Investigating the implementation challenges of the research doctoral program and providing related solutions: a qualitative study.

BACKGROUND: Doctoral programs have consistently garnered the attention of policymakers in medical education systems due to their significant impact on the socio-economic advancement of countries. Therefore, various doctoral programs have been implemented with diverse goals. In Iran, a research doctorate program, known as PhD by Research, was introduced primarily to engage in applied research related to healthcare needs. Nevertheless, the achievement of the program's goals has been questioned. This study aimed to identify the implementation challenges of the Research Doctorate Program and its solutions in Iran. METHOD: This descriptive qualitative study followed the Standards for Reporting Qualitative Research: A Synthesis of Recommendations and was conducted in two steps. Firstly, the challenges of the Iranian Ph.D. by research program were identified through the perspectives of the program's students and graduates. In the second step, relevant solutions to these challenges were determined by focus groups of key informant experts. The transcripts were analyzed using qualitative content analysis. RESULTS: Five students and six graduates were interviewed in the first step and seven experts participated in the second one. The challenges and related solutions are explored in four main themes, including: (1) admission criteria, (2) program goals and expected outcomes, (3) curricula, and (4) financial and human resources. The study showed that various dimensions of the doctoral program are not aligned with each other and how to adapt the program in these dimensions. CONCLUSION: The study revealed the importance of a systematic approach in defining various dimensions of doctoral programs according to program goals and provided specific solutions for defining a research doctorate program in the context of a low- and middle-income country.

Measuring personal characteristics in applicants to German medical schools: Piloting an online Situational Judgement Test with an open-ended response format.

Objectives: Situational Judgement Tests (SJT) are a cost-efficient method for the assessment of personal characteristics (e.g., empathy, professionalism, ethical thinking) in medical school admission. Recently, complex open-ended response format SJTs have become more feasible to conduct. However, research on their applicability to a German context is missing. This pilot study tests the acceptability, reliability, subgroup differences, and validity of an online SJT with open-ended response format developed in Canada ("Casper"). Methods: German medical school applicants and students from Hamburg were invited to take Casper in 2020 and 2021. The test consisted of 12 video- and text-based scenarios, each followed by three open-ended questions. Participants subsequently evaluated their test experience in an online survey. Data on sociodemographic characteristics, other admission criteria (Abitur, TMS, HAM-Nat, HAM-SJT) and study success (OSCE) was available in a central research database (stav). Results: The full sample consisted of 582 participants. Test-takers' global perception of Casper was positive. Internal consistency was satisfactory in both years (α=0.73; 0.82) while interrater agreement was moderate (ICC(1,2)=0.54). Participants who were female (d=0.37) or did not have a migration background (d=0.40) received higher scores. Casper scores correlated with HAM-SJT (r=.18) but not with OSCE communication stations performance. The test was also related to Abitur grades (r=-.15), the TMS (r=.18), and HAM-Nat logical reasoning scores (r=.23). Conclusion: This study provides positive evidence for the acceptability, internal consistency, and convergent validity of Casper. The selection and training of raters as well as the scenario content require further observation and adjustments to a German context to improve interrater reliability and predictive validity.

Improving selection procedures in health professions education from the applicant perspective: an interview study.

INTRODUCTION: Applicant perceptions of selection impact motivation and performance during selection, and student diversity. However, in-depth insight into which values underly these perceptions is lacking, creating challenges for aligning selection procedures with applicant perceptions. This qualitative interview study aimed to identify values applicants believe should underlie selection, and how, according to applicants, these values should be used to make specific improvements to selection procedures in undergraduate health professions education (HPE). METHODS: Thirty-one applicants to five undergraduate HPE programs in the Netherlands participated in semi-structured interviews using Appreciative Inquiry, an approach that focuses on what goes well to create vision for improvement, to guide the interviews. Transcriptions were analyzed using thematic analysis, adopting a constructivist approach. RESULTS: Applicants' values related to the aims of selection, the content of selection, and the treatment of applicants. Applicants believed that selection procedures should aim to identify students who best fit the training and profession, and generate diverse student populations to fulfill societal needs. According to applicants, the content of selection should be relevant for the curriculum and profession, assess a comprehensive set of attributes, be of high quality, allow applicants to show who they are, and be adapted to applicants' current developmental state. Regarding treatment, applicants believed that selection should be a two-way process that fosters reflection on study choice, be transparent about what applicants can expect, safeguard applicants' well-being, treat all applicants equally, and employ an equitable approach by taking personal circumstances into account. Applicants mentioned specific improvements regarding each value. DISCUSSION: Applicants' values offer novel insights into what they consider important preconditions for the design of selection procedures. Their suggested improvements can support selection committees in better meeting applicants' needs.

A Systematic Review of Variables Used in Physical Therapist Education Program Admissions Part 1: Cognitive Variables.

BACKGROUND AND PURPOSE: Physical therapist (PT) education programs seek to identify applicants who will be academically successful in the program and pass the licensure examination. Part one of this systematic literature review aimed to understand the value of cognitive variables in PT education admissions. METHODS: The initial literature search identified 1,592 articles in databases and relevant journals. Of the 39 studies meeting the inclusion criteria, 31 reported on cognitive measures. RESULTS: Seven studies identified one or more sections of the Graduate Record Examination (GRE) as significant predictors of students' academic performance in PT programs. Ten studies reported that one or more sections of the GRE predicted National Physical Therapy Exam (NPTE) performance, wheres 4 studies found no significant relationship. Undergraduate grade point average (GPA) predicted academic performance in the PT program and on the NPTE in more than 10 studies, whereas 4 found no significant relationship. Other components of the academic record, such as prerequisite course grades, undergraduate institution quality, undergraduate degree, and retaking prerequisite courses, had varying relationships with academic and NPTE performance. DISCUSSION AND CONCLUSION: These outcomes appear to inform the policies and processes for admissions into PT education programs, evidenced by customary use of applicants' GRE scores and GPAs in admission decisions. The inclusion of both cognitive measures in admission decisions may help ensure that admitted students successfully manage the academic rigor of doctoral education and pass the NPTE.

A Systematic Review of Variables Used in Physical Therapist Education Program Admissions Part 2: Noncognitive Variables.

BACKGROUND AND PURPOSE: Physical therapist (PT) education professionals agree on promoting holistic admissions practices to increase student body diversity but lack consensus about what factors in an application should be part of this process. This systematic literature review aimed to understand the value of noncognitive variables in PT education admissions. METHODS: The initial literature search identified 1,592 articles in databases and relevant journals. Of the 39 studies meeting the inclusion criteria, 29 reported on noncognitive variables. RESULTS: Commonly used noncognitive variables (interviews, written essays, letters of recommendation, and clinical experiences) were insignificant or inconsistently associated with performance in the PT program or on the National Physical Therapy Examination. Sociodemographic variables appeared to negatively affect the academic qualifications of applicants who were older, identified with underrepresented racial/ethnic groups, and reported English as a second language. Finally, 5 studies identified personal attributes, such as emotional intelligence and grit, as having a significant relationship with successful student outcomes. DISCUSSION AND CONCLUSION: Cognitive variables should serve as only one of several factors considered in admissions to achieve a more diverse class of students. Physical therapist education programs may use this evidence to reevaluate their admissions practices to include a balanced consideration of cognitive and noncognitive variables.

How Prominent Are Gender Bias, Racial Bias, and Score Inflation in Orthopaedic Surgery Residency Recommendation Letters? A Systematic Review.

INTRODUCTION: Letters of recommendation are considered an important factor in the holistic ranking of orthopaedic residency applications. The standardized letter of recommendation (SLOR) was introduced in 2017 in response to the inherent bias and limited comparative value of traditional LORs. It includes standardized questions about an applicant's orthopaedic qualifications, designed to enable fair comparisons among candidates. However, disparate and inconsistent findings have made it difficult to draw meaningful conclusions from individual studies on the SLOR and narrative letter of recommendation. QUESTION/PURPOSES: In this systematic review we asked: (1) What is the distribution of applicant SLOR rating among nine domains and summative scores? (2) Are there applicant characteristics associated with SLOR ratings? (3) Is there gender and racial bias in the SLOR and narrative letter of recommendation? METHODS: PubMed, EBSCO, and Google Scholar electronic databases were queried on March 20, 2023, to identify all studies evaluating SLOR and narrative letter of recommendations between January 1, 2017, and March 20, 2023. Articles that evaluated orthopaedic SLOR or narrative LORs were included. Systematic reviews, case reports, duplicate studies between databases, and grey literature such as abstracts and articles on preprint servers were excluded. Eight studies including 6179 applicants and 18,987 letters of recommendation were included in the final analysis. The applicant classes ranged from years 2014 to 2020. Two reviewers independently evaluated the quality of the included studies using the Joanna Briggs Institute (JBI) tool for cross-sectional studies. The mean JBI score of included studies was 7.4 out of a maximum of 8, with higher scores indicating better quality. The primary outcome was to determine the distribution of applicant SLOR rankings in their summative score. Summative scores were separated into ranked to match, top one-third, middle one-third, lower one-third, and not a fit. Four studies reported the summative SLOR scores of applicants. Our secondary study goal was to assess applicant characteristics associated with SLOR summative scores and assess any bias present in the SLOR or narrative recommendation. Five studies compared SLOR ratings across applicant characteristics including gender, race, USMLE Step 1 score, USMLE Step 2 score, Alpha Omega Alpha (AΩA) membership, clerkship grades, and publications. Gender and racial bias were also assessed across five studies. Four studies utilized a linguistic analysis software to search letters of recommendation for differences in word category use by gender and race. RESULTS: Studies consistently found that a higher percentage of candidates were identified in the top percentile blocks than is mathematically possible. For example, the two studies that tallied the proportion of candidates ranking in the top 10% of applicants found that 36% and 42% were rated as being in the top 10%. Similarly, articles found more than 87% of applicants scored in the top one-third. Studies had mixed results, but in general, they suggested that AΩA status, higher Step 1 scores, and more research publications have a slightly positive association with increased SLOR scores. We found no evidence of gender bias against women, and in fact, most studies evaluating word choices found word choices for women candidates generally were stronger. Similarly, no consistent disparities were identified in word categories utilized in SLORs based on applicant race. CONCLUSION: Most notably, a mathematically impossible proportion of applicants were counted in the top percentiles in letters of recommendation. This compromises readers' abilities to differentiate candidates. Factors like AOA status and research publications displayed a modest positive correlation with SLOR scores. Gender bias against women or candidates from racial minority groups was not evident. CLINICAL RELEVANCE: We suggest that group SLOR authorship, with a consensus assessment by clerkship or residency directors, should be considered. We also recommend the incorporation of mean and SD scores for each letter writer (or group) alongside their letters. Furthermore, studies indicate that submitting all four SLOR letters can substantially improve an applicant's chances of success. We advise students to choose strategically and submit the maximum allowable number of SLORs.

Describing a medical school's rural activity footprint: setting selection and workforce distribution priorities.

CONTEXT: There is growing evidence supporting a shift towards 'grow your own' approaches to recruiting, training and retaining health professionals from and for rural communities. To achieve this, there is a need for sound methodologies by which universities can describe their area of geographic focus in a precise way that can be utilised to recruit students from their region and evaluate workforce outcomes for partner communities. In Australia, Deakin University operates a Rural Health Multidisciplinary Training (RHMT) program funded Rural Clinical School and University Department of Rural Health, with the purpose of producing a graduate health workforce through the provision of rural clinical placements in western and south-western Victoria. The desire to establish a dedicated Rural Training Stream within Deakin's Doctor of Medicine course acted as a catalyst for us to describe our 'rural footprint' in a way that could be used to prioritise local student recruitment as well as evaluate graduate workforce outcomes specifically for this region. ISSUE: In Australia, selection of rural students has relied on the Australian Statistical Geography Standard Remoteness Areas (ASGS-RA) or Modified Monash Model (MMM) to assign rural background status to medical course applicants, based on a standard definition provided by the RHMT program. Applicants meeting rural background criteria may be preferentially admitted to any medical school according to admission quotas or dedicated rural streams across the country. Until recently, evaluations of graduate workforce outcomes have also used these rurality classifications, but often without reference to particular geographic areas. Growing international evidence supports the importance of place-based connection and training, with medical graduates more likely to work in a region that they are from or in which they have trained. For universities to align rural student recruitment more strategically with training in specific geographic areas, there is a need to develop precise geographical definitions of areas of rural focus that can be applied during admissions processes. LESSONS LEARNED: As we strived to describe our rural activity area precisely, we modelled the application of several geographical and other frameworks, including the MMM, ASGS-RA, Primary Healthcare Networks (PHN), Local Government Areas (LGAs), postcodes and Statistical Areas. It became evident that there was no single geographical or rural framework that (1) accurately described our area of activity, (2) accurately described our desired workforce focus, (3) was practical to apply during the admissions process. We ultimately settled on a bespoke approach using a combination of the PHN and MMM to achieve the specificity required. This report provides an example of how a rural activity footprint can be accurately described and successfully employed to prioritise students from a geographical area for course admission. Lessons learned about the strengths and limitations of available geographical measures are shared. Applications of a precise footprint definition are described including student recruitment, evaluation of workforce outcomes for a geographic region, benefits to stakeholder relationships and an opportunity for more nuanced RHMT reporting.

The Impact of the Recent Supreme Court Ruling on the Dermatology Recruitment Pipeline.

The 2023 ruling by the Supreme Court of the United States (SCOTUS) on the use of race-based criteria in college admissions may have implications for the selection of individuals into the dermatology workforce. This article highlights the impact of these decisions at the undergraduate, medical school, and graduate medical education levels, as well as within the field of dermatology.

Impact of corrupt admission on the mental health of Chinese adolescents.

Through preferential treatment by education officials or through bribery, some adolescents can obtain admission to a junior high school. However, it is unclear whether it affects the mental health of adolescents. This study used Propensity Score Matching to examine the effects of corruption on adolescent mental health. A total of 17,254 junior high school students sample (11-18 years old; 48.7% girls and 53.1% boys) were used from the China Education Panel Survey. 14.1% of adolescents attended a junior high school by corrupt means, corruption had a significantly negative effect on the mental health of these adolescents (ATT = -0.388, p < 0.01), the reasons grounded in the fact that they received more criticisms from teachers and wanted to leave their current school. In general, corruption in the admissions process can have detrimental effects on the mental health of adolescents. This study extends the previous articles on how to improve adolescent mental health and complements the application of cognitive dissonance theory. Findings from this study revealed that anti-corruption in the education sector is necessary, and the institutional design to ensure fair enrolment in basic education will contribute to the mental health of adolescents.

Unveiling the Need to Improve Personalized Applicant Tools: A Critical Evaluation of the Reliability of the Texas STAR database in Predicting Match Success for Plastic Surgery Applicants.

OBJECTIVES: Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models. NRMP data and literature were referenced to determine reliability. RESULTS: Of the 209 plastic surgery resident applications, 147 matched (70.3%) and 62 went unmatched (29.7%). Average United States Medical Licensing Examination (USMLE) Step 1 and 2 scores were 248 and 257, respectively. Between matched and unmatched cohorts, no significant differences were observed in Alpha Omega Alpha (AOA) status, Gold Humanism Honor Society (GHHS) status, mean number of research experiences/presentations, volunteer experiences, leadership positions, and programs applied. Significant predictors of matching included taking a research year (OR 2.07, CI 0.99-4.34, p= 0.052), 8+ peer-reviewed publications (OR 2.29, CI 1.22-4.30, p = 0.009), geographic connection (p = 0.02), and 13+ interviews attended (OR 2.94, CI 1.56 -5.51, p < 0.001). These findings are consistent with current literature and the NRMP. Upon analysis of the qualitative free text responses on general recommendations for prospective applicants by users, subinternships, connections, interviews, research, letter of recommendation quality, home advantage, and mentorship were prominent themes of advice provided by both matched and unmatched cohorts. CONCLUSIONS: Texas STAR is a resourceful and reliable tool. We conclude that a research year and geographic connections are strong predictors of matching in plastic surgery. However, more factors (e.g., applicants' home medical school, number of sub internships, and number of mentors) should be considered to make a well-informed decision on determining their own competitiveness, away rotations and residency programs.

Racial and Ethnic Disparities in Situational Judgment Testing Among Applicants to an Anesthesiology Residency Program.

Background The Computer-Based Assessment for Sampling Personal Characteristics (CASPer) is a situational judgment test (SJT) that assesses noncognitive skills like professionalism, communication, and empathy. There are no reports of the effects of race/ethnicity and sex on CASPer scores among residency applicants. Objective We examined the effects of race/ethnicity, sex, and United States vs international medical school attendance on CASPer performance. Methods Our anesthesiology residency program required all applicants for the 2021-2022 Match cycle to complete an online video and text-based SJT (CASPer). We compared these results, reported as z-scores, with self-identified race/ethnicity, sex, United States vs international medical school attendance, and United States Medical Licensing Examination (USMLE) Step 1 scores. Results Of the 1245 applicants who completed CASPer, 783 identified as male. The racial/ethnic distribution was 512 White, 412 Asian, 106 Black, 126 Hispanic, and 89 Other/No Answer. CASPer z-scores did not differ by sex. White candidates scored higher than Black (0.18 vs -0.57, P<.001) and Hispanic (0.18 vs -0.52, P<.001) candidates. Applicants attending US medical schools scored higher than those attending international medical schools (z-scores: 0.15 vs -0.68, P<.001). There was no correlation between CASPer z-scores and USMLE Step 1 scores. Conclusions Our results suggest that CASPer scores favor White applicants over Black and Hispanic ones and applicants attending US medical schools over those attending international medical schools.

Evidence-Based Practices for Interviewing Graduate Medical Education Applicants: A Systematic Review.

Background Although the selection interview is a standard admission practice for graduate medical education (GME) programs in the United States, there is a dearth of recent reviews on optimizing the trainee interview process, which has low reliability, high cost, and major risk of bias. Objective To investigate the evidence base for different selection interview practices in GME. Methods We searched 4 literature databases from inception through September 2022. Two investigators independently conducted title/abstract screening, full-text review, data extraction, and quality assessment. Disagreements were mediated by discussion. We used backward reference searching of included articles to identify additional studies. We included studies of different interview methods and excluded literature reviews, non-GME related publications, and studies comparing different applicant populations. We examined study characteristics, applicant and interviewer preferences, and interview format. We evaluated study quality using the Medical Education Research Study Quality Instrument (MERSQI). Results Of 2192 studies, 39 (2%) met our inclusion criteria. The evidence base was rated as moderately low quality using MERSQI criteria. Applicants reported preferences for several one-on-one interviews lasting 15 to 20 minutes, interviews by current trainees, and interviews including social events with only trainees. Applicants had mixed perceptions of virtual versus in-person interviews and reported that virtual interviews saved costs. The multiple mini interview (MMI) required more applicant and interviewer time than individual interviews but demonstrated construct and predictive validity and was preferred by applicants and interviewers. Conclusions Based on moderately low-quality evidence, using the MMI, training interviewers, and providing applicants with basic program information in advance should be considered for GME selection interviews.

Evaluation and Assessment of the ABATE Framework to Enhance Implicit Bias Training for Virtual Interviews in Medical Schools.

Introduction: The influence of implicit biases in virtual interviews must be addressed to ensure equity within the admissions process. ABATE is a mnemonic framework of five specific categories of implicit bias (affinity-based, backdrop-based, appearance-based, technology and media-based, and enunciation-based biases) that should be anticipated and mitigated for faculty, staff, health professionals, and medical students who conduct virtual interviews at medical schools. Methods: A 60-minute workshop was developed to educate medical school admissions interviewers about the ABATE model and strategies to mitigate implicit bias during virtual interviews. Four workshops were held over 1 year totaling 217 individual attendees. The workshops were evaluated using a single-group, pre-post questionnaire designed with the Kirkpatrick evaluation model. Results: Attendees reported that they found the ABATE workshop useful and relevant to improving their ability to minimize implicit bias during virtual interviews. Significant improvements were found in attendee reactions to the utility of implicit bias training (M pre = 2.6, M post = 3.1, p = .002). Significant changes were also reported in attendees' attitudes about interviewing confidence (M pre = 3.0, M post = 3.2, p = .04), bias awareness (M pre = 3.0, M post = 3.4, p = .002), and identifying and applying bias mitigation solutions (M pre = 2.5, M post = 3.0, p = .003). Knowledge specific to backdrop-based biases also significantly increased (M pre = 3.2, M post = 3.4, p = .04). Discussion: The ABATE workshop demonstrates promise in mitigating implicit bias in virtual medical school interviews.

Association of Medical School Gap Year Research and Degree Programs With Otolaryngology Interview and Match Outcomes.

OBJECTIVE: To investigate whether a gap year for either research or a master's degree is associated with interview offers or match outcomes among otolaryngology applicants. METHODS: Using the Texas Seeking Transparency in Application to Residency (Texas STAR) database, we conducted a cross-sectional analysis of otolaryngology applicants from 2018 to 2022. Applicants were stratified based on the presence and type of gap year during medical school. Applicant characteristics, signaling, research productivity, and application costs were analyzed, with primary outcomes including number of interview offers and match status. RESULTS: Among 564 otolaryngology applicant respondents to the Texas STAR survey, 160 (28%) reported a gap year, including 64 (40%) applicants participating in a research year, 65 (41%) completing a Master of Public Health or Science (MPH and MSc), and 31 (19%) completing a Master of Business Administration, Education, or other degree (MBA and MEd). Gap-year applicants who completed a research year or MPH/MSc degree received more interview offers (P < .01) than MBA, MEd applicants, or those without a gap year. Applicants with a research year had the most publications, oral presentations, abstracts, posters, and research experiences (all P < .01). When controlling for USMLE scores, clerkship honors, and applications submitted, applicants completing a research year or an MPH/MSc-degree received increased interview offers (P < .01). No significant differences were seen in expenditures or match rates. CONCLUSIONS: Research and MPH/MSc gap years were associated with increased residency interview offers but not increased match success. Further longitudinal studies are needed to assess how yearlong experiences affect long-term career outcomes.

Going Above and Beyond With SJTs: Impact of Applicant Characteristics on Open Response SJT Participation.

BACKGROUND: Situational judgment tests (SJT) have gained popularity as a standardized assessment of nontechnical competencies for applicants to medical school and residency. SJT formats range from rating the effectiveness of potential response options to solely open response. We investigated differences in test-taking patterns between responders and nonresponders to optional open response SJT questions during the application process. METHODS: This was a prospective multi-institutional study of general surgery applicants to seven residency programs. Applicants completed a 32-item SJT designed to measure ten core competencies: adaptability, attention to detail, communication, dependability, feedback receptivity, integrity, professionalism, resilience, self-directed learning, and team orientation. Each SJT item included an optional, nonscored, open response space for applicants to provide a behavioral response if they desired. Trends in applicant gender, race, ethnicity, medical school ranking, and USMLE scores were examined between the responder versus nonresponder group. RESULTS: In total, 1491 general surgery applicants were invited to complete the surgery-specific SJT. Of these, 1454 (97.5%) candidates completed the assessment and 1177 (78.9%) provided additional responses to at least one of the 32 SJT scenario sets. There were no differences in overall SJT performance, USMLE scores (Step 1: 235, SD 14, Step 2: 250, SD 11), race and/or ethnicity between the responder and nonresponder groups. Responders were more likely to be from a top 25 medical school (p < 0.05) compared to the nonresponder group. Among applicants who completed any open response questions, women completed a significantly higher number of questions compared to men (7.21 vs 6.07, p = 0.003). The number of open responses provided correlated with higher scores on SJT items measuring dependability (r = 0.07, p = 0.007). CONCLUSIONS: SJT design and format has the potential to impact test-taker response patterns. SJT developers and adopters should ensure test format and design have no unintended consequences prior to implementation.

Privileges, Immunities, and Affirmative Action in Medical Education.

In Students for Fair Admissions v. President and Fellows of Harvard College and Students for Fair Admissions v. University of North Carolina, the Supreme Court ruled that affirmative action in university admissions, in which an applicant of a particular race or ethnicity receives a plus factor, is unconstitutional. This ruling was based on both the Equal Protection Clause of the Fourteenth Amendment and Title VI of the Civil Rights Act of 1964. This article argues that a more natural fit as the basis for constitutional analysis would be a different clause in the Fourteenth Amendment, the Privileges or Immunities Clause. In the article, a legal analysis based on the clause is applied to medical school admissions. Depending on whether a fundamental rights reading or an antidiscrimination (equality) reading of the clause is applied, opposite conclusions are reached on the constitutionality of affirmative action in medical school admissions. This analysis demonstrates why affirmative action in admissions--in this case medical school admissions, which directly affect the composition of the Nation's physician workforce--is a complex and difficult constitutional question.

Taking Action to Promote Diversity and Inclusion: One Program's Efforts Through Pathway Opportunities, Holistic Admissions, and Curricular Changes.

AIMS: Concerted, effective, and sustainable change in healthcare education programs is a critical step towards creating more diverse, inclusive, and equitable professions. This commentary demonstrates how one entry-level physical therapist education program, through a process of reflection, prioritization, and action, is taking steps to increase diversity, equity, and inclusivity within their program. RATIONALE: This article highlights initiatives that are leveraging existing partnerships and creating new ones to reach and mentor students from diverse communities, steps taken towards a more holistic and equitable admissions process, implementation of curricular changes to intentionally discuss the social determinants of health, and engagement of faculty and students to foster personal and professional development on diversity, equity, and inclusion topics. Outcomes to track the effectiveness of the strategies being used by each initiative are shared. CONCLUSION: To create active agents of change, education programs must create a diverse and equitable space for students and guide them to become leaders who can transform society. Steps taken by an entry-level physical therapist education program to implement strategies to promote diversity, equity and inclusion can serve as a road map for other healthcare professional programs.

Dear admission committee : Which moves in application essays predict student master grades?

Application essays are a commonly used admission instrument for students entering higher education. The quality of the essay is usually scored, but this score is often subjective and has poor interrater reliability due to the unstructured format of the essays. This results in mixed findings on the validity of application essays as an admission instrument. We propose a more objective method of using application essays, using Latent Dirichlet Allocation (LDA), a text mining method, to distinguish seven moves occurring in application essays written by students who apply to a master degree program. We use the probability that these moves occur in the essay to predict study success in the master. Thereby we answer the following research question: What is the effect of discussing different moves in students' application essays on the student grades in a master program? From the seven different moves (functional unit of text) we distinguished, five of which have a significant effect on student grades. The moves we labeled as 'master specific' and 'interest to learn' have a positive effect on student grades, and the moves we labeled as 'research skills', 'societal impact' and 'city and university' have a negative effect. Our interpretation of this finding is that topics related to intrinsic motivation and specific knowledge, as opposed to generic knowledge, are positively related with study success. We thereby demonstrate that application essays can be a valid predictor of study success. This contributes to justifying their use as admission instruments.