The Performance and Trajectory of Medical Students With Disabilities: Results From a Multisite, Multicohort Study.

PURPOSE: To conduct a post-Americans with Disabilities Act Amendments Act of 2008 multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWDs). METHOD: From June to December 2020, the authors conducted a matched cohort study of SWDs and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S. MD-granting medical schools. Each SWD was matched with 2 controls, one from their institution and, whenever possible, one from their cohort for Medical College Admission Test score and self-reported gender. Outcome measures included final attempt Step 1 and Step 2 Clinical Knowledge scores, time to graduation, leave of absence, matching on first attempt, and matching to primary care. RESULTS: A total of 171 SWDs and 341 controls were included; the majority of SWDs had cognitive/learning disabilities (118/171, 69.0%). Compared with controls, SWDs with physical/sensory disabilities had similar times to graduation (88.6%, 95% confidence interval [CI]: 77.0, 100.0 vs 95.1%, 95% CI: 90.3, 99.8; P = .20), Step 1 scores (229.6 vs 233.4; P = .118), and match on first attempt (93.9%, 95% CI: 86.9, 100.0 vs 94.6%, 95% CI: 91.8, 97.4; P = .842), while SWDs with cognitive/learning disabilities had lower Step 1 scores (219.4; P < .001) and were less likely to graduate on time (81.2%, 95% CI: 69.2, 93.2; P = .003) and match on first attempt (85.3%, 95% CI: 78.0, 92.7; P = .009). Accommodated SWDs had Step 1 scores that were 5.9 points higher than nonaccommodated SWDs (95% CI: -0.7, 12.5; P = .08). CONCLUSIONS: Structural barriers remain for SWDs with cognitive/learning disabilities, which could be partially mitigated by accommodations on high-stakes exams.

Creating an objective structured teaching examination to evaluate a dental faculty development program.

This article describes the creation of an objective structured teaching examination (OSTE) to assess a dental faculty development program. An OSTE is a performance-based measure that utilizes standardized students and is designed to measure observable teaching skills. In spring 2010, the authors developed, implemented, and evaluated an OSTE to assess a New York University College of Dentistry (NYUCD) faculty development program, Class ACTS (Advanced Clinical Teaching Scholars). They created a three-station OSTE to measure changes in teaching skills resulting from participation in Class ACTS. Dental student teaching assistants were trained to act as standardized students and patients and to use the rating forms. The faculty members' OSTE scores and ratings increased after participating in the Class ACTS program in all fifteen teaching domains tested, and statistically significant improvements occurred in nine of the fifteen domains. A search of the relevant literature suggests that this is the first time that an OSTE has been used to assess a faculty development program in dental education. This study's results appear to support NYUCD's faculty development efforts to improve the teaching skills of its faculty members.