Motivation of Dutch high school students from various backgrounds for applying to study medicine: a qualitative study

Wouters, Anouk; Croiset, Gerda; Isik, Ulviye; Kusurkar, Rashmi A.

doi:10.1136/bmjopen-2016-014779

Cited by 55 publications

(87 citation statements)

References 70 publications

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“…Furthermore, our participants did not report that other commonly identified 'barriers' to medicine (financial barriers, [23][24][25] cultural factors, [17][18][19]21,22 lack of information 1,25-27 ) would deter them from aspiring to and pursuing the career of their choice. Some (although not all) participants even believed that the most significant barrier to medicineachievement of the required academic gradescould be navigated with sufficient willpower and smart choices.…”

Section: Perceived 'Fit' With Medicinementioning

confidence: 99%

“…In the UK context, ‘non‐traditional’ groups include (amongst others) those who live in areas of socio‐economic deprivation or attend schools with low rates of progression to university. International literature reveals that people from these groups may be deterred by factors including: sociocultural barriers and lack of identity ‘fit’; lack of confidence or feelings of inadequacy; perceived financial costs or material barriers, and lack of information . Greenhalgh et al.…”

Section: Introductionmentioning

confidence: 99%

“…In the UK context, 'nontraditional' groups include (amongst others) those who live in areas of socio-economic deprivation or attend schools with low rates of progression to university. International literature reveals that people from these groups may be deterred by factors including: sociocultural barriers and lack of identity 'fit'; [17][18][19][20] lack of confidence or feelings of inadequacy; 19,21,22 perceived financial costs or material barriers, [23][24][25] and lack of information. 1,[25][26][27] Greenhalgh et al's 2004 UK study reported that more affluent school pupils were happy to consider medicine for the intrinsic benefits of the career, whereas school pupils from lower socio-economic groups perceived it as a career geared towards the 'posh' (people from higher social classes) and felt they would be at an insurmountable disadvantage in competition for a place as they did not come from this group.…”

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confidence: 99%

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Bridging the cultural divide? Exploring school pupils’ perceptions of medicine

2019

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Context Literature published around a decade ago demonstrated that UK individuals from non‐traditional groups may not consider, or aspire to, medicine because of sociocultural barriers and instead may perceive medicine as ‘not for the likes of me’. Since this time, the UK higher education landscape has undergone significant change, with an increased emphasis on student choice and widening access (WA) initiatives. Consequently, the present study looks anew at the perceptions of medicine held by school pupils from non‐traditional backgrounds to assess whether sociocultural factors remain a major barrier to medicine. Methods Focus groups were conducted with 71 high‐achieving school pupils in their penultimate or final years (aged 16–18 years). Participants attended UK state‐funded schools engaged with medical school WA initiatives. Transcripts were analysed thematically using a data‐driven approach. Themes were then interpreted through the conceptual lens of the ‘reflexive habitus’, an adapted version of Bourdieu's classic concept. Results Participants did not perceive that sociocultural differences would deter them from aspiring to, or pursuing, the career of their choice. Some participants identified their ‘different’ background as a strength to bring to medicine. They reported that intrinsic motivators (personal interest and fulfilment) were most important in their own career choices. When asked what they believed might have motivated current medical students for the career, participants debated the role of extrinsic motivators (high status and income) versus intrinsic ones. ‘Hot knowledge’ (social contacts) from within medicine helped some participants reconcile any clash in perceived values and better imagine themselves in the profession. Conclusions These non‐traditional school pupils from schools engaged with WA initiatives appear to have embraced the belief that medicine is for anyone with the appropriate desire and ability, regardless of background. Furthermore, some pupils reported that some aspects of their ‘difference’ (diversity) could help enrich the workforce and patient care.

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Section: Perceived 'Fit' With Medicinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Bridging the cultural divide? Exploring school pupils’ perceptions of medicine

2019

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“…Although the percentage of non‐Western minority applicants in our study by far exceeded the percentage of non‐Western pre‐university graduates in the Netherlands (27% versus 8%) and the percentage of first‐generation students was higher among applicants than among current students (including those admitted by lottery), we still do not have any data about those who decided not to apply. A recent qualitative study, albeit small, from Amsterdam suggests that selection procedures currently applied in the Netherlands may discourage students without a ‘medical network’ from applying to medical school, therefore leading to inequalities with respect to socio‐demographic background . An interesting area of research would be whether certain types of (non‐academic) selection instruments are less discouraging for non‐traditional applicants, for example because of higher face validity.…”

Section: Adverse Impactmentioning

confidence: 99%

Lessons learned from 15 years of non-grades-based selection for medical school

Stegers‐Jager

2017

Med Educ

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ContextThirty years ago, it was suggested in the Edinburgh Declaration that medical school applicants should be selected not only on academic, but also on non‐academic, attributes. The main rationale behind extending medical school selection procedures with the evaluation of (non‐academic) personal qualities is that this will lead to the selection of students who will perform better as a doctor than those who are selected on the basis of academic measures only. A second rationale is the expectation that this will lead to a representative health workforce as a result of reduced adverse impact. The aims of this paper are (i) to describe what can be learned about the use of selection criteria other than grades from over 15 years of Dutch experience and (ii) to summarise current knowledge on the issue of adverse impact in relation to non‐grades‐based selection.MethodsA narrative review was undertaken of the (published) evidence that has resulted from non‐grades‐based school‐specific selection procedures in the Netherlands and from recent explorations of the effect of the use of non‐grades‐based selection criteria on student diversity.ResultsThe Dutch evidence is grouped into five key themes: the effect of participation in voluntary selection procedures, the assessment of pre‐university extracurricular activities, the use of work samples, Dutch experiences with situational judgement tests and the effects of changing circumstances. This is followed by several lessons learned for medical schools that aim to increase their student diversity.ConclusionOver the last 30 years, important steps towards reliable and valid methods for measuring non‐academic abilities have been taken. The current paper describes several lessons that can be learned from the steps taken in the Dutch context. The importance of sharing evidence gathered around the globe and building on this evidence to reach our goal of predicting who will be a good doctor is acknowledged.

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“…Motivation to enter a career in medicine can be underpinned by a variety of factors, including an interest in science, altruistic reasons, and prior personal experiences with doctors and patients . Early exposure to Dermatology may not capture the clinical variety the specialty offers, and may negatively influence career selection .…”

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confidence: 99%