1. KEVIN EAGAN, JUAN GARIBAY, MICHAEL SOH, SYLVIA HURTADO, MITCHELL CHANG GUNNING FOR THE WIN! HOW COMPETITIVE CLASSROOM ENVIRONMENTS AND STUDENT EXPERIENCES PREDICT PRE-MEDS’ COMMITMENT TO HEALTH RESEARCH AND PRACTICE University of California, Los Angeles

2. BACKGROUND Call for increasing the number of physicians, especially from URM groups URM <10% of physician workforce Greater diversity among medical professionals requires a better understanding of premedical student experience and context Competitive and collaborative learning environments Premedical students less likely to persist in STEM, despite entering college as more well-prepared

3. BACKGROUND Introductory STEM classrooms present significant barriers for persistence in premedical studies Competitive environment Lack of engaging pedagogy Premedical student experience “Gunners” Competition vs. journey of self discovery Premedical culture vs. medical school objectives

4. BACKGROUND Gatekeeper debate Necessary to discourage ‘unfit’ students Competitive nature of gatekeeper debate disadvantages students whose cultural backgrounds do not value competition Differential effects of competitive classroom environments By gender By race

5. RESEARCH QUESTION Controlling for students’ prior academic preparation and co-curricular experiences, how do premedical students’ experiences in introductory STEM courses, the learning environments in these courses, and the pedagogies students encounter predict the development of their commitment to health research and practice?

6. THEORETICAL FRAMEWORK Social Cognitive Career Theory (SCCT) Self-efficacy, outcome expectations, personal goals Student interests and goals precede a student’s action to become a physician Students’ basic values embedded in outcome expectations Anticipated outcomes of medical career (e.g. status, money, helping others) Hyper-competitive undergraduate STEM learning environment Self-efficacy Occupational interests reflect self-efficacy beliefs Culturally determined competition-cooperation norms

7. METHOD: DATA AND SAMPLE Introductory STEM course student surveys in spring 2010 Pre and post 3,205 respondents Pre-college experiences and academic preparation, educational and career aspirations, introductory STEM course experiences, and perceptions of the professors teaching these courses Introductory STEM faculty survey Cross-sectional 76 classrooms Perceptions of and goals for undergraduate students, the instructional strategies used in their introductory STEM courses, and opinions about institutional priorities Analytic sample: 1,218 premedical students in 65 classrooms

8. METHOD: VARIABLES Dependent variable: Commitment to health research and practice Making a theoretical contribution to science Improving the health of all communities Improving the health of minority communities Working to find a cure for a health problem Alpha = 0.75 Direct Pretest: Commitment to health research and practice Alpha= 0.72

9. METHOD: VARIABLES AND ANALYSIS Independent variables Background characteristics and pre-college preparation Measures of self-efficacy (e.g., resiliency, competitiveness) Classroom experiences (e.g., asked questions, sense of competition) Classroom context (e.g., overall competition, collaboration, faculty encouraging questions) Analysis Missing data – expectation maximization Hierarchical linear modeling (ICC = 3%)

10. METHOD: LIMITATIONS Limited generalizability Short timeframe (one academic term) Not a full test of Social Cognitive Career Theory Unobserved co-curricular variables

11. PREMEDICAL STUDENT CHARACTERISTICS Compared to non-STEM/non-premed and to STEM, non-premed students, premedical students: Are the most academically prepared (67% earned A/A- in HS) Have the greatest commitment to their major Have the greatest commitment to their career aspiration Report the highest ratings of wanting to help those in difficulty (76%) Report the highest level of involvement Come from more affluent, most well-educated families

12. FINDINGS: CLASSROOM CONTEXT VariableDirection of Effect Sig. Professors encourage solving real-world, complex problems Negative * Professor perception that there is no such thing as a question that is too elementary Positive * Overall sense of competitionNS Overall sense of collaborationNS Extent to which faculty graded on a curveNS

13. FINDINGS: STUDENT-LEVEL VARIABLES VariableDirection of Effect Sig. Participated in pre-college research program Positive ** Self-rated ability to overcome hardship Positive *** Average sense of collaboration in class Positive *** Professor made class difficult enough to be stimulating Positive ** Frequency professor graded on a curve Positive * Professor encouraged collaboration among students Positive * Students felt respected by peers Positive *** Students felt course emphasized applying concepts to new situations Positive ***

14. DISCUSSION Premedical students, as a group, not affected by competitive classrooms as it relates to their commitment to health research and practice Commitment to health research and practice reduced in classrooms where faculty include complex problem- solving Importance of faculty ethic of care – welcoming questions

15. DISCUSSION Early research exposure as a precursor to a stronger commitment to health research and practice Student resiliency and its connection to collaboration Intellectual stimulation and grading on a curve Feeling respected and having opportunities to collaborate

16. CONCLUSION Importance of implementing learning environments that: Increase student interest in health professions AND Are consistent with goals of medical field Competitive learning environments can: Impede development of interpersonal communication skills Decrease development of empathy and altruism More opportunities for collaboration Importance of premedical students learning about teamwork Creating a supportive network

17. CONTACT INFORMATION This study was made possible by the support of the National Institute of General Medical Sciences, NIH Grant Numbers 1 R01 GMO71968-01 and R01 GMO71968-05, the National Science Foundation, NSF Grant Number 0757076, and the American Recovery and Reinvestment Act of 2009 through the National Institute of General Medical Sciences, NIH Grant 1RC1GM090776-01. This independent research and the views expressed here do not indicate endorsement by the sponsors. Papers and reports are available for download from project website: http://heri.ucla.edu/nih Project e-mail: herinih@ucla.edu Faculty/Co-PIs: Sylvia Hurtado Mitchell Chang Tanya Figueroa Gina Garcia Juan Garibay Postdoctoral Scholars: Kevin Eagan Josephine Gasiewski Administrative Staff: Dominique Harrison Graduate Research Assistants: Felisha Herrera Bryce Hughes Cindy Mosqueda Michael Soh