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Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school.

ABSTRACT: OBJECTIVE:To explore graduate-entry medical students experiences of undergraduate training in the context of academic underperformance of medical students from ethnic minority backgrounds. DESIGN:Qualitative study using semi-structured focus groups. SETTING:A West Midlands medical school. PARTICIPANTS:24 graduate-entry MBChB students were recruited using volunteer and snowball sampling; all students self-identified as being from Black and Minority Ethnic (BME) backgrounds. RESULTS:BME students reported facing a range of difficulties, throughout their undergraduate medical training, that they felt impeded their learning and performance. Their relationships with staff and clinicians, though also identified as facilitators to learning, were also perceived to have hindered progress, as many students felt that a lack of BME representation and lack of understanding of cultural differences among staff impacted their experience. Students also reported a lack of trust in the institution's ability to support BME students, with many not seeking support. Students' narratives indicated that they had to mask their identity to fit in among their peers and to avoid negative stereotyping. Although rare, students faced overt racism from their peers and from patients. Many students reported feelings of isolation, reduced self-confidence and low self-esteem. CONCLUSIONS:BME students in this study reported experiencing relationship issues with other students, academic and clinical staff, lack of trust in the institution and some racist events. Although it is not clear from this small study of one institution whether these findings would be replicated in other institutions, they nevertheless highlight important issues to be considered by the institution concerned and other institutions. These findings suggest that all stakeholders of graduate-entry undergraduate medical education should reflect on the current institutional practices intended to improve student-peer and student-staff relationships. Reviewing current proposals intended to diversify student and staff populations as well as evaluating guidance on tackling racism is likely to be beneficial.

SUBMITTER: Morrison N

PROVIDER: S-EPMC6924783 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school.

Morrison Nariell N Machado Michelle M Blackburn Clare C

BMJ open 20191128 11

<h4>Objective</h4>To explore graduate-entry medical students experiences of undergraduate training in the context of academic underperformance of medical students from ethnic minority backgrounds.<h4>Design</h4>Qualitative study using semi-structured focus groups.<h4>Setting</h4>A West Midlands medical school.<h4>Participants</h4>24 graduate-entry MBChB students were recruited using volunteer and snowball sampling; all students self-identified as being from Black and Minority Ethnic (BME) backgr ...[more]

PMID: 31784444

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Project description:BACKGROUND:Psychological distress in medical students is a global issue and poses a risk to their health, academic performance, and ability to care for patients as clinicians. There has been limited research on psychological distress levels in students prior to starting medicine and no direct comparison between undergraduate and graduate-entry students. METHODS:Psychological distress was assessed using the 21-item Depression Anxiety and Stress Scale in 168 undergraduate-entry and 84 graduate-entry medical students at two separated campuses of the same university in the orientation week prior to starting classes. Mean scores and severity proportions were compared between the two cohorts of students. Demographic data was also collected and compared to distress scores using subgroup analysis. RESULTS:The response rate for the study was 60.9%. The majority of undergraduate and graduate-entry medical students were within the normal limits for depression (67.2% versus 70.2%, p = 0.63), anxiety (56.5% versus 44.0%, p = 0.06), and stress scores (74.4% versus 64.2%, p = 0.10). There was no significant difference between severity groups except for severe stress (2.3% versus 9.5%, p = 0.01). The mean scores of the clinically distressed groups indicated moderate levels of depression, moderate anxiety, and moderate stress scores. There were no significant differences between undergraduate or graduate-entry students for depressive ([Formula: see text] = 17.02 versus 15.76, p = 0.43), anxiety ([Formula: see text] = 14.22 versus 13.28, p = 0.39), and stress scores ([Formula: see text] = 20.83 versus 22.46, p = 0.24). Female gender and self-believed financial concerns were found be associated with higher levels stress in graduate entry students. CONCLUSIONS:The majority of medical students enter medical school with normal levels of psychological distress. However, a large number of undergraduate and graduate-entry medical students have significant levels of depressive, anxiety, and stress levels, without a significant difference between undergraduate or graduate-entry students. There are several limitation of this study but the results suggest that education and intervention may be required to support students from the earliest weeks of medical school.

Dataset Information

Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school.

Publications

Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school.

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