Widening access to medicine: using mid‐range theory to extend knowledge and understanding

Nicholson, Sean; Alexander, Kirsty; Coyle, Maeve; Cleland, Jennifer

doi:10.1002/9781119839446.ch4

Cited by 2 publications

(1 citation statement)

References 69 publications

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“…We acknowledge issues of diversity and widening access in the context of selection, but these issues are important enough by themselves for a separate guide and we cannot do them justice here (see, for example, the following for an overview of the issues: Alexander and Cleland, 2015;Nicholson, Alexander, Coyle and Cleland, 2022).…”

Section: Introductionmentioning

confidence: 99%

Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

et al. 2023

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Selection is the first assessment of medical education and training. Medical schools must select from a pool of academically successful applicants and ensure that the way in which they choose future clinicians is robust, defensible, fair to all who apply and cost-effective. However, there is no comprehensive and evidence-informed guide to help those tasked with setting up or rejuvenating their local selection process. To address this gap, our guide draws on the latest research, international case studies and consideration of common dilemmas to provide practical guidance for designing, implementing and evaluating an effective medical school selection system. We draw on a model from the field of instructional design to frame the many different activities involved in doing so: the ADDIE model. ADDIE provides a systematic framework of Analysis (of the outcomes to be achieved by the selection process, and the barriers and facilitators to achieving these), Design (what tools and content are needed so the goals of selection are achieved), Development (what materials and resources are needed and available), Implementation (plan [including piloting], do, study and adjust) and Evaluation (quality assurance is embedded throughout but the last step involves extensive evaluation of the entire process and its outcomes). PRACTICE POINTSMedical schools want guidance to ensure that the way they select medical students is robust, defensible, fair to all who apply and cost-effective.We provide an evidence-based step-by-step and systematic guide to help those tasked with setting up or rejuvenating their local selection process.Topics include fitness for context, blueprinting, selection tools and how to use them, cost and feasibility, and evaluation of process and outcomes.

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Section: Introductionmentioning

confidence: 99%

Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

et al. 2023

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Translating government policy into practice: How new UK medical schools enact widening participation

Cleland,

Buxton,

Hughes

et al. 2024

Medical Education

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IntroductionIncreasing the diversity of medical students, or widening participation (WP), is critical for social justice and healthcare delivery, and many governments are setting policies to encourage WP. However, establishing policy is only the first step in an educational change process: we also need to know “how” policy is enacted or how medical schools interpret and put into practice WP policy. Addressing this gap, the aim of this study was to examine policy enactment in six new UK medical schools with an explicit WP mandate.MethodsThis qualitative study, underpinned by social constructivism, used semi‐structured interviews to explore the experiences of key actors (6 Deans and 14 Admissions staff) of putting policy into practice when setting up a new medical school. Data coding and analysis were initially inductive, using thematic analysis. We then applied Ball's theory of policy enactment to organise the data into four contextual dimensions of ‘situation’, ‘professional’, ‘material’ and ‘external’.ResultsOn the surface, there were many similarities across the six schools in terms of the four dimensions. However, how these dimensions interacted illuminated tensions and differences. For example, some schools found themselves increasingly subjected to local and extra‐local rule systems, including pressure to follow host university norms and hosts struggling to accept that medical schools are heavily regulated. There were also tensions between the new medical schools and the medical education “establishment”, including lack of power and being judged by overly narrow outcomes.DiscussionDifferent contexts seem to influence the enactment of WP to medicine in different places, even in the same country, even in medical schools established at the same time. That policy enactment is a complex, non‐linear process of enactment is important to acknowledge: context is critical. Our findings will inform future policies and practices that aim to increase WP in medicine.

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Widening access to medicine: using mid‐range theory to extend knowledge and understanding

Cited by 2 publications

References 69 publications

Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

Translating government policy into practice: How new UK medical schools enact widening participation

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