Integrated Holistic Student Affairs: A Personalized, Equitable, Student-Centered Approach to Student Affairs

Grieco, Carmine A; Currence, Princess; Teraguchi, Daniel H.; Monroe, Alicia D.; Palermo, Ann-Gel S.

doi:10.1097/acm.0000000000004757

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…By expanding our holistic lens, we can build student-centered frameworks such as the Integrated Holistic Student Affairs (IHSA) model. The IHSA model, developed by leadership of the AAMC’s Group on Student Affairs, provides a road map to shift “from reactive, deficit-oriented practices to proactive, empowering, equitable practices.” Accordingly, we suggest a holistic reimagining of merit, where merit encompasses not only apex academic achievement, but “distance traveled,” structural competency, advocacy, service, and mentorship. With these frameworks in mind, the Figure outlines strategies for educational equity derived from participant observations.…”

Section: Discussionmentioning

confidence: 99%

Challenges Facing First-Generation College Graduates in Medical School

Havemann,

Mason,

Russell

et al. 2023

JAMA Netw Open

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ImportanceFirst-generation (FG) medical students remain underrepresented in medicine despite ongoing national efforts to increase diversity; understanding the challenges faced by this student population is essential to building holistic policies, practices, and learning environments that promote professional actualization. Although FG students have been extensively studied in the undergraduate literature, there is little research investigating how FG students experience medical education or opportunities for educators to intervene.ObjectiveTo explore challenges that FG students experience in undergraduate medical education and identify opportunities to improve foundational FG support.Design, Setting, and ParticipantsThis qualitative study was conducted using an online platform with 37 FG students enrolled in 27 US medical schools. An interprofessional team of medical educators and trainees conducted semistructured interviews from November 2021 through April 2022. Participants were recruited using a medical student listserv. Data were analyzed from April to November 2022.Main Outcomes and MeasuresAfter conducting a preliminary analysis using open coding, a codebook was created and used in a thematic analysis; the codebook used a combination of deductive and inductive coding.ResultsAmong the 37 students recruited for this study, 21 (56.8%) were female; 23 (62.2%) were in the clinical phase of training; 1 (2.7%) was American Indian or Alaska Native, 7 (18.9%) were Hispanic, Latino, or of Spanish origin, 8 (21.6%) were non-Hispanic Asian or Asian American, 9 (24.3%) were non-Hispanic Black or African American, and 23 (32.4%) were non-Hispanic White; mean (SD) age was 27.3 (2.8) years. Participants described 4 major themes: (1) isolation and exclusion related to being a newcomer to medicine; (2) difficulty with access to basic resources (eg, food, rent, transportation) as well as educational (eg, books); (3) overall lack of faculty or institutional support to address these challenges; and (4) a sense of needing to rely on grit and resilience to survive.Conclusions and RelevanceAlthough grit and resilience are desirable traits, results of this study suggest that FG medical students face increased adversity with inadequate institutional support, which forces them to excessively rely on grit and resilience as survival (rather than educational) strategies. By applying the holistic model often used in admissions to the postmatriculation educational process, targeted and flexible initiatives can be created for FG students so that all students, regardless of background, can achieve robust professional actualization.

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Section: Discussionmentioning

confidence: 99%

Challenges Facing First-Generation College Graduates in Medical School

Havemann,

Mason,

Russell

et al. 2023

JAMA Netw Open

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“…Success with holistic review has always depended on subsequent provision of individualized learning plans and support. The Group on Student Affairs has developed a Holistic Student Affairs model to guide schools in assessing critical supports needed for onboarding, matriculation, and retention. The challenges posed by COVID-19 over the past few years have only increased the importance of supportive programming and infrastructure.…”

Section: Commit To Holistic Review and Supportmentioning

confidence: 99%

COVID-19 Has Exacerbated Inequities That Hamper Physician Workforce Diversification

et al. 2022

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In 2021, the number of matriculating Black and Hispanic medical students in the US was the highest it has ever been. 1 Several contributing factors may explain this shift. Very visible health and health care inequities during the COVID-19 pandemic may have encouraged medical schools to actively recruit students underrepresented in medicine (UIM), including American Indian, Black, and Hispanic students. 2 These same circumstances may have encouraged UIM students to pursue careers in medicine. Additionally, the de-emphasis of standardized testing in the medical education pathway may have made medicine more appealing to groups traditionally disadvantaged by standardized testing. 3 Regardless of the reasons, this demographic shift in matriculating students is a welcome one, given evidence that racial concordance between patient and physician is associated with improved patient outcomes, 4,5 studies have shown that UIM trainees are more likely to establish practice in underserved areas, 6,7 and according to the Association of American Medical Colleges (AAMC), more than two-thirds of increases in physician demand over the next 15 years will be driven by racially and ethnically minoritized populations, such as American Indian, Black, and Hispanic patients. 8 However, in their qualitative study of the experiences of premedical students during the COVID-19 pandemic at Historically Black Colleges and Universities (HBCUs), Weiss et al 9 raise important concerns regarding ongoing threats to pathways programming. Prehealth advisors at these institutions perceived 3 types of COVID-19-related difficulties faced by HBCU students that could negatively influence students' academic progress: balancing academic responsibilities with family needs associated with the pandemic; distraction, disruption, and isolation in the virtual learning environment; and the uncertain and evolving requirements of the medical school application process. Weiss et al 9 point out that these difficulties have disproportionately affected HBCU students due to racial disparities in COVID-19-related morbidity and mortality in the Black community 10 and exacerbation of what students have perceived to be a prepandemic lack of mentorship opportunities, institutional support, and shadowing opportunities at HBCUs. 11 As an individual investigation, the study by Weiss et al 9 is significant because HCBUs produce 25% of all Black graduates earning degrees in science, technology, engineering, and medicine. 12 In addition, their study joins other important studies contributing to an evolving understanding of the role of COVID-19 in the pathways continuum and the growing need for workforce diversity efforts. This understanding has grown more robust over the last year and now warrants action.First, the pandemic has exacerbated health and health care disparities. Nationwide, Asian, Black, and Hispanic patients have experienced all-cause excess mortality that is as much as 4-fold that experienced by White patients. 13 Furthermore, changes in life expectancy have been s...

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“…Several medical schools have existing formal programs to support FG medical students 1,4 Student-centered, systems-based approaches such as the Integrated Holistic Student Affairs Model (IHSA), 6 provide a framework to shift from deficit-oriented practices to empowering learning environments. In addition to the IHSA, Havemann and colleagues 2 advocate for the holistic reimagining of merit to include distance traveled, advocacy, service, and mentorship.…”

mentioning

confidence: 99%

Supporting First-Generation Medical Students—Improving Learning Environments for All

Alves-Bradford

2023

JAMA Netw Open

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Integrated Holistic Student Affairs: A Personalized, Equitable, Student-Centered Approach to Student Affairs

Cited by 8 publications

References 31 publications

Challenges Facing First-Generation College Graduates in Medical School

Challenges Facing First-Generation College Graduates in Medical School

COVID-19 Has Exacerbated Inequities That Hamper Physician Workforce Diversification

Supporting First-Generation Medical Students—Improving Learning Environments for All

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