Widening the Gates: Redefining Excellence in Selection for Health Professions Education for a Diverse Future Workforce.

To ensure diversity in the healthcare workforce selection committees must select a cohort of students who collectively possess the wide variety of qualities necessary to serve societal needs. In practice, selection procedures primarily focus on predicting academic outcomes, which are currently based on a limited set of qualities, restricting the definition of excellence in healthcare. The authors propose a shift in the design of selection procedures by including additional considerations - student diversity and applicant perception - to select talented students who can fulfil societal needs.

Self-regulated learning profiles including test anxiety linked to stress and performance: A latent profile analysis based across multiple cohorts.

Introduction: Medical educators aim to understand why students differ in performance and stress. While performance and stress are associated with student demographics, school factors and aspects of self-regulated learning (SRL), it remains unclear how these elements interact within individuals. This multi-cohort study identified SRL profiles among medical students and explored their associations with performance and stress.

[Minority GP in training more likely to 'underperform': who is to blame?].

Recent work revealed that ethnic minority gp-trainees are more at risk of underperformance than their majority peers. We argue that causes for underperformance can be identified from two perspectives, namely that of the trainees ('them') and that of the assessors and the institution ('us'). Potential impeding factors from the student perspective include lack of practical clinical skills and differences in communication styles.

The association between how medical students were selected and their perceived stress levels in Year-1 of medical school.

Background: The prevalence of medical students' mental distress is high. While schools apply various methods to select a well-performing and diverse student population, little is known about the association between different selection methods and the well-being of these students during medical school. The present retrospective multi-cohort study assessed whether students selected by high grades, assessment, or weighted lottery showed different stress perception levels in Year-1 of medical school.

Education on medically unexplained symptoms: a systematic review with a focus on cultural diversity and migrants.

Background: Health care providers often struggle with the management of patients with medically unexplained symptoms (MUS), especially in case of a different ethnicity and/or cultural background. These challenges are insufficiently addressed in their training.

Objectives: A systematic review on education in the field of MUS in a diverse context to improve MUS healthcare provider-patient interaction focused on intercultural communication.

Medical students' crisis-induced stress and the association with social support.

Background: Medical schools are challenged to guard student wellbeing given the potential negative impact of the COVID-19 outbreak combined with an already high prevalence of mental distress. Although social support is generally associated with less crisis-induced stress, it is unknown whether this applies to medical students during the COVID-19 outbreak.

Objectives: The impact of the COVID-19 outbreak on perceived stress of medical students was assessed by comparing their perceived stress levels during the outbreak to both their own baseline and the previous cohort's pre-COVID-19 stress levels.

Applicant perceptions of selection methods for health professions education: Rationales and subgroup differences.

Context: Applicant perceptions of selection methods can affect motivation, performance and withdrawal and may therefore be of relevance in the context of widening access. However, it is unknown how applicant subgroups perceive different selection methods.

Objectives: Using organisational justice theory, the present multi-site study examined applicant perceptions of various selection methods, rationales behind perceptions and subgroup differences.

Medical educators' experiences on medically unexplained symptoms and intercultural communication-an expert focus group study.

Background: Medically unexplained symptoms (MUS) are highly prevalent and remain challenging in healthcare and medical education, along with the increase in the importance of intercultural issues regarding MUS. However, less is known about the challenges of professionally addressing patients with MUS in the interprofessional and intercultural contexts. Thus, the present study aims to provide the first exploration of the experiences of medical specialists regarding treating MUS in intercultural contexts and inputs for training development on the intercultural aspects of MUS.

Do norms unintentionally increase stereotypical expressions? A randomised controlled trial.

Introduction: Implicit biases of health professionals could cause biased judgements. Many anti-bias interventions seem to be ineffective, and some even counterproductive. People tend to be compliant to standards describing what the majority of people finds or does, and this could cause people to think in a stereotype-consistent manner.

Inferring signs from purposeful samples: The role of context in competency assessment.

Context: Medical students' clinical competencies are customarily assessed using convenience samples of performance from real practice. The question is how these convenience samples can be turned into purposeful samples to extrapolate students' overall competency profile at the end of medical school, particularly given the context specificity of clinical performance. In this paper, we will address this issue of inferring signs from samples using insights from the discipline of psychology.

Student ethnicity predicts social learning experiences, self-regulatory focus and grades.

Context: Ethnic minority students find that their ethnicity negatively affects the evaluation of their capacities and their feelings in medical school. This study tests whether ethnic minority and majority students differ in their 'self-regulatory focus' in clinical training, that is, their ways to approach goals, due to differences in social learning experiences. Self-regulatory focus consists of a promotion and prevention focus.

Epidemiology and organisation of care in medically unexplained symptoms: A systematic review with a focus on cultural diversity and migrants.

Background: Since the pathophysiology of medically unexplained symptoms (MUS) remains unclear, healthcare providers often struggle with these patients, especially with a different ethnic and/or cultural background. These challenges are insufficiently addressed in their training and in the organisation of care.

Aim: To improve healthcare provider-patient interaction focused on MUS patients in general and in ethnic minorities and refugees in particular through a systematic review of syndromal definitions and epidemiology and organisation of care of MUS patients.

Career orientations of medical students: A Q-methodology study.

Introduction: In pursuing optimal health care, an adequate medical workforce is crucial. However, many countries are struggling with a misalignment of students' specialty preferences and societal needs regarding the future medical workforce. In order to bridge this gap, it is relevant to gain a better understanding of the medical career choice processes.

Effects of raising the bar on medical student study progress: An intersectional approach.

Context: Medical schools seek for measures to improve their students' study progress and are responsible for a diverse student population.

Objectives: The effect of a stricter academic dismissal (AD) policy in medical school on short-term and long-term study progress was investigated in a longitudinal cohort study. In addition, differential effects for subgroups were assessed by intersecting gender, ethnicity and prior education (intersectional framework).

Unraveling the medical residency selection game.

The diversity of modern society is often not represented in the medical workforce. This might be partly due to selection practices. We need to better understand decision-making processes by selection committees in order to improve selection procedures with regard to diversity.

Gender-specific effects of raising Year-1 standards on medical students' academic performance and stress levels.

Context: Medical schools are challenged to create academic environments that stimulate students to improve their study progress without compromising their well-being.

Objectives: This prospective comparative cohort study investigated the effects of raising Year-1 standards on academic performance and on students' chronic psychological and biological stress levels.

Methods: In a Dutch medical school, students within the last Bachelor's degree cohort (n = 410) exposed to the 40/60 (67%) credit Year-1 standard (67%-credit cohort) were compared with students within the first cohort (n = 413) exposed to a 60/60 (100%) credit standard (100%-credit cohort).

Organic or organised: an interaction analysis to identify how interactional practices influence participation in group decision meetings for residency selection.

Objectives: This study aims to shed light on interactional practices in real-life selection decision-making meetings. Adequate residency selection is crucial, yet currently, we have little understanding of how the decision-making process takes place in practice. Since having a wide range of perspectives on candidates is assumed to enhance decision-making, our analytical focus will lie on the possibilities for committee members to participate by contributing their perspective.

Broadly sampled assessment reduces ethnicity-related differences in clinical grades.

Context: Ethnicity-related differences in clinical grades exist. Broad sampling in assessment of clinical competencies involves multiple assessments used by multiple assessors across multiple moments. Broad sampling in assessment potentially reduces irrelevant variances and may therefore mitigate ethnic disparities in clinical grades.

MUM effect in medical education: taking into account the recipient and training setting.

de Leng et al. argue that feedback communicators can be made more comfortable delivering unpleasant messages if clinical training settings promote trainees’ learning‐goal orientation.

Influence of response instructions and response format on applicant perceptions of a situational judgement test for medical school selection.

Background: This study examined the influence of two Situational Judgement Test (SJT) design features (response instructions and response format) on applicant perceptions. Additionally, we investigated demographic subgroup differences in applicant perceptions of an SJT.

Methods: Medical school applicants (N = 372) responded to an online survey on applicant perceptions, including a description and two example items of an SJT.

Integrity situational judgement test for medical school selection: judging 'what to do' versus 'what not to do'.

Context: Despite their widespread use in medical school selection, there remains a lack of clarity on exactly what situational judgement tests (SJTs) measure.

Objectives: We aimed to develop an SJT that measures integrity by combining critical incident interviews (inductive approach) with an innovative deductive approach. The deductive approach guided the development of the SJT according to two established theoretical models, of which one was positively related to integrity (honesty-humility [HH]) and one was negatively related to integrity (cognitive distortions [CD]).

The role of the assessment policy in the relation between learning and performance.

Context: Optimising student learning and academic performance is a continuous challenge for medical schools. The assessment policy may influence both learning and performance. Previously, the joint contribution of self-regulated learning (SRL) and participation in scheduled learning activities towards academic performance has been reported.

Is it them or is it us? Unravelling ethnic disparities in undergraduate clinical performance.

Given our increasingly diverse societies, there is an urgent need for research into the causes of persistent ethnic disparities in undergraduate clinical performance. It is argued that causes for underperformance can be identified from two perspectives, namely that of the students ('them') and that of the academic environment ('us'). Taking the 'us' perspective, Yeates et al.