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Open Access Publications from the University of California

Scholarly Works (3 results)

  • Thesis
  • Peer Reviewed
UC Berkeley Electronic Theses and Dissertations (2018)

The lack of diversity in the physician workforce poses a complex problem for the US healthcare system. Despite numerous efforts over the last 45 years, the lack of representation in the physician workforce persists, with no significant signs of reversing course. There is therefore an urgent need to engage in research to aid in the development of innovative, systemic and sustainable methods of addressing barriers in the educational pipeline leading into medicine for URM students.

Much of the previous research in this area has focused largely on examining undergraduate program outcomes and impact on physician specialty/service area choice with very few examining the undergraduate premed experience in detail. These experiences can have deleterious effects which serve as barriers to academic achievement and outcomes, thereby preventing matriculation into medical school and the physician workforce. This research seeks to fill this gap in knowledge and employs qualitative methodology to accomplish three overarching goals:

1. Better understand the experiences of URM premed students as they navigate their undergraduate premed pathway. Focusing on the multi-level factors associated with academic achievement and enrollment in post-bac programs.

2. Explore the role and sustainability of post-baccalaureate premed programs in facilitating entry into medical school for URM graduates of the UC system.

3. Develop empirically based recommendations to ameliorate barriers and challenges reported by URM students in the UC system.

This dissertation resulted in three papers. The first paper illuminates the barriers and challenges faced by URM premed students and outlines their relation to student achievement and outcomes. The second paper sheds light on URM student perceptions and the specific reasons they apply to post-bac programs in addition to providing data that suggests that post-bacs are not a sustainable strategy to address diversity in the physician workforce. The third paper presents a list of empirically based recommendations aimed at addressing institutional-wide barriers to student achievement such as campus climate, academic/students services and course size and curriculum.

    Cover page: The Case of the Leaky Pipeline: Exploring the Experiences of Underrepresented Minority Premed Students in the UC System
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2023)
    Latinx physician rates are lower than non-Latinx white physicians. Many pathway programs to careers in medicine have been established for underrepresented students, yet few focus on premedical college education or undergraduate pathway programs, which marks a critical junction in the commitment to and preparation for application to medical school. Moreover, little is known about the program components which prepare and support learners. Framed by Swail's Model for Persistence and Achievement, we characterize how a given program's components impact support and growth for participating students. Using the process step of the Context, Input, Process, and Product evaluation model, we conducted focus groups at the end of the program, with four cohorts of student participants between 2019 and 2022. Focus groups identified strengths and limitations in content and delivery to improve program effectiveness and plan for the future of a program. We used thematic analysis, following an inductive approach, to analyze data from transcribed focus groups. A total of 66 of 81 (81.5%) students participated in focus groups. Students described that supportive program components include long-term mentorship and advising that builds trust, academic preparation for medical school, early exposure to clinical career exploration, tools to articulate students' personal narrative, methods to recognize and address challenging situations in the professional environment, community leadership development, and leveraging health policy and advocacy to empower students to create systems change within communities. Our findings affirm and provide a needed account of program components known to be contributors to student success in undergraduate pathway programs. Our evaluation also characterizes additional supportive processes not discussed elsewhere. Our findings contribute to knowledge about development and implementation of undergraduate pathway programs and the components by which these programs create opportunities for success among underrepresented students aspiring to careers in medicine.
      Cover page: Aspiring physicians program: description and characterization of the support processes for an undergraduate pathway program to medicine.Creative Commons 'BY' version 4.0 license
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2024)
      OBJECTIVE: The unprecedented events of 2020 required a pivot in scientific training to better prepare the biomedical research workforce to address global pandemics, structural racism, and social inequities that devastate human health individually and erode it collectively. Furthermore, this pivot had to be accomplished in the virtual environment given the nation-wide lockdown. METHODS: These needs and context led to leveraging of the San Francisco Building Infrastructure Leading to Diversity (SF BUILD) theories of change to innovate a Virtual BUILD Research Collaboratory (VBRC). The purpose of VBRC was to train Black, Indigenous, and people of color (BIPOC) students to apply their unique perspectives to biomedical research. These training activities were evaluated using a pre-post survey design that included both validated and new psychosocial scales. A new scale was piloted to measure culturally relevant pedagogy. RESULTS: VBRC scholars increased science identity on two items: thinking of myself as a scientist (+1point, p = 0.006) and belonging to a community of scientists (+1point, p = 0.069). Overall, scholars perceived stress also decreased over VBRC (-2.35 points, p = 0.02). Post VBRC, scholars had high agency scores (μ = 11.02, Md = 12, range = 6-12, σ = 1.62) and cultural humility scores (μ = 22.11, Md = 23, range = 12-24, σ = 2.71). No notable race/ethnic differences were found in any measures. CONCLUSIONS: Taken together, our innovative approach to data science training for BIPOC in unprecedented times shows promise for better preparing the workforce critically needed to address the fundamental gaps in knowledge at the intersection of public health, structural racism, and biomedical sciences.
        Cover page: Virtual BUILD Research Collaboratory: A biomedical data science training using innovative pedagogy to address structures of racism and inequitable stress for undergraduates of color.
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