Selection tools and student diversity in health professions education: a multi-site study

Abstract

Student diversity in health professions education (HPE) can be affected by selection procedures. Little is known about how different selection tools impact student diversity across programs using different combinations of traditional and broadened selection criteria. The present multi-site study examined the chances in selection of subgroups of applicants to HPE undergraduate programs with distinctive selection procedures, and their performance on corresponding selection tools. Probability of selection of subgroups (based on gender, migration background, prior education, parental education) of applicants (N = 1935) to five selection procedures of corresponding Dutch HPE undergraduate programs was estimated using multilevel logistic regression. Multilevel linear regression was used to analyze performance on four tools: prior-education grade point average (pe-GPA), biomedical knowledge test, curriculum-sampling test, and curriculum vitae (CV). First-generation Western immigrants and applicants with a foreign education background were significantly less likely to be selected than applicants without a migration background and with pre-university education. These effects did not vary across programs. More variability in effects was found between different selection tools. Compared to women, men performed significantly poorer on CVs, while they had higher scores on biomedical knowledge tests. Applicants with a non-Western migration background scored lower on curriculum-sampling tests. First-generation Western immigrants had lower CV-scores. First-generation university applicants had significantly lower pe-GPAs. There was a variety in effects for applicants with different alternative forms of prior education. For curriculum-sampling tests and CVs, effects varied across programs. Our findings highlight the need for continuous evaluation, identifying best practices within existing tools, and applying alternative tools.

Applicant perceptions of selection methods for health professions education: Rationales and subgroup differences

“…For instance, while applicants hold negative perceptions towards the use of pu‐GPA as a selection method, pu‐GPA is strongly predictive of future academic performance 33 . Likewise, the findings of the present study suggest that the inclusion of curriculum‐sampling tests can attract more applicants with a non‐Western background, but we found in a submitted study that this subgroup of applicants performs less well on such tests 34 . Thus, when deciding which selection methods to include, applicant perceptions can be taken into account, while also considering other aspects of validity in a broad sense 35 .…”

“… 33 Likewise, the findings of the present study suggest that the inclusion of curriculum‐sampling tests can attract more applicants with a non‐Western background, but we found in a submitted study that this subgroup of applicants performs less well on such tests. 34 Thus, when deciding which selection methods to include, applicant perceptions can be taken into account, while also considering other aspects of validity in a broad sense. 35 Nevertheless, our findings can help identify which selection methods are less attractive and require better explanation.…”

The added value of free preparatory activities for widening access to medical education: a multi-cohort study

“…Understanding the impact of these activities on subgroups of students with non-traditional backgrounds can help medical schools in increasing student diversity. In the Netherlands, the context of the present study, male students are underrepresented [33], and students with a migration background and firstgeneration students are considered students with nontraditional backgrounds [34].…”

“…And (3) Does participation in different free institutionally-provided preparatory activities predict early academic performance and does this relationship differ for subgroups? Subgroups were based on background variables that are associated with selection and early academic performance: sex, migration background (as an indicator of ethnicity) and parental education (as an indicator of SES) [3,5,[33][34][35][36][37].…”

Selection based on athletics: What price will the candidates pay?

“…In most countries, that is, selection based on participation in athletics may do more harm than good for student diversity. In fact, research suggests that selection based on extracurricular activities (including athletics) may cause an adverse impact on applicants with an ethnic minority background and for those who do not apply for traditional pre‐university education 5 …”