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Introduction
Health
disparities in the United States are being addressed by
multiple strategies. One strategy is to increase the racial/ethnic
diversity of the health professions. Currently, the percentage
of minority health professionals in the Nation falls far
below the percentage of minorities in its population. Attempts
to increase minority student interest in, and academic preparation
for, health professions training and programs in the educational
“pipeline” (education prior to health professions
training) have been employed for many years. This document
provides an annotated bibliography of a comprehensive review
of the research literature that evaluates the effectiveness
of health career oriented pipeline programs for minority
students.
Domain
This
bibliography covers articles (published and unpublished)
that document studies of interventions to improve educational
performance of minorities in programs designed to increase
the numbers of minorities entering the health professions.
Scope
Searches
of the computerized MEDLINE/HealthSTAR, Educational Resource
Information Center (ERIC), and Cumulative Index to Nursing
and Allied Health Literature (CINAHL) databases were conducted.
Since each bibliographic database has a different subject
focus, search terms were adjusted accordingly. Search
terms in MEDLINE included: minority, diversity, education,
attrition, premed, applicants, admissions, health professions
applicants, student diversity, and minority education.
In the ERIC database search terms included: health professions,
minority health, minority education, and minority programs.
For CINAHL, following terms were used: diversity programs,
diversity education, minority program, minority education.
Searches were conducted for the years 1980-2005, with
the exception of the CINAHL search which commenced in
1982. Additionally, bibliographies at the back of many
of the selected articles were reviewed to identify additional
evaluations that may not have surfaced in the electronic
subject search or that were not catalogued in the bibliographic
databases. Also, individuals who were familiar with diversity
programs were queried about other possible evaluations
that may not have been found in the library databases,
including unpublished work.
Selection
Documents
were included in the bibliography if they: (1) evaluated
interventions at the high school, college, or post-baccalaureate
level, (2) evaluated interventions that were specifically
targeted to health professions outcomes or outcomes in
health professions “gateway” courses in science
and math, (3) included interventions that targeted minority
and disadvantaged students, (4) had study methods that
included a control group, and (5) analyzed quantitative
data on outcomes. Included studies examined outcomes that
were short-term or intermediary (e.g., improvement in
grade point average or MCAT scores) as well as those measuring
“harder” outcomes such as actual matriculation
in a health professions school. Although the search terms
identified hundreds of articles, the vast majority of
these publications were descriptive reports that did not
meet the inclusion criteria for formal review. This annotated
bibliography includes the 24 controlled evaluations that
met the inclusion criteria.
Organization
The
evaluation study articles are organized alphabetically
by author. There is also an alphabetical title listing
on page 10.
Citation
Format
Citation
format follows the National Library of Medicine Recommended
Formats for Bibliographic Citation, produced by the
U.S. Department of Health and Human services, National
Institutes of Health, National Library of Medicine.
Evaluation Study
Articles
Making
a difference for minorities: evaluation of an educational
enrichment program |
- Barlow
EL, Villarejo M. Making a difference for minorities: evaluation
of an educational enrichment program. Journal of Research
in Science Teaching 2004 Nov;41(9):861-881.
This
study compared minority participants in the Biology Undergraduate
Scholars Program (BUSP), University of California, Davis
(UCD) to a cross-section of matched biology contemporaries,
as well as to matched students pre-BUSP. The BUSP program
included academic enrichment, financial aid, and 4-week
summer program. Outcomes for the study were chemistry and
calculus grades, and the number of science graduates with
grade point averages (GPAs) 3.0 or higher.
BUSP
students were more likely than control students to successfully
complete general chemistry, calculus and biology, and to
earn higher grades in calculus and chemistry. BUSP students
were significantly more likely to graduate with a degree
in biology, and also had a non-significant trend towards
a greater likelihood of graduating from UCD and a non-significant
trend towards graduating as a biology major with a GPA>3.0.
Among
the BUSP students, those who actively participated in the
supplemental workshops earned higher calculus and chemistry
GPAs than those who did were less engaged in the program.
Ventures
in education: a pipeline to medical education for minority
and economically disadvantaged students |
- Bediako
MR, McDermott BA, Bleich ME, Colliver JA. Ventures in
education: a pipeline to medical education for minority
and economically disadvantaged students. Academic Medicine
1996 Feb;71(2):190-192.
This
study addressed the program “Ventures in Education”,
a high school enrichment program for minority studentswhich
incorporated a challenging academic curriculum, educational
enrichment in general health science, and tutoring to increase
success in professions. The pre/post design compared Ventures
graduates outcomes to school-wide rates before program implementation.
The outcomes measured included health professions school
applications and matriculation. Prior to the implementation
of the Ventures program, no students at the five participating
high schools took the Medical College Admission Tests (MCATs),
applied, were accepted, or matriculated into medical school.
After 5 years of this enrichment program, these numbers
increased, resulting in 72 students matriculating into medical
school.
Paths
to success: an evaluation of the gateway to higher education
program |
- Campbell
PB, Wahl E, Slater M, Iler E, Moeller B, Ba H, Light D.
Paths to success: an evaluation of the gateway to higher
education program. Journal of Women and Minorities in
Science and Engineering 1998;4(2&3):297-308.
The
Gateway to Higher Education, a multi-component high school
program in New York City, was designed to improve minority
students’ academic success in math and science. This
retrospective cohort study with matched controls showed
that the program was associated with increased rates of
high school graduation, taking of Statewide Regents Exams
and SAT tests, achieving higher mean SAT scores, and increased
matriculation into college.
Effect
of an intensive educational program for minority college
students and recent graduates on the probability of
acceptance to medical school |
-
Cantor JC, Bergeisen L, Baker LC.
Effect of an intensive educational program for minority
college students and recent graduates on the probability
of acceptance to medical school. JAMA 1998 Nov;280(9):772-776.
The
Minority Medical Education Program (MMEP), a 6-week residential
summer educational program for undergraduates and recent
graduates, focused on training minority students in the
sciences and improvement of writing, verbal reasoning, studying,
test taking, and presentation skills. The program focused
on enrichment rather than remediation. This cohort study
compared participants to non-participant minority applicants
to medical school, measuring the outcome as the probability
of acceptance to at least 1 medical school. The results
showed a significant increase of MMEP participants accepted
to medical school compared with minority non-participants.
Participation
in enrichment programs and its effect on interview scores
of applicants to the University of Washington School
of Medicine |
- Carline
JD, Hunt DD, Patterson DG, Garcia C. Participation in
enrichment programs and its effect on interview scores
of applicants to the University of Washington School of
Medicine. Academic Medicine 1999 Apr;74(4):360-362.
This
retrospective cohort study compared minority student applications
to University of Washington School of Medicine 1993-1995,
assessing whether any enrichment program participation was
correlated with interview scores. The results showed no
effect of participation on an applicant’s interview
scores. There was a small, but not statistically significant
effect that applicants were more likely to get interviews
if they had participated in enrichment programs.
Recruitment,
retention and matriculation of ethnic minority nursing
students: a University of Mississippi School of Nursing
approach |
- Fletcher
A, Williams PR, Beacham T, Elliott RW, Northington L,
Calvin R, Hill M, Haynes A, Winters K, Davis S. Recruitment,
retention and matriculation of ethnic minority nursing
students: a University of Mississippi School of Nursing
approach. Journal of Cultural Diversity 2003 Winter:10(4):128-33.
Designed
to increase minority representation in nursing, the Minority
Recruitment and Retention Initiative study compared the
number of ethnic minority students and faculty in the University
of Mississippi, School of Nursing. Numbers of minority students
and faculty showed an increase in a pre/post program analysis.
Mathematics
achievement among African-American undergraduates at
the University of California, Berkeley |
- Fullilove
R, Treisman PU. Mathematics achievement among African-American
undergraduates at the University of California, Berkeley:
an evaluation of the mathematics workshop program. Journal
of Negro Education 1990 Summer; 59(3):463-478.
This
study addressed the effectiveness of the Mathematics Workshop
Program at the University of California, Berkeley, assessing
whether this academic enrichment program had an impact on
the African-American participants. Outcomes included students’
final grade in Math 1A and improved persistence and graduation
compared with African- American non-participants. Participants
were additionally compared with a historical control group.
Results showed that workshop students were significantly
more successful in earning a B- or better and persisting
in school and graduation than both the non-participants
and the historical controls.
Evaluation
of a supplementary retention program for African-American
baccalaureate nursing students |
- Hesser
A, Pond E, Lewis L, Abbott B. Evaluation of a supplementary
retention program for African-American baccalaureate nursing
students. Journal of Nursing Education 1996 Oct;35(7):304-309.
The
Minority Academic Advising Program (MAAP) at the Medical
College of Georgia included supplementary retention activities
and special advising efforts to address academic, personal,
social and financial issues for undergraduate nursing students.
This pre/post evaluation for underrepresented minority students
looked at retention to graduation rates, GPA, and rate of
board-passing on the first try. The study also compared
the MAAP students to a pre-MAAP cohort. The mean grade point
average for African American students increased significantly
and the GPA gap between African Americans and other students
narrowed. Graduation rates for African American nursing
students, which were already high (92 percent) in the pre-intervention
period, increased somewhat to 97 percent, a change which
did not reach statistical significance. Passing rates at
first sitting for nursing board exams increased from 49
percent to 64 percent over the pre- and post-intervention
periods, although this difference also did not achieve statistical
significance due to the small sample size.
Evaluation
of a supplementary retention program for Black allied
health sciences students |
- Hesser
A, Lewis L, Abbott B, Vericella B. Evaluation of a supplementary
retention program for Black allied health sciences students.
Journal of Allied Health 1993 Spring;22(2):175-182.
This
study addressed the impact of the Minority Academic Advising
Program (MAAP) at the Medical College of Georgia’s
retention program. MAAP provided advising help for academic,
personal, social, financial, vocational and other concerns.
The pre/post study design compared retention variables of
African-American undergraduates across two time periods,
pre-MAAP, 1978-1982, and MAAP time period, 1984-1988, looking
at the program’s impact on retention in school. Graduation
rates for African American students increased from 72 percent
before the intervention to 83 percent after the intervention.
Graduation rates for non-African American students remained
relatively constant during the same period.
Evaluation
of a summer prematriculation program for Black and …
nontraditional students |
- Hesser
A, Lewis L. Evaluation of a summer prematriculation program
for Black and … nontraditional students. Academic
Medicine 1992 Apr;67(4):270-272.
The
Medical College of Georgia Summer Pre-matriculation Program
(SPP) provided an introduction to basic science courses
taken in the first year, developed medical and learning
skills, and supported academic and social interactions with
classmates and faculty. In this cohort study comparing entering
African-American medical students and nontraditional students
deemed at risk who chose to participate in SPP vs. those
who chose not to participate, researchers compared medical
school grades, pass rates, and retention rates. Both intervention
and control students had over 90 percent retention rates
for the first year of medical school, although there was
a slight trend for intervention students to be less likely
to leave, withdraw or repeat the first year. There was also
a non-significant trend of higher biochemistry grades for
intervention students. The sample sizes were small, limiting
the study’s statistical power.
MEDPREP—30
years of making a difference |
- Jackson
EW, McGlinn S, Rainey M, Bardo HR. MEDPREP—30 years
of making a difference. Academic Medicine 2003 Apr;78(5):448-53.
During
the 30 years included in this retrospective uncontrolled
cohort study of a post-baccalaureate program at Southern
Illinois University School of Medicine, 688 minority students
who participated in the post-baccalaureate Medical /Dental
Education Preparatory Program were accepted to a health
professions school, 578 matriculated and have either graduated
or are expected to graduate. NOTE: In the 1999 article
on this program (see Reference Item Number 15 below), the
authors included measures of improvements in MCAT scores;
those analyses were not included in this article.
Latino
Center for Medical Education and Research, University
of California San Francisco at Fresno |
- Latino
Center for Medical Education and Research, University
of California San Francisco at Fresno. (2005) An evaluation
of the Sunnyside High School Doctors Academy. Unpublished
report.
Doctors
Academy, a high school program in Fresno designed to improve
minority students’ success in pursuing medicine and
other health professions, was assessed through a retrospective
controlled cohort study. This academic, mentoring, experience
and skills-based program resulted in increased grade point
average and cumulative credits. Program participants were
more likely to graduate on time.
A
state university’s model program to increase the
number of its disadvantaged students who matriculate
into health professions schools |
- Lewis
CL. A state university’s model program to increase
the number of its disadvantaged students who matriculate
into health professions schools. Academic Medicine 1996
Oct;71(10):1050-1057.
The
evaluation of San Diego State University’s Health
Careers Opportunity Program (HCOP) compared pass rates for
entry-level competencies, GPA and applications and acceptance
to health professions schools for disadvantaged students
who participated in the multi-component program vs. those
who attended the University prior to having an HCOP program
on campus. The aggregate GPA of HCOP students was compared
to minority pre-health students in the years before HCOP
implementation. The number of minority applicants and acceptances
to health professions schools (not counting those to nursing
or public health) were analyzed as well.
Summer
Academic Program participants had higher pass rates for
the math and writing entry level competency tests compared
to other SDSU students. Mentoring journals (that mentors
kept, recording interactions with protégés) indicate that
students’ feelings of confidence and success were
correlated with a higher GPA. TheGPA of minority pre-health
students steadily increased after the advent of HCOP on
campus and continued to increase over the 5 years analyzed.
Underrepresented minority applicants to health professions
schools doubled over the 5 years post-HCOP when compared
with 5 years pre-HCOP; acceptance rates remained virtually
the same.
African-American
college students excelling in the sciences: college
and post-college outcomes in the Meyerhoff Scholars
Program |
- Maton
KI, Hrabowski FA, Schmitt CL. African-American college
students excelling in the sciences: college and post-college
outcomes in the Meyerhoff Scholars Program. Journal of
Research in Science Teaching 2000 Sep3;7(7):629-654.
This
evaluation of the Meyerhoff Scholars Program at the University
of Maryland, Baltimore County assessed effectiveness of
the program which focused on increasing the number of African-American
Ph.D. level researchers in science, engineering and math
(SEM). In a controlled cohort study, the authors compared
Meyerhoff students to those who were accepted to the program
but declined and went to another university. The researchers
also compared students in the first three Meyerhoff Program
cohorts to a pre-Meyerhoff sample of African-American students
who met the entrance requirements of the program. A sample
of matched controls were used, as well. Outcome included
GPAs; grades in “gateway” courses; science and
engineering GPAs; and graduation rates in science, engineering
or math (SEM) disciplines.
Meyerhoff
students were nearly twice as likely to graduate in SEM
majors as those who declined the program, and achieved significantly
higher SEM GPAs than either the declined or historical sample.
There were no significant differences between the two groups
in terms of overall GPA. Meyerhoff students were more likely
to attend SEM graduate school. Relatively equal numbers
attended medical school. Adjusted overall GPAs were higher
in the Meyerhoff group than in the historical African-American
group or the current Asian or Caucasian group.
Postbaccalaureate
medical/dental education preparatory program (MEDPREP)
at Southern Illinois University School of Medicine |
- McGlinn
S, Jackson EW, Bardo HR. Postbaccalaureate medical/dental
education preparatory program (MEDPREP) at Southern Illinois
University School of Medicine. Academic Medicine 1999
Apr;74(4):380-382.
The
Medical/Dental Education Preparatory Program (MEDPREP) at
Southern Illinois University School of Medicine was a post-baccalaureate
program to assist minority students in improving their credentials
to health professions schools. This study compared changes
in MCAT scores of MEDPREP participants to all others repeating
the MCAT April 1993 to August 1994. On each section of the
MCAT, repeater testers who participated in MEDPREP achieved
larger gains on average than all repeaters. No tests of
significance were conducted.
Undergraduate
student-faculty research partnerships affect student
retention |
- Nagda
BA, Gregerman SR, Jonides J, von Hippel W, Lerner JS.
Undergraduate student-faculty research partnerships affect
student retention. Review of Higher Education 1998 Fall;22(1)
55-72.
The
Undergraduate Research Opportunity Program’s major
goal was to broker intellectual relationships between faculty
and first-year and sophomore undergraduates through research
partnerships at the University of Michigan. This prospective
randomized trial with stratification showed positive impact—higher
retention rates for African American students, especially
“low-GPA” African American students. Non-significant
or moderately significant improvements in retention were
found for Hispanic, White, and high-GPA African-American
students.
Minority
recruitment to the health professions: a matched comparison
six-year follow-up |
- Philips
BU, Mahan JM, Perry RR. Minority recruitment to the health
professions: a matched comparison six-year follow-up.
Journal of Medical Education 1981 Sep;56(9 pt 1):742-747.
University
of Texas Medical Branch Area Health Education Center (AHEC)
conducted a summer program that focused on exposure to health
settings, allowing minority participants to rotate through
hospitals and teaching facilities. The program focused on
academic, communication, and interpersonal skills.
This
cohort study was a 6-year follow-up of participants and
non-participants who had applied to the program, but who
had not been accepted (because of space constraints.) Outcomes
measured included employment in a health profession, location
of employment (Texas AHEC area or not), and attainment of
career choice. A greater proportion of participants were
employed in health professions than the control group. While
not statistically significant, the results also suggest
that respondents employed in health professions tended to
be employed in the Texas area.
The
impact of a medical-school-based summer program on the
acceptance of minority undergraduate students into health
professional schools |
- Pisano
JC, Epps AC. The impact of a medical-school-based summer
program on the acceptance of minority undergraduate students
into health professional schools. Journal of the National
Medical Association 1983 Jan;75(1):17-23.
The
Medical Education Reinforcement and Enrichment Program (MEdREP),
Tulane University School of Medicine prepared minority undergraduate
sophomores and juniors for careers in medicine and other
health care fields through a 10-week summer program, academic
enrichment clinical exposure and preparation for the MCAT
and preceptorship experience. The study compared 1976 participants
to 1976 nonparticipating applicants as well as comparing
application rates of all participants (1972-1979) with respect
to application and acceptance rates to medical and allied
health profession schools.
Overall,
MEdREP participants had higher GPAs and acceptance rates
to health professions schools than non-participants. No
adjustment for potential underlying differences and no tests
of significance were done between groups.
The
impact of MCAT intervention efforts on medical student
acceptance rates |
- Pisano
JC, Epps AC. The impact of MCAT intervention efforts on
medical student acceptance rates. Journal of the National
Medical Association 1983 Aug;75(8):773-777.
This
second study of the MEdREP program compared MCAT scores
of minority students before and after a MEdREP MCAT review.
Among MEdREP participants who had taken the MCAT prior to
the intervention, scores improved when they retook the exam
after the intervention. However, sample sizes were small,
there was no comparison group to adjust for possible effects
of simply taking the exam for the second time, and no tests
of statistical significance were performed.
A
program to prepare minority students for careers in
medicine, science, and other high-level professions |
- Slater
M, Iler E. A program to prepare minority students for
careers in medicine, science, and other high-level professions.
Academic Medicine 1991 Apr;66(4):220-225.
The
Gateway to Higher Education program, a comprehensive high
school academic enrichment and support program for minority
students, was evaluated with New York State Regents subject
test scores, PSAT, and SAT scores as the outcome when comparing
Gateway students to peers in their schools.
Gateway
students had higher pass rates than their peers on the New
York State Regents examination. Comparing outcomes to national
averages, the Gateway seniors as a whole had an average
SAT score that was 75 points higher than the national average.
Of African-American students, Gateway students exceeded
the national average for African-American students by 237
points. (974 vs. 737). As Gateway selects higher achieving
students, no comparison to a similar group was available.
A
pre-admission program for underrepresented minority
and disadvantaged students: application, acceptance,
graduation rates and timeliness of graduating from medical
school |
- Strayhorn
G. A pre-admission program for underrepresented minority
and disadvantaged students: application, acceptance, graduation
rates and timeliness of graduating from medical school.
Academic Medicine 2000 Apr;75(4):355-361.
This
9-week intensive academic program, the Medical Education
Development Program (MEDP) at University of North Carolina
at Chapel Hill, was studied using a prospective cohort design.
Outcomes included medical school application, acceptance,
graduation and years of medical school. Students with better
MEDP performance rating had increased odds of application,
acceptance, and graduation from medical school. Additionally,
the MEDP participant acceptance rate was significantly higher
than national underrepresented minority and non-underrepresented
minority rates.
Results
of a summer academy to increase minority student access
to allied health and other health professions |
- Thomson
WA, Denk JP, Miller LM, Ochoa-Shargey B, Jibaja-Rusth
M. Results of a summer academy to increase minority student
access to allied health and other health professions.
Journal of Allied Health 1992 Spring;21(2):79-93.
Baylor
College of Medicine held a Health Professional Summer Academy,
a 3-week summer program for entering ninth grade minority
students at two Texas high schools. Students were eligible
for the program if they were in the bottom one-third of
academic ranking.
In a
pre/post test study design, the authors compared scores
on the Middle Grades Integrated Process Skills (MGIPS) Test
administered to participants before the summer program to
scores after the program. The MGIPS test is designed for
students in middle school to measure student knowledge of
science skills. The average scores for two academy sites
were reported, with significant improvement after the program.
Increasing
access to medical education for students from medically
underserved communities: one program’s success |
- Thomson
WA, Ferry PG, King JE, Martinez-Wedig C, Michael LH. Increasing
access to medical education for students from medically
underserved communities: one program’s success.
Academic Medicine 2003 May;78(5):454-459.
The
Premedical Honors College Program (PHC), University of Texas-Pan
American (UT-PA) and Baylor College of Medicine partnership
conducted an intensive minority undergraduate intervention
paired with conditional acceptance to Baylor College of
Medicine. The PHC was evaluated through a retrospective
controlled cohort comparing college attendee medical school
application and matriculation for students in the South
Texas region before and after PHC implementation.
This
study showed that the odds of medical school matriculation
were seven times higher for PHC students than for non-PHC
students. Additionally, PHC appears to have influenced the
culture of UT-PA, increasing the health-related interests
generally. Since PHC was established, the number of freshman
biology majors declaring themselves as premedical students
has more than doubled. UT- PA is now contributing significantly
more students to the pool of medical school matriculants,
not simply only PHC graduates, but the number of non-PHC
students matriculating to medical school has been increasing
as well.
Evaluation
of a pre-entrance enrichment program for minority students
admitted to medical school |
- Ugbolue
A, Whitley PN, Stevens, PJ. Evaluation of a pre-entrance
enrichment program for minority students admitted to medical
school. Journal of Medical Education 1987 Jan;62(1):8-16.
Pre-entrance
Enrichment Program (PEP) at Boston University was a 6-week
prematriculation academic enrichment for minority and disadvantaged
students admitted to Boston University School of Medicine.
This cohort study compared first-year performance of minority
participants to minority non-participants, with the outcomes
being first-year grades and retention rates. After participation
in PEP, participants had significantly higher proportions
of pass and honors grades than minority non-participants.
Funded
under the U.S. Department of Health and Human Services,
Office of Minority Health and the Health Resources and
Services Administration, Bureau of Health Professions,
under contract number HHSH230200432036C.
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