Longitudinal Evaluation of Research Career Intentions among Students Underrepresented in Medicine

医学领域代表性不足的学生研究职业意向的纵向评估

基本信息

批准号：
10750271
负责人：
Dowin Boatright
金额：
$ 72.87万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-23 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10750271
关键词：
Affect Alaska Native American American Indians Association of American Medical Colleges Black race Clinical Clinical Medicine Clinical Sciences Complement Data Development Discrimination Disparity Doctor of Philosophy Engineering Ethnic Origin Ethnic Population Evaluation Research Evolution Exclusion Funding Future Growth Hispanic Individual Influentials Institution Intention Interview Leadership Measures Medical Education Medical Students Medicine Mentorship Methodology Methods Native Hawaiian or Other Pacific Islander Patients Physicians Play Positioning Attribute Publishing Qualitative Methods Race Reduce health disparities Reporting Research Research Design Residencies Role Sampling Scholarship Schools Scientist Shapes Students Surveys Time Training Underrepresented Populations Underrepresented Students United States National Academy of Sciences United States National Institutes of Health Work career cohort ethnic diversity ethnic minority experience follow-up health inequalities innovation interest matriculation medical schools novel perceived discrimination pressure programs racial diversity racial minority racial population racism success

项目摘要

The physician-scientist workforce struggles to attract racial and ethnic groups historically underrepresented in medicine (URiM), including individuals who are Black, Hispanic, American Indian or Alaskan Native, Native Hawaiian, and other Pacific Islander. Because the national research agenda is often set by those conducting scientific studies, increasing the diversity of the physician-scientist workforce has the potential to bring greater focus on issues that disproportionately affect racial and ethnic minorities. Notably, racial and ethnic minority physician-scientists are more likely to pursue scholarship related to racial/ethnic health inequities. Prior work has demonstrated that research career intentions evolve significantly during medical school and that research career intentions at graduation are associated with tangible downstream measures of research success, including subsequent receipt of NIH funding. Our preliminary data show marked disparities between URiM and non-URiM students in research career intentions during medical school. We propose a 5-year, longitudinal, mixed-methods study to identify trajectories (i.e., evolution over time) of research career intentions, and determinants thereof, in 400 URiM (based on race and ethnicity) students matriculating into MD programs and to compare these with trajectories and determinants in 200 non-URiM students. We will examine experiences at the individual level, such as quality of mentorship and experiences of discrimination, as well as experiences at the institutional level, such as URiM representation in the school's leadership. The aims are to: 1) identify trajectories of research career intentions among URiM students throughout medical school training and make comparisons with trajectories in non-URiM students; 2) identify student- and institutional-level predictors of research career intention trajectories in URiM students and make comparisons with predictors in non-URiM students; 3) use qualitative methods to characterize nuanced, lived experiences related to evolution of research career intentions. Quantitative and qualitative data will be integrated using a convergent approach at the levels of study design, analysis, interpretation, and reporting of results. This study is significant because it will identify potentially influential timepoints and predictors of change in research career intention among URiM MD students that can be used to increase the racial and ethnic diversity of the physician-scientist workforce. This diversity can help mitigate health disparities by broadening the national research agenda and increasing research participation by underrepresented populations. Our assessment of the roles of racism and discrimination in shaping research career intentions is innovative. The impact of our findings will be enhanced by our strong partnerships with national organizations, including medical education leaders at the National Academies of Sciences, Engineering, and Medicine (NASEM) and Association of American Medical Colleges (AAMC) to disseminate our findings. This study will form the basis of a future proposal to conduct follow-up of the cohort assembled in this study through residency and into early- and mid-career positions.

医师科学家队伍努力吸引历史上代表性不足的种族和族裔群体医学 (URiM)，包括黑人、西班牙裔、美洲印第安人或阿拉斯加原住民、原住民夏威夷人和其他太平洋岛民。因为国家研究议程通常是由那些进行研究的人制定的科学研究、增加医师科学家队伍的多样性有可能带来更大的成果重点关注对少数种族和族裔影响尤为严重的问题。值得注意的是，少数种族和族裔医师科学家更有可能追求与种族/民族健康不平等相关的奖学金。先前的研究表明，研究职业意图在医学院期间发生了显着变化，并且毕业时的研究职业意图与有形的下游研究措施相关成功，包括随后收到 NIH 资助。我们的初步数据显示两者之间存在显着差异 URiM 和非 URiM 学生在医学院期间研究职业意向。我们提出了一项为期 5 年的纵向混合方法研究，以确定发展轨迹（即随时间的演变）研究 400 名 URiM（基于种族和民族）学生的职业意向及其决定因素入读医学博士课程，并将其与 200 个非 URiM 的轨迹和决定因素进行比较学生。我们将审查个人层面的经验，例如指导质量和经验歧视，以及机构层面的经验，例如 URiM 在学校的代表性领导。目的是： 1) 确定 URiM 学生研究职业意图的轨迹整个医学院的培训并与非 URiM 学生的轨迹进行比较； 2）识别 URiM 学生研究职业意向轨迹的学生和机构层面的预测因素，并做出与非 URiM 学生的预测变量进行比较； 3）使用定性方法来描绘细致入微、生动的特征与研究职业意图的演变相关的经历。定量和定性数据将被整合在研究设计、分析、解释和结果报告层面采用聚合方法。这项研究意义重大，因为它将确定潜在影响的时间点和变化的预测因素研究 URiM MD 学生的职业意向，可用于增加种族和民族多样性医师科学家队伍。这种多样性可以通过扩大全国范围来帮助缩小健康差距研究议程和增加代表性不足人群的研究参与。我们的评估种族主义和歧视在塑造研究职业意图方面的作用是创新的。我们的研究结果的影响我们与国家组织（包括医学教育领导者）的牢固伙伴关系将得到加强美国国家科学、工程和医学院 (NASEM) 和美国医学协会大学（AAMC）传播我们的研究结果。这项研究将构成未来建议的基础对本研究中聚集的队列进行住院实习并进入早期和中期职业生涯的跟踪。