Publications
In chapter 3 of this publication by the American Association of Medical Colleges (AAMC), AMERI researchers lay out a model for assessing holistic admissions for colleges of medicine. The model builds directly from Alexander Astin's (1991) Input-Environment-Output (I-E-O) model, developed to evaluate the impact of college on undergraduate students.
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Milem, J.F., O'Brien, C. L., Bryan, W. P. (2013). The Matriculated Student: Assessing the Impact of Holistic Review. In Roadmap to Excellence: Key Concepts for Evaluating the Impact of Medical School Holistic Admissions (pp. 19-30). Washington, D.C.: American Association of Medical Colleges.
Retrieved from https://members.aamc.org/eweb/upload/Holistic%20Review%202013.pdf
In a recent climate study of two colleges of medicine, AMERI researchers found that most diversity education in the medical school curriculum is guided and provided by the medical students themselves. As a result of this absence of diversity education in the formal curriculum, many students believed they had to seek out and create informal learning opportunities in order to gain exposure to diversity. However, when students did organize diversity discussions, they were often met with restrictions provided by the college administration team.
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Milem, J.F., O'Brien, C., Miner, D., Bryan, W. P., Sutton, F., Castillo-Page, L., & Schoolcraft, S. (2012). The Important Role that Diverse Students Play in Shaping the Medical School Curriculum. Retrieved from /sites/coe/files/Milem,O'Brien,Miner,Bryan,Castillo-Page,Schoolcraft(2012)-The_Important_Role_that_Diverse_Students_Play_in_Shaping_the_Medical_School_Curriculum.pdf
Each year, medical school admission committees face the challenge of selecting a new class of students who will develop into capable and caring doctors. While much of the emphasis in admissions is on academic ability, medical schools are also eager to choose students for their potential to practice medicine in a humanist manner. However, it is very difficult to select applicants who exhibit both scientific expertise and a humanist orientation to the practice of medicine. The objective of this study is to assess how humanistic attributes are developed. To do this, we have turned to medical students who are exemplars of humanism – members of the Gold Humanism Honor Society (GHHS).
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Cantwell, B., O'Brien, C., Miner, D., Sutton, F., López, A.M., Milem, J.F. (2010). Humanism in Medical Education: What do GHHS member have to say? Retrieved from /sites/coe/files/Cantwell,O'Brien,Miner,Sutton,Lopez,Milem(2010)-Humanism_In_Medical_Education.pdf
We believe that what happens as students complete their medical education curriculum is an understudied area that merits exploration. This study explores the relationships between students’ entry characteristics and their experiences during medical school with important personal and professional outcomes related to the humanistic practice of medicine. Using longitudinal survey data gathered at two U.S. medical schools, we examine how these input characteristics and experiences during medical school relate to student perceptions of diversity in medicine and universal health care. These attitudes and views have an important relationship with humanistic clinical outcomes, as they suggest that these future physicians respect diverse others and are willing to serve all patients, regardless of their ability to pay.
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Sesate, D.B., Milem, J.F., McIntosh, K. and Bryan, W. P. (2014, April). The First Three Years: An Analysis of Medical Student Attitude Formation. Paper presented at the meeting of the American Education Research Association, Philadelphia, Pennsylvania.
We believe that what happens as students complete their medical education curriculum is an understudied area that merits exploration. This study explores the relationships between students’ entry characteristics and their experiences during medical school with important personal and professional outcomes related to the humanistic practice of medicine. Using longitudinal survey data gathered at two U.S. medical schools, we examine how these input characteristics and experiences during medical school relate to student perceptions of diversity in medicine and universal health care. These attitudes and views have an important relationship with humanistic clinical outcomes, as they suggest that these future physicians respect diverse others and are willing to serve all patients, regardless of their ability to pay.
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Bryan, W. P., Sesate, D.B., Milem, J.F., Rodriguez, K.M., McIntosh, K. (2014, April). Are We Really Implementing Holistic Review? Paper presented at the meeting of the American Education Research Association, Philadelphia, Pennsylvania.
As the national population diversifies and healthcare disparities persist, cultural competency becomes increasingly important to future physician’s effectiveness with patients and peers. “Cultural competency is the belief that people should not only appreciate and recognize other cultural groups but also be able to effectively work with them” (Sue, 1998, p. 440). Our mixed methods findings suggest that qualitative data bring into focus accurate and detailed responses regarding students’ experiences and perceptions, which quantitative data alone fail to capture.
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Sesate, D.B., Bryan, W. P., Milem, J.F. (2014, March). Missing the Mark: A Case for a Mixed Methods Approach in Assessing Student Perceptions of Cultural Competency. Paper presented at the meeting of the Western Group on Educational Affairs (a unit of AAMC) Annual Meeting, Honolulu, Hawaii.
Holistic review in medical school admissions is intended to meet the needs of the changing demographics of the national population by improving access and medical student diversity. This occurs when metrics, attributes, and experiences are considered in a balanced way in the medical school admissions process. Assessment of holistic review practices allows medical schools to determine their progress and opportunities toward this end. This study used qualitative data to explore the methods and importance of assessing holistic review practices at one public medical school.
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Bryan, W. P., Sesate, D.B., Milem, J.F. (2014, March). Missing the Mark: A Case for a Mixed Methods Approach in Assessing Student Perceptions of Cultural Competency. Paper presented at the meeting of the Western Group on Educational Affairs (a unit of AAMC) Annual Meeting, Honolulu, Hawaii.
In the past 20 years, interest in campus climate research at undergraduate institutions has grown, thanks to existing frameworks that outline five dimensions interacting to influence the environment (Hurtado, Milem, Clayton-Pedersen & Allen, 1998; Milem, Dey & White, 2004). Unfortunately, the same cannot be said of research on medical schools, where students underrepresented in higher education enroll at low rates. In addition, while it is well documented that undergraduate students of color experience the campus climate dramatically differently than their White counterparts (Hurtado, 1992), similar data on medical students is scarce. This is despite costly efforts on the part of medical schools to recruit and retain students from diverse backgrounds who are more likely to provide health care to underserved populations after graduation (Komaromy et al., 1996). The purpose of this study is to examine in detail how medical students experience and perceive the campus climate at their institution regarding racial diversity. In particular, it examines how medical students’ background characteristics and behaviors influence perceptions. The results of this research will help inform medical school administrators how diverse groups of students may differ in their experiences, attitudes, perceptions and beliefs regarding the environment in which they are educated.
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O'Brien, C.L., Milem, J.F., Miner, D.M., Bryan, W.P. (2013, April). In the Eye of the Beholder: An examination of Medical Students' Perspectives of Campus Climate. Paper presented at the annual meeting of the American Educational Research Association, San Francisco, California.
Over the past two decades the Association of American Medical Colleges has enhanced its efforts to increase diversity within American medical colleges. Although students agree diversity enhances their educational experience, many students who are underrepresented in medicine (URiMs) still perceive the medical school institutional climate as unwelcoming, and report experiencing microaggressions from peers and faculty. This qualitative study discusses three types of microaggressions minority and female medical students encounter, and how students, faculty, and administrators have addressed these incidents.
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Miner, D.D., Bryan, W.P., Sesate, D.B., Milem, J.F. (2012, November). Did You Hear the One about a Black, a Latino and a Woman Who Walked into a Medical School Classroom? Microaggressions in Medical Education. Paper presented at the meeting of the Association for the Study of Higher Education, Las Vegas, Nevada.
As the training ground for future physicians, American medical schools are responsible for educating students to serve an increasingly diverse society. Changing population trends and an expanding health-care system have resulted in a greater demand for doctors who intend on practicing in people-oriented specialties in underserved areas (Krupa, 2010). Research suggests that medical schools are still learning how to integrate cultural competence training into the standard curriculum in ways that do not lead to stereotyping and categorizing (Betancourt & Green, 2010). Still in its infancy, little is known about the most effective ways to teach cultural competency in medical school. The purpose of this qualitative study is to investigate the extent to which students are exposed to diversity in medical education and how diverse information, ideas and experiences are reflected in the curriculum.
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O'Brien, C.L., Milem, J.F., Miner, D.M., Bryan, W.P. (2012, November). Medical Student Perspectives of Cultural Competency and Diversity Training. Paper presented at the meeting of the Association for the Study of Higher Education, Las Vegas, Nevada.
We believe that what happens as students complete their medical education curriculum is an understudied area that merits exploration. This study explores the relationships between students’ entry characteristics and their experiences during medical school with important personal and professional outcomes related to the humanistic practice of medicine. Using longitudinal survey data gathered at two U.S. medical schools, we examine how these input characteristics and experiences during medical school relate to student perceptions of diversity in medicine and universal health care. These attitudes and views have an important relationship with humanistic clinical outcomes, as they suggest that these future physicians respect diverse others and are willing to serve all patients, regardless of their ability to pay.
CITATION
O'Brien, C.L., Milem, J.F. (2012, April). What Role Do Medical Schools Play in Shaping a Humanistic Physician? The Intersection between Climate and Perception. Paper presented at the meeting of the American Education Research Association, Vancouver, British Columbia.
This study uses data from a campus climate survey administered to students at two medical schools in April and May of 2010. This survey focused on measuring attitudes and perceptions of the campus climate at the respective institutions. In particular, we analyze how constructs of collaborative learning, a diverse learning environment, humanistic values, openness to interact with peers and a resistance to diversity efforts relate to perceptions of a supportive climate, amount of leisure time and racial apathy. These constructs were chosen using findings from diversity research that has been conducted on undergraduate students.
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Gonzalez Canché, M.S., O'Brien, C.L., Milem, J.F. (2011, November). Attitudes and perceptions of medical students: Is campus climate associated with professional values? Paper presented at the meeting of the Association for the Study of Higher Education, Charlotte, NC.
Supreme Court cases such as Bakke v. University of California at Davis, Grutter v. Bollinger, Gratz v. Bollinger and now Fisher v. University of Texas at Austin have had a profound impact on how we approach diversity in medical school admissions. This presentation addresses some of the key concerns that have resulted from the rulings in the Fisher case, and provides examples of how two institutions have forged a path forward.
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Nesbitt, S.D., Moreno, F., Milem, J.F. (2014, April). Navigating Admissions in a Post-Fisher Era. Paper presented at the Group on Diversity and Inclusion (GDI) meeting of the American Association of Medical Colleges, San Diego, California.
Medical school leaders and educators are cognizant of the need for a welcoming and supportive campus climate for all students and, in the absence of overtly negative incidents, believe that the climate of their medical school is generally positive. However, the absence of overtly negative interactions may mask the reality of what is happening in their school’s climate. In a study at two public medical schools, we identified that the most common form of negative interactions were microaggressions, which are subtle insults, jokes or indignities that may be intentional or unintentional in nature. This presentation uses qualitative and quantitative data drawn from this study to provide detailed individual experiences and a comprehensive view of the campus climate. Participants will learn how to conceptualize and assess the medical school climate, identify microaggressions and their effects on students and the campus climate broadly, and combat microaggressions to create a welcoming environment.
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Milem, J.F., Bryan, W.P., McIntosh, K.L. (2014, April). It Could Just Be in My Head, But It Keeps Adding Up: Identifying Microaggressions and the Psychological Dimension of Campus Climate. Paper presented at the Group on Diversity and Inclusion (GDI) meeting of the American Association of Medical Colleges, San Diego, California.
