Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review.

BACKGROUND: Equality, diversity and inclusion initiatives seek to embed the concept of inclusive pedagogy to promote inclusive educational environments. However, no evidence synthesis exists which examines whether and how the concept of inclusive pedagogy is addressed in online simulation-based learning in the undergraduate nursing education literature. AIMS: To map the evidence regarding the adoption of inclusive pedagogy in online simulation-based learning in undergraduate nursing education. DESIGN: A scoping review. METHODS: Data were extracted, synthesized and presented in narrative and table format. DATA SOURCES: A systematic search of five databases and five sources of grey literature was conducted to search literature published between 1st January 2010 to 1st June 2022. RESULTS: Thirty-eight papers published between 2011 and 2022 were included. The results are presented under three identified themes: (1) Learner diversity; (2) Theoretical frameworks promoting equality, diversity and inclusion in online simulation and (3) Online simulation feedback. CONCLUSION: Inclusive pedagogy has not been considered or embedded in its entirety in online simulation in undergraduate nursing education literature. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Utilizing an inclusive pedagogy framework may prove advantageous in generating inclusive teaching approaches to support all students. IMPACT: This review will interest educators and managers that wish to incorporate equality, diversity and inclusion initiatives in nursing education. REPORTING METHOD: This scoping review has adhered to the EQUATOR guidelines: the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Diversity in the pathway from medical student to specialist in the Netherlands: a retrospective cohort study.

Background: Medical specialist workforces are not representative of the society they serve, partially due to loss of diversity in the path from student to specialist. We investigated which demographic characteristics of bachelor students of medicine (BSM) are associated with becoming a physician and (particular type of) medical specialist; and whether this suggests 'cloning' (reproduction of sameness) of the existing workforce. Methods: We used a retrospective cohort design, based on Statistics Netherlands data of all first-year BSM in 2002-2004 in The Netherlands (N = 4503). We used logistic regression to analyze the impact of sex, migration background, urbanity of residence, parental income and assets categories, and having healthcare professional parents, on being registered as physician or medical specialist in 2021. We compared our results to the national pool of physicians (N = 76,845) and medical specialists (N = 49,956) to identify cloning patterns based on Essed's cultural cloning theory. Findings: Female students had higher odds of becoming a physician (OR 1.87 [1.53-2.28], p < 0.001). Physicians with a migration background other than Turkish, Moroccan, Surinamese, Dutch Caribbean or Indonesian (TMSDI) had lower odds of becoming a specialist (OR 0.55 [0.43-0.71], p < 0.001). This was not significant for TMSDI physicians (OR 0.74 [0.54-1.03], p = 0.073). We found a cloning pattern with regard to sex and migration background. Nationwide, physicians with a Turkish or Moroccan migration background, and female physicians with other migration backgrounds, are least likely to be a medical specialist. Interpretation: In light of equity in healthcare systems, we recommend that every recruitment body increases the representativeness of their particular specialist workforce. Funding: ODISSEI.

Selection tools and student diversity in health professions education: a multi-site study.

Student diversity in health professions education (HPE) can be affected by selection procedures. Little is known about how different selection tools impact student diversity across programs using different combinations of traditional and broadened selection criteria. The present multi-site study examined the chances in selection of subgroups of applicants to HPE undergraduate programs with distinctive selection procedures, and their performance on corresponding selection tools. Probability of selection of subgroups (based on gender, migration background, prior education, parental education) of applicants (N = 1935) to five selection procedures of corresponding Dutch HPE undergraduate programs was estimated using multilevel logistic regression. Multilevel linear regression was used to analyze performance on four tools: prior-education grade point average (pe-GPA), biomedical knowledge test, curriculum-sampling test, and curriculum vitae (CV). First-generation Western immigrants and applicants with a foreign education background were significantly less likely to be selected than applicants without a migration background and with pre-university education. These effects did not vary across programs. More variability in effects was found between different selection tools. Compared to women, men performed significantly poorer on CVs, while they had higher scores on biomedical knowledge tests. Applicants with a non-Western migration background scored lower on curriculum-sampling tests. First-generation Western immigrants had lower CV-scores. First-generation university applicants had significantly lower pe-GPAs. There was a variety in effects for applicants with different alternative forms of prior education. For curriculum-sampling tests and CVs, effects varied across programs. Our findings highlight the need for continuous evaluation, identifying best practices within existing tools, and applying alternative tools.

Racial and Ethnic Composition of Students, Graduates, and Faculty in Environmental Health Sciences, 2011 to 2021.

The lack of diversity among the environmental health sciences (EHS) workforce has been an ongoing concern. However, limited research exists on the racial and ethnic composition of EHS students and faculty over time. We analyzed 2011 and 2021 data on EHS students, graduates, and faculty to compare changes in the racial and ethnic composition among Association of Schools and Programs of Public Health-member institutions. Among the institutions that reported data in both years, we observed significant proportion increases among Hispanic enrolled students (overall and master's: both P = .01), Multiracial enrolled students and graduates (overall: both P < .05, master's level: both P < .05), and Asian tenured professors (P = .01). Significant decreases were observed among Unknown enrolled students (overall: P = .01, master's level: P < .001), Unknown master's level graduates (P = .01), AI/AN enrolled students (overall and master's: both P < .05), and White full professors (P < .001) and tenured faculty (P < .001). Despite these findings, no substantial change existed among the other racial and ethnic groups. More efforts are needed to recruit, train, and promote racial and ethnic minorities who can leverage their lived experiences to provide novel solutions to environmental challenges.

Racial and Ethnic Diversity Among Students, Graduates, and Faculty in Biostatistics and Epidemiology, 2010-2020.

OBJECTIVE: This study is a follow-up to a study in 2020 that reviewed changes in the racial and ethnic composition of public health students, graduates, and faculty among Association of Schools and Programs of Public Health (ASPPH)-member institutions. In the current study, we evaluated how the racial and ethnic composition among biostatistics and epidemiology students, graduates, and faculty changed from 2010 to 2020. METHODS: We analyzed data on race and ethnicity of enrolled graduate students, graduates (master's and doctoral), and faculty at ASPPH-member institutions by using institutionally reported data from the ASPPH Data Center. We tabulated frequencies, percentages, and percentage-point changes by race and ethnicity. We measured differences between groups by using a test for difference in 2 proportions. RESULTS: The number of enrolled students, graduates, and faculty in all departments increased during the study period, while the number of tenure-track faculty in biostatistics decreased. The percentage of enrolled Hispanic/Latino biostatistics graduate students increased from 5.6% in 2010 to 10.2% in 2020 (P = .007), and the percentage of epidemiology graduates increased from 8.8% to 13.8% (P = .008). We found no differences among other underrepresented racial and ethnic groups. Most biostatistics and epidemiology professors at all ranks were non-Hispanic White, despite substantial decreases. The percentage of underrepresented racial and ethnic minority biostatistics and epidemiology professors was constant across all ranks. CONCLUSION: Although more Hispanic/Latino students are enrolled in and graduating from biostatistics and epidemiology departments at ASPPH-member institutions, we found no change among faculty. More work is needed to recruit and retain other (American Indian/Alaska Native, Black or African American, Native Hawaiian/Other Pacific Islander) underrepresented students and faculty.

Racial and Gender Diversity Among Students and Faculty in EHAC-Accredited Environmental Health Sciences Programs: Trend Analysis from 2009 to 2021.

Diversity in the environmental health sciences (EHS) workforce is crucial in providing culturally sensitive services to diverse communities. This may be influenced by academic faculty training a diverse student body in the field of environmental health. This study aimed to characterize the diversity of students and faculty in EHS programs accredited by the National Environmental Health Science and Protection Accreditation Council (EHAC). A retrospective analysis was conducted on secondary data obtained from annual surveys administered to program directors in EHAC-accredited academic programs that included both undergraduate and graduate EHS degrees. The database covered surveys on gender and race that were conducted by EHAC for 12 academic years spanning 2009-2010 to 2020-2021. Results show most students (undergraduate and graduate) were female (54.4% and 52.1%, respectively) and white (61.0% and 50.7%, respectively). Increasing trends were observed over the last 12 years (2009-2021) in female undergraduate (from 53.7% to 59.8%) and graduate (from 47.1% to 60.3%) students and in non-white undergraduate students (from 40.0% to 48.2%). Most faculty (teaching in undergraduate and graduate programs) were male (64.4% and 64.3%, respectively) and white (77.9% and 92.1%, respectively). Increasing trends were observed from 2009 to 2021 in female faculty teaching undergraduate (from 27.7% to 42.2%) and graduate (from 31.3% to 42.1%) students. Native American, Alaska Native, Native Hawaiian, and Pacific Islander are consistently the most underrepresented racial groups in both undergraduate and graduate students and faculty. This study provides baseline data on the diversity of students and faculty in EHAC-accredited programs, which is important in informing future research and efforts to increase such diversity. Gender and racial disparity in EHS students and faculty needs to be addressed to provide necessary support to women and non-White constituents by institutional change in culture through active recruitment and by stronger collaboration between professional organizations and minority groups.

Penn Access Summer Scholars program: a mixed method analysis of a virtual offering of a premedical diversity summer enrichment program.

In the USA, numerous summer programs are available for undergraduate students that seek to increase the number of individuals from groups underrepresented in medicine (URM) that matriculate to medical school. These programs have typically been conducted at research-focused institutions, involving hands-on-research and various enrichment experiences. For 2020, the COVID-19 pandemic resulted in the suspension of on-campus student activities at American universities, necessitating a switch to a virtual format for these URM-focused programs. Outcomes, however, from these programs conducted virtually, necessitated by the COVID-19 pandemic, have not been reported. The Penn Access Summer Scholars (PASS) program at the Perelman School of Medicine (PSOM) targets URM undergraduates, providing two consecutive summers of mentored research and enrichment experiences, with the goal of enabling participants' matriculation to PSOM. PASS has been an 8 week on-campus experience, but during summer 2020, virtual programming of 6 weeks was provided due to the COVID-19 pandemic. Participants in the 2020 virtual offering of PASS completed pre- and post-program surveys that included 5-point Likert-style and open-ended questions to determine the impact of the programing on self-assessments of research skills, familiarity with the physician identity, and preparedness to be a PSOM student. Post-program, participants also assessed program administration and content. With respect to program objectives, participants reported significant increases in their self-reported confidence in conducting research, understanding of physician identity, and sense of preparedness for medical school. The educational value of the program content, their level of engagement in the program and the overall quality of the program were rated as excellent or outstanding by large majorities of respondents. Content analyses of participant comments were consistent with these quantitative results. Therefore, a premedical summer enrichment program targeting URM undergraduates can be successfully conducted virtually to achieve program objectives and may increase the availability to these initiatives.

A review of mentoring deaf and hard-of-hearing scholars.

Diversification of the scientific workforce usually focuses on recruitment and retention of women and underrepresented racial and ethnic minorities but often overlooks deaf and hard-of hearing (D/HH) persons. Usually classified as a disability group, such persons are often members of their own sociocultural linguistic minority and deserve unique support. For them, access to technical and social information is often hindered by communication- and/or language-centered barriers, but securing and using communication access services is just a start. Critical aspects of training D/HH scientists as part of a diversified workforce necessitates: (a) educating hearing persons in cross-cultural dynamics pertaining to deafness, sign language, and Deaf culture; (b) ensuring access to formal and incidental information to support development of professional soft skills; and (c) understanding that institutional infrastructure change may be necessary to ensure success. Mentorship and training programs that implement these criteria are now creating a new generation of D/HH scientists.

Racial/Ethnic Diversity in Academic Public Health: 20-Year Update.

OBJECTIVE: This study is a follow-up to an examination of the racial/ethnic composition of public health students (1996) and faculty (1997) at schools of public health that was conducted 20 years ago. We examined data on the race/ethnicity of students, graduates, and faculty among Association of Schools and Programs of Public Health (ASPPH)-member institutions during 2016-2017 and how these data have changed in the past 20 years. METHODS: We obtained data on the race/ethnicity of students (in 1996 and 2016), graduates (in 1996 and 2016), and faculty (in 1997 and 2017) at ASPPH-member institutions from the ASPPH Data Center. We tabulated frequencies, percentages, and 20-year percentage-point changes by race/ethnicity. We examined data for all current ASPPH-member institutions and for comparable subcohorts of 1996 and 1997 member institutions that are current ASPPH members. RESULTS: In graduate student enrollment, the 20-year increase in each nonwhite racial/ethnic subgroup was ≤5 percentage points. Among tenured faculty, the 20-year increase was greatest among Asians (8 percentage points) but was <3 percentage points for black, Hispanic, and Native American faculty. CONCLUSIONS: The increasing racial/ethnic diversity among students, graduates, and faculty in schools and programs of public health contributes to parallel increases in racial/ethnic diversity in the public health workforce. Schools and programs of public health should recruit clusters of racial/ethnic minority students using holistic application review processes, provide enrolled students with racially/ethnically diverse role models and mentors, and dedicate staffing to ensure a student-centered approach. In addition, those who mentor racially/ethnically diverse students and junior faculty should be rewarded.

Relationships between academic literacy support, student retention and academic performance.

Retention and the academic success of nursing students remains a high priority in Australian and global higher education. This study examines an embedded academic support strategy, provided by Professional Communication Academic Literacy (PCAL) support staff, and undergraduate Bachelor of Nursing student uptake of the support. It reports on the profile of those who sought support, and the relationships between student support, retention and academic performance. A total of 11 290 PCAL consultations were recorded during a 17-month period from January 2016, with these consultations initiated by 2827 individual students. Among the undergraduate nursing students (n = 4472), those who sought PCAL support were over 7 times more likely (Adjusted Odds Ratio: 7.81, 95% CI: 6.18 to 9.86) to continue in the nursing program, taking into consideration age and enrolment category of students. Among students who continued or are continuing in the program, those who did not seek PCAL support had a lower grade point average (GPA) (mean: 3.9) compared to those who sought PCAL support between 1 and 3 times (mean: 4.3), and those who sought PCAL support on more than 3 occasions had the highest GPA (mean: 4.4), suggesting that frequency of consultations influenced academic success and retention.

Home students' experiences of intercultural learning: A qualitative descriptive design.

BACKGROUND: Higher education institutes are witnessing an increase in the cultural and ethnic diversity of their student population. While this adds to the learning experience, there is a dearth of evidence examining how students on nursing programmes, from different cultural and ethnic backgrounds learn with and from each other. There is need for a greater understanding of the factors that both facilitate and inhibit intercultural learning within the classroom. OBJECTIVES: This study explored the perceptions and experiences of home students on a postgraduate nursing programme, of intercultural learning within the classroom. DESIGN: A qualitative descriptive design was used. SETTINGS: Home students enrolled on a suite of postgraduate nursing programmes in one region of Ireland who were registered for co-scheduled modules with international students, were recruited to participate on a voluntary basis. PARTICIPANTS: Fourteen home students (13 females and 1 male) were purposively sampled. METHODS: Data were collected using digitally recorded one to one semi-structured interviews (ten 'face to face' and four telephone). Data were thematically analysed using a modified version of Braun and Clarke's (2006) framework. RESULTS: This study describes the value of intercultural learning in the classroom and draws attention to some of the challenges experienced by home students. Furthermore, it highlights the importance of exploring similarities, whilst respecting differences in prior educational experiences, learning styles and cultural backgrounds. The overarching theme, Navigating intercultural learning describes home students' experiences of developing awareness, connecting and sharing cultural knowledge. CONCLUSIONS: Intercultural learning takes time and requires commitment, emphasising the need for careful consideration of facilitation techniques, preparation, support and planning pedagogies that encourage effective intercultural learning. The findings make a valuable contribution to existing knowledge on internationalising nurse education, specifically with regards to intercultural relations and the perceptions and experiences of teaching and learning in intercultural classrooms.

Exploring nursing students' experiences of a drop-in support-centre: A mixed-methods study.

BACKGROUND: The increased use of blended learning approaches in undergraduate nursing programs has resulted in reduced on-campus contact with academic staff and other students. OBJECTIVES: To explore student's experiences of a Drop-In-Support-Centre and assess the impact of attendance on academic performance. DESIGN: Concurrent mixed-methods. SETTING: A large metropolitan, multi-campus university in Sydney, Australia. PARTICIPANTS: Undergraduate nursing students enrolled in a 3-year Bachelor of Nursing program. METHODS: In March 2016, to support students' learning, a weekly Drop-In-Support-Centre (DISC) initiative was piloted. The DISC provided an informal, learning space one day a week for students to access academic support. Baseline quantitative data was extracted from the University administrative dataset with a 12-month follow-up Grade Point Average (GPA) in January 2017. Attendance at the DISC was collected progressively throughout 2016. Qualitative data were collected using semi-structured interviews. RESULTS: Of 1016 undergraduate nursing students enrolled on the campus, 163 (16%) attended DISC at least once. Attendees were older, more likely to be Overseas-born (74% versus 45% native-born, p < 0.001). Sub-group analysis of first year students revealed attendees had a higher grade point average than non-attendees (4.20 versus 3.85, p = 0.005). Controlling for demographic factors, they were over three times more likely (Adjusted Odds Ratio: 3.75, 95% CI: 1.44-9.78) to achieve a higher GPA (>4.0) compared to non-attendees. Thirteen students were interviewed. Two main themes emerged; 1) 'Home away from home' and 2) 'A sense of community: Everyone supports each other' with three accompanying sub-themes. CONCLUSIONS: This study supports the usefulness of a Drop-In-Support-Centre in enhancing students' learning experiences and outcomes. The success of the program is highlighted by an improvement in academic performance of students who attended the DISC.

Selection and lottery in medical school admissions: who gains and who loses?

This article was migrated. The article was marked as recommended. Concerns related to fairness of medical school admissions through selection have led some scholars to consider selection as an expensive lottery and suggest that lottery may be fairer. This paper considers the issue of selection versus lottery from the perspectives of three groups of stakeholders: 1) applicants, 2) medical schools, and 3) society. This paper contributes to the discussion by addressing advantages and disadvantages of the use of selection and lottery for these stakeholder groups, grounded in the findings from research. Themes that are discussed are reliability and validity issues, perceived influence on selection outcomes and student uptake, effects on student diversity, financial costs, impact on rejected applicants, transparency, and strategic behaviour. For each stakeholder group both lottery and selection yield a combination of advantages and disadvantages, which implies that none of the currently available admissions strategies completely fulfils stakeholders' needs. Research indicates that selection yields only small gains compared to a lottery procedure, while the student diversity, necessary for serving the increasingly diverse patient population, may be compromised. We argue that society's needs should drive admissions policies rather than institutional gains, which means that until a selection procedure is developed that does not disadvantage certain types of students, a lottery procedure should be preferred.

Tutoría entre iguales y comprensión lectora: ¿un tándem eficaz? Los efectos de la tutoría entre iguales sobre la comprensión lectora / Peer Tutoring and Reading Comprehension: an Effective Tandem?The effects of Peer Tutoring on Reading Comprehension

Dada la relevancia de la lectura y la necesidad de encontrar formas complementarias para su enseñanza, el artículo investiga los cambios sobre la comprensión lectora durante la implementación de un programa basado en la tutoría entre iguales "Leemos en pareja" y los mecanismos causantes de dichos cambios. Se opta por la combinación de un diseño cuasiexperimental y una aproximación cualitativa, para identificar los cambios producidos y las actuaciones responsables de dichos cambios. Los resultados indican avances significativos en la comprensión lectora. El análisis del proceso muestra que las mejoras se producen gracias a la utilización de estrategias lectoras y de ayudas andamiadas ofrecidas por los alumnos tutores. Como conclusión, se sostiene que las prácticas de tutoría entre iguales pueden haber contribuido decisivamente en la mejora de la comprensión lectora.

The purpose of this research is to examine the changes occurring in the development of reading comprehension during the implementation of a peertutoring programme "Leemos en pareja" and the mechanisms underlying these changes. We opt for a design that allows multiple methodological approaches: a quantitative one, through a quasi-experimental design to account for changes to reading comprehension, and a qualitative approach to analyse the process and identify the actions responsible for the changes observed. Results show statistically significant gains on the analyzed reading comprehension variable and that improvement occurs thanks to the use of reading strategies and to the scaffolding help offered by the tutors. In conclusion, it is noted that peer tutoring practices may have contributed significantly to improving reading comprehension skills.

Participation in college laboratory research apprenticeships among students considering careers in medicine.

OBJECTIVE: We sought to determine the prevalence of college laboratory research apprenticeship (CLRA) participation among students considering medical careers and to examine the relationship between CLRA participation and medical-school acceptance among students who applied to medical school. METHODS: We used multivariate logistic regression to identify predictors of: 1) CLRA participation in a national cohort of 2001-2006 Pre-Medical College Admission Test (MCAT) Questionnaire (PMQ) respondents and 2) among those PMQ respondents who subsequently applied to medical school, medical-school acceptance by June 2013, reporting adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). RESULTS: Of 213,497 PMQ respondents in the study sample (81.2% of all 262,813 PMQ respondents in 2001-2006), 72,797 (34.1%) reported CLRA participation. Each of under-represented minorities in medicine (URM) race/ethnicity (vs. white, aOR: 1.04; 95% CI: 1.01-1.06), Asian/Pacific Islander race/ethnicity (vs. white, aOR: 1.20; 95% CI: 1.17-1.22), and high school summer laboratory research apprenticeship (HSLRA) participation (aOR: 3.95; 95% CI: 3.84-4.07) predicted a greater likelihood of CLRA participation. Of the 213,497 PMQ respondents in the study sample, 144,473 (67.7%) had applied to medical school and 87,368 (60.5% of 144,473 medical-school applicants) had been accepted to medical school. Each of female gender (vs. male, aOR: 1.19; 95% CI: 1.16-1.22), URM race/ethnicity (vs. white, aOR: 3.91; 95% CI: 3.75-4.08), HSLRA participation (aOR: 1.11; 95% CI: 1.03-1.19), CLRA participation (aOR: 1.12; 95% CI: 1.09-1.15), college summer academic enrichment program participation (aOR: 1.26; 95% CI: 1.21-1.31), and higher MCAT score (per point increase, aOR: 1.31; 95% CI: 1.30-1.31) predicted a greater likelihood of medical-school acceptance. CONCLUSIONS: About one-third of all PMQ respondents had participated in CLRAs prior to taking the MCAT, and such participation was one of the several variables identified that were independently associated with medical-school acceptance.

Recruiting underrepresented minority and low-income high school students into dentistry while educating dental and dental hygiene students about academic careers.

The objectives of this project were to create a program that would expose underrepresented minority (URM) and low income (LI) high school students to dental professions and provide an opportunity for dental and dental hygiene students from URM/LI groups to be engaged in teaching activities. Data were collected from participants during the school years 2009-10 (high school students: N=23, dental students: N=21, dental hygiene students: N=5) and 2010-11 (N=27, N=11, N=3, respectively). The students participated in fifteen Saturday sessions from October through March each year. The data showed that, from the beginning, mentees and mentors were very interested in participating in the program and getting to know each other. Lectures, general program activities, and patient-related events such as organizing a health fair and shadowing during two outreach clinics were evaluated positively by mentees and mentors. The end of program evaluations showed that the program and the mentee-mentor relationships were rated very positively and that the mentees had an increased interest in oral health-related careers. In conclusion, creating opportunities for URM/LI high school students to explore dental careers and for dental and dental hygiene students to engage in teaching resulted in positive experiences for both groups.