I'm Mark Henderson and I'm from the Department of Internal Medicine. I'm the
Associate Dean for Admissions at the UC Davis School of Medicine.
Diversity means different things to different people, but I think
fundamentally for me it means that people from different walks of life, with
different perspectives, with different upbringings, are brought together in some
way and that each of their contributions are valued
and that they are shared amongst the group -- whatever that group is to make
that group stronger.
When we have a diverse medical student community or diverse residents, they are
able to 1) relate, in many ways, better to certain cultural communities. And so I
think -- it even goes not, maybe goes without saying -- that sometimes they're able to
enhance the care of the patients that we serve. And fundamentally our mission is
to take care of the patients that come through our doors at UC Davis. And I
think cultural understanding, linguistic understanding are all ways in which
our students and residents can enhance and make the care of our patients better.
Like diversity, if you include people with diverse opinions and diverse
backgrounds and diverse perspectives, you are a stronger organization I believe.
But also when you include groups that are typically marginalized, you bring, you
know, you make health care more equitable. And you make it -- you're able, to me,
you deliver healthcare the way it's supposed to be delivered.
The project that we first published related to this Center's work has to
do with the performance of a large group of applicants to medical school in
California, at the five -- at the time -- five public California schools where we
compared the performance on two different types of medical school
interviews: the traditional interview (TI) which is a long semi-structured
interview, over 30 to 45 minutes, usually with a faculty member or a student. We
compared that method, if you will, to multiple mini-interviews (MMI), which
8-10 minute brief encounters, often with an actor and
the applicant. And these brief interactions are much more
structured and assess different elements of skills that we think are important in
medicine, like communication, like teamwork, like receptivity to feedback.
And so those two methods are very different ways of assessing candidates.
And so we compared, over several years, how different people performed on the two
interview types.
Disadvantaged students, those that designated themselves as having an
environmental or educational disadvantage, tended to have a harder
time with MMI compared to traditional interviews. And I think that probably is
explained by the fact that in a traditional interviews, you have a little
more time to talk and a little less pressure. It's not as -- the time pressure
isn't quite as great. And I think you have a little bit more of time to tell
your personal story, which I think can be quite compelling in many people who
have an educational or economic disadvantage in their background.
MMI, again, is very rapid, it's very high, you know, it's rapidly paced. And
it's a bit more pressure. So I think that you, some of those skills under, you
know, under grace, under pressure or performance under pressure, I think maybe are
more highly developed in individuals that are from advantaged backgrounds.
Multiple mini-interviews, fundamentally, to me, are a way to ensure that many
different perspectives are represented from the interview process. Specifically
when you have an MMI ,10 different people interact with each candidate. So each of
those 10 interviewers or "raters," as we call them, has a different perspective,
has a different background, brings a different set of observations to that
encounter. And so in that way, to me, you're bringing many more -- you're
bringing diversity of perspective to the process.
There's a lot to be desired or improved upon in terms of delivering healthcare
that's equitable and reaches all segments of our society. And so in order
to reach marginalized and vulnerable communities -- often communities of color --
or rural communities or communities that are distant from healthcare,
they're not able to realize the dream of the wonderful breakthroughs
that have occurred in medicine. But also just even basic care. And in order to
deliver on that promise, if you will, I think we need to have a
workforce that feels very deeply that health equity is something to
be strived for every day in what we do. And that we have to -- it's a tremendous
there's a lot of tremendous amount of work that needs to be done to achieve
health equity. And in order to do that work, which is oftentimes difficult work,
you need to be committed in a very deep, fundamental way, to want to work
on the part of, on behalf of, vulnerable communities or work in a rural community
that has fewer resources. I think that that kind of commitment is what's
required and that's why we need to figure out how to bring those different
perspectives and backgrounds and students that don't traditionally come
here to health professions schools. How to encourage them and enable them to
join the health workforce so that they can then give back to advance health
equity in our communities, our state, and frankly, our nation.
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