to career self-efficacy. Relative to US citizen trainees, both male and female non-citizen trainees showed higher interest in pursuing a career as an academic research investigator. In comparison with non-citizen female trainees and citizen trainees of all genders, non-citizen male trainees expressed the highest interest in research-intensive (and especially principal investigator) careers. The authors discuss potential causes for these results and offer recommendations for increasing trainee career self-efficacy which can be incorporated into graduate and postdoctoral training.

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Editorial Perspective: When is a ‘small effect’ actually large and impactful?

Cited by 55 publications

References 19 publications

Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

Contributions of prenatal risk factors and neonatal epigenetics to cognitive outcome in children born very preterm.

Citizenship status and career self-efficacy: An intersectional study of biomedical trainees in the United States

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