Obstacles and Opportunities Survey now available
Monday, June 1, 2015
Posted by: LMSA Membership
The purpose of the Obstacles and Opportunities Project is to measure the climate of medical training and career development issues for historically underrepresented minority (hURM) medical students. By providing insight into the experiences and career aspirations among hURM medical students, this survey will help inform the development of pipeline programs needed to increase the number of hURM physicians in the U.S. as well as improve the educational experiences of hURM medical students and the entire body of medical trainees.
Obstacles and Opportunities Survey
To complete the survey please visit: lmsa.me/1KzKNLD
PURPOSE OF PROJECT
The Obstacles and Opportunities Initiative began following a presentation by Dr. Laura Morgan Roberts to the 2003 House of Delegates during the Annual Medical Education Conference (AMEC). Dr. Roberts debuted the data collected in 2001 through the administration of a comprehensive survey to SNMA members at the 2001 AMEC in Atlanta, Georgia. The survey was divided into two parts. Part 1 asked demographic questions regarding ethnicity, gender, age, and educational background. Part 2 of the study focused on the medical school environment including perceived support, mentorship and stereotypes during training. With the use of this comprehensive survey tool, Dr. Roberts measured the medical education experience for underrepresented medical students. The two-part survey yielded responses by approximately 900 people. Results were analyzed and published in Dr. Robert's doctoral dissertation, entitled "The Nature, Antecedents and Consequences of Social Identity-Based Impression Management: Uncovering Strategies for Professional Image Construction in Cases of Negative Stereotyping." Briefly, Dr. Roberts dissertation reported that students "attempted to present themselves to non-Black colleagues in ways that dispelled stereotypes and created a positive meaning around race or that encouraged others not to view them in light of their racial group membership." She found that students employed an intuitive combination of race-based impression management strategies. Furthermore, Dr. Roberts "found that trainees who employed race-based impression management had more favorable well being outcomes." She made a point to note that although students have a more favorable well being, consequences arise when students are uncomfortable employing these strategies. This concept of the obstacles and opportunities within medical school environment as it pertains to inclusion and diversity is the cornerstone to the past and current study adopted by the SNMA.
An added layer to Dr. Roberts' foundational work includes a further focus group strategy utilized to identify perceived barriers and facilitators to the academic and professional success of hURM medical students. The study design consisted of six focus groups with members of the Student National Medical Association (SNMA) between 2002 and 2003. Overall, 748 comments were collected from 43 participants, who were predominantly African American (88%), Hispanic (10%), and Asian/Pacific Islanders (2%). The results were published in Academic Medicine and showed that the participating students identified support systems, professional exposure, financial aid, and personal characteristics as facilitators of success, while lack of financial and social support, difficulties with standardized tests, racial stereotyping and discrimination, and self imposed were noted as significant barriers by participants.
To our knowledge, following the 2002-2003 period of data collection and the 2007 publication from Dr. Roberts' group, there was no further advancement of this initiative until 2010. Under the administration of 2010-2011 SNMA National President, Bryant Cameron Webb, the SNMA partnered with the Sullivan Alliance to Transform America's Health Professions (SA) to expand on the results reported by Dr. Roberts' group. Dr. Ilana Mittman, at the time Director of Health Policy Research for the Sullivan Alliance was actively involved in the collaborations and along with Dr. Webb developed an electronic survey to measure factors impacting career aspirations within SNMA members. The goal was to examine the notion that hURM prefer to match into primary care specialties, and serve in medically underserved areas throughout the course of medical school by exploring attitudes and perceptions influencing medical specialty selection. The analysis aimed to identify barrier and facilitators associated with successful match into a student's preferred residency. An electronic survey was disseminated to SNMA chapters around the country and 228 responses were received from SMNA members. Statistical analysis of the completed surveys illustrated that hURMs are not more likely to choose primary care and/or serve in health professional shortage areas (HPSAs) when compared to nonhURMs. hURM students were statistically more likely to view diversity as important. However, the results of the 2010 study were unable to be published because most participants were second year students bringing to question the relevance of current career aspirations to future implementation. Also, the number of non-Hispanic White participants was too small to allow for powerful comparisons. Lastly, institutional review board (IRB) approval was not obtained prior to conducting the study.
The results from these previous studies provide important information about the quality and effect of the educational environment that minority medical students encounter. However, the studies have significant limitations, which can be improved by reapplying a new survey. First, both studies heavily recruited participants from SNMA membership, causing minority students who are not active in SNMA but active in other medical organizations to be excluded. This also limited responses of students from other racial/ethnic, cultural and economic backgrounds. Second, the number of responses received for both studies was unsatisfactory. SNMA has more than 6000 members nationwide, but only 43 and 228 students participated in the 2007 and 2010 studies, respectively. This limited the statistical power of the studies. Third, the results of the 2007 study relied on the ability of investigators to accurately interpret and categorize the comments made by minority students during focus groups.
In celebration of the SNMA's 50th anniversary, 2014-2015 National President, Topaz Sampson charged the Diversity Research Committee to continue this important initiative. After careful review of the project's history, discussions with original investigators, and direction from professional consultants, we have combined Dr. Roberts' two studies from 2001 and 2007, as well as the 2010 study to develop the current survey tool. The questionnaire assesses Obstacles and Opportunities that are 1) present as a result of medical school climate, and 2) are dictators in a student's career aspirations.